Monday, 16 December 2013

Award winning Menopause Magazine, what is it all about?

The Menopause affects ALL women and is a phase of significant hormonal, physical and psychological change. While all women are affected very differently, they should all have access to accurate, non-biased information to empower them to make informed choices about the management of their menopause. At Menopause Matters, our mission is to provide such information and support. To achieve this aim,Menopause Matters Ltd was founded in 2001, and in January 2002 launched what is now the leading UK based, award winning menopause website attracting an average of 4,500 visitors per day.
To provide essential information and support in a complementary, glossy format, reach a wider audience, and satisfy an evident need for a hard copy resource, Menopause Matters magazine was launched in summer 2005. Menopause Matters magazine is currently the only magazine of its kind, written specifically for women approaching and experiencing the menopause. Menopause Matters combines medical facts with glamour in an upbeat, readable style. Menopause Matters magazines are posted out to individual subscribers, GP's surgeries and menopause clinics and to gyms and yoga studios. While our print run has increased, so too has the use of our website where the online magazine can be viewed, the two mediums complementing and promoting each other, achieving our aim of a continued increase in the use of both.
With the medical background and knowledge of Dr Heather Currie, a national expert in Women’s Health and the menopause, the editorial skills and extensive publishing experience of Mr Andrew MacKay, the website expertise of Mr Rik Moncur and the advertising expertise of Mrs Annie Preuss, this innovative team cross public and private sector, medical and non-medical boundaries to provide accessible, accurate, readable, attractive information and support which is essential for all women.
Surveys of both women and health professionals showed:
  • 90% considered Menopause Matters to be very useful
  • 96% found Menopause Matters content good or very good
  • 91% found the advertisements useful
  • 90% said that the magazines were received well or very well by patients
  • 97% wish to keep receiving the magazines
  • 99% felt that the magazines should be available in all GP’s surgeries and menopause clinics
  • 98% felt that Menopause Matters helped women be better informed
While providing general menopause information, Menopause Matters magazine also sensitively tackles embarrassing menopause related topics, enabling women to understand, seek help when necessary and go on to lead as healthy, full lives as possible. With current NHS constraints, Menopause Matters goes a long way in empowering women to cope with an inevitable health process, without necessarily needing to use NHS resources.
I have just picked up a copy of 'Menopause Matters' at the GP surgery and I found it really refreshing and confidence boosting - the fact that somebody out there believes that we 55+ women are not on the sexual decline was heartening and in particular, that vaginal atrophy is treatable. I want to thank you sincerely for producing this magazine which offers such a ray of light in the apparent gloaming. You have given me such great hope.
I am sure there must be many colleagues who equally find balancing careers with the menopause a real challenge.............I cannot thank you enough for putting me back in the driver’s seat.
ALL females should have access to the magazine young & old!
Fabulous magazine. Really helpful tool and good for staff too
Brilliant. Magazines go like hot cakes
Excellent up to date glossy mag for ladies. I give copies to all my menopausal patients
Read by staff and patients alike – excellent
Please can we have some more magazines for the surgery- they go like hot cakes!
I just LOVE Menopause Matters magazine!  Thank you for sending to the United States.
My patients have found the magazines very useful, especially when they realised that other women had similar symptoms of the menopause to them and they were not alone.
Was just reading the articles in your last edition about STD issues in my age pocket, awesome piece!!! Glad to see someone getting the info out there!
Magazine extremely useful and allows women to look information for themselves and educates and builds confidence
Excellent resource for profession and public

Tuesday, 17 September 2013

Preventing endometrial cancer - is it possible?

Endometrial cancer (cancer of the womb lining) is known to be associated in many cases with being overweight, since an imbalance of hormones and growth factors which then stimulate the womb lining can be produced in fat cells. But can maintaining a healthy weight prevent this common disease? According to a new report, it is estimated that 59% of the cases of endometrial cancer (about 29,500 annually in the United States) could be prevented if women engaged in physical activity for at least 30 minutes per day and maintained a healthy body weight, with a body mass index (BMI) from 18.5 to 25.0 kg/m².

The Endometrial Cancer 2013 Report, which was published by the American Institute for Cancer Research (AICR) and World Cancer Research Fund International (WCRF), also notes that coffee consumption reduces the risk.

Increasing evidence has suggested a link between cancer risk and physical activity and body weight. Physical activity and a healthy body weight have been associated with a reduced risk for a number of cancers, including breast, prostate, and colon.

But in the case of endometrial cancer, the relation is quite striking. Currently it is thought that 7 of 10 American women are overweight or obese, and more than half do not get enough exercise to protect themselves against endometrial cancer.

The researchers also found that a high glycemic load, a diet rich in sugar-laden drinks and processed foods high in carbohydrates boosted the risk of developing the disease; it seems that diets that contain a lot of processed foods and sugary drinks can make a difference in the metabolic environment.

Coffee consumption is also associated with a reduced risk for endometrial cancer. Although too much caffeine can affect sleep quality and have other detrimental effects such as on bone health, this study shows that moderate amounts of coffee can be part of a healthy diet, and drinking decaffeinated coffee was also protective.

However, despite the increasing number of studies linking lifestyle and weight to cancer risk and the subsequent media coverage, many people are still unaware of the connection. Surveys have shown that while many people are aware that being overweight increases the risk of type 2 diabetes and heart disease, about half do not see it as a risk factor for cancer.

For someone who is sedentary and overweight, change can be a daunting task. Weight loss should be viewed as a long-term effort, not something that needs to be done immediately. Changes should be made gradually both for weight loss and for increasing exercise. This report did find that activity of all types is important, not just recreational but occupational as well. Physical activity can be done in short bursts of time, even during the work day - go for a 15-minute walk, get up from your desk periodically, take the stairs instead of the lift. It is possible to work physical activity into daily life, even if you have a sedentary job.

Tuesday, 21 May 2013

It's All About The Ovaries

Through Menopause Matters website and magazine, we have told many personal stories, covered many aspects of the menopause, and hopefully helped many women steer their way through the tangled web which is the transition from reproductive years to the stage of post-reproduction.

The key aspect is the activity of the ovaries. Ovaries working normally release an egg each month and produce the hormones estrogen and progesterone, which affect many systems of the body - this is the normal state in the reproductive years. Ovaries failing to release eggs and failing to produce estrogen and progesterone, whether due to the natural running out of eggs, the removal of ovaries surgically, or the damage to ovaries from other drugs, is the state in the post-reproductive years.

Although emphasis is frequently given to the Menopause, the last menstrual period, the Menopause is in fact only one part of the inevitable process. A term which much more accurately reflects the process is Estrogen deficiency, or, in medical terms, Hypo-estrogenism, not unlike the term Hypo-thyroidism which refers to thyroid failure.

One of my missions is to encourage women and healthcare professionals to think more broadly than just “Menopause” and its early consequences such as hot flushes, and to think more in terms of estrogen deficiency and its early, intermediate and long term consequences.

Only then can the true effects of estrogen deficiency be more widely recognised, so that women can be better prepared to cope with the next phase of their lives as healthily as possible.

To find out more about menopause, and how to improve symptoms, visit Menopause Matters.

Tuesday, 23 April 2013

Menopause in the Workplace

Women currently make up a huge proportion of the workforce. For those of us who are 'baby boomers' and are now experiencing the hormonal changes of the perimenopause and of the menopause, demands of work can become even more challenging. Many women report great difficulties coping with what was previously manageable due to sleep disturbance and hence tiredness and, in some cases, exhaustion, difficulty concentrating, lack of confidence, anxiety, joint aches, not to mention the embarrassment of the well-known flushes and sweats. Throw into this the demands from teenage children and elderly relatives, and one might wonder how women cope at this stage at all!

The sad truth is that some really struggle and need help, yet often try to get through in the knowledge that for many, these symptoms will pass. The problem is that there is no way of predicting how long the 'early' symptoms of estrogen deficiency of the menopause will last. Many women report sad tales of significant symptoms which they openly admit have affected their ability to do their job necessitating changes in their role, time off work and even early retirement. Not all have received appropriate support and there appears to be a lack of awareness of the impact that menopausal symptoms can have - “isn’t it just about a few flushes?”!

So what can we do? As a doctor working in the field of menopause, I would wish that all women could receive appropriate advice and information about the effects of estogen deficiency, what simple changes women can make to reduce symptoms and improve long term health and what specific treatments are available. Sadly, this vision is a long way off but meanwhile, if symptoms are affecting you and your work, do seek help; ask your GP or Practice Nurse, make an appointment with Occupational Health, and above all, do not battle on alone!

For more information and for support, visit Menopause Matters and the Menopause Matters Forum.

Please let us know below if menopausal symptoms have affected your working day, and what support you've received from health professionals or colleagues.

Tuesday, 9 April 2013

Renewed Confidence in HRT

Since July 2002, there has been a huge downturn in the confidence of, and use of HRT. The concern about risks of HRT followed publication of results the Women's Health Initiative trial in 2002 and of the Million Women study in 2003. The massive publicity around the apparent risks shown by these studies understandably led to HRT being viewed as dangerous and that it should rarely be used.

Both these studies have since been reviewed and reanalysed and the revised outcomes, along with new studies which have now been published paints a much different picture - when used appropriately, HRT provides more benefits than risks for most women. Yet this message has not yet been widely circulated and I continue to hear of women who have distressing menopausal symptoms, have read thoroughly, weighed up the pros and cons and know that HRT is the best option for them but have to battle with their doctor to be allowed to take it.

To sort out the ongoing confusion, a global team of representatives of Menopause Societies and organisations associated with Women's Health met in November 2012 and have published a global consensus statement. The conclusions are clear:

• HRT is the most effective treatment for symptoms related to the hormonal changes of the menopause, and is beneficial for bone health and may decrease mortality and cardiovascular disease.

• Risks are acknowledged, but benefits will generally outweigh the risks for women under sixty, or within ten years of the menopause. The risks are generally small.

• Taking HRT is a decision which needs to be individualised, in consultation with a suitably qualified physician.

This statement is extrememly important and must be widely circulated and discussed. Women should be able to be access accurate, non-biased information so that they can make informed choices and in managing the consequences of the hormonal changes of the menopause, HRT should once again be considered as a safe option.

Full statement on menopausal hormone therapy.

Read more about hormone replacement therapy.

What do you think? Have you encountered problems with getting your doctor to prescribe you HRT? Please let us know below.

Wednesday, 3 April 2013

Vaginal Dryness - Lube or Hormones?

Many women experience vaginal changes and vaginal problems due to the lack of estrogen after the menopause. Initially, this can be in the form of dryness during sex. At this stage, lubricants can be used and many effective preparations are available. Some are applied just during sexual activity, others can be applied regularly to maintain the moisture. It is often a case of trial and error to find what works best.

While lubricants and moisturisers can reduce the dryness and ease the discomfort, to treat the underlying problem of the lack of estrogen and consequent changes in vaginal blood flow, secretions, thickness, elasticity and support of the vaginal skin and acidity level, consideration should be given to replacing estrogen which can either be in the form of HRT (hormones which circulate throughout the body and would be used if other generalised menopausal symptoms are also present) or vaginal estrogen.

The debate around the risks and benefits of HRT continues, but it should be understood that vaginal estrogen provides a very low dose of estrogen which is concentrated in the vagina and bladder with minimal absorption around the body. Therefore, vaginal estrogen can be used by women who either do not want to take HRT, or have been advised not to take HRT.

Various types of vaginal estrogen treatments are available and again, it may require trial and error to find which suits best. Preparations include small vaginal tablets inserted by an applicator, vaginal creams, pessaries and a three monthly vaginal ring. Vaginal tablets, creams and pessaries are used every night for two weeks, during which time there may be a little absorption and some women may notice breast tenderness. This should not cause concern. After the first two weeks, the maintenance dose is twice weekly, during which the absorption is minimal and any breast tenderness should settle. The vaginal ring is changed every three months and produces a small regular amount of vaginal estrogen. Vaginal estrogen used at the maintenance doses can be used long term, there being no known risks with many years of treatment. Indeed, we know that if vaginal estrogen is stopped, the symptoms frequently return and long-term treatment is recommended.

Whatever you choose, be aware of menopausal effects on the vagina and look after your vagina in the happy, healthy years ahead!

See more at Menopause Matters.

What do you think? Is this a problem you've encountered yourself? If so, what impact has it had on your relationship and sex life?

Tuesday, 26 March 2013

Why Do We Flush?

Flushes and sweats are the classic, well-known menopause symptoms, or can be caused by estrogen deficiency. We have all heard of them, yet we still know relatively little about why they happen and why there is such variation in their severity and duration. From what we do know, it seems that we have a thermostat in the brain which regulates our body temperature. If our core temperature rises, as happens if we have an infection, a fever, then our thermostat triggers cooling down mechanisms such as opening up surface blood vessels (the flush) and switching on sweat production. These measures ensure that our body organs do not become too hot. In the reverse situation, if our core body temperature falls, our thermostat switches on heating up mechanisms such as shivering, in order to maintain temperature.

During every day, our core temperature fluctuates by a few degrees but our thermostat works within a buffering zone, so that we don’t spend the whole day flushing, sweating or shivering. Even additional changes in temperature as brought about by hot or cold drinks, being outside or inside, emotion or stress do not normally lead to triggering by the thermostat. However, with estrogen deficiency of the menopause, the thermostat changes in action so that even the normal daily temperature changes and additional ones described, can lead to unnecessary flushes, sweats and shivers - the thermostat thinks that the body is over-heating, or over-cooling when it is not.

While it appears that estrogen deficiency is a cause of changing thermostat function, it is clearly not the only factor since menopausal women, with the same changing and low levels of estrogen, can have very different levels and duration of symptoms. Diet and lifestyle factors are involved with being overweight, drinking alcohol and caffeine, and smoking leading to worse symptoms. Other chemicals such as serotonin, noradrenaline and gamma aminobutyric acid are also likely to be involved and the recognition of their involvement has led to the development of other non-hormonal drugs which can be prescribed to reduce symptoms in women who are not able or willing to take HRT.

So while research continues into the mechanisms and treatments for flushes and sweats, we should try to maintain a healthy weight, eat a healthy, balanced diet, minimise alcohol and caffeine, not smoke, take plenty of exercise, wear loose layered clothing, and generally look after ourselves whilst considering treatments to minimise symptoms of the menopause and the impact that they may have on our lives.

See more at Menopause Matters.

Wednesday, 20 March 2013

Breast Cancer and HRT - Fact or Fiction?

While the role of HRT for treatment of menopausal symptoms, treatment of premature menopause and beneficial effect on bones should now be well established, the debate about HRT and breast cancer risk continues.

Following a massive drop in use of HRT after publication of the Women’s Health Initiative (WHI) trial in 2002 and Million Women Study (MWS) in 2003, an apparent drop in rates of breast cancer was claimed to provide further evidence that HRT did indeed cause breast cancer. However, researchers from Cape Town University, writing in the journal of Family Planning and Reproductive Healthcare, state that it is impossible to establish a causal link. Breast cancer rates actually started to fall in 1999, before the drop in use of HRT, and the drop seen in 2002 to 2004 was far too early to be due to the fall in use of HRT.

The same journal, in 2012, published reviews by Shapiro et al of both the WHI trial and the MWS and concluded that these studies did not in fact prove a link between HRT and breast cancer.

So, can we be completely reassured that HRT does not cause breast cancer, and can women go back to using HRT without any fear that it will increase their risk of this tragic disease? It seems that it is extremely unlikely that HRT causes breast cells to become cancerous. But it is possible that, if certain types of HRT (combined HRT containing estrogen and progestogen, rather than estrogen alone) are taken for more than five years after the age of fifty, there may be promotion of cancer cells which are already present in some women, but not in the majority. To add to the complexity, even within types of combined HRT, it appears that different progestogens have differing effects, some types appearing to be “breast-friendly”.

Finally, to try to understand the level of risk, it is known that drinking two or more units of alcohol per day, or being overweight after the menopause both provide a far greater level of risk than taking HRT for five years. Read more about the effects of diet, exercise and lifestyle on menopause.

No medicine is perfect and everything that we do carries some level of risk. It is essential that women who are considering taking HRT, and healthcare professionals who are considering prescribing HRT, should access accurate information to help them make informed choices. Currently, many women are missing out on the benefits of HRT because of fear of risk. But for the majority, when HRT is used appropriately,  the benefits outweigh the risks.

You can see more about balancing the risks and benefits of HRT at

Monday, 4 March 2013

Mental Health and Menopause

Many women notice changes in mood around the time of the perimenopause and menopause.

It can be difficult to know if the symptoms of low mood, anxiety, panic attacks, depression and mood swings are caused by the hormone changes associated with changing ovarian function, or are due to an underlying mental health problem. Indeed, it appears that when presenting with such symptoms, many women have been offered antidepressants when they have wondered themselves if the symptoms could be hormonal.

If these symptoms occur along with evidence of change in ovarian function, from a change in the period pattern with or without other menopausal symptoms such as hot flushes, sweats, joint aches and sleep disturbance, then a trial of hormone replacement rather than an antidepressant, would seem worthwhile. In fact, many women take HRT purely for control of such symptoms, rather than control of the classic flushes and sweats. Such mood, psychological and coping symptoms are often completely unexpected and, when untreated, cause more distress than the expected flushes and sweats.

We know that women who have previously suffered from clinical depression, particularly those who have experienced postnatal depression or premenstrual syndrome, are sensitive to hormonal fluctuations and are at risk of developing depression in the perimenopause, a time of significant hormonal fluctuation. Otherwise, while depressed mood is common around the time of the menopause, new onset clinical depression is not increased purely due to the menopause.

Mental health problems are very common, and can be associated with the menopause so should be treated early.

For more information, visit the symptoms section and psychological section of Menopause Matters.

Monday, 25 February 2013

A Sore Point

In many issues of Menopause Matters magazine we have included articles, results of surveys, research findings and advice about the very embarrassing topic of vaginal dryness and discomfort which is common during the menopausal changes of vaginal atrophy. With a lack of estrogen, many women experience thinning, drying changes, in the vagina which can lead to irritation, pain, discharge, bleeding, soreness and reduced response during sex. This can then also lead to relationship problems.

We know from our surveys that still, in the 21st century, women find it very difficult to discuss this with their partner, let alone a healthcare professional. This results in women often making excuses not to have sex, and putting up with the symptoms for many years. We know that their confidence can be affected, and this common symptom can have a great effect on self-esteem, quality of life and relationships.

Vaginal atrophy often occurs a few years after the menopause, or a few years after stopping HRT. Symptoms can be reduced using lubricants or moisturisers, and the underlying cause of lack of estrogen can easily be treated with vaginal estrogen in the form of small vaginal tablets, cream, pessaries or a vaginal ring. Vaginal estrogen can be used even when HRT is not desired or not recommended since the dose of estrogen is very small and is concentrated in the vagina. Vaginal estrogen can be used for many years and indeed may be required indefinitely.

If you are experiencing vaginal changes, be sure that help is available. See more info on the Menopause Matters website.

Friday, 15 February 2013

Menopausal Middle-aged Spread - Fact or Fiction?

For many generations, women have battled with the 'middle-aged spread', which so often starts to appear around the time of the menopause, with blame often being laid on the menopause, or on the use of HRT. Although it is often the source of jokes and teasing, weight gain can have significant health implications, not to mention the psychological effects - we all know how depressing it can feel when clothes just feel too tight, or don't fit at all.

It is known that as our hormone balance changes, with a shift in the balance of estrogen and testosterone production (estrogen declining and so steady levels of testosterone have more of a dominant effect), we tend to distribute fat more around the middle and tend to develop the male-like apple shape instead of the female-like pear shape. Along with the change in hormone balance, our rate of metabolism changes as does the way that our body handles glucose and insulin. So all in all, the hormone changes of the menopause itself contribute to weight gain and a change in shape. Taking HRT has not been shown to cause weight gain and, in some women, may help to restore the hormone balance and so have a beneficial effect.

What else can we do? There is no simple magic answer, but the time of the menopause should be the time that we review our diet and lifestyle and, when necessary, make simple changes to reduce weight or maintain a healthy weight and increase exercise to both reduce menopausal symptoms, and to improve later health. If we are overweight, losing weight can reduce risks of heart disease, stroke, breast cancer, diabetes and cancer of the womb. We all need to find an eating style that includes a good variety of vegetables, salads, fruits, lean meats, fish and with minimal sugars and processed foods that we enjoy and can stick to. Similarly, exercise should be something that we enjoy and is sustainable, whether it be walking, Zumba, a sport, gym classes, swimming...and don't forget lots of sex!

We can use the time of the menopause as a positive wake up call to invest more time than we may have done for many years, to look after ourselves.

For more advice, visit the Diet, Lifestyle & Exercise section of Menopause Matters.

Tuesday, 5 February 2013

Ten Wasted Years?

Having been involved for many years in advising, educating and always still learning myself about the menopause, the effects of estrogen deficiency, and treatments, I have seen many changes but none so dramatic as the views on Hormone Replacement Therapy (HRT). In the early days, HRT was seen as the answer to many problems and while it was known that it was not perfect and that all medicines carry some risk, it was strongly believed that for most women, the benefits outweighed the risks. Then, in July 2002, publication of the Women’s Health Initiative (WHI) trial led us to be more concerned about risks and less aware of benefits with a subsequent huge fall in the use of HRT.

Ten years on, and a full review of the WHI trial and of other available evidence has been published. The key message is that in fact, when used appropriately especially for women under the age of 60, or within ten years of the menopause, HRT provides far more benefits than risks. It is reassuring that the media did give this news some attention, since women and their healthcare providers need to be aware of this information, so that they can make informed choices about the management of their menopause. It seems that for the last ten years, decisions have been made based on incorrect information.

Many have stated that as a result of the WHI trial and the ensuing publicity, we have had ten wasted years and that women have suffered unnecessarily. This may be the case but we cannot turn back the years and decisions were made in good faith. Lessons have been learned and perhaps we should realise that major shifts in practice should not be based on one study, no matter how large. Women can once again be reassured that HRT is safe when used correctly and while not all women will need HRT, those that do need not worry unduly about risks but can enjoy the benefits. It is time to move on.

For more information about Menopause and HRT, visit

Friday, 1 February 2013

Menopause is Everywhere

It cannot be said often enough, menopause, and the consequences of ensuing estrogen deficiency affect EVERY woman.

Yet why, in the 21st century, do we still find it difficult to discuss, surround it with embarrassed laughter, and speak in hushed tones? What is so bad about openly discussing a physiological process which is simply a hormone deficiency, the consequences of which have now a much greater effect on our health than ever before, because we are living longer, so we are experiencing the consequences for more years than any previous generation?

I do get the feeling that more people now are wanting to talk about it, wanting to find out more information, but it doesn’t come easily. A recent taxi journey during a trip to Dublin highlights the issues: when asked why I was in Dublin, I replied that I was speaking at the Irish Menopause Society annual conference. The response was hilarious—“Holy Mother of Jesus, my wife has been through the menopause 3 times!!” There then followed an enlightening discussion about her symptoms, which were severe, but there was frustration that she did not feel that she could visit her doctor, or indeed talk to anyone about this highly embarrassing subject. A Menopause Matters magazine was duly produced from my bag and given to pass on, in the hope that the information would be helpful!

Perhaps it’s the word “Menopause” which is so highly charged with associations with negativity, periods, female hormones? Whatever the reason, this needs to change. In the absence so far of an internationally accepted alternative word to describe the transition that all women experience, let’s just all do what we can to help others be open, informative and supportive.

Monday, 21 January 2013

National Shortage of Testosterone

Hormone replacement therapy aims to replace estrogen to control the effects, both short and long term, of estrogen deficiency. In addition, for women who still have their womb, some form of progestogen is given to protect the womb lining from being stimulated by the estrogen. Some women also benefit from the replacement of testosterone, particularly those who experience premature ovarian failure, or have surgical removal of their ovaries, since our ovaries produce about 50% of our testosterone, the rest being produced from the adrenal glands. The lack of testosterone in women can cause fatigue, low mood and low libido.

Previously, women could be given testosterone in the form of a twice weekly patch or a six monthly implant and many found these preparations very helpful. Unfortunately, the patch has now been withdrawn from the market, and implants of both estrogen and testosterone are not readily available in the UK, although some clinics have been able to purchase them from America.

This has caused much concern, reducing treatment options for some women and the British Menopause Society are trying very hard to provide pressure on relevant organisations to improve the situation. Meanwhile, for postmenopausal women, the HRT tablet tibolone provides a combination of estrogen, progestogen and testosterone and is a very useful option for postmenopausal women who wish to take HRT and for whom low libido is a symptom. For women who require to use a separate form of testosterone along with HRT, several brands of testosterone gel are available. While they are only licensed for use in men, they can be used for women “off-license” under specialist supervision.

Wednesday, 9 January 2013

New Year, New Me

A New Year is here again and many will be thinking about the year just gone, and forward to the year ahead. Inevitably, many, including myself, start the year determined to make changes, common areas being in diet and exercise. Yet again, I resolve to take more exercise by dragging my friend with me to Zumba at least once per week, walking whenever possible, and to increase my salad, vegetable and fish intake while cutting down on tempting biscuits and cakes. The difference this year is that now that I am officially postmenopausal myself, I realise that I need to actually follow this through since my hormonal changes will already be having an effect on my blood pressure control, cholesterol level and vessel function. I do take HRT which should be providing protection against these heart risk effects of estrogen deficiency, but it is vital that in the menopausal years in particular, we all do as much as we can to reduce our heart risk.

Let’s find healthy food that we can enjoy and stick to, and find an exercise that is fun and sustainable. Zumba works for me, especially since it has become my weekly catch-up time on the way there and back with my friend. The music is fab, the steps are fun and before you know it, you have stepped out, jiggled and shaken your bum for an hour without feeling like it was serious exercise. Going with a friend is not only fun but the commitment of picking up on the way makes it much harder to stay at home because of being “too tired”, or have “too much to do”.

So ladies, while the emphasis is frequently on breast cancer as a major health risk for women, take note that three times more women die from heart disease than breast cancer

We can all make changes this year to look after our hearts so let’s do it!

More information on heart disease and CVD.