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Norma Goldman BPharm. MRPharmS. MSc.
Founder & Director of The Menopause Exchange.
I have a pharmacy degree and worked as a pharmacist for many years. I am a qualified health promotion specialist, presenting talks and workshops since 1999 as well as, more recently, webinars for workplaces, companies and organisations.
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Many women struggle with vaginal dryness (atrophy) during the menopause. Vaginal dryness is caused by the thinning, drying and inflammation of your vaginal tissues, and can happen as your oestrogen levels fall. Doctors often describe the condition as the genitourinary syndrome of the menopause (GSM).
I ’ve been presenting talks and workshops in the workplace for 21 years, and more recently webinars. An important focus of interest over the last two years has been the preparation of a menopause policy or guidance for employees and employers.
Plant oestrogens (also known as phytoestrogens) are substances that occur naturally in plants. It’s thought that plants may use them as part of their natural defence against the overpopulation of herbivore animals by controlling female fertility. Plant oestrogens have a similar chemical structure to human oestrogen (one of the main female hormones), and are able to bind to some of the same receptors as your own oestrogens. This means they have an oestrogenic effect on your body, although it’s weaker.
HRT should be avoided in some clinical situations. But no one should be denied it based on outdated evidence or the personal opinion of the healthcare professional involved. Taking recent scientific data along with the most up-to-date information, I aim to clarify what information is needed to help make the decision about who can and can’t use HRT.
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 87 (winter 2020/21) and issue 88 (spring 2021) 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 found your recent article on workplace menopause policies and guidance (issue 86) really interesting. You mentioned having a menopause champion or ambassador. Who would be the best person for this role?
Norma Goldman, founder and director of The Menopause Exchange, replies:
You could choose an employee going through the menopause or someone with an interest in the menopause. This could be a learning and development manager, an equality, diversity and inclusion officer or a health and wellbeing manager. It could also be someone working in the PR or occupational health departments.
Boiling Betty and Freezing Freddie
A poem by Roger Bulgin, husband of a member of The Menopause Exchange
Boiling Betty is a woman of a certain age, whose children have grown up and moved away.
Though still an object of desire, her body now creates a different fire.
So when she goes out, her coat stays undone, and she carries a fan in case of the sun.
While Freddie’s collar is up and his cap pulled down, he wears his scarf and gloves while he walks through the town.
For where once Betty’s eggs were laid and hatched, her hormones have left for the coast, their bags all packed.
At night she steams with her sleep often broken, and even in winter the window is left wide open.
While Freddie freezes under blankets and pyjamas, he thinks his wife has gone bananas.
“Freezing Freddie,” she calls in her night sweats, “if you’re cold, just go put on another vest!”
So while Freddie shivers like ice beneath the duvet, Betty sizzles like a pancake on Shrove Tuesday.
“I’m boiling,” cries Betty. “I think I’m on fire!” “I’m freezing,” thinks Freddie. “Can we turn the heating higher?”
So like all good marriages built on give and take, they moved to the middle of the bed to arbitrate.
Where Betty is embraced by Freddie’s cooling arms, and Freddie is warmed by Betty’s enduring charms.
Copyright © The Menopause Exchange
Most women with menopausal symptoms are seen and successfully treated by their GP or practice nurse. However, sometimes they may need to go to a menopause clinic for special advice. This may be because they have had breast cancer, have medical conditions that make treatment difficult or have experienced a premature menopause. Sometimes a menopause clinic can offer treatments not available to GPs.
If you currently attend, or have attended, a menopause clinic (NHS/private), or you work at a menopause clinic, please email norma@menopause-exchange.co.uk with the clinic’s name and address details.
Amenorrhoea: the absence or stopping of menstrual periods
Bilateral oophorectomy: operation to remove both ovaries
Body mass index (BMI): the weight of a person (in kilograms) divided by the square of the height of that person (in metres): used to indicate whether or not a person is over or underweight
Bone density: measurement of the bone’s mass in relation to its volume
Cervix: neck of the uterus (womb)
Climacteric: marks the transition from reproductive to non-reproductive state
Conjugated equine oestrogen: an oestrogen used in HRT which is obtained from mares’ urine
Corticosteroids: hormones produced naturally by the adrenal glands
Dual energy x-ray absorptiometry (DEXA): method of measuring bone density
Endometriosis: a condition in which fragments of the lining of the uterus grow outside the uterus
Endometrium: uterus lining
Endometrial hyperplasia: a thickening of the lining of the uterus, caused by overgrowth of the cells that line the uterus
Fallopian tubes: tubes which lead from the ovaries into the uterus
Fibroid: benign tumour of fibrous tissue and muscular tissue, one or more of which may develop within or attached to the outside of the uterus
Follicle stimulating hormone (FSH): one of the female hormones produced by the pituitary gland
HDL: High-density lipoproteins
Hormone assay: a test or trial to determine the strength of hormones
HRT: hormone replacement therapy
Hyperthyroidism: an overactive thyroid gland
Hypothyroidism: subnormal activity of the thyroid gland
Hyperparathyroidism: an overactive parathyroid gland
Hysterectomy: operation to remove the uterus
Implants: small pellets inserted under the skin
Laparoscopic hysterectomy: an operation to remove the uterus through four small cuts on the abdomen below the navel
LDL: Low-density lipoproteins
Libido: sexual drive
Mammogram: a breast X-ray
Menopause: the occurrence of the last natural menstrual period
Oestrogen: a female sex hormone produced by the ovaries
Osteopenia: a degree of bone loss less severe than osteoporosis
Osteoporosis: loss of bone tissue, resulting in bones that are brittle and liable to fracture
Ovaries: a pair of female sex glands which produce sex hormones and release eggs
Ovulation: The process by which an ovum (egg cell) is released from the ovary
Pelvic floor: spans the area under the pelvis
Perimenopause: the time from the beginning of irregular periods until 12 months after your last period
Pessary: a device which fits into the vagina
Phytoestrogens: natural plant oestrogens
Post-menopause: the stage when menstruation has not occurred for a least 12 months
Premenstrual syndrome (PMS): a group of symptoms experienced in varying degrees by women of reproductive age in the week before menstruation
Progesterone: a female sex hormone produced by the ovaries during the second half of the menstrual cycle
Progestogen: the synthetic form of progesterone
Prolapse: downward displacement of an organ or tissue from its normal position
Systemic: relating to or affecting the body as a whole
Testosterone: a steroid hormone formed by the ovary and adrenal glands
Unilateral oophorectomy: operation to remove one ovary
Urethra: the opening of the bladder
Uterus: a female organ which holds the developing unborn child. Also called the womb
Vagina: the lower part of the female reproductive tract
Vaginal atrophy: inflammation of the vagina and the outer urinary tract
Vaginitis: vaginal inflammation
Vasomotor symptoms: symptoms caused by the irregular function of the part of the brain that controls body heat (such as hot flushes and night sweats)
Vulva: the lips outside of the vagina
Withdrawal bleed: the breaking down of the lining of the uterus and shedding after stopping a course of progestogen
Womb: also called the uterus