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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 71 (winter 2016/2017), 72 (spring 2017) and 73 (summer 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’m taking the combined contraceptive pill. I’m 46. How will I know if I’m going through the menopause?

This question was answered by Dr Nicola Mullin, consultant.

The short answer is you won’t know because of the hormones in the combined contraceptive pill. The oestrogen in the pill will smooth out fluctuations of your natural oestrogens and may help hot flushes. This pill can help to improve heavy irregular periods that may occur in the perimenopause, and reduces the risk of endometrial and ovarian cancer by 50% for up to 10 to 15 years after the pill is stopped. Bone density is higher in combined pill users, but research hasn’t yet proved ex-pill users have fewer fractures in later life. Normal healthy women may safely take the combined contraceptive pill to age 50. The oestrogen content means that a menopause blood test (follicle stimulating hormone, FSH) will be inaccurate. If you do want a blood test, you will need to change to a progestogen-only pill or implant, IUD or IUS. However, official NICE guidelines say menopause blood tests aren’t necessary in women over 45 if they have menopausal symptoms..

I am 49 and have irregular periods. I have been experiencing nausea. Is this a menopausal symptom and, if so, what can I do about it?

This question was answered by Kathy Abernethy, senior nurse specialist.

Nausea isn’t a commonly reported symptom of the peri-menopause, but it could be related to other things caused by hormonal changes. It may be related to stress, anxiety or headaches, as well as digestive problems, such as acid reflux, ulcers or gallbladder disease.

Some women experience nausea when they have hot flushes. Since nausea occurs for a wide variety of reasons, it’s worth checking it out with your GP if it’s persistent. Also consider whether you could be pregnant. Women sometimes forget this cause of morning nausea, and during the peri-menopause, contraception plans sometimes go awry.

What can you tell me about using natural progesterone cream to help menopausal symptoms?

This question was answered by Dr Sarah Gray, GP.

Natural progesterone cream is available from a variety of sources but not on NHS prescription. This is because scientific assessment has shown that very little, if any, progesterone is absorbed through the skin. Some years ago, a study showed that natural progesterone cream didn’t bring about the protective changes to the uterine lining that are required to balance the effect of oestrogen. It’s not recommended by menopause experts.

I’ve recently been diagnosed with restless leg syndrome. My legs keep twitching at night and I have an urge to keep moving them. This is interfering with my sleep. Please can you tell me more about this condition.

This question was answered by Dr Jenifer Worden, GP.

Restless legs is a fairly common condition affecting one in ten people at some stage in their lives. It’s diagnosed in women twice as often as in men, and usually strikes in middle age. Sufferers experience unpleasant sensations in their legs, usually when resting in bed or sitting for long periods. They can experience jerking movements of their legs, which can happen at intervals of several seconds up to every minute. This can occur through the night and are called ‘periodic limb movements in sleep’. Moving or rubbing the legs should stop these uncomfortable symptoms. Restless legs can be treated by adopting a good bedtime routine, stopping smoking, not drinking excessive coffee or alcohol shortly before bed and taking regular exercise during the day. Occasionally, in severe cases, your doctor may prescribe medicines that are also used to treat Parkinson’s disease.

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