Gynaecological Treatment - ovarian cyst

Menopause happens when a woman’s menstrual cycle reduces and stops.

Sometimes called "the change" you may find you view menopause with mixed feelings as you recognise a different stage in your life. Menopause usually happens between the ages of 45 and 55.

Premature menopause can occur due to choromosomal disorders, autoimmune disorders, following surgical removal of the uterus and/or ovaries (hysterectomy) or following chemotherapy or radiotherapy.

Hormonal changes cause you to stop having periods. The amount of the hormones (estrogen and progesterone) your ovaries produce at this time drops significantly.

Menopause is a gradual process that has three stages:

• Perimenopause: This begins over several years when the ovaries gradually make less estrogen and lasts up until menopause. In the last 1 to 2 years of perimenopause, the drop in estrogen quickens and many women experience various menopause symptoms
• Menopause: This is the point of having no menstrual period for one year. At this stage, the ovaries have stopped releasing eggs and making most of their estrogen
• Postmenopause: These are the years after menopause. During this stage, menopausal symptoms such as hot flashes usually ease. However, health risks related to the loss of estrogen increase as you get older.

In the run-up to the menopause, your periods become very erratic and sometimes heavy. Your periods will usually not stop suddenly but become less frequent and then stop gradually. The menopause sometimes aggravates osteoporosis – bone mass is lost because of the reduced levels of some hormones.

Menopausal women often experience:

• Tiredness
• Hot flushes
• Night sweats and sleeplessness
• Vaginal dryness
• Weight gain
• Urinary tract infection
• Headache and joint pain
• Grogginess
• Memory problems
• Depression
• Racing heart 
• Reduced sex drive
• Reduced muscle mass, painful or stiff joints
• Hair thinning or loss
• Difficulty doing usual tasks

We take a holistic approach to menopause and how we help women to manage their symptoms. Ensuring a healthy diet and preventing weight gain can reduce the severity of symptoms and our consultants work closely with our gyms and dietitians to provide lifestyle advice, which may include recommendations about minimising your intake of caffeine, alcohol or spicy foods. 

We also offer hormone replacement therapy (HRT) to make the menopause easier. HRT replaces your lost hormones to counteract the effects of the menopause. Your consultant can recommend the right type of HRT that's right for you. 

The most common way to have HRT is by a daily tablet, but there are other ways:

• A skin patch applied to the skin
• A small pellet or implant under the skin
• Gel medication applied to the skin

• Relief from hot flushes and night sweats
• Maintenance of muscles tone, helping reduce any incontinence problems
• Reduced mood swings
• Help with sleep disturbances
• Effective treatment for vaginal dryness
• Help for hormonal related mood swings
• Reduced risk of osteoporosis

It’s important to discuss all aspects with your consultants, to decide what’s best for you, as not all treatments suit everyone.

Lifestyle changes, herbal remedies, alternative therapies, and complementary therapies can help with some menopausal symptoms.

Regular aerobic exercise, low-intensity exercise, and reducing consumption of caffeine and alcohol may help with menopausal symptoms. Herbal extracts such as St John’s wort, black cohosh and isoflavones (soy products) can help reduce hot flushes and night sweats. However, care must be taken as they can react with medicines taken for conditions such as breast cancer, epilepsy, heart disease or asthma.

Acupressure, acupuncture, homoeopathy, aromatherapy, and cognitive behavioural therapy (CBT) has also been tried for various menopausal symptoms however their role needs further research.

What does Menopause care involve?

• A consultation with a consultant gynaecologist
• Full history taking + abdominal and pelvic examination
• Blood pressure assessment
• Blood tests including
  • Haemoglobin - blood count check
  • Thyroid function test
  • Fasting blood glucose
  • Vitamin D levels
  • Lipid (cholesterol) profile
  • CA125 (ovarian cancer screen)
  • Kidney function
  • Liver function
  • Hormones level check
• Comprehensive report
• Direct access for any urgent health concerns

Additional tests can be added to a menopausal health check

• Cervical smear test & HPV sub typing test
• Pelvic ultrasound scan
• Breast screening (mammogram or breast ultrasound)
• Bone density scan for osteoporosis