You’ve been taking hormones since your first period, so you’re understandably sceptical when your doctor recommends hormone replacement therapy (HRT).
First things first, Dr Philip Zinn tells Drum, we need to get the terminology right. Menopausal hormone therapy (MHT) is the more acceptable description for when what medical experts prescribe when you are approaching ‘the change of life’, explains the gynaecologist and obstetrician from Cape Town who’s affiliated with the South African Menopause Society (Sams).
Read more | It’s not perimenopause or menopause, but your vagina is constantly dry
While it is estimated that nearly half of the patients who go through this therapy may potentially develop cancer, the benefits may very well outweigh the risks, according to Dr Peter Roos, former Sams president.
The internationally recognised medical stance on MHT is that it’s recommended for women who experience vasomotor symptoms – caused by dilation and restriction of blood vessels – such as hot flushes and night sweats, between the ages of 50 and 60.
Sometimes, it can happen has young as the mid-30s, and will be brought on in a woman who has a hysterectomy (has her womb removed) for medical reasons.
“A 2021 analysis of four studies found that women who took systemic HRT had a 46% higher risk of recurrence than women who didn’t take HRT. Current recommendations say that women with a history of breast cancer should not take any type of systemic HRT,” says the Breast Cancer organisation.
It can be a miserable time for some women – though some sail through it with no problems at all.
Here are seven ways to manage it so that you can continue to feel well and positive.
- What is menopause?
This is the time of life that a woman stops having monthly periods and can no longer conceive a baby. It doesn’t happen suddenly, though. There is a period of months or years when the oestrogen (female hormone) levels become lower and lower in the body.
This is called the ‘peri-menopause’.
- Approaching menopause
There are a number of symptoms that a woman may notice, which can alert her to the fact that she is heading for menopause. These include:
- Hot flushes and night sweats
These can be very uncomfortable, and it feels as if your body is ‘on fire’.
- Vaginal discomfort.
As oestrogen levels go down, the vagina can feel itchy and dry, and sexual intercourse can be uncomfortable or painful.
- Does it have to be bad?
Women often dread menopause, because they feel it marks the end of their attractiveness as a woman and they fear that their partners will no longer desire them.
However, for others, there is a feeling of immense relief and freedom when menopause arrives.
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They no longer have to put up with messy – and possibly painful – periods every month, and they can enjoy sex without worrying about getting pregnant.
- Urinary problems
You may find that you get urinary infections, or feel the need to pass urine more often.
- Difficulty sleeping
If you suffer from night sweats, or you feel depressed and anxious, you may find that your sleep is disturbed.
- Feeling bad about yourself
You may start to have negative feelings, such as feeling old, or think you are unattractive and ‘unsexy’. You may have mood swings and be irritable, snapping at your family for no reason.
- Weight gain
You may notice that your waistline is thickening, and it is difficult to get back into shape.
This can be a very confusing time for the woman’s loved ones, as she may seem to change from a sweet, caring, patient person into a ‘monster’ whom they don’t recognise. But, with patience and understanding, these mood changes will pass. These are things you can do to help her:
- Be aware. Learn about menopause so that you know what to expect and don’t judge her too harshly when she has mood swings, for instance.
- Be patient. If she is behaving in an irrational way, and is snappy or tearful, don’t argue with her. Rather offer to make the supper and let her rest and calm down.
- Appreciate her. Remind her that she is still a vibrant, sexy woman who is always loved and needed.
- Support her. If things are getting out of hand, persuade her to seek advice from a doctor or clinic. Some women try to ‘tough it out’, but they may benefit from some medication to help them through this time.
- Don’t insist on sex. If she is feeling bloated or miserable, she quite possibly won’t be in the mood for her partner’s approaches.
- Be understanding towards this, and show your love for her in different ways – by stroking her arm in bed, offering to rub her back, or giving her a long foot massage, for example. She will let you know when she is ready to resume full sexual relations.
