




Facts
A lack of menopause awareness and support costs the UK economy approx. £20 Billion a year
Over 70% of Women blame menopause for their divorce or breakdown of a relationship
Early detection avoids referrals to secondary care and potentially misdiagnosis (most common are fibromyalgia, chronic fatigue and long covid)
Over 25% of women have taken a considerable amount of time off work and consider leaving their jobs
22% of women working for the NHS have taken time off for more than one month due to menopausal symptoms
Menopause is 12 consecutive months without a period and the average age is around 51 in the UK
Almost 50% of women haven't spoken to their GP about their menopausal symptoms
Approximately 14
Million women in the UK are either peri or post menopausal at the present time
67% of women report an increase in domestic abuse and arguments due to menopause
Correct treatment keeps women in the workforce, many are at the peak of their career and very experienced in their field
10% of women in the workforce leave their job due to the debilitating effects of their menopausal symptoms
The highest rate of suicide and attempted suicide in women is between the ages of 45-55
Menopause is not just hot flashes, the top 3 most dibilitating symptoms are lack of sleep, brain fog and anxiety
NICE guidance states that hormone replacement therapy should be offered to women who are struggling with menopausal symptoms as first line treatment
There are over 50 recognised menopausal symptoms
Correct treatment reduces future health issues, including Osteoporosis, Heart disease, Dementia, Diabetes, and Depression
94% of women report a negative impact on work due to the severity of their symptoms
48% of women working within the NHS were considering quitting their job as a result of menopause symptoms
One in a hundred women will experience menopause under the age of 40
41% of UK universities do not have mandatory menopause education on the curriculum
77% of women find at least one menopause symptom extremely difficult to live with
Currently around 14% of menopausal women in the UK are on Hormone Replacement Therapy
For the vast majority of women, the benefits of taking HRT far outweigh any risk
When a woman becomes Post Menopausal, she is living with a long term hormone defiency. This will have health implications for most women
Body Identical hormone replacement therapy is derived from the wild yam plant
Body Identical HRT contains hormones that are the same in molecular structure to the hormones that your own body produces before menopause
In the most recent trials, there is no known associated risk of increasing your chance of developing breast cancer with Body Identical HRT
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Frequently Asked Questions
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Compiled by Menopause Specialists and Nurses from our friends at Menopause Support
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1. What is the difference between body identical and bio identical HRT?
Body identical refers to HRT products which are licenced, regulated and available from your GP for a usual NHS prescription charge, if you pay for prescriptions. They are also prescribed by both NHS and private menopause specialists. Bio identical HRT is not licenced or regulated and is only available from private practitioners who are not necessarily menopause specialists. Bio-identical products are made up for the individual, in compounding pharmacies and can be very expensive, safety concerns have been raised over these.
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2. Can your GP refer you to a menopause specialist on the NHS? What if they refuse?
Yes, your GP can refer you and if they refuse they should have a good reason why. You can seek a second opinion from another GP within the same practice. Details of menopause clinics can be found on the British Menopause Society website.
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3. Is anxiety a symptom? What if my doctor offers me anti-depressants?
Anxiety is a very common symptom of perimenopause and menopause. Anti-depressants are not the first line treatment for menopausal anxiety, as detailed in the NICE guidance to menopause.
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4. My doctor has said that I can’t have HRT as I am still having periods, is this true?
No, you can start HRT while you are still having periods.
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5. My GP has said that I have to stop using HRT after 5 years or at the age of 55, is this true?
No, this is outdated information. There is no time limit on HRT use.
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6. I am overweight and have been told that I can’t have HRT, is this right?
No, you can have HRT, but it should be offered as a patch, gel, or spray.
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7. My skin feels very itchy and like I have insects crawling on me, is this a symptom and what should I do?
Yes, this can be a symptom for some women. Formication, as it is known, is caused by a lack of oestrogen and HRT can help to resolve this.
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8. I’ve just picked up my HRT patches/gel/spray/tablets and Utrogestan, when can I start?
Your GP should advise when and how you should use your HRT. It is likely that your GP would expect you to start straight away, but always check if in any doubt.
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9. Vaginal Atrophy – is it possible to have this without symptoms and what are the symptoms?
The most common symptoms of vaginal atrophy are vaginal dryness, soreness, irritation and burning, and repeated urinary tract infections. However, some women can be shocked by the appearance of their labia or clitoris, particularly if they are not use to checking and they have not experienced any symptoms.
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10. Can menopause cause changes to your hair? E.g., hair loss, drying, change in texture?
Yes, women have oestrogen receptors all over their bodies and hormonal fluctuations can result in different symptoms for different women.
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11. I have been referred to a gynaecologist instead of a menopause specialist, but they know all about menopause don’t they?
Unfortunately, gynaecologists do not all receive mandatory menopause training, so you need to see a doctor who specialises in menopause.
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12. Can I use vaginal oestrogens alongside my HRT? Is it safe to use both?
Yes, you can use vaginal oestrogen at the same time as your systemic HRT.
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13. Is restless legs a symptom and what can I take for it?
Yes, restless limbs can be a symptom for some women. HRT and/or a magnesium supplement can be useful.
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14. Magnesium – what does it do and what types are available, can it help with muscle aches and pains?
Magnesium is one of the most abundant minerals in our body, needed for literally hundreds of different chemical processes. Low levels of magnesium can interfere with your sleep, contribute to low mood, brain fog, fatigue, muscle and joint aches and pains as well as headaches. Magnesium is available in many synthetic forms as a supplement but can be found naturally in nuts and seeds, whole grains, dark green vegetables, and avocados.
If you are looking for a supplement, look for a chelated magnesium such as magnesium citrate. This is easily absorbed and therefore more likely to work more quickly and least likely to cause any digestive problems. Magnesium citrate is good for calmness and relaxation and can be taken in the morning to help with anxiety or at night to help with sleep.
Magnesium glycinate is also absorbed very easily and has a more potent calming effect, it can be useful to take in the evening (an hour before bed) to help with disrupted sleep.
At higher doses, magnesium can have a laxative effect. If you already suffer with a sensitive gut (such as IBS), be particularly mindful of starting with a low dose (100-200mg) and do not exceed 400mg without consulting a qualified practitioner.
Alternatively, adding Epsom Salts (that contain magnesium sulphate) to a warm bath can be good for relaxing muscles and achy joints, as can using a magnesium oil spray directly to the affected areas.
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15. What are the official figures for cancer risks for HRT?
It very much depends on which piece of research you choose to read but the overall risks of taking HRT are very low and for the vast majority the benefits outweigh the risks. Your doctor should discuss up to date statistics with you when prescribing.
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16. Can my GP prescribe testosterone?
In theory they can as the NICE guidelines say that in some circumstances testosterone should be considered, but many doctors do not feel confident to prescribe and some are told not to by their practice or ICB.
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17. What are the official contra-indications to HRT?
This is very much assessed on a patient-by-patient basis and should always be assessed taking into account the individual’s quality of life.
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18. What is testosterone used for?
Testosterone is often prescribed to women who report a continued reduction in libido even once established on HRT. It must be considered for women in surgical menopause. Testosterone also has a part to play in bone, muscle and skin health and can have an effect on cognitive function and confidence.
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19. Does HRT cause weight gain?
No, menopause causes weight gain. During peri-menopause and menopause, the amount and type of the hormone oestrogen alters, and this can cause body shape and weight distribution changes.
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20. I have a family history of breast cancer, does this mean that I can’t have HRT?
No, not necessarily. Your risk should be individually assessed. Your GP may feel that a referral to a menopause specialist is required to discuss all possible treatment options for you.
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21. Can I have HRT if I have high blood pressure?
High blood pressure (hypertension) puts us at greater risk of developing blood clots. Oral HRT is also known to slightly increase the risk of developing blood clots. Therefore, it is appropriate to use transdermal forms (patches/gels/spray) of HRT along with micronised progesterone (if required) to minimise these risks. It is appropriate for your high blood pressure to be stabilised using medication, if necessary, prior to introducing HRT.
