tag:blogger.com,1999:blog-23069517094790765522024-03-13T03:03:28.336-07:00Menopause MattersHeather at Menopause Mattershttp://www.blogger.com/profile/01182407217623657491noreply@blogger.comBlogger39125tag:blogger.com,1999:blog-2306951709479076552.post-82625353002952351892021-05-13T12:19:00.002-07:002021-05-13T14:11:39.648-07:00Davina McCall: Sex, Myths and the Menopause<div style="font-family: sans-serif; font-size: 12.8px;">I was delighted to see menopause in the spotlight on Davina McCall's programme, <span style="color: black;">Sex, Myths and the Menopause,</span> raising awareness of the effects of the menopause, for which the impact can be devastating, and what options are available. Two main issues of concern were raised--provision of information for women and education of GPs.</div><div style="font-family: sans-serif; font-size: 12.8px;">From the women interviewed and from previous surveys, including from the British Menopause Society, it is clear that many women are not prepared for the onset of perimenopause and menopause, and do not always receive the advice and support that they need from their primary care teams. We know that there has been a huge upsurge in development of resources for women over recent years with websites, support groups, festivals, and much more, not to mention Menopause Matters website (launched January 2002!), Menopause Matters magazine (since 2005!) and Women's Health Concern; patient support from the British Menopause Society. There has also been a massive increase in provision of education for healthcare professionals in the form of meetings, publications, webinars, particularly from the British Menopause society, whose membership is now at an all time high, and meetings are full or over subscribed. </div><div style="font-family: sans-serif; font-size: 12.8px;">Therefore why still the problem?</div><div style="font-family: sans-serif; font-size: 12.8px;">Women are entering the transition phase of changing ovarian function every day. Perimenopause and menopause can present in many ways, not just in the form of well known flushes, and women may only start to look for information if they recognise that these symptoms may be hormone related, and if they realise that these changes can start in the early to mid 40s, or earlier.</div><div style="font-family: sans-serif; font-size: 12.8px;">Menopause education in schools is key in early preparation and those of us committed to providing information and support must just keep doing what we are doing, and embrace opportunities and creative ways of delivering.</div><div style="font-family: sans-serif; font-size: 12.8px;">Despite the criticisms expressed about the lack of menopause training and knowledge by GPs, most menopause management is provided appropriately by knowledgeable primary care teams. Implementation of the BMS vision for menopause care in the UK is essential to address the lack of consistency and implementation needs to be progressed urgently. </div><div style="font-family: sans-serif; font-size: 12.8px;">I am excited about the future of menopause care in the UK since, while much has been achieved, so much more is possible, and will continue to work tirelessly through Menopause Matters and BMS, and link with other organisations so that together we can <span style="color: black;">continue to<b> </b></span>make a difference!</div>Heather at Menopause Mattershttp://www.blogger.com/profile/01182407217623657491noreply@blogger.com9tag:blogger.com,1999:blog-2306951709479076552.post-61183528431820421072017-01-05T04:56:00.002-08:002017-01-05T05:00:22.670-08:00Bio IdenticalsIt is fantastic to see that more attention is being paid to the importance of the menopause, estrogen deficiency and its consequences, both in respect to symptoms and later health.<br />
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Since publication of the NICE guideline on diagnosis and management of the menopause in November 2015, more clarity has been provided about treatment options, although the information has not yet reached everyone with many women and some healthcare professionals still expressing confusion around benefits and risks of Hormone Replacement Therapy (HRT) in particular.<br />
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Sensationalist headlines do little to dispel myths, and indeed are more likely to add to the confusion. However, I do strongly believe that enough evidence has now been provided and thoroughly analysed such that the time has come to view HRT as a very useful option for controlling menopausal symptoms and providing later health benefits with little risk for the majority of women.<br />
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HRT is an obvious option to consider when treating menopausal symptoms which are caused by estrogen deficiency, since its aim is to replace estrogen. In women who have not had a hysterectomy, progestogen or progesterone is added to the estrogen to prevent the estrogen stimulating and causing a thickening of the womb lining (the endometrium).<br />
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Different types and routes of both estrogen and progestogen are available and the type and route chosen are determined by each woman’s preference, as well as the type of symptoms that she is experiencing, her medical and family history and any other current medication.<br />
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Individualisation is essential.<br />
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This may appear straight forward so far. However, an increasing concern is the development of practitioners prescribing “compounded bio identical hormones” which are promoted as being natural and individually prepared to best suit the hormonal needs of individual women. The term “Bio identicals” refers to hormones that very closely resemble estradiol, estriol, estrone (all types of naturally occurring estrogen), progesterone, dehydroepiandrosterone (DHEA), and testosterone as produced by the human ovary and adrenal gland. While the message of replacing hormones which are very like the hormones that we produce ourselves until the menopause seems sensible, hormones are being provided by compounding pharmacies which are not standardised or government approved in terms of content, dose and balance between estrogen and progesterone.<br />
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Compounding bio identical pharmacies have been practicing in USA for a number of years and have recently appeared in the UK. Investigations in the USA are being reported. In 2001 the Food and Drug Administration (FDA) collected and analysed 29 compounded drugs. Two of the compounded hormone drugs failed analytical tests because of contamination risks.<br />
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In 2012 “More” magazine commissioned laboratory tests of bio identical hormones produced by 12 compounding pharmacies. It was found that these hormones were of unreliable potency and would not meet the standards for the FDA requirements for commercially manufactured drugs and in fact because of the variable hormone levels, concern was expressed that endometrial cancer risk could be increased.<br />
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When considering the use of HRT, emphasis on risk has been widely publicised over recent years and it is understandable that women may wish to take hormones which are seen to be as natural as possible and closely resemble women’s own hormones.<br />
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What is often not realised is that both estrogen and progesterone can be prescribed as standardised, regulated, government approved HRT in ways that very closely mimic our own hormones. These preparations which are available with NHS prescriptions could also be described as “bio identical” and are prescribed in approved forms.<br />
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The difference between hormones prescribed in compounding pharmacies and those prescribed in approved forms is that while some of the basic hormones used in both settings may be the same, ie estroegn and progesterone, the amounts and balance between estrogen and progesterone are not provided in regulated, approved forms in compounding pharmacies such that the stimulating effect of the estroegn on the endometrium may not be adequately balanced by the progesterone provided.<br />
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This has raised concerns about these compounded combinations leading to increased risk of endometrial cancer, and cases have been reported. In approved regulated forms of HRT, the appropriate dose and balance has been thoroughly investigated. Use of the term “bioidenticals” is in itself confusing and misleading and better would be to adopt the terms—government approved, or non-government approved hormone therapy.<br />
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Another concern is that compounding pharmacies may recommend blood tests or saliva tests to supposedly determine hormone requirements and to assess response to treatment, all at a cost to the woman. While there are some situations when measuring hormone levels by blood test may be useful, saliva levels are of no benefit and blood tests are rarely helpful or required. Better is to start treatment in standardised doses and measure response by effect on symptoms and presence or not of side effects.<br />
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Finally, it should be noted that individualisation is indeed the key and that even the use of natural type estrogen and progesterone in government regulated and approved form may not suit the woman. It is always necessary to be prepared that often changes in type and/or route of hormone therapy may be required to provide treatment which provides benefit while minimising side effects, but at all times regulated, government approved hormones should be used rather than compounded, non-government approved hormones.<br />
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Recently published national and international guidelines support this advice with NICE guideline on Diagnosis and Management of Menopause stating “..bio identical formulations that are compounded for an individual woman according to a healthcare provider’s prescription are not subject to government regulations or tested for safety or quality and purity of constituents, therefore their efficacy and safety are unknown”.<br />
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The recently updated International Menopause Society recommendations on women’s midlife health and menopause hormone therapy state that “Prescribing of compounded BHT is not recommended due to the lack of quality control and regulatory oversight associated with these products, together with lack of evidence of safety and efficacy.”<br />
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<br />Heather at Menopause Mattershttp://www.blogger.com/profile/01182407217623657491noreply@blogger.com15tag:blogger.com,1999:blog-2306951709479076552.post-37889092335334720112016-11-18T07:23:00.001-08:002016-11-18T07:23:20.704-08:00What do you know about prolapse?<b><i>Let's talk about prolapse...</i></b><br />
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What’s the best way to talk about prolapse?<br />
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It seems to me that women are better now at talking about bladder leakage – either to their friends or their GP – using phrases such as ‘don’t make me laugh’ or ‘I couldn’t go on a trampoline’. A ‘legs crossed and oops’ moment with a sneeze is easily understood and ‘wearing a pad just in case’ doesn’t need to be said in hushed tones.<br />
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The products for incontinence are much more available and taking up more and more space on the shelves – for men and women. We can also talk about the effects of ageing on the body: ‘everything heading south’, ‘not as young as I once was’, ‘laughter lines’ not age creases. I have been a specialist women’s and pelvic floor physiotherapist for over 20 years but don’t yet have the answer to “What is the right language to talk about prolapse?”<br />
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<i>What actually is a prolapse</i>?<br />
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Prolapse is a very common problem for women who have had children, and the risk of prolapse increases with each decade of life. Estimates are that up to 50% of all women will have a prolapse at some point in their life. Prolapse or pelvic organ prolapse is where the walls of the vagina or the uterus (womb) move downwards creating a feeling of something coming down, vaginal heaviness or bulge.<br />
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It does not always have to involve the uterus, and although some people talk of their ‘bladder falling down’, it is the wall supporting the bladder rather than the actual bladder itself. The same goes for the back wall of the vagina, which is the one that supports the bowel or back passage. You can still have a prolapse even if you have had your womb removed (hysterectomy), in which case the ‘roof’ or top of the vagina can slip downwards.<br />
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The heavy feeling associated with a prolapse may not be the most bothersome problem. Prolapse may also cause difficulties with your bladder or bowel either with leakage or problems emptying your bladder or bowel completely. This can cause a sensation of never feeling properly finished on the loo. Sometimes, a prolapse can mean that you feel the need to go for a pee less often during the day but seem to need to go more often during the night.<br />
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<i>What can be done for this common problem</i>?<br />
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Not all prolapses get worse over time, so it may be that you don’t need to do anything apart from taking care not to do things that are likely to make the symptoms worse – heavy lifting, putting on too much weight, getting constipated and straining on the loo.<br />
Sometimes an operation is advised, to try and lift the vaginal wall back into place. This might include having a hysterectomy.<br />
There are non-surgical options which include exercising your pelvic floor muscles to be stronger to help lift the fallen walls back up. Your pelvic floor muscles are slung from the front to the back of your pelvis and just like your other muscles need to be exercised – ‘use it or lose it’. These muscles help keep your back passage and bladder closed to stop leakage of urine or wind or poo. But also help support the vagina and back passage.<br />
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You might also be offered a pessary.<br />
What is a pessary?<br />
A pessary is a synthetic device usually made of silicone which is positioned inside the vagina to help support the walls or uterus and lift them back into place. Usually a doctor will fit the pessary, which might take a few attempts to get the sizing right, and it will stay in for 3-6 months before it gets checked and replaced. You can keep using a pessary as long as there are no problems with it. A pessary is not: ‘just for the elderly’, ‘not suitable for those who want an operation’, ‘a last resort option’, but using a pessary does require follow up care to make sure that it remains correctly fitted and right for you.<br />
So let’s talk about prolapse<br />
The first thing to be clear about is that bladder and bowel problems aren’t an automatic consequence of having children or ageing – yes more likely- but not to be assumed. So don’t accept ‘well you’ve had children’ or ‘at your age……’ Instead you need to work out what you might feel ok saying to your doctor, family, partner, friends without feeling ashamed or embarrassed.<br />
How about:<br />
•<span class="Apple-tab-span" style="white-space: pre;"> </span>I am having a problem with my bladder and can’t empty properly, or need to return to the loo soon after I have been<br />
•<span class="Apple-tab-span" style="white-space: pre;"> </span>I can feel a heaviness vaginally (or ‘down below’ if that seems easier) which is making me uncomfortable<br />
•<span class="Apple-tab-span" style="white-space: pre;"> </span>I am not constipated, but can’t empty my bowel properly which leaves me feeling uncomfortable<br />
•<span class="Apple-tab-span" style="white-space: pre;"> </span>I am aware of a bulge protruding out when I wipe myself after being to the toilet<br />
•<span class="Apple-tab-span" style="white-space: pre;"> </span>I can feel something coming down, particularly after I have had the grandchildren for a day, or have had a long day on my feet.<br />
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Then you need to ask how best to find out exactly what the problem is and what treatments are available to help things to feel better. Your doctor should refer you to see a specialist in the hospital for further assessment and to give you access to specialist physiotherapists or nurses who can help.<br />
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My research is to try to find out what questions women and clinicians have about pessary use for prolapse and have a survey open until January 2017. If you would like to take part, click on this link:<br />
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http://www.gcu.ac.uk/hls/pspsurvey/<br />
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The questions will all be included in a process to find the top ten priorities for future research.<br />
What words do you use to talk about this subject?<br />
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<br />Heather at Menopause Mattershttp://www.blogger.com/profile/01182407217623657491noreply@blogger.com1tag:blogger.com,1999:blog-2306951709479076552.post-54315767356180812342016-10-17T11:21:00.000-07:002016-10-17T11:21:20.984-07:00Menopause: What does it mean? <div style="background-color: white; box-sizing: border-box; color: #333333; font-family: "Open Sans", sans-serif; font-size: 13px; letter-spacing: 0.325px; line-height: 1.68em; margin-bottom: 10px;">
<span style="box-sizing: border-box; font-size: 1em; line-height: 1.41421em;">All women become menopausal at some stage. Natural <a href="https://www.jostrust.org.uk/about-cervical-cancer/cervical-cancer/moving-forward-from-a-cancer-diagnosis/living-with-side-effects/early-menopause-and-hrt" style="background-color: transparent; box-sizing: border-box; color: #336699; font-weight: bold; padding: 0px !important; text-decoration: none; word-wrap: break-word;">menopause</a> is due to the ovaries gradually running out of egg cells and being unable to produce the usual cyclical production of oestrogen and progesterone. With changing balance of these hormones, the stimulation of the womb lining changes and so periods may become irregular and heavy. This changing phase, known as the perimenopause, can last for a few years until finally the ovarian hormone production is so low that the womb lining is not stimulated and periods stop, the time of the menopause. The resultant low level of oestrogen can produce a range of symptoms such as flushes, sweats, low mood, joint aches, disturbed sleep, and also some later consequences on vaginal, bladder, bone and heart health. The severity, duration and impact of symptoms and later health effects varies hugely between women, and hence the need for treatment is very individual.</span></div>
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Natural menopause usually takes place around the age of 51. However, for some women menopause can occur at a younger age and may be the result of treatment for another condition. When menopause occurs early after cancer treatment, it may seem like the last straw. Women may be unprepared for the onset of menopausal symptoms when they are also dealing with the devastating effects of diagnosis and treatment, and indeed may not initially realise what is happening.</div>
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The importance of provision of information before treatment which may lead to an <a href="https://www.jostrust.org.uk/about-cervical-cancer/cervical-cancer/moving-forward-from-a-cancer-diagnosis/living-with-side-effects/early-menopause-and-hrt" style="background-color: transparent; box-sizing: border-box; color: #336699; font-weight: bold; padding: 0px !important; text-decoration: none; word-wrap: break-word;">early menopause</a>was recognised in the recent NICE guideline on diagnosis and management of the menopause which recommends that healthcare professionals should:</div>
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<li style="box-sizing: border-box;"><span style="box-sizing: border-box; font-size: 1em; line-height: 1.41421em;">Offer women who are likely to go through menopause as a result of medical or surgical treatment (including women with cancer, at high risk of hormone sensitive cancer or having gynaecological surgery) support and:</span></li>
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- information about menopause and fertility before they have their treatment<br />
- referral to a healthcare professional with expertise in menopause</div>
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For women who have had treatment for cervical cancer, the type of treatment will determine whether or not the treatment will lead to early menopause. A <a href="https://www.jostrust.org.uk/about-cervical-cancer/cervical-cancer/treatments/surgery/hysterectomy" style="background-color: transparent; box-sizing: border-box; color: #336699; font-weight: bold; padding: 0px !important; text-decoration: none; word-wrap: break-word;">hysterectomy </a>may be performed and the ovaries may be able to be conserved. The ovarian function may then continue until they naturally stop working, but of course having a hysterectomy stops any periods and so it may be difficult to know whether or not the ovaries are still working. In this situation it is important to know what signs and symptoms to look out for.</div>
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If the ovaries are removed at the time of surgery, or are exposed to <a href="https://www.jostrust.org.uk/about-cervical-cancer/cervical-cancer/treatments/radiotherapy" style="background-color: transparent; box-sizing: border-box; color: #336699; font-weight: bold; padding: 0px !important; text-decoration: none; word-wrap: break-word;">radiotherapy</a> or <a href="https://www.jostrust.org.uk/about-cervical-cancer/cervical-cancer/treatments/chemotherapy" style="background-color: transparent; box-sizing: border-box; color: #336699; font-weight: bold; padding: 0px !important; text-decoration: none; word-wrap: break-word;">chemotherapy</a>, then menopause can happen suddenly. This sudden drop in oestrogen can lead to rapid onset of menopausal symptoms for which earlier preparation with provision of information is essential.</div>
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Whether treatment for cervical cancer leads to an early menopause, or women subsequently experience menopause at the usual age, treatment options need to be considered. The main reason to consider treatments is for symptom control. Symptoms affect around 80% of women but in varying degrees and not all require treatment. Diet and lifestyle measures can be the first step, with losing weight, stopping smoking, and reducing alcohol and caffeine being helpful both for symptom control and for later health benefits.</div>
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The most effective treatment for the effects of oestrogen lack is to replace oestrogen in the form of Hormone Replacement Therapy (HRT). HRT is recommended for women with troublesome menopausal symptoms, but is also recommended in women who experience a premature, (before age of 40) or early, (before age of 45) menopause, even if they do experience symptoms since HRT offers long term heart and bone health benefits. In this situation, HRT should be continued at least until the average age of the menopause.</div>
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Many women have concerns about taking HRT after much publicity in recent years about risks, but the current view is that for most women, the benefits outweigh the small risks. Having had cervical cancer does not mean that HRT should be avoided, there being no known association between HRT use and risk of cervical cancer. The type of HRT taken will depend on the treatment, such as whether or not a hysterectomy has been performed. Particular attention should be given to vaginal health, particularly if radiotherapy has been required. In this situation, vaginal oestrogen may be required in addition to HRT to help maintain vaginal health and prevent dryness and thinning of the vaginal skin.</div>
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It is sincerely hoped that with better education and understanding, the unwanted additional effects of treatment for cervical cancer can be reduced by appropriate preparation and treatment.</div>
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Further resources:</div>
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<a href="http://www.menopausematters.co.uk/" style="background-color: transparent; box-sizing: border-box; color: #336699; font-weight: bold; padding: 0px !important; text-decoration: none; word-wrap: break-word;">www.menopausematters.co.uk</a></div>
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<a href="http://www.womens-health-concern.org/" style="background-color: transparent; box-sizing: border-box; color: #336699; font-weight: bold; padding: 0px !important; text-decoration: none; word-wrap: break-word;">www.womens-health-concern.org</a></div>
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<a href="http://www.managemymenopause.co.uk/" style="background-color: transparent; box-sizing: border-box; color: #336699; font-weight: bold; padding: 0px !important; text-decoration: none; word-wrap: break-word;">www.managemymenopause.co.uk</a></div>
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<a href="http://www.daisynetwork.org.uk/" style="background-color: transparent; box-sizing: border-box; color: #336699; font-weight: bold; padding: 0px !important; text-decoration: none; word-wrap: break-word;">www.daisynetwork.org.uk</a></div>
Heather at Menopause Mattershttp://www.blogger.com/profile/01182407217623657491noreply@blogger.com6tag:blogger.com,1999:blog-2306951709479076552.post-74136961876841526632016-07-05T11:45:00.000-07:002016-07-05T11:45:22.712-07:00What's in a Name? <span style="font-size: x-small;">What’s in a name?</span><br />
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<span style="font-size: x-small;">When considering effects of the menopause, hot flushes and sweats regularly come top of the list of expected symptoms. Increasingly though, women and healthcare professionals are becoming aware of other symptoms due to declining and low levels of estrogen following natural decline in ovarian function, ovaries affected by other treatments, or removal of the ovaries. </span><br />
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<span style="font-size: x-small;">These may include sleep disturbance, low mood and joint aches. However, there is still a low level of awareness of the effects of estrogen lack on the vagina, bladder and pelvic floor, effects which can cause significant discomfort and distress yet still are hugely under reported and under treated.</span><br />
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<span style="font-size: x-small;">To address this issue, let’s start with the name. Many terms have been used including, vaginal dryness (to demonstrate a common symptom), vaginal atrophy (to indicate thinning changes of the vagina), vulvovaginal atrophy (to include thinning effects also of the vulva or “outer lips”), urogenital atrophy (to indicate that the urological system, ie bladder, can also be affected), and, the most recently recommended term—Genitourinary Syndrome of the Menopause (GSM).</span><br />
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<span style="font-size: x-small;">None of these roll easily off the tongue, which is indeed part of the problem. Women often find it very difficult and embarrassing to discuss gynaecological issues, especially related to the vulva and vagina and confusing terminology does not help.</span><br />
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<span style="font-size: x-small;">Whatever we choose to call the vulva and vagina, we need to recognise that the lack of estrogen can have significant and sometimes devastating effects on this very personal, sensitive area. In fact, it is thought that up to 50% of all postmenopausal women can experience symptoms due to GSM. However, it is believed that the true number of women affected is unknown since many women do not report symptoms and so this figure is likely to be an underestimate.</span><br />
<span style="font-size: x-small;">Symptoms can include dryness, pain during sexual intercourse, irritation and itching, susceptibility to vaginal infection and also bladder symptoms such as urgency to pass urine, passing urine more often and urinary tract infections.</span><br />
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<span style="font-size: x-small;">Vaginal dryness, irritation and pain during sexual intercourse are due to estrogen lack affecting vaginal and vulval blood supply, lubrication, loss of elasticity and thinning and inflammation of the vaginal walls and vulval skin with reduced sensation and response. Not surprisingly, these changes often lead to reduced interest in sex. In addition, estrogen helps to maintain vaginal acidity by facilitating production of lactic acid from lactobacilli (normal vaginal organisms). An acidic vaginal environment is a good barrier to infection. With less estrogen, vaginal acidity changes and both vaginal and urinary infection risk is increased. Bladder symptoms are due to estrogen lack on bladder muscle contractions; estrogen is thought to play a role in regulating bladder and urethral muscle contractions so that estrogen lack can lead to increased muscle contractions and feeling of urgently needing to pass urine. Further, there has been recent increased interest in the effect of estrogen on support of the pelvic floor. With low estrogen levels, pelvic floor support is reduced leading to dragging sensation and even prolapse.</span><br />
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<span style="font-size: x-small;">It has been recognised that GSM, particularly the vulval and vaginal symptoms, can have significant impact on quality of life and relationships. Previous surveys from our Menopause Matters website visitors have shown that women often feel that these symptoms had a negative effect on their confidence, self-esteem, and relationships and many made excuses not to have sex because of the discomfort.</span><br />
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<span style="font-size: x-small;">These symptoms often become noticeable a few years after periods have stopped, or a few years after stopping Hormone Replacement Therapy (HRT). This apparent delay in these effects appearing is due to the fact that estrogen lack on the vulva, vagina and bladder generally takes a few years to become evident, in contrast to the flushes, sweats, low mood and joint aches which are triggered early in the stage of falling and low estrogen levels.</span><br />
<span style="font-size: x-small;"> </span><br />
<span style="font-size: x-small;">The other important difference between urogenital symptoms and flushes and sweats is in relation to duration; while flushes and sweats can last many years, for many women they do reduce with time but urogenital symptoms do not reduce. Indeed, these symptoms gradually worsen with time and so any treatment needs to be continued long term. This message was confirmed by the recently published NICE guideline on Diagnosis and Management of the Menopause, recommending that “Treatment should be started early before irreversible changes have occurred and needs to be continued to maintain benefits” (NICE guideline. Menopause:diagnosis and management.)</span><br />
<span style="font-size: x-small;"><br /></span>
<span style="font-size: x-small;">For such a common consequence of the menopause which can have significant effects, it is clear that effective treatment is required, should be started early, and continued long term, perhaps even indefinitely. Before discussing which treatments are available, it is worth emphasising the need for women to be aware of this consequence, to look out for early signs and to feel able to seek help and treatment. Hopefully the wide distribution of this magazine, along with the popularity of our website and increasing use of social media will help more women to access this information.</span><br />
<span style="font-size: x-small;"><br /></span>
<span style="font-size: x-small;">Regarding treatment options, vaginal estrogen has been shown to be able to reverse the changes of estrogen lack and significantly reduce symptoms. For women in whom symptoms of GSM are the predominant effect of the menopause, vaginal estrogen alone can be offered and is recommended in the NICE guideline. Vaginal estrogen needs to be prescribed and can be taken in the form of a small vaginal tablet inserted using an applicator, a vaginal cream which can also be applied to the vulval area, or a vaginal ring. Personal preference, dexterity and discussion of symptoms should lead to individualisation when choosing which type to use.</span><br />
<span style="font-size: x-small;"><br /></span>
<span style="font-size: x-small;">Vaginal estrogen is not the same as taking HRT; HRT replaces estrogen throughout the body and is taken by a tablet, patch or gel. Vaginal estrogen is concentrated in the vagina and bladder and is minimally absorbed throughout the body. This major difference means that vaginal estrogen will not control symptoms such as flushes and sweats (systemic symptoms) nor have any effect on bone or heart health, unlike HRT. It also means that women who may have concerns about taking HRT because of past medical history, can often still use vaginal estrogen. </span><br />
<span style="font-size: x-small;"><br /></span>
<span style="font-size: x-small;">Women who take HRT for systemic symptoms may find that the HRT also helps GSM, but in some, while systemic symptoms may be controlled, vaginal estrogen may be needed in addition to reduce vaginal and bladder symptoms. This need for both HRT and vaginal estrogen may be increasing as lower doses of HRT are now often used. Regarding duration of treatment, many women stop treatment after a few weeks if they have not noticed a benefit, or after a few months if symptoms have reduced assuming that the problem has been cured. It is important to understand that vaginal estrogen needs to be used for a few months before full benefit can be realised, especially if significant changes are already present when treatment is started. Also, symptoms do often return after treatment is stopped and so continuing treatment is recommended.</span><br />
<span style="font-size: x-small;"><br /></span>
<span style="font-size: x-small;">For many women, the use of vaginal lubricants and moisturisers can help the dryness and reduce discomfort. While these do not correct the cause ie estrogen deficiency, they may be preferred for women with mild to moderate vaginal dryness or for those who do not wish to use vaginal estrogen. The value of moisturisers and lubricants was confirmed in the NICE guideline which states “..women with vaginal dryness..moisturisers and lubricants can be used alone or in addition to vaginal estrogen”.</span><br />
<span style="font-size: x-small;"><br /></span>
<span style="font-size: x-small;">Many types of both lubricants and moisturisers are available and knowing which to choose can be very difficult. Lubricants provide a rapid effect and are applied just before sex. They can be particularly helpful for women who experience discomfort only during sex due to dryness. Lubricants are available as water, silicone, mineral oil or plant oil based.</span><br />
<span style="font-size: x-small;"><br /></span>
<span style="font-size: x-small;">Moisturisers are applied more regularly such as daily or every two to three days. They rehydrate the vagina and maintain the moisture for two to three days. The longer lasting effect may be helpful for women who experience discomfort not just during sex. Moisturisers mostly contain water but different products vary in the content of other ingredients.</span><br />
<span style="font-size: x-small;">When choosing a moisturiser or lubricant, the pH (acidity) and osmolality (measure of concentration of chemical particles) should be considered. Many commercially available products show a high osmolality which may cause tissue irritation. It is recommended that products with pH which most closely resemble healthy vaginal pH of 3.8 to 4.5, and with low osmolality are preferred.</span><br />
<span style="font-size: x-small;"><br /></span>
<span style="font-size: x-small;">If lubricants are used as well as vaginal estrogen, they should be used at different times of the day since estrogen absorption may be reduced if used immediately after a lubricant. In addition regarding timing, it is recommended not to have sexual intercourse immediately after applying vaginal estrogen since absorption by the partner may occur; wait at least one hour.</span><br />
<span style="font-size: x-small;"><br /></span>
<span style="font-size: x-small;">It can be difficult to talk about sex and vaginas, but maintaining vaginal and vulval health after the menopause is essential. It’s time to speak up, whatever name we choose to use!</span><br />
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Heather at Menopause Mattershttp://www.blogger.com/profile/01182407217623657491noreply@blogger.com1tag:blogger.com,1999:blog-2306951709479076552.post-74262387394519452062016-04-04T04:46:00.000-07:002016-04-04T04:46:11.534-07:00HRT and breast cancer.<h2 style="line-height: 1.3800000000000001; margin-bottom: 10pt; margin-top: 0pt;">
<span style="background-color: transparent; color: black; font-family: Calibri; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"><b><span style="font-size: large;">HRT and breast cancer.</span></b></span></h2>
<div dir="ltr" style="line-height: 1.3800000000000001; margin-bottom: 10pt; margin-top: 0pt;">
<span style="background-color: transparent; color: black; font-family: Calibri; font-size: 14.666666666666666px; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">When considering the use of Hormone Replacement Therapy for treating menopausal symptoms, many women and healthcare professionals have been strongly influenced by the risk of breast cancer thought to be associated with the use of HRT. Previous publications have strongly emphasised the risk and headlines such as “HRT doubles risk of breast cancer” has understandably had an impact. In many cases, this concern has led to women choosing to tolerate menopausal symptoms, which, at times, can be severe, and to healthcare professionals refusing to prescribe HRT or advising women to stop HRT unnecessarily. While no medication is entirely without risk, it is essential that risk is kept in perspective and that there is a clear understanding of the balance between benefits and risks.</span></div>
<div dir="ltr" style="line-height: 1.3800000000000001; margin-bottom: 10pt; margin-top: 0pt;">
<span style="background-color: transparent; color: black; font-family: Calibri; font-size: 14.666666666666666px; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">Breast cancer is the most common cancer affecting women in the UK with just over 50,000 diagnoses in 2011, equating to around 155 per 100,000 women per year. However it is not the leading cause of death in women, many more women dying each year from cardiovascular disease and dementia. The baseline risk for breast cancer for women around the age of menopause in the UK is around 23 cases per 1000 women, but each woman’s risk will vary according to her history, family history, and in relation to some modifiable risk factors. While the association between HRT and risk of breast cancer is well known and often exaggerated and misunderstood, the risk from other modifiable factors is often unknown and ignored.</span></div>
<div dir="ltr" style="line-height: 1.3800000000000001; margin-bottom: 10pt; margin-top: 0pt;">
<span style="background-color: transparent; color: black; font-family: Calibri; font-size: 14.666666666666666px; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">The recent NICE guideline on diagnosis and management of menopause included a section on breast cancer as part of the section on Long-term benefits and risks of hormone replacement therapy. Over the years many individual publications have shown varying levels of risk, with some showing no increase in breast cancer and others showing an alarming increase. Each publication has received varying levels of publicity leading to widespread confusion. The NICE guideline development group have closely examined all publications not only for their findings but also for the quality of the study. The result is an unquestionable authoritative document which supports both women and healthcare professionals to make informed choices about menopause management and use of HRT.</span></div>
<div dir="ltr" style="line-height: 1.3800000000000001; margin-bottom: 10pt; margin-top: 0pt;">
<span style="background-color: transparent; color: black; font-family: Calibri; font-size: 14.666666666666666px; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">So what does NICE say? The first important point is that the levels of risk were reported as absolute figures rather than percentage or relative risk. This may seem an academic point but in fact how risk is reported can have a huge impact on how risk is perceived. For example, a risk being reported as “doubled” or “100% increase” sounds much more alarming than if the absolute rise was an increase from 1 case per 1000 to 2 cases per 1000. Sadly alarmist headlines rarely report absolute figures. The reporting of the Women’s Health Initiative trial in 2002 was an example of the use of percentage increases which led to dramatic loss of confidence in the use of HRT despite the fact that absolute risks were very small.</span></div>
<div dir="ltr" style="line-height: 1.3800000000000001; margin-bottom: 10pt; margin-top: 0pt;">
<span style="background-color: transparent; color: black; font-family: Calibri; font-size: 14.666666666666666px; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">Secondly, NICE clearly describes different effect from different types of HRT. The purpose of HRT is to replace estrogen since it is the declining and low level of estrogen that is believed to cause the consequences of the menopause in terms of menopausal symptoms and later health effects. Women who have had a hysterectomy can generally take estrogen only HRT while women who have an intact uterus need to take progestogen along with the estrogen (combined HRT) to prevent estrogenic stimulation of the uterine lining. It has been suggested for some time that estrogen only is not associated with the same level of risk of breast cancer as combined HRT but there has been a lack of awareness of this difference, many young women who have had a hysterectomy stopping estrogen early or being advised to do so. NICE confirms that HRT with estrogen alone is associated with little or no change in the incidence of breast cancer. The absolute figure given is for 4 fewer cases of breast cancer in women taking estrogen only HRT per 1000 menopausal women over 7.5 years, based on baseline risk for that group being 22.48 per 1000.</span></div>
<div dir="ltr" style="line-height: 1.3800000000000001; margin-bottom: 10pt; margin-top: 0pt;">
<span style="background-color: transparent; color: black; font-family: Calibri; font-size: 14.666666666666666px; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">For women who take combined HRT, NICE confirms that this can be associated with an increase in the incidence of breast cancer. The absolute figure given is 5 more cases of breast cancer in women taking combined HRT per 1000 menopausal women over 7.5 years, baseline risk as noted. This increase in risk appears to be associated with the length of time that HRT is taken, the risk being higher when combined HRT is used for more than 4 years. However, the risk reduces and returns to each woman’s baseline risk after HRT is stopped. Another important point highlighted is that the mortality from breast cancer does not appear to be increased compared to women who develop breast cancer and are not taking HRT. The conclusion from these two points is that combined HRT may, in a small number of women, stimulate the growth of cancer cells which are already present, rather than cause breast cells to turn into cancer, and the natural history of disease for each woman is not altered.</span></div>
<div dir="ltr" style="line-height: 1.3800000000000001; margin-bottom: 10pt; margin-top: 0pt;">
<span style="background-color: transparent; color: black; font-family: Calibri; font-size: 14.666666666666666px; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">The NICE group did examine whether different types or routes of HRT affect risk. With the knowledge that estrogen only seems to be less likely to affect risk than combined HRT, it has been suggested that certain types of progestogen may also differ in association with risk. NICE concluded that the evidence was not yet strong enough to recommend that certain types of progestogen were better than others. It has been recommended that further research be carried out to determine if there are differences in risk between different types of progestogen within combined HRT so that preparations can be offered which maximise benefits and minimise risk.</span></div>
<div dir="ltr" style="line-height: 1.3800000000000001; margin-bottom: 10pt; margin-top: 0pt;">
<span style="background-color: transparent; color: black; font-family: Calibri; font-size: 14.666666666666666px; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">While any diagnosis of breast cancer is devastating, it is really important to fully understand the role of HRT, that any risk is small, the risk returns to baseline when HRT is stopped, that each woman’s risk of dying from breast cancer is not affected by the use of HRT and that each woman should take this into consideration along with the benefits of HRT for her.</span></div>
<div dir="ltr" style="line-height: 1.3800000000000001; margin-bottom: 10pt; margin-top: 0pt;">
<span style="background-color: transparent; color: black; font-family: Calibri; font-size: 14.666666666666666px; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">It has been known for some time that there are other factors which affect breast cancer risk and the table shows that being overweight, having first birth after age 31, and regular alcohol are all associated with higher level of extra cases of breast cancer than the use of combined HRT. Further, regular physical activity is associated with reduced risk. Therefore, the decision around use of HRT and consideration around health benefits and risk should also take into account other factors, particularly weight, which can be addressed.</span></div>
<div dir="ltr" style="line-height: 1.3800000000000001; margin-bottom: 10pt; margin-top: 0pt;">
<span style="background-color: transparent; color: black; font-family: Calibri; font-size: 14.666666666666666px; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">Finally, concern and confusion often arises around the options for treatment of menopausal symptoms in women who have had breast cancer, or who may be thought to be at high risk for breast cancer, for example due to strong family history. Menopause may occur as part of the treatment for breast cancer when it may lead to premature menopause, or may occur naturally regardless of treatment. The NICE guideline recommends that women should be given information about all available treatment options. These include non-hormonal treatments such as the antidepressants, Selective serotonin reuptake inhibitors (SSRIs) which have often been used in this situation to reduce hot flushes and sweats due to the serotonin action. However the guideline emphasises that paroxetine and fluoxetine should not be offered to women who are taking tamoxifen for breast cancer treatment since interactions with medication may occur leading to the tamoxifen being less effective. </span></div>
<div dir="ltr" style="line-height: 1.3800000000000001; margin-bottom: 10pt; margin-top: 0pt;">
<span style="background-color: transparent; color: black; font-family: Calibri; font-size: 14.666666666666666px; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">NICE also reviewed the role of Alternative therapies for women in this situation and concluded that while there is some evidence that St John’s Wort may be helpful for reducing menopausal symptoms, women should be aware that there is lack of clarity about appropriate doses, there may be variation in preparations and that it may interact with other medications including tamoxifen. Further research has been called for to examine the effectiveness and safety for treatments for menopausal symptoms in women who have had breast cancer.</span></div>
<div dir="ltr" style="line-height: 1.3800000000000001; margin-bottom: 10pt; margin-top: 0pt;">
<span style="background-color: transparent; color: black; font-family: Calibri; font-size: 14.666666666666666px; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">Referral to a healthcare professional who is a menopause specialist is often required for women who have had, or are at high risk for breast cancer.</span></div>
<span id="docs-internal-guid-5bc58398-e117-28df-abb3-440c35463b8b"></span><br />
<div dir="ltr" style="line-height: 1.3800000000000001; margin-bottom: 10pt; margin-top: 0pt;">
<span style="background-color: transparent; color: black; font-family: Calibri; font-size: 14.666666666666666px; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">Overall, the association of breast cancer risk with use of HRT does cause concern to many women and healthcare professionals but the NICE guideline provides clear information and goes a long way in putting the small risk in perspective. Work is still required to understand which treatments can be safely offered to women who have had breast cancer.</span></div>
Heather at Menopause Mattershttp://www.blogger.com/profile/01182407217623657491noreply@blogger.com5tag:blogger.com,1999:blog-2306951709479076552.post-14936774959257975462015-11-19T09:05:00.002-08:002015-11-19T09:05:44.034-08:00Menopause: Time for Change. <div dir="ltr" style="line-height: 1.295; margin-bottom: 8pt; margin-top: 0pt;">
<span style="background-color: transparent; color: black; font-family: Calibri; font-size: 14.666666666666666px; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">Menopause: Time for change</span></div>
<div dir="ltr" style="line-height: 1.295; margin-bottom: 8pt; margin-top: 0pt;">
<span style="background-color: transparent; color: black; font-family: Calibri; font-size: 14.666666666666666px; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">Women need clear, evidence-based information to break through the conflict and confusion about menopause treatments </span></div>
<div dir="ltr" style="line-height: 1.2; margin-bottom: 0pt; margin-top: 0pt; text-align: justify;">
<span style="background-color: transparent; color: black; font-family: Calibri; font-size: 14.666666666666666px; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">Often referred to as “the change”, the menopause refers to the biological stage in every woman’s life when their periods stop and the ovaries lose their reproductive function. Usually, this occurs between the ages of 45 and 55, but in some cases, women may become menopausal in their 30s, or even younger. </span></div>
<div dir="ltr" style="line-height: 1.2; margin-bottom: 0pt; margin-top: 0pt; text-align: justify;">
<br /></div>
<div dir="ltr" style="line-height: 1.2; margin-bottom: 0pt; margin-top: 0pt; text-align: justify;">
<span style="background-color: transparent; color: black; font-family: Calibri; font-size: 14.666666666666666px; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">The recent launch of the NICE guideline on the diagnosis and management of the menopause was a monumental menopausal moment! For the first time, leading experts in the field have examined all of the existing evidence and we have been presented with information and advice which will not only enable women to better understand the consequences of the menopause and make informed choices about their treatment, but also ensure that healthcare professionals can provide women with evidence-based information about the benefits and risks of different treatment options in order to come to decisions on an individual basis. </span></div>
<div dir="ltr" style="line-height: 1.2; margin-bottom: 0pt; margin-top: 0pt; text-align: justify;">
<br /></div>
<div dir="ltr" style="line-height: 1.2; margin-bottom: 0pt; margin-top: 0pt; text-align: justify;">
<span style="background-color: transparent; color: black; font-family: Calibri; font-size: 14.666666666666666px; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">Every woman experiences the </span><a href="http://www.nhs.uk/conditions/menopause/Pages/Introduction.aspx" style="text-decoration: none;"><span style="background-color: transparent; color: blue; font-family: Calibri; font-size: 14.666666666666666px; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: underline; vertical-align: baseline; white-space: pre-wrap;">menopause</span></a><span style="background-color: transparent; color: black; font-family: Calibri; font-size: 14.666666666666666px; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"> differently. Symptoms can last from a few months to several years and up to 80% of women experience physical and/or emotional symptoms during this time. These can include; hot flushes and night sweats, tiredness and sleep disturbance, joint and muscle ache, mood swings and depression, forgetfulness or lack of concentration, vaginal dryness and loss of interest in having sex.</span></div>
<div dir="ltr" style="line-height: 1.2; margin-bottom: 0pt; margin-top: 0pt; text-align: justify;">
<br /></div>
<div dir="ltr" style="line-height: 1.2; margin-bottom: 0pt; margin-top: 0pt; text-align: justify;">
<span style="background-color: transparent; color: black; font-family: Calibri; font-size: 14.666666666666666px; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">With life expectancy at 83.2 years, many women are living in this post-menopausal phase for half to one third or their life, and these symptoms can have a significant impact on their health and wellbeing as well as their work and relationships. The menopause is not something that just affects ‘older women’ but those in ‘mid-life’ - often when they are juggling demanding jobs, school-age children and elderly parents. Despite this, many women are unaware of the impact of symptoms and later health problems and that diet and lifestyle changes can help improve their symptoms. Sadly, many are also often confused about the benefits and risks of treatment options. </span></div>
<div dir="ltr" style="line-height: 1.2; margin-bottom: 0pt; margin-top: 0pt; text-align: justify;">
<br /></div>
<div dir="ltr" style="line-height: 1.295; margin-bottom: 8pt; margin-top: 0pt;">
<span style="background-color: transparent; color: black; font-family: Calibri; font-size: 14.666666666666666px; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">We know that many women choose to go through the menopause without seeking treatment. Others prefer to help to manage their symptoms either by using </span><a href="http://www.nhs.uk/conditions/Hormone-replacement-therapy/Pages/Introduction.aspx" style="text-decoration: none;"><span style="background-color: transparent; color: blue; font-family: Calibri; font-size: 14.666666666666666px; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: underline; vertical-align: baseline; white-space: pre-wrap;">hormone replacement therapy</span></a><span style="background-color: transparent; color: black; font-family: Calibri; font-size: 14.666666666666666px; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"> (HRT) or an alternative treatment option such as cognitive behavioural therapy, relaxation techniques or herbal medicines such as black cohosh, isoflavones (plant estrogens) or St John’s wort. </span></div>
<div dir="ltr" style="line-height: 1.2; margin-bottom: 0pt; margin-top: 0pt; text-align: justify;">
<span style="background-color: transparent; color: black; font-family: Calibri; font-size: 14.666666666666666px; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">HRT has been controversial for many years and has frequently divided opinion. The evidence underpinning the benefits and risks has been accumulating for many years and this guideline has focused specifically on the risks of breast cancer, heart disease, stroke and bone health in women aged between 50 and 59.</span></div>
<div dir="ltr" style="line-height: 1.2; margin-bottom: 0pt; margin-top: 0pt; text-align: justify;">
<br /></div>
<div dir="ltr" style="line-height: 1.2; margin-bottom: 0pt; margin-top: 0pt; text-align: justify;">
<span style="background-color: transparent; color: black; font-family: Calibri; font-size: 14.666666666666666px; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">This guidance is unequivocal in recognising that HRT is an effective treatment for menopausal symptoms, particularly with the management of hot flushes. However, the benefits and risks will stack up differently for each woman, and whether or not to take HRT is an individual choice. </span></div>
<div dir="ltr" style="line-height: 1.2; margin-bottom: 0pt; margin-top: 0pt; text-align: justify;">
<br /></div>
<div dir="ltr" style="line-height: 1.2; margin-bottom: 0pt; margin-top: 0pt; text-align: justify;">
<span style="background-color: transparent; color: black; font-family: Calibri; font-size: 14.666666666666666px; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">Let’s start with the good news. The evidence tells us that HRT not only reduces symptoms but can also improve bone health and reduce the risk of osteoporosis and fractures in later life.</span></div>
<div dir="ltr" style="line-height: 1.2; margin-bottom: 0pt; margin-top: 0pt; text-align: justify;">
<br /></div>
<div dir="ltr" style="line-height: 1.2; margin-bottom: 0pt; margin-top: 0pt; text-align: justify;">
<span style="background-color: transparent; color: black; font-family: Calibri; font-size: 14.666666666666666px; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">The slight increased risk of breast cancer associated with HRT has been widely documented and is not disputed in this guidance. To put this into perspective, breast cancer is the most common cancer in women and approximately 23 in every 1,000 women in the general population will suffer from breast cancer over a period of 7.5 years. For women taking estrogen and progesterone HRT, we will see around five extra cases of breast cancer over the same timeframe. Estrogen only treatment, which is given to women who’ve had a hysterectomy, shows four fewer cancers in same time frame. It’s the progesterone which appears to have effect of increasing disease. This risk is related to the treatment duration and reduces after stopping HRT, suggesting that HRT may, in a small number of women, promote the growth of breast cancer cells which are already present rather than cause the cancer . </span></div>
<div dir="ltr" style="line-height: 1.2; margin-bottom: 0pt; margin-top: 0pt;">
<br /></div>
<div dir="ltr" style="line-height: 1.2; margin-bottom: 0pt; margin-top: 0pt; text-align: justify;">
<span style="background-color: transparent; color: black; font-family: Calibri; font-size: 14.666666666666666px; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">Heart health and stroke risk are other areas that are widely debated. Looking at the most recent evidence from the Cochrane collaboration, we can conclude that if 1,000 women under 60 years old started HRT, we would expect six fewer deaths, eight fewer cases of heart disease and five extra blood clots over about seven years, compared to 1,000 similar women who did not start HRT.</span></div>
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<span style="background-color: transparent; color: black; font-family: Calibri; font-size: 14.666666666666666px; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">We must remember that HRT is just a small component of post-reproductive health and the treatment of menopause depends on a clear and complete understanding of an individual woman’s circumstances as well as the health of women in their later years. Our focus as healthcare professionals is to ensure that women receive clear, evidence-based information to help them make decisions about their health. </span></div>
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<span style="background-color: transparent; color: black; font-family: Calibri; font-size: 14.666666666666666px; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">It’s also important to remember that lifestyle factors such as obesity and smoking play a huge role in a woman’s short and long-term health and we encourage all women, no matter what their age is, to maintain a balanced diet, engage in regular physical activity and refrain from smoking. This advice is particularly relevant for menopausal women, as lifestyle factors – particularly being overweight - impacts on the severity and length of menopausal symptoms and on later health. </span></div>
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<span id="docs-internal-guid-7e44dd81-20b2-248a-1867-d2cae5d5821c">---</span>Heather at Menopause Mattershttp://www.blogger.com/profile/01182407217623657491noreply@blogger.com4tag:blogger.com,1999:blog-2306951709479076552.post-13637745817153877232015-07-03T20:30:00.002-07:002015-07-03T20:30:09.538-07:00Women’s Views on HRT and Alternative therapies.<div class="MsoNormal" style="background-color: white; color: #222222; font-family: Arial, Tahoma, Helvetica, FreeSans, sans-serif; font-size: 13.1999998092651px; line-height: 18.4799995422363px;">
<b>Women’s Views on HRT and Alternative therapies.</b><o:p></o:p></div>
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It is well known that many women and healthcare professionals are uncertain about the pros and cons of treatment options for menopausal symptoms and are particularly concerned about risks of Hormone Replacement Therapy. </div>
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It is also recognised that many women consider using Alternative therapies for control of menopausal symptoms, a previous survey published in 2007 showing that 96% of women would try alternatives before using HRT.</div>
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With much media attention and sometimes conflicting reporting of study results, it is understandable that both women and healthcare professionals are unsure what to believe and so what decisions to make.<o:p></o:p></div>
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Results of a recent survey on the Menopause Matters website has provided further information about women’s views on alternative therapies and hormone replacement therapy. 1476 responses were received from 33 countries, with 92% from the UK.</div>
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Regarding women’s views on HRT, almost 70% had used or would consider using HRT with almost 30% saying that their views on the use of HRT had changed for the better over the last 5 years. There appears to have been an improvement in women’s understanding of HRT since the previous survey, with now the majority feeling that they were clear about risks and benefits, many aware that different types were associated with different risks and over half were aware that the age at which HRT was started affected an individual’s risk.<o:p></o:p></div>
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While the percentage of women who felt that they know enough about HRT to make an informed choice has increased from 27% in 2007 to 53.2% in 2014, it is still concerning that almost half from this survey did not know enough. Most women obtained their information from their health professional or the internet and so it is essential that health professionals are up to date and able to provide correct information. Sadly, over half felt that their family doctor did not recognise the importance of the menopause.<o:p></o:p></div>
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Regarding women’s views on Alternative therapies, still the majority of women (76%) would try alternatives before taking HRT for menopausal symptoms. Around 55% of women had used alternatives despite almost 40% of those women stating that they did not know enough to make an informed choice. The main reasons for trying alternatives were desperation, concern with risks of HRT, seeming to be more natural than HRT and recommendation by a friend. Of those women who had not used alternatives, almost 40% were unconvinced that they were effective or had concerns about safety.<o:p></o:p></div>
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Whatever is decided for managing menopausal symptoms whether it be diet and lifestyle changes, alternative therapies or hormone replacement therapy, women should be supported to make the right individual decision. The recent survey suggests that much is still required to help this to happen.</div>
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It is very much hoped that more and more women will have access to accurate information so that they can make truly informed choices about what treatment option they choose.<o:p></o:p></div>
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<a href="http://www.menopausematters.co.uk/" style="color: #888888; text-decoration: none;">www.menopausematters.co.uk</a></div>
Heather at Menopause Mattershttp://www.blogger.com/profile/01182407217623657491noreply@blogger.com1tag:blogger.com,1999:blog-2306951709479076552.post-71249403400184775182013-12-16T09:22:00.000-08:002013-12-16T09:22:12.425-08:00Award winning Menopause Magazine, what is it all about?<div style="-webkit-text-stroke-width: 0px; background-color: white; color: #222222; font-size-adjust: none; font-stretch: normal; font: 13px/normal arial, helvetica, sans-serif; letter-spacing: normal; text-indent: 0px; text-transform: none; white-space: normal; word-spacing: 0px;">
<span>The Menopause affects<span class="Apple-converted-space"> </span></span><b><span style="font-family: Verdana; font-size: 10pt;">ALL</span></b><span><span class="Apple-converted-space"> </span>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,<b>Menopause Matters Ltd<span class="Apple-converted-space"> </span></b>was founded in 2001, and in January 2002 launched what is now the leading<span class="Apple-converted-space"> </span></span><span style="font-family: Verdana; font-size: 10pt;">UK</span><span><span class="Apple-converted-space"> </span>based, award winning<b><span class="Apple-converted-space"> </span></b>menopause website<b><span class="Apple-converted-space"> </span><a href="http://www.menopausematters.co.uk/" style="color: #1155cc;" target="_blank">www.menopausematters.co.uk</a></b></span><span style="font-family: Verdana; font-size: 10pt;"><span class="Apple-converted-space"> </span>attracting an average of 4,500 visitors per day.</span></div>
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<span style="font-family: Verdana; font-size: 10pt;">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,<span class="Apple-converted-space"> </span><b>Menopause Matters magazine</b><span class="Apple-converted-space"> </span>was launched in summer 2005.<span class="Apple-converted-space"> </span><b>Menopause Matters magazine</b><span class="Apple-converted-space"> </span>is currently the only magazine of its kind, written specifically for women approaching and experiencing the menopause.<span class="Apple-converted-space"> </span><b>Menopause Matters</b><span class="Apple-converted-space"> </span>combines medical facts with glamour in an upbeat, readable style.<span class="Apple-converted-space"> </span><b>Menopause Matters</b><span class="Apple-converted-space"> </span>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.<span></span></span></div>
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<span style="font-family: Verdana; font-size: 10pt;">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.<span></span></span></div>
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<span style="font-family: Verdana; font-size: 10pt;">Surveys of both women and health professionals showed:</span></div>
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<li class="MsoNormal" style="margin: 0px 0px 0px 15px;"><span lang="EN-GB" style="font-family: Verdana; font-size: 10pt;">90% considered Menopause Matters to be very useful</span><span style="font-family: Verdana; font-size: 10pt;"></span></li>
<li class="MsoNormal" style="margin: 0px 0px 0px 15px;"><span lang="EN-GB" style="font-family: Verdana; font-size: 10pt;">96% found Menopause Matters content good or very good</span><span style="font-family: Verdana; font-size: 10pt;"></span></li>
<li class="MsoNormal" style="margin: 0px 0px 0px 15px;"><span lang="EN-GB" style="font-family: Verdana; font-size: 10pt;">91% found the advertisements useful</span><span style="font-family: Verdana; font-size: 10pt;"></span></li>
<li class="MsoNormal" style="margin: 0px 0px 0px 15px;"><span lang="EN-GB" style="font-family: Verdana; font-size: 10pt;">90% said that the magazines were received well or very well by patients</span><span style="font-family: Verdana; font-size: 10pt;"></span></li>
<li class="MsoNormal" style="margin: 0px 0px 0px 15px;"><span lang="EN-GB" style="font-family: Verdana; font-size: 10pt;">97% wish to keep receiving the magazines</span><span style="font-family: Verdana; font-size: 10pt;"></span></li>
<li class="MsoNormal" style="margin: 0px 0px 0px 15px;"><span lang="EN-GB" style="font-family: Verdana; font-size: 10pt;">99% felt that the magazines should be available in all GP’s surgeries and menopause clinics</span><span style="font-family: Verdana; font-size: 10pt;"></span></li>
<li class="MsoNormal" style="margin: 0px 0px 0px 15px;"><span lang="EN-GB" style="font-family: Verdana; font-size: 10pt;">98% felt that Menopause Matters helped women be better informed</span><span style="font-family: Verdana; font-size: 10pt;"></span></li>
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<span style="font-family: Verdana; font-size: 10pt;">While providing general menopause information,<b><span class="Apple-converted-space"> </span>Menopause Matters</b><span class="Apple-converted-space"> </span>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.</span></div>
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<b><span lang="EN-GB" style="font-family: Verdana; font-size: 10pt;">Testimonials</span></b><span style="font-family: Verdana; font-size: 10pt;"></span></div>
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<i><span style="font-family: Verdana; font-size: 10pt;">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.</span></i></div>
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<i><span style="font-family: Verdana; font-size: 10pt;">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.</span></i></div>
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<i><span style="font-family: Verdana; font-size: 10pt;">ALL</span></i><i><span style="font-family: Verdana; font-size: 10pt;"><span class="Apple-converted-space"> </span>females should have access to the magazine young & old!</span></i></div>
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<i><span style="font-family: Verdana; font-size: 10pt;">Fabulous magazine. Really helpful tool and good for staff too</span></i></div>
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<i><span style="font-family: Verdana; font-size: 10pt;">Brilliant. Magazines go like hot cakes</span></i></div>
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<i><span style="font-family: Verdana; font-size: 10pt;">Excellent up to date glossy mag for ladies. I give copies to all my menopausal patients</span></i></div>
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<i><span style="font-family: Verdana; font-size: 10pt;">Read by staff and patients alike – excellent</span></i></div>
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<i><span style="font-family: Verdana; font-size: 10pt;">Please can we have some more magazines for the surgery- they go like hot cakes!</span></i></div>
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<i><span style="font-family: Verdana; font-size: 10pt;">I just LOVE Menopause Matters magazine! Thank you for sending to the<span class="Apple-converted-space"> </span></span></i><i><span style="font-family: Verdana; font-size: 10pt;">United States</span></i><i><span style="font-family: Verdana; font-size: 10pt;">.</span></i></div>
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<i><span style="font-family: Verdana; font-size: 10pt;">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.</span></i></div>
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<i><span style="font-family: Verdana; font-size: 10pt;">Was just reading the articles in your last edition about<span class="Apple-converted-space"> </span></span></i><i><span style="font-family: Verdana; font-size: 10pt;">STD</span></i><i><span style="font-family: Verdana; font-size: 10pt;"><span class="Apple-converted-space"> </span>issues in my age pocket, awesome piece!!! Glad to see someone getting the info out there!</span></i></div>
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<i><span style="font-family: Verdana; font-size: 10pt;">Magazine extremely useful and allows women to look information for themselves and educates and builds confidence</span></i></div>
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<i><span style="font-family: Verdana; font-size: 10pt;">Excellent resource for profession and public</span></i></div>
Heather at Menopause Mattershttp://www.blogger.com/profile/01182407217623657491noreply@blogger.com0tag:blogger.com,1999:blog-2306951709479076552.post-47855112682863965802013-09-17T03:35:00.000-07:002013-09-19T02:57:02.303-07:00Preventing 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.<br />
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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.<br />
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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.<br />
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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.<br />
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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.<br />
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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.<br />
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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. <br />
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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.
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgspt7BF6bM25TZbe-c3LdiQPKHpoa5Y8zXJJD04lATAvsC2fw-9mL53TV_FVfjdYabdhSMxvmdCDeL_ejxsj2oR9IMqBdzhp85ycOnLwckVHIenXBIVW2boK7_pudZdL5ZczbrBpHstcAL/s1600/mag-promotion.jpg" imageanchor="1" ><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgspt7BF6bM25TZbe-c3LdiQPKHpoa5Y8zXJJD04lATAvsC2fw-9mL53TV_FVfjdYabdhSMxvmdCDeL_ejxsj2oR9IMqBdzhp85ycOnLwckVHIenXBIVW2boK7_pudZdL5ZczbrBpHstcAL/s1600/mag-promotion.jpg" /></a>Heather at Menopause Mattershttp://www.blogger.com/profile/01182407217623657491noreply@blogger.com0tag:blogger.com,1999:blog-2306951709479076552.post-34912651993624470802013-05-21T02:54:00.000-07:002013-05-21T02:54:11.544-07:00It's All About The OvariesThrough <a href="http://www.menopausematters.co.uk/" target="_blank">Menopause Matters website</a> and <a href="http://www.menopausematters.co.uk/magazine.php" target="_blank">magazine</a>, we have told many personal stories, covered many aspects of the <a href="http://www.menopausematters.co.uk/menopause.php" target="_blank">menopause</a>, 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.<br /><br />
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.<br />
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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.<br />
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One of my missions is to encourage women and healthcare professionals to think more broadly than just “Menopause” and its early consequences such as <a href="http://www.menopausematters.co.uk/symptoms.php" target="_blank">hot flushes</a>, and to think more in terms of estrogen deficiency and its early, intermediate and long term consequences.<br />
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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.<br />
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To find out more about menopause, and how to improve symptoms, visit <a href="http://www.menopausematters.co.uk/menopause.php" target="_blank">Menopause Matters</a>.Heather at Menopause Mattershttp://www.blogger.com/profile/01182407217623657491noreply@blogger.com2tag:blogger.com,1999:blog-2306951709479076552.post-47986369689379454922013-04-23T05:55:00.004-07:002013-04-23T05:56:07.494-07:00Menopause in the WorkplaceWomen 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 <a href="http://www.menopausematters.co.uk/article-perils-of-the-perimenopause.php" target="_blank">perimenopause</a> and of the <a href="http://www.menopausematters.co.uk/menopause.php" target="_blank">menopause</a>, 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!<br />
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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?”!<br />
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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!<br />
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For more information and for support, visit <a href="http://www.menopausematters.co.uk/" target="_blank"><b>Menopause Matters</b></a> and the <b><a href="http://www.menopausematters.co.uk/forum/index.php" target="_blank">Menopause Matters Forum</a></b>.<br />
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<i>Please let us know below if menopausal symptoms have affected your working day, and what support you've received from health professionals or colleagues.</i><br />
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<br />Heather at Menopause Mattershttp://www.blogger.com/profile/01182407217623657491noreply@blogger.com3tag:blogger.com,1999:blog-2306951709479076552.post-73727105743357791232013-04-09T04:20:00.002-07:002013-04-09T04:20:30.313-07:00Renewed Confidence in HRT<br />
Since July 2002, there has been a huge downturn in the confidence of, and use of <a href="http://www.menopausematters.co.uk/oestrogens.php" target="_blank">HRT</a>. 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.<br />
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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, <b>HRT provides more benefits than risks for most women</b>. 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.<br />
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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:<br />
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• 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.<br />
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• 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.<br />
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• Taking HRT is a decision which needs to be individualised, in consultation with a suitably qualified physician.<br />
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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.<br />
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<a href="http://www.menopausematters.co.uk/newsitem.php?recordID=143/Global-consensus-statement-on-menopausal-hormone-therapy" target="_blank">Full statement on menopausal hormone therapy</a>.<br />
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Read more about <a href="http://www.menopausematters.co.uk/oestrogens.php" target="_blank">hormone replacement therapy</a>.<br />
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<i><b>What do you think? Have you encountered problems with getting your doctor to prescribe you HRT? Please let us know below.</b></i><br />
Heather at Menopause Mattershttp://www.blogger.com/profile/01182407217623657491noreply@blogger.com0tag:blogger.com,1999:blog-2306951709479076552.post-40480704670535828742013-04-03T04:17:00.002-07:002013-04-03T04:17:23.747-07:00Vaginal Dryness - Lube or Hormones?Many women experience vaginal changes and <a href="http://www.menopausematters.co.uk/vaginalsymptoms.php" target="_blank">vaginal problems</a> due to the lack of estrogen after the <a href="http://www.menopausematters.co.uk/menopause.php" target="_blank">menopause</a>. 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.<br />
<br />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 <a href="http://www.menopausematters.co.uk/oestrogens.php" target="_blank">HRT</a> (hormones which circulate throughout the body and would be used if other generalised menopausal symptoms are also present) or vaginal estrogen. <br />
<br />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.<br />
<br />Various types of <a href="http://www.menopausematters.co.uk/dryness.php" target="_blank">vaginal estrogen treatments</a> 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.<br />
<br />Whatever you choose, be aware of menopausal effects on the vagina and look after your vagina in the happy, healthy years ahead!<br />
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See more at <a href="http://www.menopausematters.co.uk/" target="_blank">Menopause Matters</a>. <br />
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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? <br />
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<br />Heather at Menopause Mattershttp://www.blogger.com/profile/01182407217623657491noreply@blogger.com4tag:blogger.com,1999:blog-2306951709479076552.post-25505871668098229142013-03-26T06:20:00.000-07:002013-03-26T06:20:00.197-07:00Why Do We Flush?Flushes and sweats are the classic, well-known <a href="http://www.menopausematters.co.uk/symptoms.php" target="_blank">menopause symptoms</a>, 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. <br />
<br />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 <a href="http://www.menopausematters.co.uk/menopause.php" target="_blank">menopause</a>, 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. <br />
<br />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. <a href="http://www.menopausematters.co.uk/diet.php" target="_blank">Diet and lifestyle</a> 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 <a href="http://www.menopausematters.co.uk/oestrogens.php" target="_blank">HRT</a>.<br />
<br />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.<br /><br />
See more at <a href="http://www.menopausematters.co.uk/" target="_blank">Menopause Matters</a>.<br />
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<br />Heather at Menopause Mattershttp://www.blogger.com/profile/01182407217623657491noreply@blogger.com0tag:blogger.com,1999:blog-2306951709479076552.post-89150346199060757822013-03-20T03:44:00.000-07:002013-03-21T02:41:41.331-07:00Breast Cancer and HRT - Fact or Fiction?While the role of <a href="http://www.menopausematters.co.uk/oestrogens.php" target="_blank">HRT</a> for treatment of <a href="http://www.menopausematters.co.uk/symptoms.php" target="_blank">menopausal symptoms</a>, treatment of <a href="http://www.menopausematters.co.uk/prematuremenopause.php" target="_blank">premature menopause </a>and beneficial effect on bones should now be well established, the debate about HRT and breast cancer risk continues.<br />
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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.<br />
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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.<br />
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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 <a href="http://www.menopausematters.co.uk/oestrogens.php" target="_blank">estrogen</a> and <a href="http://www.menopausematters.co.uk/progestogens.php" target="_blank">progestogen</a>, 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”. <br />
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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 <a href="http://www.menopausematters.co.uk/diet.php" target="_blank">diet, exercise and lifestyle</a> on menopause. <br />
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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 <a href="http://www.menopausematters.co.uk/benefit.php" target="_blank">benefits </a>outweigh the <a href="http://www.menopausematters.co.uk/risks.php" target="_blank">risks</a>.<br />
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You can see more about balancing the risks and benefits of HRT at <a href="http://www.menopausematters.co.uk/balance.php">http://www.menopausematters.co.uk/pdf/breastCancerRisklinks.pdf</a>Heather at Menopause Mattershttp://www.blogger.com/profile/01182407217623657491noreply@blogger.com0tag:blogger.com,1999:blog-2306951709479076552.post-22865905263080901102013-03-04T04:39:00.001-08:002013-03-04T04:39:53.136-08:00Mental Health and Menopause<br />
Many women notice changes in mood around the time of the perimenopause and <a href="http://www.menopausematters.co.uk/menopause.php" target="_blank">menopause</a>.<br />
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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.<br />
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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.<br />
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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.<br />
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Mental health problems are very common, and can be associated with the menopause so should be treated early.<br />
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For more information, visit the <a href="http://www.menopausematters.co.uk/symptoms.php" target="_blank">symptoms section</a> and <a href="http://www.menopausematters.co.uk/psychological.php" target="_blank">psychological section</a> of Menopause Matters.<br />
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Heather at Menopause Mattershttp://www.blogger.com/profile/01182407217623657491noreply@blogger.com0tag:blogger.com,1999:blog-2306951709479076552.post-83148716831488097222013-02-25T02:54:00.002-08:002013-02-25T02:54:33.513-08:00A Sore PointIn many issues of Menopause Matters magazine we have included articles, results of surveys, research findings and advice about the very embarrassing topic of <a href="http://www.menopausematters.co.uk/vaginalsymptoms.php" target="_blank">vaginal dryness</a> 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.<br />
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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.<br />
<br />Vaginal atrophy often occurs a few years after the <a href="http://www.menopausematters.co.uk/menopause.php" target="_blank">menopause</a>, or a few years after stopping <a href="http://www.menopausematters.co.uk/oestrogens.php" target="_blank">HRT</a>. 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.<br />
<br />If you are experiencing vaginal changes, be sure that help is available. See more info on the <a href="http://www.menopausematters.co.uk/" target="_blank">Menopause Matters website</a>.Heather at Menopause Mattershttp://www.blogger.com/profile/01182407217623657491noreply@blogger.com0tag:blogger.com,1999:blog-2306951709479076552.post-74621523457311541772013-02-15T04:58:00.002-08:002013-02-15T04:58:24.626-08:00Menopausal 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 <a href="http://www.menopausematters.co.uk/menopause.php" target="_blank">menopause</a>, with blame often being laid on the menopause, or on the use of <a href="http://www.menopausematters.co.uk/oestrogens.php" target="_blank">HRT</a>. 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.<br />
<br />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.<br />
<br />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!<br />
<br />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.<br />
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For more advice, visit the <a href="http://www.menopausematters.co.uk/diet.php" target="_blank">Diet, Lifestyle & Exercise</a> section of <a href="http://www.menopausematters.co.uk/" target="_blank">Menopause Matters</a>.<br />
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<br />Heather at Menopause Mattershttp://www.blogger.com/profile/01182407217623657491noreply@blogger.com0tag:blogger.com,1999:blog-2306951709479076552.post-30839447744177945192013-02-05T03:57:00.000-08:002013-02-11T03:00:24.956-08:00Ten Wasted Years?<br />
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Having been involved for many years in advising, educating and always still learning myself about the <a href="http://www.menopausematters.co.uk/menopause.php" target="_blank">menopause</a>, the effects of estrogen deficiency, and treatments, I have seen many changes but none so dramatic as the views on <a href="http://www.menopausematters.co.uk/oestrogens.php" target="_blank">Hormone Replacement Therapy</a> (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.<br />
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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.<br />
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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.<br />
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For more information about <a href="http://www.menopausematters.co.uk/menopause.php" target="_blank">Menopause</a> and <a href="http://www.menopausematters.co.uk/oestrogens.php" target="_blank">HRT</a>, visit <a href="http://menopausematters.co.uk/">Menopausematters.co.uk</a><br />
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<br />Heather at Menopause Mattershttp://www.blogger.com/profile/01182407217623657491noreply@blogger.com1tag:blogger.com,1999:blog-2306951709479076552.post-90519300198983846842013-02-01T02:30:00.002-08:002013-02-12T02:30:49.456-08:00Menopause is EverywhereIt cannot be said often enough, <a href="http://www.menopausematters.co.uk/menopause.php" target="_blank">menopause</a>, and the consequences of ensuing estrogen deficiency affect EVERY woman.<br /><br />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?<br /><br />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!<br /><br />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.<br /><br /><a href="http://menopausematters.co.uk/">Menopausematters.co.uk</a><br /><br />
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<br />Heather at Menopause Mattershttp://www.blogger.com/profile/01182407217623657491noreply@blogger.com3tag:blogger.com,1999:blog-2306951709479076552.post-14173103134277691282013-01-21T05:29:00.000-08:002013-01-21T05:29:32.301-08:00National Shortage of Testosterone
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<a href="http://www.menopausematters.co.uk/oestrogens.php">Hormone replacement therapy</a> 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 <a href="http://www.menopausematters.co.uk/progestogens.php">progestogen</a> 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.</div>
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Previously, women could be given
<a href="http://www.menopausematters.co.uk/testosterone.php">testosterone</a> 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.</div>
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<a href="" name="_GoBack"></a>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.</div>
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For more information see
<span style="color: blue;"><span lang="zxx"><u><a href="http://www.menopausematters.co.uk/testosterone.php">www.menopausematters.co.uk/testosterone.php</a></u></span></span>
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Heather at Menopause Mattershttp://www.blogger.com/profile/01182407217623657491noreply@blogger.com0tag:blogger.com,1999:blog-2306951709479076552.post-52544378977605464702013-01-09T02:22:00.002-08:002013-01-09T03:05:03.505-08:00New Year, New Me<br />
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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 <a href="http://www.menopausematters.co.uk/oestrogens.php">HRT</a> 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.<o:p></o:p></div>
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Let’s find healthy food that we can enjoy and stick to, and find an <a href="http://www.menopausematters.co.uk/diet.php">exercise</a> 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”.<o:p></o:p></div>
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So ladies, while the emphasis is frequently on breast cancer as a major health risk for women, take note that <b>three times more women die from heart disease than breast cancer</b>. </div>
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We can all make changes this year to look after our hearts so let’s do it!<o:p></o:p></div>
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More information on <a href="http://www.menopausematters.co.uk/cvd.php">heart disease and CVD</a>.<br />
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Heather at Menopause Mattershttp://www.blogger.com/profile/01182407217623657491noreply@blogger.com0tag:blogger.com,1999:blog-2306951709479076552.post-34442123274678931172011-03-24T14:01:00.000-07:002011-03-24T14:01:03.564-07:00#Menopause Matters event<div id="leftsidebar"><div class="block" id="block-ad-12"><div class="content"><div class="advertisement group-tids-12" id="group-id-tids-12"><script src="http://www.thelakedistrictmessenger.com/sites/all/modules/ad/serve.php?q=1&t=12&u=node%2F2143&l=news%2F23-03-11%2Fmenopause-matters-event" type="text/javascript">
</script><!-- No active ads were found in t12 --></div></div></div></div><!--END SIDEBAR--><div id="rightsidebar"><div class="block" id="block-block-3"><div class="content"><div class="addthis_toolbox addthis_32x32_style addthis_default_style"><a at_titled="1" class="addthis_button_facebook at300b" href="http://www.addthis.com/bookmark.php?v=250&winname=addthis&pub=karenmorley&source=tbx32-250&lng=en-gb&s=facebook&url=http%3A%2F%2Fwww.thelakedistrictmessenger.com%2Fnews%2F23-03-11%2Fmenopause-matters-event&title=Menopause%20matters%20event%20%7C%20The%20Lake%20District%20Messenger&ate=AT-karenmorley/-/-/4d8bb067cd4f38cd/1&uid=4d8bb067b71f0c48&CXNID=2000001.5215456080540439074NXC&pre=http%3A%2F%2Fuk.mg.bt.mail.yahoo.com%2Fdc%2Flaunch%3F.partner%3Dbt-1%26.gx%3D1%26.rand%3Ddd5dmtruo1q4u&tt=0" ost="1" target="_blank" title="Send to Facebook"><span class="at300bs at15nc at15t_facebook"></span></a><a at_titled="1" class="addthis_button_twitter at300b" href="" noh="1" ost="1" target="_blank" title="Tweet This"><span class="at300bs at15nc at15t_twitter"></span></a><a at_titled="1" class="addthis_button_email at300b" href="" ost="1" title="Email"><span class="at300bs at15nc at15t_email"></span></a><a at_titled="1" class="addthis_button_google at300b" href="http://www.addthis.com/bookmark.php?v=250&winname=addthis&pub=karenmorley&source=tbx32-250&lng=en-gb&s=google&url=http%3A%2F%2Fwww.thelakedistrictmessenger.com%2Fnews%2F23-03-11%2Fmenopause-matters-event&title=Menopause%20matters%20event%20%7C%20The%20Lake%20District%20Messenger&ate=AT-karenmorley/-/-/4d8bb067cd4f38cd/2&uid=4d8bb0678a1bfa29&CXNID=2000001.5215456080540439074NXC&pre=http%3A%2F%2Fuk.mg.bt.mail.yahoo.com%2Fdc%2Flaunch%3F.partner%3Dbt-1%26.gx%3D1%26.rand%3Ddd5dmtruo1q4u&tt=0" ost="1" target="_blank" title="Send to Google"><span class="at300bs at15nc at15t_google"></span></a><a class="addthis_button_compact at300m" href="" ost="1"><span class="at300bs at15nc at15t_compact"></span></a><div class="atclear"></div></div>Menopause matters event</div></div></div><div id="bodysection"><div id="node_cont"><br />
Menopause Matters is a free afternoon event for women in Carlisle – with leading specialist in the field Dr Heather Currie leading the session.<br />
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Dr Currie is the founder of <a href="http://www.menopausematters.co.uk/" rel="nofollow">http://www.menopausematters.co.uk/</a> and she will be joined on the day by local specialist Dr Jenny Lyons of Carlisle.<br />
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Supported by Carlisle Partnership, the event will take place at Tullie House in Carlisle on Tuesday, March 29 from 12 noon until 4.30pm.<br />
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There will be information and advice on everything from diet and fitness to skin and beauty.<br />
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For more information or to book a free place at the event visit <a href="http://www.cumbriatherapists.com/menopause" rel="nofollow">www.cumbriatherapists.com/menopause</a> or call 01228 409090.</div></div>Heather at Menopause Mattershttp://www.blogger.com/profile/01182407217623657491noreply@blogger.com0tag:blogger.com,1999:blog-2306951709479076552.post-33319575219800781642011-03-08T13:38:00.000-08:002011-03-08T13:38:38.077-08:00#Menopausal #hormone therapy and cardiovascular disease<span lang="EN" style="font-family: Arial; font-size: 10pt; mso-ansi-language: EN;">Cardiovascular disease remains the single largest cause of death in women. Much interest has been shown in the effects of Hormone Replacement Therapy on the risk of cardiovascular disease, with observational studies showing a significant reduction in risk, and randomised controlled trials (RCTs) showing an increase.</span><br />
<span lang="EN" style="font-family: Arial; font-size: 10pt; mso-ansi-language: EN;">The Timing Hypothesis suggests that the time since menopause that </span><stockticker><span lang="EN" style="font-family: Arial; font-size: 10pt; mso-ansi-language: EN;">HRT</span></stockticker><span lang="EN" style="font-family: Arial; font-size: 10pt; mso-ansi-language: EN;"> is commenced influences the effect of hormones on the cardiovascular system and continues to be questioned as an explanation for the discrepant outcomes. A group has recently reported on the evidence regarding the basis of the hypothesis and its suitability to explain differences in outcomes between trials of hormone therapy commenced early following the menopause, as in observational studies, and therapy which is delayed as in RCTs.</span><br />
<span lang="EN" style="font-family: Arial; font-size: 10pt; mso-ansi-language: EN;">From a literature review, reports of laboratory, animal and human studies were shown to support the different effect of </span><stockticker><span lang="EN" style="font-family: Arial; font-size: 10pt; mso-ansi-language: EN;">HRT</span></stockticker><span lang="EN" style="font-family: Arial; font-size: 10pt; mso-ansi-language: EN;"> on normal versus diseased vessels, with a beneficial effect when </span><stockticker><span lang="EN" style="font-family: Arial; font-size: 10pt; mso-ansi-language: EN;">HRT</span></stockticker><span lang="EN" style="font-family: Arial; font-size: 10pt; mso-ansi-language: EN;"> is commenced early with healthy blood vessels, compared to a negative effect when therapy is delayed with vascular disease. Age and time since menopause have been related to the extent of vascular disease in women. The group concluded that there is ample evidence of the validity of the Timing Hypothesis as an explanation of the different outcomes of observational studies and RCTs and recommend that research on cardiovascular disease prevention by early </span><stockticker><span lang="EN" style="font-family: Arial; font-size: 10pt; mso-ansi-language: EN;">HRT</span></stockticker><span lang="EN" style="font-family: Arial; font-size: 10pt; mso-ansi-language: EN;"> should be the highest national priority.</span><br />
Read more about Menopause, hormones and cardiovascualr disease at <a href="http://www.menopausematters.co.uk/cvd.php">www.menopausematters.co.uk/cvd.php</a>Heather at Menopause Mattershttp://www.blogger.com/profile/01182407217623657491noreply@blogger.com0