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Dear Dr Murage,
I am now 41 years and my periods started being irregular two years ago. In the last one year, I only got two periods six months apart. I am now experiencing hot flushes and general fatigue symptoms. How can I be helped?
Golden Girl
Dear Golden Girl,
What you are describing is commonly referred to as peri-menopausal symptoms. You are at an age group where ovarian function is declining. This means you are producing lower levels of female hormones, in an irregular pattern. Your bleeding pattern will likely continue to be very irregular, and the symptoms you are experiencing will also likely continue, or even get worse.
At some point, the bleeding will stop completely, tipping you over to menopause. You are deemed to be menopausal if a full year elapses without any periods.
You do not, however, need to suffer dreadful peri-menopausal symptoms in silence. There are plenty of remedial interventions that can help out. I would suggest you start by reviewing your general lifestyle. If you keep yourself fit and healthy, with physical exercises and a good balanced diet, you may notice less severe symptoms.
If you are a smoker, try and stop. Women who smoke experience more severe hot flushes, and may go into the menopause earlier.
Hormone replacement therapy, commonly abbreviated as HRT, may be suitable for you. This aims at replacing the deficient female hormones, and usually reverses the peri-menopausal symptoms. You need to see your gynaecologist for a basic review prior to commencing on HRT. For the majority of women, HRT is completely safe, and serves to improve their quality of life. You even get other beneficial effects of HRT, related to cardiovascular and bone health.
Your gynaecologist will advise if you fall into the category where HRT should be used with caution. If genuine concerns arise based on your medical history, other alternatives to HRT may be advised. These may include plant-based products rich in natural oestrogens, or other medications that have been observed to give relief of peri-menopausal symptoms.
You will usually be advised to watch on specific symptoms whilst on HRT. These are usually related to unscheduled bleeding, vague pelvic symptoms, or breast symptoms. Most symptoms will be innocent and do not require any specific interventions or discontinuation of HRT. You may however be asked to have some evaluations that may include ultrasound scans and evaluation of cells within the uterus depending on individual circumstances. You should also continue with your regular gynaecological health screening visits.
Once on HRT, you could continue with this till the expected age of natural menopause, which is about the age of 51. Beyond that, use of HRT should be reviewed every six to 12 months. This ensures you continue to derive benefits from ongoing use of HRT, whilst minimising the potential for unwanted harm.
- Dr Alfred Murage is a consultant obstetrician and gynaecologistMake an effort to obtain an excellent knowledge of food, nutrition, eating habits and proper exercise routines and encourage discipline while following the above strategies.
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