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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 79 (winter 2018/19) and 80 (spring 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.

I’m 62 and still have hot flushes. These affect my life just as much as they did when I was in my 50s. What advice can you give me? I don’t want to take HRT. I don’t have any medical conditions and I’m not taking any medicines.

Dr Sarah Gray, GP, replies:

Every woman experiences the menopause and post-menopause differently, both in how bad their symptoms are and how long these last. Not all women have flushes but for the majority that do, these typically last for at least five years and then gradually get better. But I often see women who tell me that their flushes aren’t any better. Sometimes, these even seem to get worse at around the ten-year point. This may be linked to reduced testosterone production. There are limited options to ease flushes, but the most useful self-help ones are to exercise vigorously and avoid alcohol.

I’ve heard that having phytoestrogens (plant oestrogens) in food and drink is helpful at the menopause. Which menopausal symptoms do they help and which foods contain them?

Gaynor Bussell, dietitian, replies:

When your body goes through the menopause, your level of oestrogen falls, causing menopausal symptoms. Having extra phytoestrogens in your diet can help to boost your oestrogen levels but only mildly. This won’t be as much as if you were taking HRT, but may be enough to offset hot flushes and other symptoms. As an added bonus, phytoestrogens can also help to lower cholesterol levels. Research shows that to reduce hot flushes, you need around 40 to 80 mg of phytoestrogens daily. Soya products are one of the richest sources of phytoestrogens: a 250 ml glass of soya milk contains around 20 mg and a portion of tofu contains around 30 mg. Other foods containing phytoestrogens include oats, linseeds and lentils.

Is bio-identical HRT available on the NHS?

Dr Nuttan Tanna, pharmacist consultant (women’s health & older people), replies:

‘Bio-identical hormone’ products contain exact copies of hormones made by the ovaries and adrenal and thyroid glands. The hormones in these products will include oestradiol, oestriol, oestrone, progesterone, testosterone, dehydroepiandrosterone and levothyroxine. Some doctors in private practice will prescribe what they call ‘bio-identical hormones’ after a woman has a series of expensive serum and saliva tests, a practice that’s not backed up by strong research as being good medical practice. These private prescriptions may be dispensed by specialist compounding pharmacies, but it’s important to note that the production of these isn’t regulated. These medicines are not available on the NHS. There are regulated HRT products that are ‘body identical’ on the NHS. These can be prescribed after a good medical history has been taken alongside a risk-benefit discussion with the patient.

I’m 53. I’m going through the menopause and I worry about everything. It’s difficult to cope with a job, three children and an elderly mother who has health problems. Do you think I should see a counsellor?

Dani Singer, specialist menopause counsellor and psychotherapist, replies:

It can be challenging to manage all the balls you’re currently juggling while also trying to manage your hormonal changes. Consider consulting your GP first. They can check, and advise on, your physical health and may be aware of local support groups. Sharing coping strategies with similarly placed women can be fun and supportive. As a counsellor, my inclination is to say that, yes, counselling would be potentially helpful. It may help you access ways to manage stress effectively through, for example, relaxation techniques and mindfulness, and may encourage you to make more time for yourself, to see friends and to do pleasurable activities. If you would like to find a local counsellor, contact the British Association of Counsellors & Psychotherapists ( and the British Association for Behavioural & Cognitive Psychotherapies (

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