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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 81 (summer 2019) and 82 (autumn 2019) 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.

Do the risks of HRT fall once I stop using it?

Dr Sarah Gray, GP, replies:

Yes. Oestrogen acts mainly by activating genes inside your cells. So if you stop using it, it isn’t present to exert an effect. The action on breast cancer cells is believed to be one of increased growth – if you stop HRT, this effect is lost. Oestrogen increases blood clotting through processes in your liver. Oral oestrogen has the biggest influence on this as it passes through your liver before being distributed around your body. If you stop HRT, within a few weeks that effect is lost.

Is dizziness a menopausal symptom?

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

Some people refer to a feeling of rotating or spinning as dizziness but the proper medical term for this is vertigo. Vertigo isn’t linked to the menopause and is usually due to a viral infection, or less commonly a problem with the inner ear (such as labyrinthitis or Meniere’s disease) or very rarely a stroke. Some people use the word dizziness when they feel light-headed, faint or giddy. This can be accompanied by buzzing in the ears, feeling sweaty and looking pale, if the symptoms are immediately before a fainting episode. I think this feeling can sometimes happen to women when they experience hot flushes or sweats, but more commonly it’s because they have low blood sugar, have stood up too quickly or have a tendency to faint. This type of dizziness can often be eased by eating sensibly and regularly, not getting up too quickly and lying down flat when the symptoms occur. Most dizziness is self-limiting and will disappear with time, but if it’s persistent (or with other symptoms such as ringing in the ears or deafness), visit your GP.

I’ve been diagnosed with irritable bowel syndrome. Which products can I buy from a pharmacy? I’m not taking any medicines.

Lila Thakerar MBE, community pharmacist, replies:

Irritable bowel syndrome (IBS) can be treated with medicines that release gas from your stomach, relax stomach muscles or reduce colicky pain. These medicines can be bought from a local pharmacy. The pharmacist will recommend the most appropriate one for your symptoms. Brands include Audmonal and Audmonal Forte Capsules, Buscopan Cramps and Colpermin IBS Relief Capsules. You may need to take medicines to control diarrhoea or constipation associated with IBS: various Imodium products will treat the diarrhoea and Fybogel-mebeverine sachets will help with constipation. It’s important to consider your lifestyle as well, such as avoiding stress, making changes to your diet and doing more exercise.

I’m 54 and experiencing hot flushes and night sweats. My friend is taking a product containing phytoestrogens to help these. What do these products contain and are they suitable for all women?

Angie Jefferson, consultant dietitian, replies:

Phytoestrogens are plant oestrogens that have a similar structure to human oestrogens and have mild oestrogen-like effects in the body. As supplements or foods such as soya and linseeds, they are one of the most popular complementary remedies for the menopause. Some studies have found that phytoestrogens help to ease the frequency and severity of hot flushes and night sweats when compared with placebo (dummy pills). However, other studies found them not to be helpful. This is partly because the studies are too small in size and may also be affected by the fact that some women appear to respond well to phytoestrogens and others don’t. Foods rich in phytoestrogens are a useful part of a healthy balanced diet. The only way to find out if supplements help is to try them for three to four months and see if your hot flushes improve, bearing in mind that they will help some but not all women. Some women with oestrogen-sensitive types of breast cancer may be advised not to use phytoestrogen supplements, so check if this applies to you before using them.

Ref Cochrane Database of Systematic Reviews

Phytoestrogens for menopausal vasomotor symptoms.  Cochrane Systematic Review – Intervention Version published: 10 December 2013 see what’s new https://doi.org/10.1002/14651858.CD001395.pub4

 

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