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Menopause
Menopause - NICE guidelines
(37 Posts)Hello,
There have been plenty of discussions on the forums about gransnetters’ experiences of the menopause and the support your encountered from health professionals whilst going through it.
The National Institute for Health and Clincal Excellence (NICE) has now put together draft guidelines about Menopause: diagnosis and management which they would really value your thoughts on.
This is your opportunity to put forward your views and experiences and possibly influence NICE guidelines in this area going forward. If you would like to comment please read through the draft guidelines NICE has provided and if you can, make a note in your comment on the numbered paragraph you are referring to.
If you’d prefer to remain anonymous but still want to contribute please email [email protected] with 'Menopause' in the subject.
Here is more information from NICE:
Professor Mark Baker, Centre for Clinical Practice Director at NICE, said: “Menopause affects millions of women, and its symptoms can severely upset a woman’s day to day life. The effects of menopause are often misunderstood and underestimated – it can result in problems ranging from hot flushes to brittle bones, joint stiffness and cardiovascular disease.
“When women seek medical help for their symptoms, there is considerable variation in what is offered to them. So NICE is pleased to be developing the first guideline for the NHS on diagnosing and managing menopause, to help improve the lives of women affected by it.”
Draft recommendations include which tests can be used to diagnose menopause, and advice on offering holistic, individualised care that takes into account the woman’s symptoms and preferences. The draft guideline also highlights that clinicians should give support and advice to 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-dependent cancer or having gynaecological surgery. To help women and clinicians decide on what approaches are right for each individual, drug and non-drug treatment options are covered. This includes draft recommendations based on the benefits and risks of treatment with HRT, with specific information provided for women in various clinical circumstances. For example, it’s often considered that women at risk of hypertension or other cardiovascular conditions should not take HRT, but the draft recommendations propose that they shouldn’t automatically be prevented from taking it.
NICE welcomes comments from stakeholders on the draft recommendations as part of our public consultation.
Draft recommendations include:
• Diagnose the following without laboratory tests in otherwise healthy women aged over 45 years with menopausal symptoms:
o perimenopause (the lead up to menopause) based on vasomotor symptoms (like hot flushes) and irregular periods
o menopause in women who have not had a period for at least 12 months
o menopause based on symptoms in women without a uterus (womb)
• Offer holistic, individualised care that takes into account the woman’s symptoms and preferences. Give information to menopausal women and their family members or carers (as appropriate) that includes:
o an explanation of the stages of menopause
o common symptoms and diagnosis
o lifestyle changes and interventions that could help general health and wellbeing
o the benefits and risks of treatments for menopausal symptoms.
• Consider cognitive behavioural therapy (CBT) for alleviation of low mood and anxiety in menopausal women
• Ensure that menopausal women and healthcare professionals involved in their care understand that HRT:
o does not increase cardiovascular disease risk when started in women aged under 60 years
o does not affect the risk of dying from cardiovascular disease
• Ensure that menopausal women and healthcare professionals involved in their care understand that HRT does not affect the risk of dying from breast cancer, and explain to women that:
o that HRT with oestrogen alone is associated with little or no increase in the risk of breast cancer, but that HRT with oestrogen and progestogen can be associated with an increase in the risk of breast cancer
o any increase in risk of breast cancer is related to treatment duration and reduces after stopping HRT.
Hi gill bob....I really feel for you...I too started the menopause at age 45...the severest time was 45 to 50 when I had my last period...however it went on and on for a further seven years 12 years in total....I nearly lost my marriage, it was the most horrendous time in my life, night sweats and hot flushes most of the day and night, depression, crying, anxiety and panic attacks.......I gave in at one point and took hrt for one week and ended up calling the gp uut one night as I was climbing the walls with anxiety and panic....would never wish this on anyone.
I tried every herb under the sun, acupuncture, massage, reflexology, strict diet of natural oestrogen so like yams and vitamins with phytonutrients.....some things I tried did help....but the one thing that really made a difference eventually ( and please be aware, that no natural remedy will ever get rid of all symptom completely) was black cohosh...however you need to take it for a min of two months to start to really notice the difference...I can honestly say it made life bearable again, reduced the sweats and flushes by half...I swear by it....sage dried me up too much, Angus cactus made my nipples really sensitive and enlarged it was quite frightening how I reacted to this one...red clover didn't make much difference....but BLACK KOHOSH, really really made the difference...please try it....pleased to say now 61 and apart from a little warm at night still have fan on...I am normal again...lovely ������
Hi Gillybob, if you possibly can,go and see a private gynaecologist. I saw one based in Guildford, I didn't need a GP referral, and got put on HRT at the age of 65. There are some women who continue with meno symptoms indefinitely and for me after 12 years of hell I'd had enough. Sending you a hug.
I am most interested in this thread. My GP played stink with me when I asked for repeat of my HRT prescription. I started taking it in my very early 30s following a hysterectomy, I am now 66. He told me that all the research then pointed to CA Breast etc. I showed him the latest research which did not agree with these findings.
I changed GPs , although the same practice, and now take it 9 months out of every 12. I have never had any problems whatsoever and for myself, I would say that everywoman should have it made available as of right, giving her the option to opt out if she wishes to.
Gillybob I have finally got a referral to specialist Menopause clinic. It has taken me well over a year and four visits with doctor to get this far. It is Monday 9th 2017 and I am hoping for the oestrogen patch. My blood pressure is high and on medication so my GP, who I am very happy with except on this issue, refused me HRT because of this.
My dh will be so very pleased if I get any sex drive back at all and if i can stay awake all day/evening without falling asleep on sofa.
Well things have moved on quite a bit since this thread started newnanny (was it really over 2 years ago??)
A good few months ago I was finally given HRT and whilst I had almost instant relief from the sweats, I started bleeding very heavily (started in June) and I was given male hormones to stop it. Which have worked but caused so many other nasties such as even more hair loss, cramps, spots (on my back and chest), tearfulness and a permanent feeling of doom and gloom. I saw a gynae specialist this week who has removed all medication and performed several biopsies (apparently my womb is worryingly large). As a result of removing the male hormone the bleeding is back with a vengeance and I am quite literally drained. Talk about the devil and the deep blue sea!
My sister is 5 years younger than me and sailed through the menopause (years ago) without any symptoms at all. She persuaded her GP to give her HRT though as she says it keeps her feeling young. I'M NOT JEALOUS !!
Here I am waiting for results of biopsies but dreading them at the same time and feeling and looking like an old hag.
Hope your appointment goes well. Fingers crossed you get the help you need. x
Trenna, I was fortunate to have a problem free menopause as well and I am not vegetarian, although I do eat a lot of fruit and veg. I think it is just good luck rather than any particular life style.
Gillibob - not sure if you will see this but it is not usual to be given a male hormone to stop the bleeding - this would be testosterone. However some of the synthetic progestogens are derived from testosterone but they are not the same thing! Norethisterone is the most common one given to control bleeding from the uterus. You could have a Mirena coil which will also control the bleeding and also allow you to take oestrogen as well.
Gillibob - not sure if you will see this but it is not usual to be given a male hormone to stop the bleeding - this would be testosterone. However some of the synthetic progestogens are derived from testosterone but they are not the same thing! Norethisterone is the most common one given to control bleeding from the uterus. You could have a Mirena coil which will also control the bleeding and also allow you to take oestrogen as well.
I meant to add ( was trying to do "return" but ended up posting twice!) - hope the biopsies are OK
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