Do you have questions about menopause? Ask Vira Health’s expert Dr Michelle Griffin - £200 voucher to be won

[CeriMumsnet]

Please note this Q&A is now closed for questions but you can see Dr Griffins answers here

Menopause can feel daunting and complicated. Maybe you’re perimenopausal; maybe your periods have stopped but you’re still having menopause-related symptoms. Maybe you’re going through an early menopause, or one brought on by medical treatment. Or maybe you’re just wondering what the next few years might hold for you and how you can best embrace (or at least get through) whatever may be heading your way. Vira Health is here to help, and their expert Dr Michelle Griffin will be answering your questions about everything to do with menopause from 18th to 27th Jan.

Here’s some more information about Dr Griffin: ‘Dr Michelle Griffin qualified as a doctor from University of Cambridge and specialised in Gynaecology, working in a number of hospitals in London and the East of England. She is a Member of the Royal College of Obstetrics and Gynaecology and has completed her training with the Faculty of Sexual and Reproductive Healthcare. She has worked in the NHS for over a decade, as well as for the Department of Health, Public Health England and the World Health Organisation on women’s health projects. She is leading the clinical development of Stella, a new app to help you manage your menopausal symptoms'.

Here’s what Vira Health, the team behind Stella has to say: “Women spend on average 7-10 years in menopause, with symptoms changing and fluctuating all the time. Yet, in the UK, less than 7% of women are satisfied with the care they receive. That’s not ok. Stella offers women personalised plans to help manage menopause symptoms better with support from an expert coach. From insomnia to weight gain and anxiety to incontinence issues, Stella supports women to find relief backed by proven science. Plans are customised to your needs and you can track your progress quickly and easily.”

If you feel in the dark about the symptoms of menopause, you’re looking for advice on managing its effects in day to day life, or you have questions about treatment or care options, you’re in the right place. Share your questions for Dr Griffin below and you’ll be entered into a prize draw where one Mumsnet user will win a £200 voucher for the store of their choice (from a list).

Thanks and good luck!

MNHQ
Insight Terms and Conditions apply

[claza93]

Thank you x

[DrMichelleGriffin]

Thank you all so much again for all your questions! This thread officially closed on the 27th Jan but there were so many good questions in the last few weeks, we wanted to come on and answer them!

You can follow Dr Griffin on Instagram @thedrcalled) for more information and useful guidance on menopause and women's health. You can also check out new blogs on these topics and more at //www.onstella.com/the-latest!

[DrMichelleGriffin]

@Ntinyn

What is it really like to go through the menopause without hormones? How do you know you need them?

Hi @Ntinyn every woman's menopause journey is different and some women suffer terribly with symptoms and other women do not. You should be guided by your symptoms with regard to taking HRT. The benefits and risks of taking HRT are specific to each woman, their age, medical history, family history and their own symptoms. It also needs to take into account how you feel with regard to risk - please see my blog on HRT for more information here.

[DrMichelleGriffin]

@Whatapickle78

Is frequent urination and dull, burning pain (in bladder area) a symptom of perimenopause? It’s much worse at night and is keeping me awake!

I have been for several UTI tests and all are negative. Recently had a vaginal ultrasound which was fine too.

I’m 42 and have been taking oestrodiol gel and urrogestan for 1 year.
Could the HRT be causing it?

Thanks!

Hi @Whatapickle78 and @MiddleOfThePack see my response to Montydoo for advice on this.

[DrMichelleGriffin]

@LoveMySituation

I'm 42 and am in perimenopause. My symptoms thankfully, are much better now I'm five years in, which I'm glad about as I read they just get worse and worse until periods actually stop. Not on HRT. My question is after menopause, do oestrogen levels fall as low as they were before puberty started, and if so, why is HRT seen as having a protective effect on bones, heart etc, when we did without these hormones all through childhood?

Hi @LoveMySituation this is a really interesting question! I am glad your symptoms are better. Yes postmenopause your oestrogen levels are low. The body is making the less active form of oestrogen, oestrone, whereas post puberty and up to the point of menopause, the body mainly makes oestrodiol which is much more effective. Pre puberty, our bones are much 'younger' in age and 'fed ' and strengthened by growth hormone in both boys and girls and oestrogen has less of an effect here. However, post menopause, the lower oestrodiol levels lead to osteoporosis.

[DrMichelleGriffin]

@claza93

What are the early signs? I am 41 and getting more and more ratty every month - is this a symptom? Or could it just be a result of kids at home, trying to work from home and home schooling!

Hi @claza93 and @BabyMimzy please see my response to Cotswoldmama with regard to signs and you may want to look at our latest blog about the different stages of menopause here

[DrMichelleGriffin]

@flowersanam

How do you deal with heavy periods

Hi @flowersanam please see my answer to The ProvincialLady regarding heavy periods. This is one of the hallmarks of perimenopause but it is best to be reviewed by a doctor to check if anything else such as fibroids is causing or contributing to this. With regard to treatment, the Mirena is a very good way to regulate and reduce the flow of your periods and some women do not bleed at all when they have on.e. There are some other hormonal treatments available but it is needs to be matched to you, your medical history and the cause of the heavy bleeds.

[DrMichelleGriffin]

@Sid98

how to deal with cold sweats

Hi @Sid98, please see my response to Whispersofwickedness

[DrMichelleGriffin]

@DenisetheMenace

Hello. At 56, not suitable for HRT, I was prescribed paroxetine around a year ago to deal with disabling hot sweats. Simply couldn’t function properly. It’s worked extremely well (though have had to gradually increase dose from 10 to 30mg daily).

No ill effects but I’ve never liked taking meds if I can help it.
How long can hot sweats (day and night) persist, please?

Hi @DenisetheMenace, I am so pleased the paroxetine has helped. Night sweats and hot flushes typically settle after a few years once the body has settled with regard to the hormone levels. However, it is not unusual that some women can suffer from these symptoms for a lot longer. Please see my response to WhispersofWickedness for more information about what causes hot flushes and night sweats and some additional tips and tricks on helping with reducing and managing them.

[DrMichelleGriffin]

@RSItooloud

Has anyone asked about headaches yet?! Are these perimeno signs? Mine are so frequent - sometimes as much as 3 x a week and they can last a couple of hours or three days. I’m 44. Periods variable, might have a bit of weight gain but it’s slight say 2-3 lbs in recent years.

Hi @RSItooloud please see my response to Chalalala90

[DrMichelleGriffin]

@Oblahdeeoblahdoe

Is it ever too late to start HRT and can libido be increased without it?

Hi @Oblahdeeoblahdoe it is never too late to start HRT in that there is no set age limit for HRT as per the NICE guidance. However, it is about revieweing the benefits and risks for an individual woman to start HRT. So it is definitely worth having a conversation with your GP and/or menopause specialist to discuss HRT. Libido and desire is a very complex area which is unlikely to be solved completely by HRT. Some women find it helps enormously whilst others find it does nothing, and the same applies for testosterone. It helps to understands a bit more about the pattern of your libido and if there is anything else affecting it such a poor sleep leading to fatigue and no energy or interest in sex, similarly change in mood or weight concerns which affect self esteem and relationships. Please take a look at one of our latest blogs www.onstella.com/is-your-sex-life-part-of-your-menopausal-future for more information abour different experiences and suggestions about improvements. Also do sign up for our Stella app where we will have a plan dedicated to reduced libido.

[DrMichelleGriffin]

@Tray07

Please can you help I seriously don’t know what to do next ? I’m 46 on 4 pumps of estradiol gel daily and take utrogestan 7 days in my cycle as when I take them with citalapram I’m more of a fatigue then I usually am . I take vagifem for constant urine symptoms and burning dry sensation of my vagina . Plus testosterone as I had nill in my body . Each doctor tells me a different solution . I’ve cannot cope with feeling like everyday is dragging through mud and the fatigued plus vagifem isn’t really helping urine problems .

Hi @Tray07, I am sorry to hear about your symptoms, it sounds as though you ar having a really tough time. I would start by heading back to a doctor that you previously found helpful and listened to your problems. If you feel you are not getting the help you need, do look into getting another doctor or finding a menopause specialist. You are on HRT at the moment but it doesn't seem to be providing enough relief and as I say, HRT is a bucket of different medications. There are different types of hormone, doses and ways of taking it (see menopausewhatworks.com/ for more information) . You should discuss trying a different HRT with your doctor who can review your individual risks and benefits. There are also different types of vaginal oestrogen not just Vagifem that may work better for you to help with the burning sensation. Also, make sure you stop any irritants. You do not need to wash or douche a vagina. The vulva can be washed but only gently with a water, emoillient cream or a non perfumed, non allergenic soap. Then pat dry, do not rub. Wear comfortable, cotton underwear. And use a gentle non biological washing powder. Don't use scented sanitary or incontinence products, nor scented toilet paper. You can buy vaginal moisturisers over the counter in a pharmacy, these can also be given on prescription. It can take 3-4 weeks to see an effect. Do not use a non vaginal, 'body' moisturiser on your genitals as it will cause irritation. If you struggle with dryness during sex, you may want to use a lubricant as well (a moisturiser would be used more regularly, a lubricant is just used for sex, and you can be use both products). Note lubricants can cause irritation to a sensitive sore vulva and vagina. There are many different types - I would recommend a oil based one as it is thicker and creamier and lasts longer (water based feel more like natural lubrication but do not last very long and can become sticky). It is best to try a couple of different ones and see which you prefer.

[DrMichelleGriffin]

@Quietvoiceplease

What's a good menopause look like? What should we be aiming for?

Hi @Quietvoiceplease, every woman's menopause journey is different, and it affects every woamn differently. However, I would advise that a good menopause is one where you have sufficient control of your symptoms so that you can carry out your normal life and that you have taken the opportunity during this period of significant physical and mental change, to optimise your health as much as possible. The changing in hormones and how the body responds to that leads to significant increase in risk to longterm health conditions such as cardiovascular disease, dementia and menopause. Everyone can always imrpove their health and lower their risk of these conditions and so the menopause is a great time to check in and see what improvements they can make.

[DrMichelleGriffin]

@Kemosabeimalone

I had an unexpected but lovely surprise baby girl last year at 48 - she is ebf and my periods haven’t returned yet - is there any chance that I’ll go straight into menopause and bypass all the hormonal turmoil? Before she came along I was experiencing lots of peri menopausal symptoms such as night sweats / fatigue / mood swings etc Pregnancy and breastfeeding seem to be acting like a kind of hrt as I don’t have these symptoms now. Will I have my menopause at the original age I would have had I not become pregnant or have I created a kind of holding patten till I stop feeding?

Congratulations @Kemosabeimalone on your baby! Every woman's menopause journey is different and so I cannot predict how or when yours will be. However, if you were having peri menopausal symptoms pre pregnancy, you will return to that once your body has settled post birth and stopping of breast feeding.

[DrMichelleGriffin]

@Chalalala90

Can the menopause cause migraines to increase in severity and frequency? If so, what is the best treatment for this

Hi @Chalalala90, yes it can. Sometimes people with migraines pre menopause find their symptoms improve as they go through menopause hwoever, others find they start having migraines or they worsen. I would advise to review any potenttial triggers for migraines such as foods and alcohol and then eliminate them. You should also try to incorporate regular exercise into your routine which can improve symptoms but also provide other health benefits. If you find there is a hormonal element to your migraines, e.g. linked to your periods, some hormonal control with HRT may improve your symptoms. Please do go and disucss with your GP to review you migraine diary, triggers and discuss management options.

[DrMichelleGriffin]

@CathBookworm

Are wildly erratic periods for a year, at the age of 43 a sign of peri, and if so, would HRT be advised, even if few other symptoms, due to the health benefits (protecting against osteoporosis etc?)

Hi CathBookworm please see my response to UpOnDown regarding what happens to periods during perimenopause and onwards. It is best to be guided by your symptoms, there are other hormonal treatments that can helpregulate and lighten your periods, for example the Mirena. However, if you have other symptoms, you should discuss with your GP about the benefits of HRT and your specific risks.

[DrMichelleGriffin]

@StressedTired

If you are still taking questions, is it possible to have success with IVF using an egg donor if you are going through menopause? Does the menopause affect the ability to carry?

Hi @StressedTired, it depends where you are in your menopause journey. Please take a look at my response to Teaplease29.

[DrMichelleGriffin]

@VintageGill

Why is testosterone not licensed now for women who would benefit from it? Men are not treated similarly dismissively when they present with loss of libido. There is a care disparity for women.
You are correct that GPs are disinclined to prescribe a treatment that is not licensed and this makes life extra difficult for women, when their GP may not be supportive or informed. Is the removal of the licence part of a cost-cutting exercise? Surely if the topic of testosterone for women comes up very regularly, it’s time to reassess whether the licence should be reinstated.

Hi @VintageGill. I completely agree it is a care disparity and one that many women and healthcare professionals are trying to rectify. In the meantime do try to find a doctor who is happy to prescribe it and if you do use it, please leave a review at our website where we are collecting data to help boost the evidence base on this topic. Also,do take a look at our recent blog on reduced libido and sign up to the Stella app waiting list as we will be launching a plan fo reduced libido.

[DrMichelleGriffin]

@theresacoo

My skin is terrible recently - my cheeks are very dry and red easily.
could this be a sign, my periods are a bit ad hoc.

Hi @theresacoo, thinning and drying skin is a common change during the menopause journey as the falling oestrogen levels reduce the collagen in our tissue, which leaves the skin less plump and elastic. However, it is also very cold and windy and as we age our skin does become more sensitive to the weather conditions and central heating. Make sure you are drinking plenty and do use SPF everyday to protect your skin.

[DrMichelleGriffin]

@leafygarden42

When will the hot flushes end? Been going at least 3 or 4 years and just about had enough now...

Hi @leafygarden42 please see my response to WhispersofWickedness for advice on hot flushes.

[DrMichelleGriffin]

@yearinyearout

I'm 51 and started having irregular periods a few years ago. Sometimes I'd skip one, sometimes they'd be extra light and sometimes extremely heavy (flooding). I was fitted with a mirena coil to help with the periods and they've gradually disappeared altogether.

The other thing I've really suffered with has been bad mood swings, which I assume are hormone related because of the extreme changes, being completely fine for a week or two then in floods of tears, feeling really anxious, being angry and irritable. This tends to last a few days then I'm fine again. I can't really track this with my cycle as I don't have periods.

I spoke to my gp (phone) about this and three months ago was prescribed oestrogel, one pump on each arm daily. I'm not feeling a massive change, although my low moods aren't quite as extreme. I just tend to get irritable and a bit tearful rather than having full on panic attacks and breaking down like I was before. I phoned my gp again and was told I could increase to four pumps daily but this seemed to make me worse so I went back to two.

Is it normal to prescribe this without having any hormone levels checked? I'm not sure whether this is as good as I'm going to get or whether there's anything else to be done for me. Should I give the gel much longer to have an effect?

Hi @yearinyearout. I am glad your periods have improved with Mirena coil. We find it particularly helpful for these symptoms or erratic and heavy bleeding. Please see my response to Kweenxo regarding your mood swings. It is very common not to have your hormone levels measured whilst on HRT of whatever kind. Sometimes, it is used for some types of HRT for example a HRT implant or if a woman is taking a prescribed above maximal dose. HRT typically takes a few weeks and often months to provide the full relief so do give it time.

[Ntinyn]

What is it really like to go through the menopause without hormones? How do you know you need them?

[MiddleOfThePack]

I'm 57 and haven't had a period for about 20 years now [partly due to mirena coil but when I had a spell of a year or so without it, my periods did not come back. I've had breast cancer so can't use HRT.

The last couple of years I have started getting up to pee so often at night that I am now barely sleeping more than a couple of hours at a stretch. No discomfort and I can hold it in until I get to the loo, so not incontinent and daytime I'm fine.

I have tried a couple of drugs from the GP but they made no difference and I'm waiting to see a specialist in May.

Any advice would be appreciated!

[Whatapickle78]

Is frequent urination and dull, burning pain (in bladder area) a symptom of perimenopause? It’s much worse at night and is keeping me awake!

I have been for several UTI tests and all are negative. Recently had a vaginal ultrasound which was fine too.

I’m 42 and have been taking oestrodiol gel and urrogestan for 1 year.
Could the HRT be causing it?

Thanks!

[LoveMySituation]

I'm 42 and am in perimenopause. My symptoms thankfully, are much better now I'm five years in, which I'm glad about as I read they just get worse and worse until periods actually stop. Not on HRT. My question is after menopause, do oestrogen levels fall as low as they were before puberty started, and if so, why is HRT seen as having a protective effect on bones, heart etc, when we did without these hormones all through childhood?