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The Menopause Exchange Blog

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 issues 76 (spring 2018) and 77 (summer 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.

Which complementary medicines can I try to help anxiety? I don’t have any medical conditions and don’t take any medicines.
Dr Nuttan Tanna, pharmacist consultant (women’s health & older people), replies:

Various herbal remedies are available to help anxiety but unfortunately the research isn’t as strong for those as it is for licensed anxiety medicines. Herbal medicines that may help to ease anxiety symptoms include passiflora, valerian, kava, chamomile, ginkgo biloba, St John’s Wort and ginseng. Ideally, if you want to try herbal medicines, you should consult a qualified herbalist, who will ask about your personal history and, based on your profile, advise about which herbs you should try. Other complementary therapies that may help anxiety include lifestyle changes, talking therapies (e.g. cognitive behavioural therapy), yoga, reflexology, meditation, acupuncture and massage. Herbal remedies can interact with prescribed medicines, so although you’re not taking any other medicines at the moment, ask your doctor or pharmacist for advice if that changes.

Please can you tell me whether there are any testosterone products in the UK that can be prescribed for women?
Dr Sarah Gray, GP, replies:

There are no testosterone products with a licence for women on the UK market. Doctors can write prescriptions for products to be used outside of their licence if they take responsibility for their effects. But non-experts are quite rightly reluctant to do this. Currently, one choice is a 1% testosterone cream (AndroFeme 1 from Clinigen), which has a licence in Australia but is only available on private prescription in the UK. The alternative is a 2% testosterone gel (Tostran which delivers a 10mg dose), which has a UK licence but only for men. This delivers double the dose and is therefore used on alternate days. A man requiring testosterone replacement may typically use six measures a day. Women who are genuinely deficient can benefit from testosterone, and it can make a huge difference to their lives. But this isn’t everyone and doctors need to be very careful that the decision to prescribe testosterone, and the dose used, are appropriate. This is therefore something you should speak to an expert about.

Have there been any new HRT products in the UK in the last 18 months?
Dr Nuttan Tanna, pharmacist consultant (women’s health & older people), replies:

Duavive was licensed in the UK in early 2017. It’s used for women who are post-menopausal (they haven’t had any natural periods for a year or more), who have had a personalised risk-benefit evaluation with their doctor and who have been told that they can take HRT. Duavive is a new option for women whose medical history shows they are sensitive to progestogen, or if they have tried other HRT products and struggled with progestogen side effects. It’s important to note that this is a new HRT product, and doctors don’t have any long-term safety data yet.

Are there any foods that may trigger hot flushes or make them worse?
Angie Jefferson, consultant dietitian, replies:

Triggers for hot flushes vary from woman to woman, and learning what sparks your own flushes is an important way to try to regain an element of control over them. Foods that often trigger hot flushes include hot foods, spicy foods, those containing monosodium glutamate (MSG) and alcohol and coffee. Cutting back or avoiding these foods may help, but it doesn’t mean you can never have these foods again. In a high-pressure business meeting, choose iced water rather than coffee and save the caffeine hit for when you’re under less scrutiny. Or if you know you’re likely to break out in a sweat, choose to opt for the spicy curry in the privacy of your own home or in a dimly lit curry house where friends won’t notice.

My friend suffers from body odour but she’s too embarrassed to ask for advice. What products are available?
Lila Thakerar MBE, community pharmacist, replies:

As well as taking usual regular hygiene measures, I would recommend your friend uses antiperspirants and deodorants throughout the day. There are numerous brands and types of deodorants and antiperspirants available from pharmacies, and the best one for your friend will be her personal choice. Roll-on deodorants may last longer than sprays and are more convenient to carry around. If these aren’t effective, your friend can buy stronger products from a pharmacy; these contain higher concentrations of the chemical aluminium chloride. These should be used at night and washed off in the morning, so the aluminium chloride blocks her sweat glands when she’s not active and sweaty. Look out for over-the-counter brands containing aluminium chloride, such as Anhydrol Forte and Driclor. Follow the instructions on the enclosed leaflet, making sure the product isn’t applied straight after shaving under your arms.

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