How can HRT help my partner with menopause symptoms?
Not sure what menopause is exactly? Or HRT? Get clued up before reading this article.
Hormone Replacement Therapy (HRT) is basically replacing a woman's hormones that she is gradually losing or has lost. The two main hormones replaced are oestrogen and progesterone, but women also produce testosterone like men but in much lower quantities.
The two main hormones regulate a woman's monthly menstrual cycle, and they play an important role in reproduction. Oestrogen, progesterone, and most of the testosterone are produced in the ovaries in women; in men, testosterone is produced in the testes.
When a woman enters peri-menopause, and the menopausal transition, the hormones produced are lower in quantity and can fluctuate. When a woman is post-menopause, these hormones are no longer produced – both phases cause the symptoms many women experience.
Most women experience menopause by their 50s as a normal part of ageing. As they get older, hormone levels gradually decrease, and their ovaries stop releasing eggs, leading to a change in the normal pattern of their menstrual periods, with possible irregular periods that eventually stop altogether. Natural menopause symptoms often begin around four years before a woman's final period and cease at around four years after, yet can start as early as ten years in advance and finish twelve years after.
These hormonal changes result in the common symptoms of menopause, which can include vaginal dryness, vasomotor symptoms including night sweats and hot flashes (a sudden feeling of heat in the upper part of the body), urinary incontinence, a sudden urge to urinate, mood changes, weight gain, changes to menstrual cycles, sleep problems, and discomfort during sexual intercourse. Other menopause symptoms can be related directly to mental health issues such as depression and anxiety, often escalated by sleep problems (See basics of menopause – what men need to know).
As well as HRT, certain lifestyle changes can help alleviate many menopause symptoms. For example, kegel exercises can help strengthen the pelvic floor muscles to aid with urinary incontinence. Different sleeping strategies aimed at staying cooler can relieve sleep disturbances and night sweats, resulting in a much-needed good night's sleep. Deep breathing exercises and diet can help to combat anxiety, promoting improved mental health. A frozen cold pack may help with hot flushes or with disrupted sleep when placed under the pillow.
Menopause Symptoms and HRT
Replacing these hormones with HRT is the most effective way of treating menopausal symptoms, and most women can safely take HRT. HRT has to be prescribed by the GP or a private doctor; it is not available over the counter.
Most women will be prescribed the two main hormones, oestrogen and progesterone. The medication can come in several different preparations, such as tablets, skin sprays, gels, and patches that stick to the skin. Your partner may already use a Mirena IUS (Mirena coil) for contraception, birth control, or to control her menstrual periods if they are heavy; this contains progesterone, so it can be used as part of HRT. It is important to know that women can still become pregnant if they are peri-menopausal, so contraception is still required; the Mirena IUS is a great solution.
If your partner has had a hysterectomy, she will only be prescribed oestrogen hormone; progesterone is unnecessary.
So how does HRT work?
HRT replaces the body's natural hormones with a very small dose of synthetic hormones, just enough to control the symptoms of menopause. Usually, women are started on a low dose; if this isn't helping, then the dose can be increased, usually after 3 months. This gives the body time to get the maximum benefit of the treatment and for any potential side effects to subside. Sometimes the treatment may not help; the GP will usually change the route of the HRT, so if a skin patch isn't working, a tablet might.
As with any medication, there may be side effects or contraindications. Most women can safely take HRT, but for some groups of women, it's not considered safe to take. If your partner has, or has had, breast cancer or has a very strong close family medical history of breast cancer, it is very unlikely that she will be prescribed HRT as there is a very small increased risk of breast cancer with HRT use. If your partner has had a blood clot or has a strong family history of blood clots, again, it might not be likely she can have HRT as there is a small increased risk with HRT use.
It is always important that any other medical conditions, such as diabetes, thyroid problems, high blood pressure etc., are well controlled before starting HRT. Maintaining a healthy weight and eating a wholesome, well-balanced diet is also important.
A woman is usually prescribed testosterone to help with low sex drive. This cannot be given in isolation, and she must have HRT alongside it to work. Testosterone is not licensed for use in women, so it is used ‘off licence' and in much smaller quantities than is given to men. She will also have to have a blood test first to check the testosterone levels in her blood and then regular tests afterwards.
A low sex drive can be caused by uncomfortable or painful intercourse. After menopause, the vagina can become drier as periods stop, so maintaining vaginal health becomes necessary. Vaginal changes can result in urinary incontinence and vaginal dryness from decreased moisture production. This can be reduced by using vaginal moisturisers and lubricants. Also, regular sexual stimulation, through painless sexual activity, can promote blood flow into the genitals and help maintain vaginal health.
Many women who take HRT notice an improvement in their symptoms soon after starting treatment. It is recommended that treatment is started earlier rather than later when symptoms start as there are significant long-term health benefits to using HRT, such as reducing the risk of coronary heart disease, reducing the risk of osteoporosis and a positive impact on brain health.
If your partner is suffering from menopausal symptoms, no matter how mild, seek medical advice; it's always worth consulting your healthcare provider or GP to discuss HRT or speaking to a menopause expert.
Understanding what your female colleagues could be going through during menopause is a simple, yet impactful first step in supporting them through it.Read post