WELLBEING EXPERTS  /  MENOPAUSE / What can I do to help myself during menopause?

What can I do to help myself during menopause?

Historically, women have been very limited in their options when it comes to managing the unwanted consequences of menopause. The most commonly talked about solution is HRT, but that isn’t suitable for everyone, not everyone wants to take it and often it only addresses certain symptoms. However, the world is beginning to talk about menopause more and as a result there are options available.

The starting point with all things is to be informed. In a world of information overload that means accessing advice, information and data from trusted sources. Your doctor is a great place to start but it doesn’t have to be the only place to find help. Most GPs by nature lean towards medical solutions – most notably antidepressants and HRT. Some GPs have a specific interest and knowledge in hormonal wellbeing, nutrition and other therapies, in which case you may find that they are able to discuss additional ideas with you.

Everyone is different, and their experience of menopause will be personal, so often it’s a question of finding the right thing or things for you. Typically, women will find that it’s best to combine a couple of different approaches – perhaps some holistic, some lifestyle and some medical. The important thing is to find what you feel happy and comfortable with.

Hormone Replacement Therapy (HRT)
Hormone Replacement Therapy (HRT) is the most widely talked about approach to addressing menopause symptoms, it works by replacing the hormone levels that have dropped to help reduce the symptoms you’re experiencing.

HRT is often considered by doctors to be the most effective treatment option for relieving menopausal symptoms, especially hot flushes. For many women this proves to be the path they are happiest to take. The type of HRT and the dose that’s recommended will depend in part on a person’s individual and family medical history, or whether it’s suitable at all.

There are two main hormones used in HRT: oestrogen and progestogen. They either come as a combined hormonal therapy or oestrogen only.

  • Combined HRT: More commonly recommended, especially for continued use for women who are postmenopausal.
  • Oestrogen-only HRT: This is usually only recommended if an individual has had a hysterectomy. It’s also sometimes recommended for women going through menopause before the age of 45.

HRT is either taken as a tablet, in the form of skin patches, oestrogen gel, implants or as vaginal oestrogen. These tend to be in either cyclical or sequential routines. You can find out more from your GP. You might also be given a testosterone gel if you find HRT does not improve your libido.

It’s important to be aware that there are different types of HRT, so get all the information you can. Talk to your GP and keep an open mind – you are not obligated to take it and there’s no right or wrong. If you don’t get along with it, it may be worth trying a different type. It’s also worth seeking out a GP with specialist knowledge in menopause and women’s health if possible.

Some women can’t take HRT due to underlying conditions or don’t want to, and they need alternatives. It’s also important to remember that not everyone needs HRT, and lifestyle interventions such as nutrition, exercise, supplements) can be equally important.

Bio-identical hormone replacement therapy (BHRT)
There is a rise in interest in bio-identical hormones, which are essentially man-made hormones, similar to those produced by the human body. The impact is largely the same as HRT – it helps to relieve symptoms of menopause such as hot flushes or night sweats. This is a relatively new area and as with all new things you do need to be careful what you’re getting and where you’re getting it from. On balance in the UK, they are not recommended by the powers that be.

  • rBHRT – Regulated Bioidentical Hormone Replacement Therapy – is authorised by the regulators such as the MHRA in the UK.
  • cBHRT – Compounded Bioidentical Hormone Replacement Therapy – usually in the form of creams or gels – are not recommended or regulated in the UK. In fact, a study in 2019 deemed them unsafe.

Typically BHRT is not suited to most cancer patients.

Holistic options
For those who can’t take HRT, don’t want to take HRT or want to support their medical treatment with other holistic options to address the consequences of menopause, there’s a growing body of research into lifestyle and medical solutions that can provide invaluable support.

At Jennifer Young, we conducted a State of the Art Scoping Review, commissioned from the UK’s Keele University, to provide academic validation and statistical scrutiny of holistic therapies on specific symptoms. It found that menopausal women looking to treat their symptoms with non-pharmaceutical approaches should consider:

  • Phytoestrogens (plant hormones) to help reduce the frequency of hot flushes/hot flashes (these can be found in natural skincare ingredients as well as certain foods).
  • Cognitive Behavioural Therapy (CBT) for relief across the spectrum of symptoms
  • Acupuncture or acupressure to address a broad spectrum of unwanted physical and emotional consequences of menopause.

Other holistic therapies and lifestyle solutions were also shown to offer meaningful benefit, including:

  • Reflexology
  • Homoeopathy
  • Hypnosis
  • Mindfulness
  • Exercise
  • Yoga

Acupressure is particularly powerful because it has a broad spectrum of benefits, is non-invasive and can be used to target particular symptom groups. It’s also suitable for anyone who has had cancer or who is undergoing cancer treatment.

Lifestyle solutions
Leading on from holistic therapies, lifestyle plays a huge part in how we feel at any time, and it can be a wonderful way to influence the way we experience menopause. This is an area that covers a multitude of aspects, from nutrition and supplementation to exercise, our home environment, wellbeing at work, and practices like meditation.

We sometimes hear it referred to as social prescribing, but Dr. Shashi Prasad, an Advanced Menopause Specialist and Lifestyle Medicine Physician says:

“Lifestyle medicine is a very powerful tool to manage your health and wellbeing. It has 6 pillars – Nutrition, Movements, Sleep, Stress Reduction, Relationships and reducing Addictive substances like smoking and alcohol.  It empowers people to take control of their own health in a preventative manner, and moves away from doctor led to patient led medicine. It enables people to take steps to improve their health and feel better – whether it’s nutritional interventions, exercise, stress reduction or quitting smoking.”

This can be an incredibly empowering way to address how you feel through menopause, even before it’s started – preparing your body to be in the best place to accommodate change.

BY JENNIFER YOUNG

Meet our other wellbeing experts