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The Menopause Exchange Blog


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 76 (spring 2018) 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.

Since my periods have stopped, my desire for sex has decreased. Is this normal?
Dr Nicola Mullin, consultant, replies:

A woman’s appetite for sex is influenced by many factors. The physical changes of the menopause, poor health and ageing in general can make her feel less confident about her body. Fluctuating levels of oestrogen can cause hot flushes and night sweats, which may disturb a woman’s sleep and affect her mood during the day. Tiredness is a common cause of a lack of libido (sex drive).

Vaginal dryness may lead to painful sex, and then couples sometimes avoid intimacy. If this is the case, talk to your GP about using vaginal oestrogen treatments. Some couples find that arousal and orgasms become more difficult to reach as they age, and erectile difficulties in men become more common at this time of life too.

This is a time of life when multitasking women are also very busy. The menopause may be a positive or negative time when a woman can embrace her freedom from periods and the risk of pregnancy or mourn the loss of her perceived femininity and roles. Keeping healthy, with a positive approach to life and relationships is important.

What is an induced menopause and when does it occur?
Kathy Abernethy, senior nurse specialist, replies:

The term ‘induced menopause’ usually refers to a menopause brought on by external factors (i.e. affecting the body from outside), including chemotherapy, radiotherapy or other medicines, such as those sometimes used for endometriosis or fibroids. Women having treatments or medicines usually have the chance to discuss in advance the likelihood of this happening and how they can manage any resulting health changes. If you have your ovaries removed by surgery (in an operation called a bilateral salingo-oophorectomy), your menopause will also be induced. This is usually described as a ‘surgical menopause’.

Please can you give me information about pelvic floor exercises. How can I find out how to do them correctly?
Dr Jenifer Worden, GP, replies:

Healthcare professionals often recommend pelvic floor exercises after giving birth or to help with the symptoms of urinary stress incontinence or bladder weakness (leaking when coughing or sneezing). There are a number of devices available to buy online that you can insert into your vagina to stimulate your pelvic floor muscles. But the easiest way to do the exercises is to think of stopping having a wee and a bowel movement at the same time, as well as keeping a tampon in. Tightening up those muscles for 10 seconds 10 times, followed by 10 quick tightenings, and then repeating the whole exercise routine two to three times a day should start to make a difference after a month or so. Alternatively, a specialist women’s health physiotherapist or local NHS Continence Service can also advise you, though some services need a GP referral first.

If I come off HRT, how likely is it that my hot flushes will return? If they do come back, what should I do?
Dr Kathryn Clement, consultant in sexual and reproductive healthcare, replies:

Unfortunately, some women’s hot flushes do come back when they stop their HRT, but this isn’t the case for everyone. Hopefully if you’re a bit older when you stop the HRT, you’ll find that your symptoms aren’t as troublesome. For many women, the symptoms are easier to cope with. Most women find that their hot flushes do improve over the first few months after stopping HRT, as they get used to being without the medicine. It’s sensible to stop HRT gradually rather than suddenly, and you should talk to your HRT provider about ways of doing this. It’s also sensible to choose a calmer time of your life to stop the HRT, e.g. not just before an important event. Many women choose to come off their HRT once they’ve retired, when life is easier. If you do find it difficult without HRT, I would recommend that you persevere for several months before going back to your GP to discuss your options. Many options are available, including trying non-hormonal preparations, or perhaps trying a lower dose of HRT for a bit longer before stopping completely.

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