THE PHYSICAL IMPACT OF MENOPAUSE Dr K. McKinney Department of Obstetrics & Gynaecology, Daisy Hill Hospital
What is Menopause? Menopause is the last menstrual period Perimenopause: beginning of menopausal symptoms to the postmenopause Postmenopause: is after the last period
Menopause - when? Average age of natural menopause is 51 years
Effect of menopause on daily life Home Social 36% of women said their 50% of women said their menopause symptoms affected menopause symptoms affected their social life their home life Work Sex 36% of women 50% of women said their menopause said their menopause symptoms symptoms affected their work life affected their sex life
Menopause and work This police officer considered leaving her job because of the menopause
New menopause policy for PSNI considered Over a third of the PSNI workforce are women 70% thought there should be a menopause policy “Menopause can impact some individuals adversely at work” Assistant Chief Constable Barbara Gray 26th April 2018
Menopause and work In NI women make up 50.5% of the workforce In SHSCT - workforce is approximately 86.8% female 56% of women over 50 are in employment Menopause at work will affect more women as they continue to work longer
Liz Jones Daily Mail May 2018
Early Menopausal Symptoms • Periods changing • Palpitations • Vasomotor 2-5yrs • Connective tissue • Insomnia • Skin/hair • Tiredness, irritability, poor • Joint aches concentration • Cognitive function • Mood swings • (Weight gain) • ‘foggy head’ • Headaches • Low self esteem • More emotional
Hot flushes/ night sweats 60-85% of women experience symptoms 20% so severe that they affect quality of life Previous belief- 2 to 3 years 10%, symptoms can continue for more than 15 years So no arbitrary limits for treatment
Lifestyle Modification Core body temperature • Lower air temperature reduces hot flushes • Keep cool / cold food • Avoid thermally hot food/drinks
Hot flushes
Hot flushes
Lifestyle Modification Exercise High BMI predisposes to more severe hot flushes Non-smokers fewer hot flushes Risk increases with cigs smoked
Lifestyle Modification Relaxation Techniques
Non prescription remedies
Prescribable Non-HRT Clonidine /Dixarit SSRI DRUGS (Selective Serotonin Reuptake Inhibitors) Venlafaxine, Fluoxetine, and Paroxetine Gabapentin
HRT Sequential combined Continuous combined Oral vs transdermal
Vaginal Problems Vaginal dryness Vaginal discomfort Pain during sex Vaginal itching /burning Vaginal or urinary infections Lack of bladder control
The French approach to menopause
Treatment
Treatment
Treatment
Osteoporosis
HRT: When to be referred Persistent side effects Poor symptom control Bleeding problems Complex medical history Individual request History of hormone dependant cancer
Different women…..different risks Individual women need individual assessment and Individual treatment
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