MENOPAUSE can feel like a confusing and very isolating time.
But at any given moment, a third of the female population is going through it.
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There are so many resources out there.
And the most important thing I can tell women is that if their symptoms are affecting their lives, see a GP or nurse.
This week, as Menopause Awareness Month draws to a close, here are a selection of the questions readers sent in on the topic.
Q: HAVE been on HRT for quite a few years and my repeat prescription includes testosterone.
The doctor has taken it off without telling me why.
When I eventually spoke to him he said it’s because he can’t prescribe it any more and it has to be done by a specialist.
Can you tell me why this is and how I can get around it?
A: Testosterone is recommended for women by the National Institute for Health and Care Excellence solely for low libido and lack of sexual desire associated with menopause, and only if HRT including optimal levels of oestrogen has been tried first and hasn’t worked.
But it is not licensed to be prescribed for women.
The General Medical Council states that doctors should usually prescribe licensed medicines in accordance with the terms of their licence.
However, they may prescribe unlicensed medicines where, on the basis of an assessment of the individual patient, they conclude, for medical reasons, that it is necessary to do so to meet the specific needs of the patient.
What that means is that the GP should only go ahead and prescribe it if they feel they have the correct knowledge and expertise to do so — in other words, if they’re a menopause specialist.
Some GPs who have had additional training in menopause can prescribe testosterone, too.
Typically, it’s down to a GP to decide if they have the correct expertise to prescribe it.
If they do, it means they’re taking on all of the risk should something go wrong.
What’s unusual in your case is that the GP was prescribing it and then stopped — have you had a new GP take over your care recently?
If not, it’s worth making an appointment or doing an online consultation to find out what’s happened.
If there are no GPs who are able to prescribe at your practice then you could ask for a referral to a menopause specialist clinic.
Q: I AM in my late forties and taking thyroid medication.
Can I take perimenopause supplements?
The only symptoms I have are brain fog, low mood and sometimes sleep problems.
I have low confidence so some of these issues could be down to this.
A: I’m glad you’ve written in with this question because quite often women turn to supplements around your time of life but don’t always check whether this can interact with prescription medication.
It’s important to do so.
I’m assuming the medication you’re taking is levothyroxine for an underactive thyroid.
With levothyroxine specifically, generally, the advice is to take it when you wake up, on an empty stomach.
It’s advisable to take supplements later in the day, at least four hours after, to reduce any risk of them altering the absorption of the thyroid medication.
But it is important to still check with the pharmacist.
If pharmacists don’t feel well- equipped to tackle that, then check with the GP.
Once you’re cleared to take supplements, there are several types that can help in menopause.
Black cohosh has been found to help with hot flushes, and isoflavones can help with night sweats.
A magnesium supplement can be beneficial as our bodies need magnesium for the production of progesterone, oestrogen and testosterone.
Calcium absorption can decline during menopause but is needed to help prevent osteoporosis, which becomes more likely during and after menopause too.
However, calcium is one that can alter the absorption of levothyroxine if taken too close together.
I also note that you mention your low confidence.
Sometimes people who lack confidence are less likely to approach their GP.
If these symptoms are bothering you significantly then please do have a chat with your GP or a nurse at your practice.
They can discuss the best options for treatment with you, including weighing up the various forms of HRT.
Q: I DON’T know where to turn, I feel so isolated and alone.
I’m a married mum with two sons and I feel like no one understands menopause.
I’m forgetful, I cry a lot and my husband seems to think I’m mad or weird.
A: Menopause can be an incredibly isolating and lonely experience if the people around you don’t understand what you’re going through.
You don’t say if you’re on any treatment for menopause symptoms — if not, the first thing you need to do is make an appointment with your GP.
Write a list of all your symptoms for your GP and make sure you leave the consultation with a resolution you’re happy with.
If you don’t feel understood by the first doctor you see, please confide in the receptionist, explain and ask to see another, or a nurse.
Next, if the men in your life are amenable, try a family meeting.
You don’t say how old your sons are.
Consider explaining to them that what you’re experiencing is, in fact, like a second puberty.
You are, of course, who you always were, but things are a bit up in the air and you need their patience and understanding.
You were there for them — or you will be there for them — when they go through puberty, mood swings, irrational behaviour and drama.
Explain that you need to prioritise yourself a bit more than you have been.
You can’t pour from an empty jug so whatever you enjoy, find some time to do it.
Reconnect with old friends or make time to see the ones you have close to you, and share what you’ve been going through.
I’m sure that many of your female friends will start to reciprocate with their own experiences.
There are lots of online support networks too — check out the Issviva Facebook group for starters.
If you don’t exercise already, start with some walking.
Being outdoors does wonders for helping a confused head.
Read more on the Scottish Sun
Good luck:
This can be a tricky time for the ones we love as much as it can be for the women going through it, so you must start by letting them in and making sure they understand and that you all pull in the same direction.
Moles make me feel ugly
Q: THE skin on my neck is very bumpy.
There are marks like skin tags and flesh-coloured “moles”. It makes me feel ugly.
I am on HRT – though still trying to find what is right for me.
A: Like women didn’t have enough to deal with during menopause, their skin starts to change too.
The loss and lack of collagen in menopause means skin starts to thin and benign growths such as skin tags and keratoses may become more evident.
The causes of this include a decrease in the number and activity of skin cells and reduced levels of oestrogen.
There’s nothing that can be done to safely remove skin tags at home, despite what the internet might say. It can cause excessive bleeding, infection and scarring.
The first port of call should be your nurse practitioner, who can do an assessment to make sure the skin changes aren’t concerning.
Unfortunately, removal is not covered by the NHS as it’s deemed a cosmetic procedure.
If you choose to go private, please make sure you use someone who is properly trained at skin surgery because skin tags can bleed a lot if not treated professionally.
The British Association of Dermatologists has a website where you can look for a registered doctor near you.
To support your skin during menopause and beyond, use a good SPF cream every day and moisturise the skin well twice daily.