Managing Menopause - Q4 - Dec 2018

AN INDEPENDENT SUPPLEMENT DISTRIBUTED IN THE GUARDIAN ON BEHALF OF MEDIAPLANET WHO TAKE SOLE RESPONSIBILITY FOR ITS CONTENTS

Managing Menopause DEC 2018 HEALTHAWARENESS.CO.UK

Why information is empowering when it comes to the menopause P4 CREDIT: NICKY JOHNSTON

Andrea McLean on everything you need to know about menopause P6

2 HEALTHAWARENESS.CO.UK

AN INDEPENDENT SUPPLEMENT BY MEDIAPLANET

MEDIAPLANET

READ MORE ON HEALTHAWARENESS.CO.UK

IN THIS ISSUE

Knowing your rights and dealing with menopause in the workplace

ONLINE Why menopause practices and guidelines should become compulsory for all businesses says MP Carolyn Harris

ONLINE How lifestyle changes can improve symptoms of the menopause by menopause expert Dr Louise Newson

P6

Menopause – still a taboo?

Sitting in a room of a Londonbased insurance company, presenting a session on menopause awareness, I look out at the audience and see women of a certain age – lots of them – keen to find out what’s normal about menopause, what’s not and how symptoms can be helped, especially at work.

T

here is a lot of laughter, even a few tears (menopause often causes that), and most of all immense relief that the topic is being mentioned at work, that managers are being encouraged to attend and that menopause is at last being spoken about in the workplace.

There is a lot of support for menopausal women – finally I see menopause in every newspaper, every woman’s magazine and, because I too am of ‘a certain age’, I get targeted with adverts every day Follow us

for products to help ‘ease through the menopause’. I could join Facebook groups, go to a menopause café, join an online support forum or attend a wellbeing event all around the topic of menopause.

Women are finally open to discussing what was once considered a very personal journey. This has been primarily driven by women; those who have ‘been there, done that’ and see the need to help other women.

They have filled the gaps left by others, often providing much-needed, easily accessible, evidencebased information.

In 2015, NICE guidance on diagnosis and management of menopause was published. This was the culmination of a lot of hard work by healthcare professionals with an interest in menopausal health and MediaplanetUK

it took time to gather the medical evidence needed to offer strong recommendations.

The result is clear and lengthy guidance, about advising women on this important topic; the importance of offering hormone replacement therapy (HRT) if symptoms are bothersome; of giving women choices and helping them understand the changes that may occur at this time. Yet, still, women say it can be hard to get medical support if needed, that the myths of HRT still abound, even among medics and that the treatment options are not always offered.

Teaching GPs on how to give women the best advice The British Menopause Society (BMS), works towards improved @MediaplanetUK

Kathy Abernethy Specialist Nurse, Author of ‘Menopause: The One Stop Guide’

education for healthcare professionals and educates hundreds of GPs all around the country every year. This year, on World Menopause Day, it published the first ‘Register of Specialists’. The clinicians on this register have all met an agreed professional level of expertise, stay up-to-date and see women regularly for menopausal issues.

The vision – a menopause practitioner in every UK GP practice The number is growing by the day as more doctors and nurses complete the courses and meet the specialist criteria agreed by four professional organisations. Yet more is needed; the BMS vision is that every GP practice in the UK has someone with a special interest in menopause and that every area has a menopause specialist, accessible to those who need it the most and to support local practitioners.

So, with women empowering @MediaplanetUK

other women and with enthusiastic and skilled healthcare professionals educating their peers, the outlook should be positive for menopausal health.

Yes, there is long way to go: there are still stories of women let down by their doctors, of employers and managers being discriminatory and of women at the end of their tether, left to cope without help or support – that is not good enough and must improve. The menopause is a natural life event, let’s not medicalise it, but equally, let’s not trivialise it.

Information, support and treatment where needed is all women ask, that should be achievable, surely?

Menopause: the One Stop Guide’, by Kathy Abernethy, a practical guide to understanding and living with menopause is available in bookshops and online at kathyabernethy.

com/menopause-theone-stop-guide Please recycle

Project Manager: Oryandlee Mormont E-mail: oryandlee.mormont@mediaplanet.com Business Development Manager: Georgia Gerstein Content and Production Manager: Kate Jarvis Managing Director: Alex Williams Head of Business Development: Rebecca Nicholson Digital Manager: Jenny Hyndman Designer: Kiane Blackman Content and Social Editor: Harvey O’Donnell Mediaplanet contact information: Phone: +44 (0) 203 642 0737 E-mail: uk.info@mediaplanet.com

HEALTHAWARENESS.CO.UK 3

MEDIAPLANET

CO2 laser – the new treatment for menopausal symptoms Laser treatment could be the answer to treating signs and symptoms of menopause including, urinary incontinence, sexual dysfunction and vaginal atrophy.

Menopause is a natural part of ageing. However, the changes associated with the significant decline in oestrogen levels can cause many women to feel low. Signs and symptoms of menopause include genital, sexual and urinary symptoms.

G

enital symptoms can include dryness, burning and irritation; sexual symptoms may include discomfort, pain, impaired function and lack of lubrication. Urinary symptoms are common with many getting the urge to urinate more frequently, dysuria (burning while urinating) and recurrent urinary infections.

Often, there is also a decreased quality of life and sexuality with loss of confidence, sleeping disorders and disruption to social function.

20-45% of older women experience pain during intercourse Symptoms associated with vulvovaginal atrophy, such as lack of lubrication and pain during intercourse affect 20-45% of middle aged and older women. Over time, vulvovaginal atrophy can be progressive and less likely to resolve without intervention. It can have a significant effect on a woman’s sexual health and quality of life.

Although hormone replacement therapy is one of the treatments for vulvovaginal atrophy, some women cannot use it due to medical

problems such as history of breast cancer or history of thrombosis (blood clots) or if they are on certain medications.

Furthermore, many women who are not keen to use HRT and instead prefer natural options, often choose to live with their symptoms.

Consultant Gynaecologist, Dr Hina Sra at Cosmebeaute on Harley Street says: “Patients have been able to get their quality of life back after years of being told they just have to manage their symptoms.”

“In my Harley Street clinic, I have been treating clients with menopausal symptoms including vulvovaginal atrophy with lifechanging results. ” C02 laser treatment Incredible results have

been

Dr Hina Sra Consultant Gynaecologist MRCOG, MA Hons (Oxon), MBBS

shown with a CO2 laser treatment, which is used to treat symptoms of vulvovaginal atrophy. It has very few contraindications and can be used safely in women who cannot use HRT. The CO2 laser gently and uniformly heats the vaginal tissue, which contracts existing collagen and elastin fibres and stimulates the production of new collagen fibres. This restores the mucosal quality of the vaginal walls. The neovascularisation (new blood vessel formation) leads to improved vaginal lubrication and normalises vaginal flora to help eliminate chronic vaginal infections.

The full treatment comprises of three sessions four to six weeks apart, followed by a once-a-year maintenance treatment.

Cosmebeaute Address: 127 Harley St, Marylebone, London W1G 6AZ Email: hina@cosmebeaute.co.uk Instagram: @drhinasra_gynaecology

SPONSORED

Read more at

cosmebeaute.co.uk

4 HEALTHAWARENESS.CO.UK

AN INDEPENDENT SUPPLEMENT BY MEDIAPLANET

MEDIAPLANET

Empower yourself with information about the menopause The menopause can be debilitating, so it’s important to empower yourself by seeking help, support and information.

Dr Heather Currie Associate Specialist Gynaecologist specialising in Menopause Spokesperson for the Royal College of Obstetricians and Gynaecologists Trustee and past Chair of the British Menopause Society and Managing Director of Menopause Matters

The menopause is a natural stage in every woman’s life.

It marks the time when her periods stop as her ovaries run out and no longer produce eggs. It usually occurs between 45 and 55 years of age. For some women this can be seen as a liberating time.

F

or others, the symptoms can be debilitating, significantly impacting their physical and emotional health, career, relationships and social life. It’s important for women to know that help and support is available to ensure this natural process is as positive as possible.

Don’t suffer in silence with the menopause Taboo around the menopause

can cause women to ignore their symptoms and avoid treatment, leaving them suffering in silence.

We must work together to end the stigma around the menopause and fear of embarrassment when talking about gynaecological health. It’s important to encourage conversations so women can feel comfortable discussing their symptoms, which may be having a huge impact on their life.

Symptoms include hot flushes, difficulty sleeping and mood swings Each woman is different and will respond to the menopause in her own way, both physically and emotionally. Before the full onset of menopause, there is a stage known as perimenopause. This can last for four to five years or longer.

During this stage, some women

may experience symptoms such as a change in menstrual cycle, hot flushes, night sweats, headaches or dizziness, vaginal dryness, difficulty sleeping, mood swings, memory problems, loss of interest in sex and weight gain. These symptoms are due to the body adjusting to the decline in levels of the hormones oestrogen and progesterone.

Vaginal dryness is also a common problem for women going through the menopause and can have an impact on sexual confidence and enjoyment. There are a number of treatment options available including vaginal lubricants and moisturisers to keep the vagina moist, and vaginal oestrogen which can be prescribed by doctor.

Menopause can greatly affect a woman’s sex life It is common for women to lose interest in sex around the time of the menopause as hormone levels fall.

This is often temporary and being able to talk things through with an understanding partner may be all that’s needed. Other symptoms of the menopause can also indirectly contribute to a reduced libido such as hot flushes, sweats, tiredness and mood changes.

RCOG’s information hub provides support Good quality information can help inform women about menopausal symptoms and treatments available, and empower them to take control during this period of transition.

The Royal College of Obstetricians and Gynaecologists’ (RCOG’s) information hub on the menopause and women’s health in later life aims to help women manage their way through this life stage. The

information hub addresses topics women have told us are most important and directs them to resources to support self-care, to help support them to make lifestyle changes and explains treatment options for those women who may need extra help.

If symptoms are stopping you from carrying on with your normal life, please talk to a GP or call NHS 111. A GP can make a diagnosis and discuss treatment options such as hormone replacement therapy, which is widely used to treat menopause symptoms, and offer cognitive behavioural therapy.

Read more at

healthawareness.co.uk

Make these simple lifestyle changes to help manage your menopausal symptoms: • Get a regular, good night’s sleep • Eat a well-balanced, healthy diet

• Wear light, lose clothing • Drink cool drinks • Use a fan and/or air conditioning

• Take part in regular exercise such as running and swimming

• Avoid potential triggers such as spicy food and smoking

• Try to reduce stress levels

• Try to reduce stress levels

• Practice relaxation techniques such as yoga, Tai Chi, meditation and breathing exercises

• Lose weight if overweight

CREDIT: GETTYIMAGES

• Reduce alcohol and caffeine intake

MEDIAPLANET

HEALTHAWARENESS.CO.UK 5

AN INDEPENDENT SUPPLEMENT BY MEDIAPLANET

CREDIT: GETTYIMAGES

Enhancing sexual wellbeing during the menopause Samantha Evans Co-founder, Jo Divine

When dealing with a myriad of menopausal symptoms, sexual wellbeing can take a backseat, especially when you experience vaginal dryness or atrophy, decreased sexual sensation or low libido, making it feel painful or uncomfortable or simply not working for you anymore.

M

any women abandon sex or continue to endure painful sex, which is neither pleasurable, good for their

vaginal health or their relationship because they struggle to talk to their partner about it. Women who previously had a good sex life may get frustrated that the menopause has impacted upon it.

Use lubricant One simple way to increase sexual wellbeing, which promotes vaginal lubrication, is to use lubricant.

It’s important to maintain vaginal health by using a pH balanced lubricant. Many commercial lubricants/moisturisers contain ingredients that can irritate the

tissues of the vulva and vagina, including propylene glycol, parabens, perfume and dyes in addition to ‘tingling’ or ‘warming’ ingredients too.

Always check the ingredients before you buy or ask your GP before they prescribe you a product.

Nothing is worse than lubrication causing itching or stinging!

Have regular orgasms Enjoying regular orgasms increases vaginal lubrication, reduces stress and exercises your pelvic floor.

Orgasms can also improve the

quality of your sleep, a common problem during the menopause, as the release of feel-good endorphins induces a state of relaxation helping you drift off.

Exercise your pelvic floor muscles Regular pelvic floor exercises can make orgasms feel stronger and help incontinence issues.

Don’t give up Don’t give up on your sex life, talk to your partner, use lubricant, explore sex toys, be imaginative, adventurous

and have fun in whatever way feels pleasurable for you!

I believe sexual health and sexual pleasure go hand-in-hand. By working with medical professionals, we hope to encourage patients and healthcare professionals alike in talking more freely about sexual problems. A health issue doesn’t mean your sex life will have to stop!

Read more at

healthawareness.co.uk

6 HEALTHAWARENESS.CO.UK

AN INDEPENDENT SUPPLEMENT BY MEDIAPLANET

MEDIAPLANET

CREDIT: GETTYIMAGES

Menopause in the workplace: what are your rights?

Deborah Garlick Founder of Henpicked, Menopause in the Workplace

Managing menopause in the workplace benefits employers and employees.

Research shows good employers are putting this in place and it’s time all did.

W

omen are working for longer. The Office of National Statistics figures show menopausal women are the fastest-growing demographic at work. Thankfully, more employers are putting the right awareness and support in place.

Over 5,000 people took part in our recent survey with the TUC and over one in ten respondents said their employer has a menopause policy or

guidance in place. Three years ago, that was rare.

How could menopause affect a woman at work?

Menopause symptoms are individual. The top six symptoms women said affected them at work were fatigue and insomnia, hot flushes, difficulty concentrating, memory recall, anxiety and worry.

Many people don’t appreciate these can be as a result of menopause.

Knowing they are is often a huge relief for women experiencing them.

Yet this is a natural phase in every woman’s life. If you experience symptoms, talk to your GP or a qualified menopause expert.

If your symptoms are affecting you at work, check what support your employer offers and ask for the support you need.

Menopause symptoms are protected under employment law through the Equalities Act 2010.

It’s an employer’s responsibility to support employees at work. Even for those without menopause policies, existing policies such as sickness or flexible working will cover menopause.

Your line manager can help Research by the Faculty of Occupational Medicine (FOM) and the Government Report tells us the majority of women are unwilling to

HEALTHAWARENESS.CO.UK Get in touch for the next edition (0) 2036 420 736 georgia.gerstein@mediaplanet.com uk.info@mediaplanet.com @mediaplanetUK

disclose menopause-related health problems to line managers.

Women often don’t want to be thought of as getting older, or to even feel they may be discriminated against.

There’s absolutely no need to feel this way, a woman could be working for 20 years and be menopausal.

Symptoms may be a bump in the road but can be alleviated. It’s time we accepted that and normalise conversations.

Your line manager is there to help and may well surprise you – talk to them. If you really can’t face it, you could talk to HR or Occupational Health. Establish changes that could be made – such as an extra uniform

or flexible working. These may only be temporary.

Menopause awareness and support works for everyone Experience tells us that colleagues – men and women – are grateful to employers who put the right support in place. As women continue working later in life it’s important they ask for the support they may need and find out what your employer is doing.

Read more at

healthawareness.co.uk

MEDIAPLANET

HEALTHAWARENESS.CO.UK 7

AN INDEPENDENT SUPPLEMENT BY MEDIAPLANET

CREDIT: GETTYIMAGES

Managing menopause naturally Maryon Stewart BEM Healthcare Expert and Pioneer, Natural Menopause Movement

Almost every day of my life I hear horror stories about women who are at their wits’ end when they reach menopause.

I

n my latest survey, of over 1,100 women, 96% said they weren’t prepared for menopause and 68% said they were shocked by it.

But the good news is that published medical research clearly shows that menopause doesn’t have to be the beginning of the end of quality life, because, with a little science-based knowledge, it can be the beginning of a whole new, fulfilling chapter in a woman’s life. For over 27 years I have been successfully helping women become symptom-free and feel better than they can remember.

Whether women are suffering with frightening panic attacks and palpitations, melting with hot flushes, battling insomnia due to night sweats, aches and pains making them feel prematurely old, vaginal dryness and low libido taking

sex off the menu or scary brain fog, making dietary and lifestyle changes is a viable option for women at the time of their menopause, as detailed in the NICE Guidelines on Menopause.

Women usually hear about hormone replacement therapy (HRT), but they are often not familiar with their alternative options.

Here are some of my top line recommendations to manage menopause naturally.

Adapt your diet for menopause Research indicates that hormonal balance can be affected by the levels of nutrients in our body, and it’s widely acknowledged in medical literature that women often have low levels of important nutrients.

One key nutrient to include is magnesium, which we found to be in short supply in between 50% – 80% of women. When taken together with other essential nutrients, such as B vitamins, vitamin D, calcium, zinc, and fatty acids, it has

shown a positive influence on brain chemistry and hormone function.

Good sources of magnesium include fresh fruit and vegetables, especially green ones.

Essential fatty acids – like those found in vegetable oils and oily fish, like salmon – also play a big role in hormone health. Those who consumed a diet rich in omega-3s had fewer mood swings, better libido and far more energy.

Try taking phytoestrogens Consume Mother Nature’s phytoestrogens throughout the day and evening to satisfy the needs of the oestrogen receptors in our cells. These plant foods have a molecular structure so similar to our own oestrogen, we can fool the brain into thinking we have normal levels of oestrogen, again resulting in the thermal surges we know as hot flushes and night sweats disappearing altogether.

Phytoestrogen has been hailed by many as the natural alternative to HRT, and can be found in everyday

foods like soya, flax seed, and supplements of red clover.

Supplements of isoflavones As much as we try, it’s not always possible to achieve all the nutrients we need by diet alone. That’s why I recommend scientifically-based supplements that support your body nutritionally.

For many years, I have recommended the isoflavone-rich supplement, Promensil, which is a natural, standardised red clover product. It contains high concentrations of the isoflavones genistein, daidzein, formononetin and biochanin. Red clover is the richest known source of these four estrogenic isoflavones. It has up to 10 times as much of these isoflavones as the next richest source, soya and has a better bioavailability and therefore absorbs better in your body.

Exercise releases endorphins Exercising regularly releases the happy hormones called endorphins,

which help relieve menopause symptoms, making irritability and mood swings easier to cope with.

Even going for daily walks or doing some yoga stretches can help keep your body functioning well. As a bonus, exercise helps to speed up our flagging metabolism at midlife, burning up fat rather than it setting around our middle.

Practice some relaxation techniques Relaxation techniques such as deep breathing, visual imagery, and mindfulness can help to significantly reduce hot flushes and relieve other menopausal symptoms including anxiety, insomnia and fatigue.

Taking these tips on board can help relieve your symptoms, leaving you feeling happier, more focused, less irritable and much more like your old self.

CREDIT: GETTYIMAGES

Menopause – everything you need to know Andrea McLean Author of ‘Confessions of a Menopausal Woman’ and Co-Panelist, ITV’s Loose Women

What is the menopause? Ask a hundred people and you will get a hundred different answers. I asked 240,000 people (my social media followers), ‘What does the word ‘menopause’ mean to you?’ The response I got was a tsunami of symptoms and feelings, from women who felt helpless, anxious and lost.

I

then did what anyone else would do when they want to know the answer to something; I googled: ‘What is the menopause?’. It offered me 24,300,000 answers…

According to nhs.uk: ‘The menopause is when a woman stops having periods and is no longer able to get pregnant naturally… The menopause is a natural part of ageing that usually occurs between forty-five and fifty-five years of age, as a woman's oestrogen levels decline. In the UK, the average age for a woman to reach the menopause is fifty-one.’

Oestrogen, in the simplest terms, is a sex hormone that women produce, which is responsible for development at puberty.

As well as regulating our menstrual cycle, it also affects how our skin looks and how strong our bones are.

Symptoms of menopause Each one of us will experience the buildup to the menopause in our own way, and there is a whole host of symptoms and experiences that come under the umbrella term of ‘menopause’.

There are apparently 30 signs of being menopausal, these include: • Anxiety and stress • Bloating • Breast tenderness • Brittle nails • Body odour changes • Depression • Difficulty concentrating • Dizziness • Overwhelming fatigue • Gastrointestinal problems • Bleeding gums • Hot flushes • Hair changes; increased facial hair, but thinning hair elsewhere • Headaches, especially at the start of the menopause • Bladder incontinence • Irregular pounding heartbeat • Irregular menstrual cycle • Irritability • Itchy skin • Joint pain • Loss of libido • Memory lapses • Mood swings • Muscle tension • Night sweats • Osteoporosis • Sleep disorders • Tingling extremities • Vaginal dryness • Weight gain How beneficial is HRT? Menopause Consultant, Dr Tina Peers MBBS, DRCOG, DFSRH, MBCAM says hormone replacement therapy (HRT) can

help women with both the physical and mental symptoms of menopause because it stimulates the oestrogen receptors and so stops these symptoms occurring.

HRT has got some bad press over the years, with headlines linking it to an increase in breast cancer, for example.

Women are worried about using it and GPs are reluctant to prescribe it.

According to Dr Peers, The Women’s Health Initiative study in 2006, “overstated risks − many of which were not statistically significant and did not take account of confounding factors, in a very poorly designed study.” She believes women need re-educating about HRT. But, if they would still prefer not to use HRT, or are unable to, then diet, exercise, food, cognitive behavioural therapy (CBT), reducing alcohol intake and losing weight are all recommended.

How can my diet help with menopause?

Here are some pointers: • Eat plenty of calcium: milk, yoghurt, kale, canned fish complete with the bones • Eat less junk – your body is going through a tough time, so give it the nourishment it needs • Drinks lots of water − it’s not only good for the body but it helps your skin stay plump and hydrated • Drink less alcohol, especially in the evenings, when the sugar

slips through your lips and lands on your hips, and you’re not moving from in front of the telly to work it off • Stay clear of spicy foods in the evening too, especially if you are suffering with night sweats – they only make things worse • No caffeine after lunch – it only adds to the sleepless tossing and turning Let’s talk about sex Whatever your experience of sex has been throughout your life − good, bad or indifferent − the menopause is one of those times when it most definitely changes.

The menopause makes you feel more sensitive about everything: criticism that comes your way, your body, how you think you look, how you think they think you look! A lot of your conversations will be happening in your head and may not be happening in his, so keep this in mind. Explain that you aren’t feeling like you used to and try and find a way for you to work through it together.

Talk about it Whether it is talking to your doctor, your friends or your partner, getting the best support you can means asking for it. You only live once, so make sure you live a life that is on fire for all the right reasons!

Read more at

healthawareness.co.uk