Menopause Q&A with Dr Rosemary Leonard

I recently came off Tibolone after 10 years on it without problems and with relief from constant nighttime hot flushes. My GP in his wisdom felt it was time to change me to Ellesse Duet. After one month I had a considerable bleed and was found on hysteroscopy to have thickened endometrium and an ovarian cyst which is now being monitored by two further scans four months apart. Thankfully no cancer was found but it was a shock. I was warned throughout the treatment years of risks to heart and B/P but the possibility of abnormal cells in the uterus was never mentioned. Now I am cold turkey without HRT and apart from a few hot flushes at night if I have a glass of wine too many its fine. My achiness and tiredness I put down to arthritis. I just wonder if we are outing to many other symptoms down to the menopause when they might juts be 'normal' ageing.

Hi, Dr Rosemary. I'm 53 and haven't had a period now for almost two years. I have noticed a problem with memory (I have to keep a list), motivation/energy and difficulty with sleeping. I have blamed it on the husband snoring, but I'm not sure that's it entirely as it's just as bad when he's away. My biggest problem though is a complete lack of sex drive. I just can't be bothered. As I'm still married, this is a problem!
My question is, I suppose, am I right to put these down to the menopause?

Hello Dr Rosemary

I am 51, presumably peri menopausal though no symptoms to speak of. I was prescribed the combined pill by my gynaecologist (Qlaira) which I continue to take. They felt despite my age I was low risk for any of the other contraindications. Does this sound right? Also if I ended up on HRT at some point how would the risks of that compare to those of the combined pill?

Thank you

I am 52 and not yet menopausal. I've noticed some sleep disturbance and the odd memory lapse but otherwise nothing at all. That's fine of course, but I have started to become increasingly panicky about what will happen when I do finally reach that point. The experience of most of my friends has not been positive and the worry has really started to get to me. I realise this is a bit silly but would love some reassurance and also tips on anything i might be able to do to 'prepare' myself

I would like to know whether there is any correlation between the age you start your periods and the age you reach menopause? Also whether reaching it earlier or later has any effect on how many symptoms you get and if you have had bad PMT with your periods, are you likely to get worse symptoms with the menopause?

Energy is my worry, l care for four grandchildren four days a week, two at a time from early doors till tea time. I can see I'm quickly running out of steam most days now, any advice?

Hi Dr Rosemary, I had a total hysterectomy at 42 due to endometriosis and was immediately given an oestrogen only HRT estradiol. It worked for years extremely well until my Gp put me under pressure to come off it last year. Now all the menopause symptoms have returned with bad night sweats, horrible hot flushes, mood swings and little energy. I'm now 60 and coming off HRT coincided with a worsening auto immune disease, which I've had for over 30 years, psoriatic arthritis, which then started in my spine, neck and lower back, knees, hands etc. So I'm already struggling to cope with work, chronic fatigue and constant pain. The hospital doctor indicated that coming off HRT may not be a good idea given the increased risk of osteoporosis together with my degenerative spinal disease. Is there any reason we can't stay on a low dose of HRT if it's working? Or is there an effective alternative. I've been looking at bio identical natural HRT but don't know how effective this would be? Any advice would be much appreciated.

At 64 I am in a new relationship after 20 years celibacy (my ex husband's choice not mine) My new partner (who at 54 is 10 years younger) has a high sex drive. My libido is at zero and i make every excuse to avoid sex. I had a smear test recently and my GP noted i had the vaginal vault of a younger woman so its not dryness causing problems as it does some menopausal women. I should be delighted that i am sexually attractive after doubting myself during my marriage but the opposite is true!!

I had a partial oophrectomy at age 43, cancer at 46, periods stopped at age 47. It's over 10 years later, I notice my muscle mass is shrinking quite fast and am worried about bone mass. Legs feel frail and weak at times. Any suggestions?
I don't drive and walk everywhere, can't take HRT because of the c, and also have palpitations at night which wake me up. Hot flushes ended about 3 years ago.

Had chemo induced menopause 2001 but still not fully in menopause. Awful symptoms loss of libido,urinary probs etc. Not on hrt as on lots of medication; what can you recommend naturally please( not too good on valerian based meds)

How late in life can you start taking HRT. I am nearly 65 and am concerned about dryness of skin,hair loss, muscle wastage,my joints and generally becoming more frail and elderly looking!!!

Surely if HRT helps with these issues and is safe to take, it should be prescribed for older women. It would save masses for the NHS in terms of joint replacement ops, depression treatments,gynological problems and other treatments that i am not aware of.

i had a total hysterectomy in 1995 at the age of 48 because of ovarian cancer. op on thursday - full blown menopause by friday!
had patches but i'm allergic to them then an implant every 6 months until they stopped making them
i'm now on elleste solo 2 mg tablets and have never felt better!
i'll be 70 in august and will continue on hrt for as long as i can.
i weighed up the pros (feeling good) and cons (possible breast cancer and possible osteoporosis) and decided the pros won!

When can you tell it is safe to stop using contraception?

Hi Dr Rosemary
I take Elleste Duet HRT which gives me a monthly bleed. I've been on it nearly seven years to control flushes and moods. I'm 54. No history of breast cancer in family. GP has advised me to wean myself off it and go for a no-bleed preparation if I feel I need still need HRT. She says that my periods may have stopped but that this could be being masked by the HRT which allows monthly bleeds so I could actually be through the menopause but not know it.
She advised to take my HRT every second day. I've started this, am 4 days into it and already had breakthrough bleeding. How long should I expect this type of bleeding to last?
I'm frightened to go cold turkey incase my flushes and moods come back with a vengeance. Also, before the HRT I had absolutely no interest in sex. I still don't really, although it's a little better than before.
I've spoken with another Gransnetter who says there is a blood test which will confirm if I'm through the menopause, so should I go for that?
Not sure what to do really.

I have had hot flushes and mood swings since I came off oestrogen 10 years ago after taking it since a hysterectomy 20 years previously. The doctor advised that the risk of breast cancer was increasing each year.
The worse thing is the inability to sleep and the consequent tiredness and irritability and fatigue.
I would go back on the oestrogen tomorrow and risk the consequences just to be able to feel myself again,

I have been having hot flushes for 10 years and take sage and Isoflavones which seem to help a bit. My mother is in her late 70s and sill has flushes and knows a number of women, also in their 70s who still have them. Has anyone properly investigated menopausal symptoms that endure long after the last period? My second question is every time I have a flush at night I get really thirsty and need to wee - do other women experience this and why?

Hi DR Rosemary
I'm 57 and have had what I believe a late menopause
My last period was a year past February.
How things have changed.
I can't have HRT because my mother died at 54 from breast cancer

I can safely say that unlike a lot of people who say they now feel happy in their own skin.,
I most definitely don't.

I actually don't like myself.

My body aches especially my feet
My ankles are always swollen.
I snarl at DH and my tolerance levels have dropped considerably.
I'm tired in the mornings due to night flushes
I feel I'm in a permanent fog. My memory is awful.
My skin has lost its elasticity and my eyes seem to have sunk in to my head!

This is the first time I have allowed myself to actually say that my life at the moment is not very good.

I try to remind myself that at least I have lived longer than my poor DM

My DH has just retired and is raring to go on days out, holidays etc but after a week of child minding I just CBA.

I wish I could accept the changes instead of living in fear of what the menopause is going to throw at me next
and I would like my mojo back!

My hot flushes and general tiredness do get me down. I seem to need a long time in the morning before I even feel able to shower and get dressed. I'd love to sleep right through the night again but hot flushes and/or pain wakes me 3 or 4 times every night. I'd be interested in the best natural remedies I could try to generally feel healthier all round.

cant sleep at night, I dont take pills whats the best solution

Hi - I am Peri-menopausal at the moment and have already been through some time of this and am now at the spot bleeding only stage (goodness knows when this will stop) I have been luck with skin/hair/nails to date although hair and skin are noticeably drier than usual. My concerns are more around weight gain. I exercise regularly as a keen walker and cyclist - I go on a couple of 4 mile marches every week and a couple of 15 mile cycles, I eat healthy foods and not great quantities and do not have a sweet tooth but the weight is creeping on fast ? IS there anything I should be doing ?

Hello, hope I'm not too late to comment, noticed gradual decrease in periods over the last 3 years - prior to this had no bleeding anyway due to Mirena coil which i had for 12 years (2 lots) .. felt fine, actually enjoyed not having the monthly ebb and flow of fatness and tears..!! Then out of the blue having just got off a flight to Italy I started to bleed. On and off for the next 2 months. Finally was referred to hospital who checked me out and confirmed that I was peri-menopausal. I couldnt sleep for twitchy legs although had no hot flushes. Tearful moody and felt useless and unable to cope - not useful as am single parent of 3 teens. Was prescribed Elleste Duet which seemed to change my life overnight. Can sleep again, happy and enthusiastic sex life - handy as I have a lovely boyfriend - with the only down side being the annoying monthly bleed, but even this seems to be abating to about 4 not too heavy days. Hair and skin feel better and I dont feel like I've got one foot in the glue pot anymore (turned 50 last year and like to think I look closer to 45 . My experience has been positive BUT yes I pay £16.50 for 3 months supply - and do wonder what will happen if I ever stop taking the tablets...............

Oh and regarding weight gain, I'm 5"6 and lost weight due to stress about 3 years ago. Went from 10 and a half stone down to about 8 and a half and looked terrible. Hair fell out and skin hung on/off me. I now weigh about 9 and a half, and will probably have to struggle the rest of my life to not gain more. No carbs, bread, potato, pasta or rice (well only very occasionally and small portions). Lots of veg. Try not to snack on chocs biscuits and crisps.

I am having a very difficult time of the menopause. I want to go on HRT to help but I don't want the synthetic. I read somewhere that there is such a thing about bio identical hormones, which I believe are safer. Can I get these from my doctor and will I need blood tests? Thankyou

Liz46

I started on HRT when I was in my forties after a hysterectomy. My main problem was and is hot flushes. I am 70 now and have tried to give up the patches (Evorel 25) several times. The last time I stopped them I went Christmas shopping in Liverpool. I was carrying parcels and had a dreadful hot flush and panicked. I had nowhere to put the parcels as the shop I was in was very full of stock and I HAD to get my coat off.

I'm back on the patches but still wake up with hot flushes. They are so bad that if my husband happens to touch my arm, he notices it is sweaty and there is a river between my boobs.

My problems started after I had children and I ended up with endometriosis.

Strictly speaking a hysterectomy means just the removal of the womb, but I suspect your had your ovaries removed as well. This will have plunged you into an instant menopause, but it sounds as if you were prescribed oestrogen patches straight away, and this will have prevented menopausal symptoms such as flushes and sweats. One of the problems of HRT is that when you come off it, the body has to get used to being without oestrogen all over again, and this can mean a return of flushes and sweats. The only way to try and reduce the problem with this is to come off HRT slowly, especially if you have been on it for a long time. Now you are 70, the risks of continuing with HRT are quite high ( such as an increased risk of a stroke or breast cancer ) and certainly at your age I would recommend that you try and stop it. You are already on the lowest dose patch, so I suggest you wean your self off them by slowly reducing their size. Cut off a small amount of the patch – say about a quarter, and wear this size for a couple of weeks. Then remove a bit more – a third – and again wear them this size until your body is used to the slightly lower oestrogen dose. It may take you about 3 months, but slowly but surely, your body should adjust to less and less oestrogen. During this process you may well a few flushes and sweats, but they shouldn’t be as bad as suddenly stopping the patches. Clonidine tablets, which don’t contain any hormones, may help too. They are available on prescription from your GP.