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Dealing With The Menopause

meopause cartoon bed

Article by Dr Carol Cooper

Hot flushes, night sweats, aches and pains, insomnia, thinning hair, feeling low, painful sex, difficulty concentrating – just reading a list of menopause symptoms can make you feel you’re losing your marbles. Luckily, many symptoms are short-lived. Even better, there’s a lot you can do to help yourself.

Hot flushes and night sweats

Hot flushes and night sweats have the same basic cause – the blood vessels beneath the skin don’t function properly when oestrogen levels start plummeting. In fact flushes and night sweats can start 3-4 years before the last period, when hormone levels begin to drop.

Night sweats can be a messy drenching business, demanding a change in bed-linen and ruining a decent night’s sleep. Try to sleep in the coolest environment you can, with minimal bed-clothes – and no synthetic materials like polyester pillows and duvets.

Give up smoking, avoid excess alcohol and caffeine-containing drinks, and limit spicy foods or heavy meals, especially in the evening. All these can affect the circulation and trigger night sweats.

Even so, you’re unlikely to get through “the change” without a single night sweat. Water (or cologne), sponge and a hand-towel on the bedside table can help cool you down after a sweat.

menopause at workHot flushes, which occur by day, may or may not involve sweating. Usually flushes (called “flashes” in the USA) make you go deep red, as if you’ve told a whopping lie. It’s the sheer unpredictability that can be most unpleasant and embarrassing, as a TV guest once told me after she had a flush on air.

Again, avoiding known triggers like spicy food, coffee and alcohol can help reduce the number. If you feel a flush coming on, try to get somewhere cool if possible. Running cold water onto your forearms can help. Or just press your arms and forehead onto a cool surface, like a tiled wall (easier to do if you wear short sleeves).

If you have flushes by day, you don’t necessarily get night sweats, and vice versa, but it’s common to get both. Most women find these symptoms last around 6-9 months or so – for some it’s much less, for others it’s a little longer.

Vaginal dryness

When oestrogen levels drop, the vaginal lining becomes thin, dry and more delicate. This can cause problems during sex – at best, sex will just feel different. At worst, it can be painful, putting you off the whole exercise.

Taking more time for foreplay is one strategy. Another is to use a simple lubricant, whether it’s KY jelly, Sylk (see www.sylk.co.uk), or your favourite massage oil. If you still have trouble, consider HRT, especially in the form of vaginal cream or pessaries – ask your doctor.

Irritable bladder
The lining of the bladder is also sensitive to the hormone oestrogen, becoming thinner and more irritable during the menopause. This can cause something called urethral syndrome. Typically, you might want to use the loo often and have some burning, a bit like cystitis even though there’s no infection. Common over the counter remedies can help, but if they don’t, or there’s any doubt in your mind, see the GP and get your urine tested – because it’s possible to have a urine infection and be menopausal at the same time.

harrassed womanLack of concentration

A huge number of women feel tired, irritable or low, or have trouble concentrating, remembering thing and doing such things as simple sums. Others develop headaches and various aches and pains. None of these has been proven to be directly due to falling oestrogen levels. However, it’s easy to see how, say, night sweats and painful sex can lead to irritability, stress and headaches.

Then again, there’s often so much else going on at mid-life – children leaving home, dependent parents developing serious health problems, and possibly you or your partner facing redundancy or retirement. Perhaps it would be more surprising to go through these challenges without the odd hiccup.

Try to keep your mind and body active, and make time for yourself despite other demands on you. If you can’t remember things, write them down. It’s what paper, pens and BlackBerries are for. Tiredness can improve with healthy eating, and to getting to bed earlier (also good for your looks). And if you’re depressed, counselling or antidepressants (or both) can make all the difference.

Hormone replacement therapy
HRT is the single most effective treatment for hot flushes, night sweats, and many other menopausal symptoms like vaginal dryness and hair thinning. A lot of women also say it relieves tiredness, lack of concentration, and feelings of mild depression. It doesn’t do this for everyone though.

Like all medicines, HRT has potential side-effects. Important ones are a slightly increased risk of thrombosis (such as DVT or deep vein thrombosis), heart attack, stroke, and breast cancer. Taking HRT (or not) is a decision you need to make with your own doctor. It’s impossible to give advice to suit everyone.

You can get more information from:

Patient UK http://www.patient.co.uk/health/Menopause-and-HRT.htm

General information about the menopause and women’s health:




There’s no doubt that healthy eating can relieve osteoporosis and even some of the other health problems linked with the menopause. These will be covered in later features.

Dr Carol Cooper

Carol is a practising doctor and prolific medical journalist. She graduated from Cambridge University but says that most of her training took place since then. Now she works as a GP in London where she deals with women's health concerns every working day. She also teaches at Imperial College Medical School. She has been the doctor for The Sun newspaper for 10 years, and contributes to a number of other titles including Top Sante. Carol regularly appears on TV and radio, often giving expert medical opinions on topical health matters. She is also the author of many popular parenting and health books. A lone parent, Carol finds that her three sons, now all young adults, provide endless inspiration as well as welcome relief from medical practice. www.drcarolcooper.com

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