Menopause occurs in women at 51 years of age on average. The time leading up to this can begin years earlier and is known as the perimenopause. Although some women will be lucky to escape any symptoms, the majority of women will experience some symptoms of during both stages, either emotional or physical or both.
A recent panel discussion hosted by RCSI University of Medicine and Health Sciences explored the challenges women face as they go through perimenopause and menopause.
The discussion entitled: 'Living well through perimenopause and menopause' took place as part of RCSI’s ‘MyHealth Series’. The Series brings together leading health and well-being experts to share their knowledge and help to empower people to make informed decisions about their own health and wellbeing.
Led by Prof. Tracy Robson, Head of School of Pharmacy and Biomolecular Sciences, the panel comprised experts in the physical, physiological and psychological areas associated with menopause. Experts included: Dr Caoimhe Hartley, GP at Menopause Health and GP Tutor at RCSI; Dr Maria Pertl, Lecturer in the Department of Psychology, Division of Population Health Sciences, RCSI; and Maeve Whelan, RCSI Alumnus and Practice Associate at Milltown Physiotherapy.
The purpose of the discussion was to empower women, to let them know that they are not alone and to encourage them to understand the signs and symptoms of perimenopause and menopause. The panelists emphasised the positive aspects of this stage of life for women and provided treatment solutions for the physical and emotional symptoms that women experience.
Physical symptoms include less regular periods, joint aches, skin and hair changes, urinary tract infections, hot flushes, palpitations and cognitive issues such as memory loss and verbal fluency issues. Emotional issues were described as increased anxiety and /or low mood.
Perimenopause is characterised by a change in periods that occurs as a result of a drop or fluctuation in oestrogen levels in the ovaries. Menopause is characterised as the pause of menstruation. A woman is considered to be in menopause when they have had no period within 12 months and every other potential cause is eliminated. The main issues experienced by women in menopause are cardiovascular disease, a decline in cognitive function and changes in bone density, which can lead to osteoporosis,.
Dr Maria Pertl, outlined some of the psychological symptoms experienced by women as low mood and increased anxiety and explained that many women may also experience a feeling of grief for their fertility. Dr Pertl recommends that women share experiences with others and engage in an activity that reduces their symptoms such as yoga, walking or mindfulness. Dr Pertl also offered some guidance to managing disturbance in sleep caused by the perimenopause or menopause.
Maeve Whelan emphasised the role that maintaining strength and stability plays through the perimenopause and menopause. She explained that exercise can help with many aspects including irritability, sleep and weight gain. Most importantly weight bearing exercise is recommended to counteract the impact of the menopause on bone density, which can decrease at a rate of 2% per year after menopause. Maeve also recommended regular pelvic floor exercises.
A combination of hormone treatment such as HRT and exercise were recommended as an effective way to treat most symptoms of menopause and perimenopause. Women were encouraged by the panelists to seek advice if they find the symptoms impacting on their lives.
Dr Caoimhe Hartley explained that hormone replacement gives women back some of what has been lost from the ovarian production of hormones and that it is proven to have benefits for bone health and cardiovascular health, as well as for the management of menopause symptoms.
Dr Hartley said that if a woman in peri-menopause is experiencing symptoms that are affecting her quality of life, then she should talk to her GP about her options and about the potential benefit of HRT.
Women with concerns about potential risks of taking HRT were advised to talk to their GP. The role of the GP is to provide guidance and find the right balance of treatment for each woman.
Watch the full discussion below.
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