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WHY DO WE KNOW SO LITTLE ABOUT THE MENOPAUSE?

May 12, 2017 8 Comments

kale pesto copy

It’s a question I’ve heard a lot recently – from Kirsty Wark in her excellent documentary The Menopause and Me, and from my school friends when we shared our experiences of hitting 50. Every woman goes through it, yet we talk so little about it.  Kirsty Wark bravely tackles it head on – her film is on BBC iPlayer for another week or so, do check it out. She is very open about feeling below par after suddenly coming off HRT following a series of reports linking HRT and breast cancer in 2008.

She was surprised to learn that Dr Heather Currie, the chair of the British Menopause Society and consultant obstetrician and gynaecologist at Dumfries and Galloway Royal Infirmary and who runs https://menopausematters.co.uk is on HRT. “Discovering Heather was on HRT was an absolute eye-opener for me,” says Wark. “The US study that prompted me to come off HRT has been considerably revised and HRT only increases the risk of breast cancer if you are already predisposed. I’m back on a small dose of HRT and think I’m starting to see my sleep improve.”

So is HRT safe?  One of my school friends is a GP with a special interest in women’s health and menopause. This is her update on the latest advice (given to friends, of course, not dispensed in a surgery):

  • Every woman experiences menopause differently, and has other medical and social contexts that will influence treatment discussions. In the UK we would offer an individual assessment of potential benefits and harms.
  • Broadly, any treatment which replaces the falling hormones is delaying the symptoms of menopause until treatment ends, this can be useful if hot flushes or night sweats make work or sleep difficult.
  • We don’t recommend HRT for prevention eg of osteoporosis, unless there is a premature menopause (under 40). Treatment is based on the need to alleviate symptoms against the other potential risks and benefits of treatment.
  • HRT does reduce the risk of osteoporosis, and bowel cancer.
  • Different HRT preparations carry different risks.
  • If HRT is started at the time of the menopause (rather than years later) and a woman is thought to have ‘clean arteries ‘ ie with no symptoms of heart disease or significant risk if atherosclerosis, then the evidence is that HRT reduces the risk of heart disease (but not stroke).
  • There is also emerging evidence that under the same conditions it may reduce the risk of dementia (this is fascinating and we’ll blog about it separately).
  • It is thought that rather than trigger breast tissue to become cancerous, the hormones in HRT probably stimulate already cancerous cells to grow more. There is an increased number of cases of breast cancer detected in women taking HRT.
  • If a woman is her 40 or 50s, menopausal and healthy,  HRT is thought to on balance to proffer greater benefits than risks. As before, an individual assessment of risks and benefits should always be made, and follow up undertaken.

Summarised as: if you need it we’ll offer it,  but be aware of the risks. Which is fair enough. Everyone has their own way of self-managing the symptoms too: more exercise and less caffeine; evening primrose oil for headaches, breathable single duvets so your sleeping partner isn’t disturbed when the duvet is flung off during a night sweat and lots of sleeveless tops for hot flush moments!

Many women mention menopause brain fog but one bit of good news has emerged from recent research into the midlife brain – despite a dip during the menopause women still outperform men of the same age in memory tests. Go girls! A study published in the journal Menopause showed that women aged 45-55 years performed better in all memory tests.

The team found that memory is effected by hormonal changes during menopause – a fall in oestrogen levels relates directly to changes in brain activity in the hippocampus, which plays a role in memory function. The impact of the menopause on the brain, and how we feel, is clearly immense. Carol Vorderman spoke movingly this week about her battle with depression during her menopause. She described how ‘this depression hit me – and I don’t use the word depression lightly. This was a blackness where I would wake up – nothing else in my life was going wrong, I’m a very lucky woman, no money worries, nothing like that – and I would wake up and think ‘I don’t see the point in carrying on. I just don’t see the point in life”. Carol found medication helped her; the NHS also recommends Cognitive Behavioural Therapy to help with symptoms.

Depression needs proper treatment, of course, but for most of us I think the key is to try and stay positive – and to talk about menopause. We have many good years – and many more adventures – ahead of us and this is just one hurdle on the road.

Good nutrition is also key to surviving the menopause. This week’s pesto recipe is a super-simple one that’s packed with all the things we love here at Kale & Cocoa – kale, obvs, almonds, lemon and tons of flavour. I like to keep a jar in the fridge.  National Vegetarian Week www.nationalvegetarianweek.org starts on Monday so why not make some at the weekend to pep up a variety of dishes during the week?

KALE AND SMOKED ALMOND PESTO (serves 4)

  • 50g smoked almonds (I use Blue Diamond Smokehouse)
  • 50g kale (weighed with stalks removed)
  • Leaves from a small bunch of basil
  • Zest and juice from half a lemon
  • 25g parmesan, finely grated
  • 4 tbs olive oil
  • Black pepper

Blend all the ingredients and season with pepper – no need for salt. This is a thick mixture, if I’m using it with pasta I keep a cup of the pasta water to thin it out. Otherwise dollop on roasted vegetables, risottos and soups.

 

Susan

  • Conditions: Ageing, Menopause
  • Ingredients: Almonds, Kale
« WHY CLEAN AIR MATTERS – VEGETABLE & NETTLE SOUP
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Comments

  1. Sarah says

    May 12, 2017 at 7:10 pm

    Great post as always. Have you read The Hormone Cure by Dr Sara Gottfried? The book seems to be very popular in both the US & Australia. Full of interesting information, science & protocols to follow. I wish I’d found it in my 30’s!

    Reply
    • Susan Saunders says

      May 18, 2017 at 2:19 pm

      Thanks so much Sarah, we’ll check it out!

      Reply
  2. Sally says

    May 13, 2017 at 3:55 am

    I have found myself wondering why delay the symptoms? If it were possible to bypass them then it’s worth taking HRT. But it seems you will have to cope with them some time anyway, so why not get it over with?

    Reply
    • Susan Saunders says

      May 18, 2017 at 2:18 pm

      Good point Sally. I think it is more to do with what you can cope with and when at different stages of your life.

      Reply
  3. Tania Fawcett says

    July 31, 2017 at 3:08 pm

    It’s good to get a dialogue going on this subject. And if we can eat good food to allay the symptoms then I want to hear more! Your posts are always thought-provoking…

    Reply
    • Annabel Abbs says

      August 4, 2017 at 8:33 am

      Thanks for your kind words… the dialogue continues!

      Reply
  4. Emma says

    August 1, 2017 at 7:28 pm

    I agree – any debate on the way nutrition can help, especially with brain fog and anxiety, is very welcome.

    Reply
    • Annabel Abbs says

      August 4, 2017 at 8:24 am

      Thanks Emma, we agree!

      Reply

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Everything we’ve learnt about ageing well points Everything we’ve learnt about ageing well points to a time (for women at least) in their mid-60s when the chronic conditions of ageing, like diabetes, heart disease and dementia, are - statistically - more likely to kick in. 

And we know that our reproductive hormones do so much more than prepare us to have periods and babies, we have receptors for them throughout our bodies and brains. 

Oestrogen, in particular, helps keep bones strong, blood vessels flexible, brains firing and inflammation levels low. Essentially, it wraps us up in a cosy protective cloak to keep us safe and healthy while we're able to reproduce, but once the eggs have run out - we're on our own! 

Between the average age of menopause at 51, and that time in our 60s when the chronic conditions of ageing are more likely to kick in, we have a decade or so in which it’s vital to focus on our health.

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If you’re lucky enough to have good metabolic he If you’re lucky enough to have good metabolic health you might want to thank your Mum today. Recent studies have found that women who move around during their reproductive years and during pregnancy and then breastfeed for a bit pass on a compound in their milk called 3SL which provides lifelong protection against poor metabolic health. The offspring of moving, breastfeeding Mums appear to have a lower lifetime risk of heart disease, type 2 diabetes and other chronic metabolic disease. Even gentle strolling during pregnancy and while nursing can produce this compound. So today we thank our Mums for that - as well as everything else.  Susan’s mum in the hat. Annabel’s mum in the pony tail. 

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The campaign this year reminds us to embrace equity as a way to recognise that each of us has different circumstances, and we need different resources and opportunities to reach an equal outcome. Of course, this is as vital in ageing and health outcomes as in every other field.  

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