Menopause webchat with Liz Earle

I'll be 70 this year and I'm very glad I'm on HRT. I'm in much better condition than many women my age. I am wondering if the benefits reduce with time though.

Thank you

onandon

I seem to be displaying a lot of the typical symptoms of menopause. Weight gain, mood swings, irritability and so on and so forth. My periods stopped about four months ago but for the last couple of weeks I have felt very much like I am 'pre menstrual' and along with this have very tender breasts and the odd cramp. is this normal? Does it mean my period is on its way? I know that you have to have a year without to be truly in the menopause and I know various people who have had stop start periods before this happened.

What we often don’t appreciate is that before the menopause there can be many years of menopausal symptoms during the period called the perimenopause. It sounds very much as though you are in the middle of this. Worth reading up on the subject on websites such as the British Menopause Society and considering HRT.

malki

I am 52 and have not had a period for six months. In the last month or so I have started to notice what might be some sort of stress incontinence - not when coughing/sneezing/laughing etc but when I need to urinate it's as though I can't quite hold it in. It's only sometimes. I have not had children and never had any pelvic floor issues in the past. Is this linked to menopause and what can I do?

Yes unfortunately this is linked to the menopause. Lowering oestrogen levels can affect our pelvic floor due to reduced muscle strength. Taking HRT can obviously help or you could even consider ‘vaginal rejuvenation’ where lasers are used internally to help increase collagen production which in turn strengthens the opening around the bladder area which then helps to reduce incontinence.

SuzC

How do I actually know when I am in menopause territory?

I suffer from hot flushes (any random time of day) and wake up in the night sweating terribly.
Despite eating the same/less than I ever have the pounds are creeping on, especially over the last year. No matter what I do (diet/exercise), I can't seem to lose them.
My patience levels are also shortening and I find myself upset or angry, or both - sometimes quite irrationally.

Yet at 46 everyone keeps telling me that it is too soon for me to menopausal!

Would I have to have a blood test to be able to determine? I'm not one for going to the doc's and generally soldier on with most things!

It definitely sounds as though you are perimenopausal - the average age for perimenopausal symptoms such as yours if 45. There is not much point in having a blood test as hormone levels fluctuate from week to week. In fact the latest NICE guidelines say doctors should not give blood tests to women over the age of 45 and that they should simply prescribe HRT on their symptoms alone.

lexigran

One thing I have noticed these last few years is a lack of confidence. I see a job or activity and think "I could do that", then I talk myself out of it. I also have a lot of CRAFT moments...Can't remember a flippin thing!
I attribute the above to the menopause rightly or wrongly.
Will these things improve again or I am going to be Crafty forever ?

Low mood and anxiety is unfortunately a very common symptom of the menopause, you may or may not find it passes but unfortunately for most women it can often simply get worse. I’d suggest a discussion with your GP and consider trying HRT. You could try it for 3-6 months to see if it made any difference to how you feel. Good luck.

Breda

I have spent the last 15 years battling with menopause and it has driven me absolutely mad. I had a hysterectomy when I was 36 and started menopause at 49. I am now 64 and still suffering miserable episodes which have severely affected my overall health. As a person who enjoyed extremely low blood pressure even when pregnant with each of my four children I now have worryingly high blood pressure, and that’s despite being a healthy weight following a good diet, lots of exercise and yoga, never a smoker or a drinker. I would love someone to tell me how best I can cope with this, so that life would be more bearable.

I feel like I have lost so much time struggling to cope, and apart from medication to attempt to control my BP (which has been mosty unsuccessful) my GP hasn’t been able to help at all.

I’m so sorry to hear this. HRT could help here and just to reiterate, there is no upper age limit for starting HRT according to the latest NICE guidelines

LizH13

I had a hysterectomy aged 40, then almost 20 years on HRT. During this time it was the best I've ever felt. 5 years ago mY GP would no longer prescribe the patches. Since then, I have put on weight, (hard to move) don't sleep well, low mood and anxiety, for which I take fluoxetine, have brain fog, vaginal atrophy and worst of all the flushes and sweats. I've tried soya products, sage tablets, cutting out caffeine but nothing seems to make any difference. I'm sure I could feel better if only the flushing/sweats were less. Any advice would be welcome.

This is absolutely awful, I feel outraged on your behalf. If you get no luck, it would be well worth a second opinion.

nixon

What can I do about brain fog? It's got so bad recently I even worried it might be early onset dementia. I am reassured by conversations with friends who are also going through the menopause but am so frustrated not being able to think of things I could easily have done a year ago. Any tips?

Brain fog is one of the lesser known symptoms associated with the menopause, caused by shifting hormones and can be addressed – for most women – by HRT.

gardenoma

Good to see there are some more ladies in their 70s still coping with hot flushes! I saw a doctor in a menopause clinic who could only prescribe clonedine, which reduces the number of really intense flushes but I still get them regularly as clockwork every 45-50 mins. I was told by my gp, when I decided enough is enough I now want quality of life.. that I'd missed my slot for HRT as it would now be too risky to start. Does this mean I'll go on till I die?? I have tried virtually all the alternative solutions on the market these 20 years without any improvement whatsoever. Have you any advise??

You have definitely not missed your slot for HRT and being in your 70’s does not mean, according to the latest NICE guidelines, that it would be too risky to start. My advice is to read up on the subject, download a copy of the NICE guidelines and go back to your GP armed with all the up to date information. All doctors can prescribe any form of HRT.

M0nica

I am someone else who had an almost symptomless menopause. I did develop fibroids in the run up, but the menopause puts paid to them.

The one thing I did do is start gaining weight. It became impossible to lose weight my usual way of reducing food intake and upping exercise. Over about 5 years, despite every attempt to stop the weight gain and get back to my accustomed weight I put on about 21 lbs and was lumbered with it until I was about 70, when my metabolism returned to normal and I succeeded in losing all the extra weight I had gained in a couple of months and I have been back at my pre-menopausal weight, now, for nearly five years. Is this a menopausal problem, and how common is it?

My daughter is now approaching the menopause and is wondering whether she might have the same problem and is there anyway she can avoid it..

Our metabolism slows as we age, it’s a sad fact that we need to eat a little less and move a little more - research shows we need to eat 200 calories a day less than we did in our thirties just to maintain a steady weight. Switching to low GI can be really helpful and also help with sugar cravings and mood swings. All the recipes in The Good Menopause Guide are low GI for this reason.

Kazzy

My question is this, my Dr put me on HRT but many people have told me that it only delays things and that as soon as you come off it you get menopause symptoms back, I asked the Dr and she said there was no evidence of this but everyone is different ! What are your thoughts on this ?

HRT is a daily treatment with no cumulative effect - the day we stop taking it, our body reverts to its natural hormone level at that time and there are no ongoing benefits. However, there is no upper age limit for taking it - indeed many women in their 70’s, 80’s or 90’s still take HRT. This is just one of the many myths on HRT I’ve busted in the summer edition of Liz Earle Wellbeing magazine or on the menopause section of Liz Earle Wellbeing – worth a read!

Lyndie

My doctor won’t let me have HRT. I feel so much better on it. More energy. Is there an alternative? X

Change your doctor!

Shinyredcar

One of my oldest (long-standing) friends and I are still suffering from hot flushes in our seventies. She gets night sweats, too. No one seems to mention that some aspects menopause never go away!

Yes, some aspects never go away which is why it’s so important to get help when you need it. Bear in mind the latest NICE guidelines say that HRT can be prescribed with no upper age limit and no maximum length of time either. I know women in their 90’s who have taken it for decades and would never be without it. On the herbal side black cohosh seems to be an effective herbal remedy for night sweats, but doesn’t have much impact on any of the other symptoms. I really hope this is helpful.

gran1

I am noticing changing preferences for food and drink.
May not be connected to the menopause and nor of great concern. Coffee seems preferable to tea which was my favourite and salty snacks are irresistible.

Absolutely, our taste buds change as our oestrogen levels fall. So many seemingly unrelated symptoms are actually due to oestrogen levels from tinnitus and dizzy spells to dry eyes, dry mouth, achy joints and a change in taste and smell.

Willow500

I'm another who sailed through it - a couple of days in hospital due to heavy bleeding when I was about 43 or 44 where they gave me medication and never had anything after that. No hot sweats or mood swings (as far as I know). My DIL on the other hand is 47 and suffers with many symptoms of the menopause but her GP still tells her it's not. She sweats profusely which is extremely embarrassing at work, finds it impossible to lose weight, and has very heavy bleeds. She's now had a coil fitted to try and control the bleeding. Is it possible to have all the menopause symptoms but still be undiagnosed? Are there any herbal remedies I could suggest to her to help?

I hear this so often and it is disappointing how little many GPs know about the menopause. Do take a look at the work of Dr Louise Newson, the menopause doctor, it may well be that a form of oestrogen gel or patch could help by working alongside the mirena coil. You might also find this recent podcast I did with Louise as part of the Wellness with Liz Earle series helpful.

Autumnleaves

I wanted to ask, if our bodies start to drop in oestrogen levels and this can cause so many different problems, are there any foods or natural products that we could have to boost our levels?

My special ingredients for looking and feeling your radiant best during the mid and later life include phyto-oestrogens, which provide oestrogen-like compounds that occur naturally in the plant kingdom. Phyto-oestrogens can help ease many menopausal symptoms, but they’re also tasty and nutritious in their own right. Soya milk and soya flour, linseeds, tofu, Japanese tempeh and miso, pumpkin seeds, sesame seeds, sunflower seeds, celery, rhubarb and green beans all contain phytoestrogens. Look for recipes rich in these ingredients, such as one of my favourites from the Liz Earle Wellbeing website – my famous menopause cake!

gilbert

My question is about mood swings although they are not so much swings as a permanent mood. I can see I am being grumpy but feel powerless to stop it. I am also low a lot of the time. It's like PMT but worse and it's non stop. What can be done?

Mood swings are one of the main symptoms of the menopause and one that can be easily addressed – for most women – by HRT. As far as I’m concerned, HRT is simply topping up what our body naturally lacks as we age, as our oestrogen levels naturally decline. That’s not to say all women can take HRT or all are suited to it. It’s important that you discuss your own personal needs with your GP or specialist doctor, who will take into account your personal health history, underlying conditions and lifestyle.

One of the things that concerns me most is the number of women who are wrongly prescribed anti-depressants for low mood and anxiety, anti-depressants can make low moods and brain fog even worse. There are some great Instagram accounts that you can follow that talk about this such as Menopause Doctor and Meg’s Menopause. Flashes of extreme rage are also not uncommon during the menopause! You might also find this recent podcast I did with Meg Matthews on the menopause helpful.

Pebbles77

Most noticeable for me is chocolate cravings ... as bad a cigarette ( I used to smoke many years ago ... been a non smoker for 37 years but I remember it well ) ... don’t get me wrong I’ve always loved it but now it’s a compulsion and I worry if I have none in my possession and it has to be a certain brand ... I’m on HRT gel ... small dose and trying supplements like chromium complex etc ... and grumpy and very emotional ... not sure if anymore periods as I have Mirena coil anyway and no periods with that which has been amazing ... 55 this year ... I guess I could be post meno

If you are on the HRT gel, you could try increasing the number of pumps that you use each evening and see if that makes a difference. The guidelines tend to be between 1-4 pumps daily.

Newbiedoobie

I’m 51 and haven’t had a period for 9 months. I have very few symptoms which I would say are menopause, but I am generally achy and stiff jointed. In the mornings my hands are stiff and I can’t touch my toes at all as my back and legs are stiff. It does ease during the day, but is there anything for this or is it just age? I kind of feel like I’ve aged over these last few months!

There are at least 45 symptoms associated with the perimenopause and menopause and the list includes aching joints. You could find that HRT might make a difference here. Low levels of magnesium can also be a contributing factor so you may like to look at increasing this in your diet as well as enjoying the odd soak in a warm Epsom salt bath!

cookiemonster66

I had a full hysterectomy at age 25 yrs, put on HRT couple of yrs after that. At 50 my Dr constantly hinted to stop taking HRT (as I had been taking it for 20 yrs) I now take those menopace herbal supplements (but use tesco own make as much cheaper) what are your thoughts on herbal rememdies?

I think herbal remedies can be helpful for many women, the clinical evidence is often lacking so it is hard to be sure and many are unregulated so you do need to be very careful with what you take. Ultimately though if your body is lacking in oestrogen the most ideal option is to top it up with body identical oestrogen on prescription. By body identical oestrogen I’m talking about the form found in oestrogen gels and patches, not the more old fashioned tablets.

Yearoff

I’ve been on HRT for three years. I didn’t really want to take it but my partner has dementia and I couldn’t deal with the emotional side effects of menopause and the sleepless nights due to hot flushes. I still had my periods at this point (although irregular). My question is - because I’m on combination HRT I have a monthly bleed. How will I ever know if I’m through the menopause to come off the HRT?

Go back and talk to your GP, you could potentially change to a daily form of progesterone such as the mirena coil which would mean no monthly bleeds.

Helenleeds

I started the menopause in my early 50s & was prescribed HRT for the hot sweats & insomnia. I'm now 67 & unfortunately I still have the same symptoms if I don't have the HRT. I now apply half a patch twice-weekly which keeps the symptoms at bay. I dread the day the doc says I can't have it anymore as the sweats are so severe & debilitating. I really envy you ladies who have sailed through it!

It’s worth being aware that HRT is a daily treatment with no cumulative effect (the day we stop taking it, our body reverts to its natural hormone level at that time and there are no ongoing benefits). It’s important that you discuss your own personal needs with your GP or specialist doctor, which will take into account your personal health history, underlying conditions and lifestyle, but for most women there is no need to stop taking HRT once successfully on it. The NICE guidelines are very clear on this, there is no time limit as to when you have to start taking HRT. I know women in their 90’s who say they will never stop it!

kex66

Hello Liz, I started getting symptoms four years ago. They were not too bad so I assume I am one of the ones that has rather sailed through it. However since I hit menopause I have really struggled with my weight. I used to be able to lose a few pounds when I wanted to but now it is really an uphill battle and I am finding it impossible. Is this a temporary thing and what can I do about it?

As our oestrogen levels drop our fat distribution changes in our body which is why we literally get middle age spread and get fatter around the middle. Taking oestrogen does help to prevent this. I’ve also found eating a low GI diet very helpful – low sugar and almost no refined sugar. It’s very important to maintain a good fat content though because good fats help to create healthy hormones, so the last thing we need in our middle to later years is to go fat free when we are in need of good quality hormones to help us age well.

patto

Well I for one am glad to see this. I am 54 and only now beginning to experience symptoms so I am obviously the other side of the average. I have had no periods for four months. I've had a few flushes but no sweats. My main symptom is insomnia which I believe to be very common from talking to friends. I have no trouble getting to sleep but I wake often and can take up to two hours to get back to sleep and my health and most especially my mood are suffering badly. What can I do?

For me too, pretty much my only symptom of menopause was sleep disturbance and that was the one that sent me booking the doctor’s appointment. As a busy working mother of five, I can handle most of what life throws at me – but only if I get a good night’s sleep! I’d suggest printing off the NICE guidelines on HRT which clearly say that over the age of 45 no blood tests are needed and that GPs should prescribe HRT according to the symptoms being presented. Insomnia and sleep disturbance is a very common symptom you might find this Liz Earle Wellbeing piece helpful. Good luck and hope you get a good night’s sleep soon.