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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 issues 77 (summer 2018) and 78 (autumn 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.

I’ve had breast cancer and I’m taking tamoxifen tablets. They’re giving me hot flushes. I’ve read about the use of phytoestrogens, both in foods and as supplements, to help hot flushes. Because of my breast cancer, are they safe for me?

Kathy Abernethy, senior nurse specialist,replies:

Although there’s no evidence that phytoestrogens may be harmful if you take them, there also isn’t sufficient evidence to reassure women that they’re safe to use after breast cancer. Most cancer doctors and menopause clinicians suggest you avoid taking phytoestrogen supplements, although normal dietary intake is fine. Other prescribed treatments may help, so ask your doctor for support and advice.

I am 48 and have just started going through the perimenopause. Because I have experienced bad pre-menstrual syndrome(PMS), am I now likely to experience more problems with symptoms?

Dr Kathryn Clement, consultant in sexual and reproductive healthcare, replies:

Women with a history of bad PMS don’t necessarily suffer with more menopausal symptoms than other women going through the menopause. In fact, there are no longer any monthly fluctuations of hormones, so their PMS-type symptoms disappear. The challenge with women with PMS is that sometimes HRT can make PMS-type symptoms worse and finding an HRT product to suit them can be difficult. Not all women will need HRT. If HRT is necessary, the lowest dose possible given continuously (e.g. as an oestrogen patch or a levonorgestrel-releasing intra-uterine system (IUS)) is often tolerated the best.

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.

I have brittle nails. What can I buy from a pharmacy to help them?

Lila Thakerar MBE, community pharmacist, replies:

Brittle nails are caused by a deficiency of biotin, which is commonly know as vitamin H.  Biotin levels reduce with age and low levels can be supplemented with over-the-counter products.  Health Aid’s Biotin 800mcg, NailVit Capsules, Perfectil Tablets and other vitamin B combination products made by various companies are excellent choices. Speak to a pharmacist about the best products for you and whether you should also consider taking other supplements. A pharmacist should also be able to advise you about eating a healthy diet to boost nail growth.

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