By Dr. Ginni Mansberg
The whole experience of being a woman has changed drastically over the past 100 years – some positive and some, not so much. And, when it comes to menopause, the traditional message to grin and bear it could use an update. Feeling hot, tired, cranky, teary, itchy, un-sexy, achy and bloated can all be totally natural at this time of life. But that doesn’t mean a woman needs to surrender to the authentic experience without at least trying to make her life more bearable.
Hot flashes, experienced by 75 per cent of women around menopause can range from mildly annoying to debilitating. For most, when it comes to hot flashes, time can be a healer and the flashes will fade (average 7.4 years but you might be lucky and only get them for a year.) Untreated vaginal symptoms on the other hand, will never get better and will only get worse. Studies tell us that 80 per cent of women over 65 have at least some vaginal menopause symptoms such as dryness, itch and urine leakage. Endured as “just part of getting older”, women don’t talk to each other about those issues and we sure as hell don’t talk to our doctors about it. We often stop talking to our partners about it, buy continence pads and avoid sex like the plague. Yet we have great remedies in abundance.
On top of that we put up with insomnia, mood swings, aches and pains and bloating, just believing there’s nothing that can be done. But lots can be done. Take hot flashes. HRT is up to 98 per cent effective for combating them. That kind of efficacy is almost unheard of in medicine. If we had medication with those stats for heart disease and diabetes, we’d all live to 150. Yet HRT is still often taboo.
When the Women’s Health Initiative study first reported a link between taking HRT and developing breast cancer and heart disease, women and their doctors panicked. Suddenly a mere hot flash seemed like a trivial complaint in comparison to dying of cancer. Most women refused to take it, their doctors wouldn’t prescribe it and governments made drug companies plaster warnings on the packaging. Those women who went begging for some relief from their menopause symptoms were given an ear bashing and then kept their prescriptions a secret.
We know now that the risks posed by taking HRT are in fact pretty minor. And probably only for particular women on particular forms of HRT that are rarely prescribed any more. Not everyone needs HRT. If you have healthy bones, have only a couple hot flashes a week, aren’t moody, exhausted and your vagina is pinging on overdrive, why would you bother taking any medication? If you have a strong aversion to HRT, there are other options. Simple interventions like hypnosis, complementary therapies and prescription drugs from your doctor all work pretty well.
My passion is to give women choices, empowerment and agency over this time in their life, free of unnecessary fear, guilt and shame, and able to enjoy the second era of life with as much gusto as the first!
Dr Ginni Mansberg has been a GP for 30 years, specializing in women’s and children’s health, and author of The M Word.