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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 issue 86 (autumn 2020) 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.

Am I likely to experience the menopause at the same age as my mum did?

Dr Diana Mansour, consultant doctor, replies:

It’s likely that you’ll experience your menopause within a few years of your mum’s age at the menopause. Most women go through the menopause between 45 and 55, with the average age being about 51. So if your mum went through the menopause at this age, it’s highly likely that you will too, unless you have certain medical conditions or treatments or have had gynaecological surgery affecting how your ovaries work. If your mum went through an early menopause before age 45, you’ll have a greater risk of an early menopause (before the age of 45). Research is still investigating this complex issue, with a number of genes seeming to play a role.

I’m 50 and am having regular periods. I had acne as a teenager, but it has now come back. Which products can I buy from the pharmacy to help clear up my skin?

Lila Thakerar MBE, community pharmacist, replies:

You can buy various products for mild to moderate acne. The Acnecide range includes a gel that needs to be left on and a wash-off treatment. These products need to be used with caution, so it’s crucial that a pharmacist gives you advice on how to use them safely, especially in direct sunlight. Regularly washing your whole face with Clearasil or Quinoderm face washes will cleanse your skin and open blocked pores, but it can take weeks to see any results. If your symptoms are getting worse, ask your GP for advice.

Can natural progesterone cream reduce hot flushes and night sweats?

Dr Sarah Gray, GP, replies:

Adverts for natural progesterone cream promise relief, but this isn’t classified as a pharmaceutical product so doesn’t have to meet the same standards. Hot flushes and night sweats are a symptom of a lack of oestrogen in menopausal women. Adding in progesterone will either make no difference or make your flushes worse by opposing the oestrogen. So little progesterone is absorbed through your skin that the effects are minimal. If your flushes clear up with natural progesterone cream, this is likely to be due to a natural fluctuation in your symptoms, rather than the cream itself.

I’m 49 and perimenopausal. Hot flushes are making my life very difficult. I don’t have any medical conditions or take medicines. Which herbal remedies could I try?

Mr Nick Panay, consultant gynaecologist, replies:

I would recommend using a product that has, at least, some evidence for its effectiveness and safety through basic research and clinical trials. You could either opt for herbal remedies that don’t have any oestrogenic (oestrogen-like) action or phytoestrogens, which are plant products with some similarities to oestrogen in how they work. Evidence-based non-oestrogenic herbal remedies include St John’s Wort and pollen extract products. Evidence-based phytoestrogenic products include red clover and soy-derived products. In my view, it’s better to opt for pure preparations containing one rather than multiple ingredients. Be aware that some of these products interact with medicines, so it’s important to read the label carefully. It’s also important to look for the Traditional Herbal Registration kitemark; the manufacturers of these products have to submit information about the safety, quality and traditional use of the product (but not its effectiveness).

Does HRT have an effect on migraine?

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

If you have a history of migraines during your period and you’re prescribed a monthly bleed type of HRT, you may get migraines with your HRT-pack bleeds. You should discuss this with your GP or healthcare professional, as a different HRT may suit you better. If you’ve never had migraines but find you’re getting them with a particular type of HRT, discuss this with a healthcare professional, as you may need to change your HRT. Changing the progestogen hormone may be a simple solution. If you have very bad migraines, stop HRT and seek medical advice. To manage stress-induced migraines or headaches, try relaxation therapy and identify any triggers. If stress is partly due to menopausal symptoms and affects your quality of life, HRT will help.

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