DR SUZANNE SAIDEMAN
MBChB MRCGP DFSRH, Private GP
menopause specialist & Private GP
menopause clinic
The Wellington Hospital Elstree Waterfront
The Waterfront Business Park
Beaufort House, Elstree Road
Elstree WD6 3BS
Visit HCA Healthcare’s website or view full directions.
For all administrative and
general enquiries please
contact Michelle Silvester, my
Personal Assistant,
on 07392 636013 or by email to michelle@saidemanpractice.com
There are more than 11 million women in the UK over 45 years experiencing a range of changes around the menopause which for over 50% have a significant impact on quality of life lasting on average 7 years or longer.
Let’s discuss the range of options available for you which may include lifestyle changes, hormonal and non hormonal therapies.
Why not bring balance, calm and quality back in your life?
Let me help you by keeping it simple and understanding the facts and by helping you to cope … don’t suffer in silence.
Saideman Practice offers a menopause clinic and private GP services for patients based in London.
My menopause clinic in the new beautiful HCA Outpatient & Diagnostic Centre Elstree is located in Beaufort House at the Waterfront Park and provides easy access for patients all over North London. There are fantastic diagnostic facilities avoiding the need to travel into central London.
Call 07392 636013
or email michelle@saidemanpractice.com
the menopause in numbers
Top tips for healthy lifestyle around the menopause
There are many options for every woman to optimise your lifestyle and reduce symptoms. Make sure you understand the benefits and choose the decision you are most comfortable with. Be well informed and discuss your worries and concerns. Remember this is a transition and as new symptoms appear or change you may need new information and new treatments.
Look after yourself!
1. weight
This stage in life also finds a lot of women facing changes in their body shape and often weight gain and it is important to tackle these changes with a combination of a healthy diet and regular exercise. Reducing weight will also help with hot flushes
2. Alcohol
Have a sensible approach to alcohol as this can provoke hot flushes
3. bone health
Ensure you have a good dietary intake of calcium and Vitamin D alongside weight bearing exercise to strengthen all your long bones
4. emotional support
Anxiety and depression are common symptoms so it is important to ensure you have a good supportive network and seek professional help if you are struggling
5. contraception
Don’t forget that even if you have stopped your periods you still need to continue with contraception for 2 years if you are under 50 years and 1 year if you are over 50 years
6. fertility
Going through the menopause early either naturally or after surgical or medical treatment will affect fertility and women need support to help them know what choices there are on offer
7. sexuality
Vaginal dryness and soreness is a common problem and there are many options for treating this ranging from lubricants, moisturisers, vaginal oestrogen and psychosexual counselling
8. healthy heart
Make sure you attend for blood pressure monitoring and review of cholesterol as there are metabolic changes around the perimenopause and menopause
9. breast care
It is important to attend for routine screening Mammograms and perform regular breast self examination
10. cervical smears
Make sure you attend for your routine cervical screening
MENOPAUSE SYMPTOMS
Here are some of the tell-tale signs that you may be experiencing with the menopause.
Do some of these symptoms seem familiar to you? Don’t suffer in silence …
physical symptoms
night sweats and flushes
daytime sweats and flushes
palpitations
insomnia
low energy
tiredness
headaches
joint and muscle pain
itchiness
anxiety symptoms
panic attacks
low mood
tearful, depression
irritable, frustrated
anger
aggression
bitterness
feeling unworthy
inability to cope
not feeling yourself
loss of memory
loss of concentration
bladder or sexual problems
passing urine more frequently
leakage of urine
bedwetting
vaginal dryness, soreness or itching
painful sex
bleeding with sex
low sexual desire
difficulty with achieving orgasm
change in periods
irregular periods
heavier or longer periods
lighter periods
bleeding between periods
My 10 Top tips on HRT - Hormone Replacement Therapy
The Oestrogen commonly prescribed in most HRT products either as a tablet, gel or patch in the UK is a synthetic hormone that is identical to the hormone produced by the ovaries therefore we call this body identical. If a woman still has a uterus she will need additionally progesterone to protect her uterus lining. There are different ways to prescribe the progesterone component either as a tablet, patch or intrauterine device. Currently there is only one licensed body identical Progesterone that can be prescribed for this use in the form of a tablet.
(The safety of unregulated compounded bioidentical hormones is unknown)
1. Benefits
Relief of hot flushes which are related to the drop in oestrogen which occurs around the menopause, so replacing this hormone gives relief of this symptom. Depression and low mood which are also such common symptoms for women improve with HRT
2. Body identical hormones
The Oestrogen commonly prescribed in most HRT products either as a tablet, gel or patch in the UK is a synthetic hormone that is identical to the hormone produced by the ovaries therefore we call this body identical. If a woman still has a uterus she will need additionally progesterone to protect her uterus lining
3. HRT not always an option
For some women HRT is not an option if they have a genetic mutation and are high risk for or have had a hormone dependant cancer
4. libido
Reduced libido is a result of dropping levels in oestrogen and testosterone and HRT can improve this. Women should understand the options for them so that can be empowered to make choices. If oestrogen is not effective then testosterone supplementation may be another option
5. Vaginal Oestrogen
For most women Vaginal Oestrogen should be offered for vaginal symptoms for as long as needed
6. bleeding
Bleeding after starting any HRT product can occur in the first 3 months
7. how long?
There is no arbitrary limit of the length a woman should stay on HRT
8. safety?
Transdermal Oestrogens do not increase the risk of blood clots or stroke so are safer than oral HRT in women over 60 years and if their BMI more than 30
9. other risks?
Starting HRT under the age of 60 years does not increase your risk of heart attacks and HRT does not increase your risk of developing Diabetes
10. Breast cancer
The individual risks of breast cancer around the menopause varies between women according to their risk factors including genetic factors, being overweight,alcohol intake and smoking. HRT with oestrogen alone is associated with little or no change in this risk.
10 facts about the menopause
1.
Menopause means your last period
2.
Being post menopausal means 1 year after your last period
3.
The average age of natural menopause in UK is 51 years
4.
1% of women reach menopause before the age of 40
5.
Peri menopause is the time interval before the menopause when women start to notice a change in their period cycle & onset of mood changes
6.
No need to perform blood tests for healthy women +45 years with menopause symptoms to confirm a diagnosis of perimenopause or menopause
7.
75% of post menopausal women experience hot flushes with 25% of them being severely affected
8.
50% of women experience vaginal symptoms including dryness, itching, discharge & painful sex. This can also cause changes in urinary continence, more urine infections, thrush & bacterial vaginosis
9.
Women going through a premature or early menopause should be offered HRT treatment at least until the natural age of the menopause
10.
All women are different both in the way they go through the menopause and the way they respond to treatment so an individualised approach is crucial
Top tips on alternative or complementary therapy
Always use registered herbal products to ensure their quality and safety
1 Herbal remedies
Isoflavones black cohosh, St John’s Wort & red clover may be helpful but be aware they can interact with other medicines like Tamoxifen and for some women are contraindicated if they have had a hormone related cancer
2 Anti depressants
Should not routinely be offered for low mood around the menopause but have a role to play if HRT is not a suitable option but be cautious especially with taking Paroxetine or Fluoxetine if you are taking Tamoxifen
3 Clonidine
Can be used as an alternative for women if HRT is not suitable but can have unacceptable side effects at higher doses
4 Gabapentin or Pregabalin
Isoflavones black cohosh, St John’s Wort & red clover may be helpful but be aware they can interact with other medicines like Tamoxifen and for some women are contraindicated if they have had a hormone related cancer
5 supplements
Phytooestrogens are contained in certain food groups and can have weakly oestrogen properties so be cautious if a history of breast cancer of taking additional supplements
6 CBT
CBT alongside relaxation techniques, sleep hygiene, hypnotherapy and learning to take a positive attitude to menopausal challenges are all important aspects of menopause care