Drenching night sweats, debilitating brain fog and irritability – does this sound familiar? As a female GP it is not uncommon to see women come in thinking they are losing their mind or going crazy.
Reassuringly, this is usually not the case at all. Menopause affects women in a variety of ways. Some might breeze through it, without so much as a hot flush, or a bad mood. Whereas for others it can be devastating, leading to relationship breakdown, job loss and mental health disorders.
For most, it seems to be somewhere in between, and it can feel like you are on an emotional and physical rollercoaster. This is because the oestrogen our body produces does not suddenly ‘switch off.’ It rises and falls, day to day, and in doing so plays havoc with our bodies. It is little wonder this can be an overwhelming and exhausting time.
For this reason also, there is little to gain from testing hormone levels, as they only reflect a moment in time. As a GP, it is far more useful to take a detailed history and enquire about what symptoms you are experiencing, and the impact this has on you.
The menopause consultation also provides an opportunity to check heart health by measuring blood pressure, cholesterol and blood sugars; as well as bone health and the risk of osteoporosis. We enquire about your mood, sleep, sexual health and lifestyle, breast/ cervical and bowel screening and so on. Hence there is a lot to get through in a menopause consultation.
Back to the troublesome symptoms of menopause, the good news is that for most women, menopause hormone therapy (MHT) is a safe and effective way to ease symptoms and restore quality of life. MHT works by replacing oestrogen and progesterone, in a steady and balanced way, reducing dramatic fluctuations. For many women, this means better sleep, clearer thinking, fewer hot flushes, and a noticeable lift in mood. This can lead to improved relationships, work performance, sex life and overall wellbeing. Many patients come back and say ‘I feel like my old self again,’ which is lovely to hear.
Of course, MHT isn’t a one-size-fits-all solution. MHT, like all medicines, has associated risks and benefits. Our role is to discuss how these might apply to you. Shared decision-making between you and your GP is at the heart of all good general practice. Treatment must not only be safe and effective, but also aligned with personal values and choices. The key is to having an open, personalised discussion with your GP about your symptoms, your general health and overall wellbeing. MHT is often only part of the picture. However for some, it can be life-changing.
Dr Georgie Olesnicky is a GP at Kirribilli Doctors with a special interest in menopause and women’s health.