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MENOPAUSE ‘ASK THE EXPERTS’ QUESTIONS & ANSWERS

The following ‘Ask the Experts’ questions were sent in to The Menopause Exchange by our members, the answers were provided by our ‘Ask the Experts’ panel and included in issue 74 (autumn 2017) of The Menopause Exchange newsletter. If you would like to read the questions and answers in the latest issue of The Menopause Exchange newsletter sign up for FREE emailed newsletters.

I am 47 and going through the menopause. I am healthy and I am not taking medicines.  Apart from general health advice, what do you suggest will help my hot flushes?
Dr Sarah Gray, GP, replies:

Don’t dismiss general health advice, as exercise and alcohol reduction will reduce flushing while other elements keep you well. Soy isoflavones (plant oestrogens) have some ability to reduce flushing but generally this doesn’t last for many months. Black cohosh has a similar ability though it comes with some concerns about liver damage. This isn’t a worry for most women as the effects are rare and haven’t been shown to be directly caused by the products. Some antidepressants in low doses will reduce flushing but can increase them in high doses; they’re not recommended unless you’re depressed. Replacing missing oestrogen is the most effective way to reduce flushing. It will ease other symptoms and protect bones. If you’re otherwise healthy, the risks are greatly outweighed by the benefits.

Can vitamins and minerals help anxiety?
Angie Jefferson, consultant dietitian, replies:

Vitamins and minerals are involved in a wide range of body functions, including the correct working of the nervous system, so it makes sense that a shortfall in one or more of these could affect mood and anxiety. Research is wide-ranging with reports of B-complex vitamins, C, D, E, magnesium, copper, selenium and iodine (to name a few) involved in the prevention and easing of anxiety and stress. For mild anxiety, eat a healthy varied diet. If you want to, supplement this with a ‘one-a-day’ multivitamin/mineral. The results won’t be instant and it may take several weeks to feel any improvements. If your anxiety is more severe, speak to your GP.

I suffer from painful periods. What can I buy from a pharmacy to help this?
Lila Thakerar MBE, community pharmacist, replies:

You can buy various paracetamol and ibuprofen products, some in combination (e.g. Nuromol). Your pharmacist will recommend the most suitable one for you. Paracetamol and codeine (e.g. Paracodol) can also be bought in combined products, giving effective relief. Feminax Ultra is different to common analgesics and recommended if other painkillers don’t relieve the pain. As well as pain relief, you could try using a hot water bottle to ease the pain and discomfort.

I am 55 and wake up in the night with terrible cramp in my toes and feet, occasionally in my calf muscle. What can I do about it?
Dr Sarah Gray, GP, replies:

My advice as a GP is to have a warm bath before you go to bed, massage your calves and then stretch. This is intended to increase the clearance of toxins that trigger the spasm of the muscle you recognise as cramp. Stretching is used by athletes and others to avoid cramp. It’s much better to do this with warm rather than cold stiff muscles. My other standard advice is to consider eating a banana a day (for potassium) and have a glass of tonic water in the evening (gin optional) as quinine contained in the tonic water is used medically to avoid cramp.  If these simple tricks don’t help, see your GP.

I have heard that turmeric helps aches and pains. Is this true? Which supplement dose should I take, rather than adding it in food?
Angie Jefferson, consultant dietitian, replies:

Turmeric is used as a spice in cooking and also as a traditional Indian (Ayurveda) or Chinese medicine to relieve pain and inflammation. Its active ingredient is curcumin (also called curcuminoids). Clinical evidence is limited (trials have been too few and too small in size) so curcumin is unlikely to be recommended as part of routine medical care. Recent reviews of existing evidence suggest that curcumin (typically around 1000mg/day) may help to relieve arthritic joint pain but more research is needed. Curcumin isn’t easily absorbed, so supplements often contain much higher doses that you may or may not be able to make use of. Choosing a reputable manufacturer is important. Although few side effects are associated with curcumin, the spice can react with other medicines, so speak to a pharmacist or GP.

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References:

Dragos D et al (2017) Phytomedicine in Joint Disorders Nutrients. 9: 70. Published online 2017 Jan 16. doi:  10.3390/nu9010070 PMCID: PMC5295114

Daily JW et al (2016) Efficacy of Turmeric Extracts and Curcumin for Alleviating the Symptoms of Joint Arthritis: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. J Med Food. 19:717-29. doi: 10.1089/jmf.2016.3705.

Adverse effects – none listed in the EU Compendium Botanicals https://www.efsa.europa.eu/en/data/compendium-botanicals

Kaplan BJ et al (2015) A randomised trial of nutrient supplements to minimise psychological stress after a natural disaster. Psychiatry Res. 228: 373-9. doi: 10.1016/j.psychres.2015.05.080. Epub 2015 Jun 27.

 

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