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

Hi @Miranda15110. I am so pleased that HRT has helped with your symptoms. It is very common that there are still some symptoms remaining that HRT does not cover. It is useful to determine what is the cause of the symptoms - it is not always menopause. Although the symptoms you mention may be related to menopause. I would suggest going back to your GP to discuss your options - including increasing your HRT dose, discussing the use of testosterone (off license in the UK) for increasing libido, and other options such as more exercise to help manage anger and provide more energy to help with the tiredness.

Unfortunately I sought advice from my GP just before the first lockdown so didn’t have the greatest experience but why isn’t it something we talk about more. Bearing in mind it affects 50% of the population?

Also, are there other alternatives to HRT if I’m overweight?

45 and suspect I'm in peri menopause. Periods have always been regular but have become much lighter. I'm now experiencing spotting mid cycle as well as constant sore boobs and pmt. is this spotting due to peri menopause or should it always be investigated?

I’m mid 40s and have never thought that much about menopause. This thread is making me worry. Is there any good news?

@Kweenxo

Can menopause cause changes in personality?

Hi @Kweenxo This is a really interesting question. It depends what you mean by changes in personality. Mood swings, feeling more angry and anxious are common menopausal symptoms, as well as the psychological effects of all the other symptoms a woman may face (e.g. difficulty sleeping, brain fog and hot flushes). So I would definitely expect that women do change in their behaviour and feelings as there is a lot going on. Also, it is a time of great change and an opportunity to practice more self awareness and self care which can lead to more positive changes in personality.

@Theredjellybean

Would hrt help with change in fat distribution pattern. I eat the same, exercise the same, and scales say same weight but in the last Yr I have got much bigger around chest, upper abdominal area and back fat. I eat well, run marathons, strength train x 2week. Its so depressing I am 52, perimenopausal with mirena fitted ready for hrt.. But no other symptoms so held off starting oestrogen gel

HI @Theredjellybean This is a very common complaint. As we get older our metabolism slows down, so in essence even if we eat exactly the same and do as much exercise as we used to, we would put on weight. So you have to eat more healthily and do more exercise to keep up! Many women enter menopause already overweight, and the falling oestrogen levels affect how and where we store fat. Hence you see the changes you mention. HRT will not be able to directly affect this. It is better to target it with exercises specific to your new fat distrubition. However, enabling yourself through lifestyle, nutrition and potentially HRT to sleep and feel better, can help many women to better manage their weight.

@Nordman

I am hoping to have fertility treatment to conceive using both donor egg and donor sperm (unfortunately both are necessary). While trying to save up the funding I now believe I am peri menopausal. Will this affect the treatment or outcome? I am 43, mother also had early menopause.

HI @Nordman. I can understand you are currently on a very difficult journey and this is an additional concern. It is very difficult to say with the information you have given. But if you are perimenopausal, then your hormone levels are starting to fluctuate and this could have an effect on the effectiveness of fertility treatment. If you have not done so already, I would recommend going and seeing a fertility specialist to discuss your concerns and be assessed, so you can understand what your options look like.

@sharond101

I am going through early menopause and my Gynaecologist insists I need to take HRT to protect my heart and bones. I am not tolerating it. I have tried several different preparations but I either get very depressed and anxious or do not sleep at all. How important is it to take something? Iam 38 and this started 18 months ago.

Hi @sharond101 I am sorry that you are having difficulties tolerating the HRT so far. It is unusal to see difficulties sleeping with HRT (it is usually the reverse!).Your GP sounds as though they are helping you through this and they are correct to outline the risk of osteoporosis and heart disease which HRT can help reduce. I would suggest you keep trying different preparations - this should include route (patch, gel, spray, tablet), dose, type of hormone and pattern of medication (e.g. monthly or 3 monthly cycling).

@tinatulip78

I am a 42 year old mother of 9( all biologically mine) for the last few years I have had extremely heavy monthly periods which have affected my normal daily life and work as I was unable to leave the house for the first couple of days. I had an internal scan done and there was nothing untowards indicating as to why my periods have become so heavy, following that my GP prescribed Tranexamic Acid tablets which have been a godsend. I would like your opinion, considering the investigations failed to explain a reason, do you think I could be going through the menopause?

Hi @tinatulip78. It sounds as though you have undergone all the necessary investigations and I am pleased nothing untoward has been found. Also, I am pleased Tranxamic Acid has helped. However, there are additional options to help here. The Mirena IUS can be particularly helpful in lightening periods and definitely worth speaking to your GP about.

@popsocks

I have started feeling very sick and headachy every few months a day before my period starts. So bad I spend the day in bed sleeping and take a day off work. My period is then very heavy and crampy. I have not experienced this at all until I turned 41. I also get very hot although am not sure it is hot flushes as its not what is described. Is this part of perimenopause? As soon as my period starts, the sick feeling goes away and I kind of forget until it happens again. Would seeing the GP help or is it something I have to put up with until the actual menopause happens?

Hi @popsocks , it does sound as though you are facing perimenopausal symptoms and I would suggest you take note and track them a little more. It is then definitely worth going to see your GP and explaining your symptoms. It sounds as though you could benefit from relief of these symptoms especially if you are having to take time off work, and there are several options to discuss with your GP depending on your medical history.

@Ledkr

I had breast cancer aged 27 and had a double mastectomy and radio and chemo. No glandular involvement. At 47 i had my ovaries removed as i have the braca1 gene. I was put on hrt about 2 years later after my breast specialist said it would be safe as my ca was oaestrogen negative. I had tibelone with good results. So about 2 years later and just before the march lockdown, a gp was horrified that i was on it and took me off it pending a referral to gynaecology. This has not happened and the appointment i was given for tomorrow via phone was today cancelled. I dont suffer many physical symptoms but am more concerned about the long term effects on my bones, brain and heart and I have literally no sex drive whatsoever and dreading having any vaginal dryness or worse and ive heard it can also protect against covid. I work in a school so as much protection is vital. Can you advise me what to do now and is it safe for me to have something.

Hi @Ledkr, I am sorry that you are caught up in this. However, you should push to see your GP (which can be a telephone consultation) or seek out another GP. A referral to gynaecology is in fact not necessary. Your GP needs to contact their local breast oncologist and ask their specialist advice. Previous breast cancer is not a contraindication to HRT, especially if you take HRT as a patch, gel or spray. So please push on and I hope you get it sorted!

@PickledChicory

I'm hoping Im still a few years off the menopause but would like to know as far as possible how I can best prepare. Is it worth speaking to older female family members about there experiences, is reproductive family history likely to have a bearing? Should I concentrate on my physical health and other environmental factors, would these have more of a bearing on my likely experience? Are there any particular vitamins/minerals or things I can introduce into my diet?

Hi @PickledChicory, I think it is a great idea to speak to other females in your family but also friends etc to get a better understanding of what to expect and what to look out for. If a woman is informed heading into their menopause journey, they are more likely to have a better outcome. However, every woman's journey is different - the timing, duration and experience, so whilst information from female relatives is very useful, it does not mean yours will be like their experience. Heading into menopause, you want to be in your best health physically and mentally. So if you have any current medical issues, work to optimise them as far as possible. It is also a great time to review your diet and exercise - your overall lifestlye. I cannot emphasise enough how important this is. Medications including HRT are not magic pills which can solve all problems, and therefore women should also look at their lifestyle too. Around menopause is a great opportunity to review your individual lifestyle and see if you are making the best choices. Many issues during perimenopause and beyond respond to an improvement in diet and having an active varied exercise plan. Regarding diet, as we age our metabolism slows and due to the falling oestrogen level, fat is redistributed to central areas - this poses a bigger heart disease risk. So overall, it is recommended to ensure you are eating plenty of fruit and vegetables, minimise the proportion of fat and carbohydrate in each meal and ensure you are eating plenty of fibre. Look at incorporating some meat free meals to help with reducing fat content. Also, focus on reducing your sugar and salt content. Take a look at how much caffeine and alcohol you are drinking. And of course if you are smoking, use this time to stop. There are many different cessation programmes available and some are on the NHS. There is much more to cover here in diet and exercise, it a very broad topic. To help women optimise their lifestyle, we have developed a programme on the Stella app. This offers specific advice about diet and exercise for women during their menopause journey. You can sign up for the waitlist at www.onstella.com

@smartiecake

I'm 48 and have no obvious symptoms and still having a period roughly every 4-6 weeks and they are very light, maybe a day of some light blood loss. I feel fine, but should I be starting to take any supplements? And at what point do i go to the GP?

Hi @smartiecake. I would advise taking calcium and vitamin D if you are not getting adequate levels in your diet. Otherwise I would be led by your symptoms and it seems as though you are doing well currently, which is great news. As we say, everyone experiences a different menopause. If things change and you suffer issues as discussed across these questions, do seek out help and advice.

@BlackCakeyStuff

I have vaginal atrophy and use a pessary every day. I previously used the ring but it stopped working for me after 8 months. I am starting to get pain and urinary symptoms again - are there any other treatments I can try? I'm allergic to the cream.

Hi @BlackCakeyStuff. I am sorry you are having such pain and discomfort, especially in such an intimate area. Sadly, vulval and vaginal symptoms such as atrophy and urinary symptoms are very common during the menopause journey, and unlike most symptoms, actually may continue and worsen as we get older. This is due to the response of the tissue to the lack of oestrogen over time. It can become a very debilitating condition as it is relentless if not managed appropriately. Please see my answer to Montydoo for more treatment options.

@famousforwrongreason

Imm using sandrena gel alongside the progesterone coil. I am really struggling with my weight at the moment annd cutting calories doesn't make any difference. Does Sandrena cause weight gain? Is there any way to counteract this when metabolism seems to have slowed down so much? (I have disabilities and struggle to exercise too).

Hi @famousforwrongreason @SantasBritchesSpelleas and @Twistiesandshout

There is no evidence that HRT causes weight gain. It can cause fluid retention when you first start HRT but this usually settles. It is more the consequence of ageing and our metabolism slowing. Then menopausal symptoms and life can make it hard to stick with a healthy diet and regular exercise. It is however key to persevere and maintain a healthy lifestyle and get to and keep to a healthy weight, as it has such positive effects now and in the long run.

@starofandromeda

Hello and thank you for reading my question! I'm 42 years old and wonder if I might be experiencing perimenopausal symptoms. For the last year I've had so many physical symptoms and changes in my mental health that I increasingly wonder if my hormones may be contributing. My hair is thinning, I have gained weight - particularly over my abdomen, I wake up in the night very hot and have flushes after eating spicy food (but not at other times in the day) I feel very achy and have been suffering with a lot of anxiety for 12 months now. I take the progestogen only pill for contraception and can't take the combined pill as I have migraine with aura. I have been getting a lot of migraines the last 12 months too! My blood tests and FSH x 2 at the GPs are normal. I don't get periods on the mini pill. My GP is a bit dismissive as my bloods are normal but I would be quite keen to trial HRT. Is this something you would consider even though my FSH is normal? I don't have any contraindications to this. Thank you so much for your advice!

Hi @starofandromeda FSH tests are notoriously inaccurate especially if you are on the progesterone only pill! I would go with your symptoms which suggest you are perimenopausal. I would go back to your GP or seek out another who you can discuss your symptoms with and have a fully informed discussion about your management options. HRT is one option but it rarely solves all problems. You need to optimise your health through diet (e.g. reduce caffeine and spicy food for helping hot flushes), exercise and try additional ways to help with your symptoms. The British Menopause Society recently published their 2020 recommendations on hormone replacement therapy and highlight that there should be a holistic and individualised approach in assessing and advising women, with particular reference to lifestyle advice and dietary modification. The Stella app will offer you exactly this all in one place, providing personalised programmes based on your symptoms that can be used with or without other treatments such as HRT. Sign up to the waitlist at www.onstella.com

@MrsFHolmes This may help with your question too!

@Fumnudge

I would, I think, prefer to get through my pending menopause without drug intervention unless it becomes unbearable but on the flip side I'm very vain and hate my aging face already, does HRT hold back the aging tide? Having taken the combined contraceptive pill before with many side effects including weight gain and horrid, really nasty moods I'm worried about taking HRT. Are the drugs that caused this in the pill also in HRT? Thanks

Hi @Fumnudge collagen nicely 'plumps' all of our tissues. As you say, older women's faces are less 'full' and skin is less elastic - this is due to falling collagen levels as we age and it happens to men and women. However, in women, the falling oestrogen also has an effect on collagen as well as on our muscles. It is unlikely that replacing oestrogen will affect the loss of collagen and elasticity. Also HRT cannot be prescribed for cosmetic purposes only. To your other point, HRT contains oestrogen and if combined, progesterone too. However, compared to the combined oral contraceptive pill,the doses in HRT are much lower and the oestrogen is not synthetic.

@Tipster100

I am perimenopausal and went to see my GP recently. She said I can't take HRT as I get migraines with auras. She said instead I should take anti depressants which would do the same thing. Is that the standard advice for migraine sufferers? I thought it was Odd. I'd love to get a specialists view but not sure how to do that now. Thanks for your help.

Hi @Tipster100 and @hutchy73 This is a common question. HRT cannot be grouped together in this way since there are many different ways to take HRT. I do not know your entire medical history, but people with migraines can look to take HRT as a patch or gel just not as oral HRT tablets. It is worth going back to your GP and asking about the HRT patch.

Thanks for your reply. I will definitely start keeping track of things and hopefully be able to get things under control once I've seen a gp.

DrMichelleGriffin thank you so much for taking the time to reply to me. It gives me such a good place to start from so I can reapproach my doctors surgery. Very grateful.

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?

Many thanks @DrMichelleGriffin really helpful to have some clarification.

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

Hi @Gnome134 insomnia is a a common menopausal symptom. Please see my response to purplepandas for more information. With regard to the combined contraceptive pill - it contains oestrogen and progesterone and therefore can be used for symptoms of HRT and contraception at the same time. In this way, it is replaces any lack of oestrogen and so can 'mask' symptoms of menopause. Women cannot use the combined contraceptive pill if they are are over 35 and smoke, have high blood pressure, focal migraine, and complicated diabetes. If this is you, you should go to your GP and discuss alternative management to provide contraception and offer relief from any 'unmasked' perimenopausal symptoms.

@museumum

I’m 44 and have a Mirena which needs replaced in two months. I’m not sure if I should get another? I don’t have any periods so how will I ever know if I’m in menopause. I feel pretty crappy this year and have ballooned in weight but assume this is just how I am now? Is there any way to lose weight at this time of life? I literally cannot seem to burn fat at all, I will collapse from lack of energy before my body will burn fat.

Hi @museumum please see my answer to Notjustacigar for more information about changing the Mirena IUS. Regarding your weight, this is a very common complaint. As we get older our metabolism slows down, so in essence even if we eat exactly the same and do as much exercise as we used to, we would put on weight. So you have to eat more healthily and do more exercise to keep up! Many women enter menopause already overweight, and the falling oestrogen levels affect how and where we store fat. Try to target it with exercises and changes in diet - but the key is to do it in an appropriate and sustainable way that is suitable to your lifestyle. We have built a Nutrition and Exercise programme in Stella exactly for this which works with busy women struggling to control their weight throughout the menopause journey. You can sign up for the waitlist at www.onstella.com