Professor Janice Rymer, RCOG Vice President, writes...
Today marks the first World Menopause Day since the National Institute of Health and Care Excellence (NICE) published its first guideline on the diagnosis and management of the menopause nearly one year ago.
The guideline was a major milestone for both healthcare professionals and women, to encourage more women to seek help and access safe and effective treatments for menopausal symptoms. Unfortunately, awareness of its presence remains low. A study by the British Menopause Society (BMS) earlier this year, found just 3% of women surveyed had heard of the guideline. I hope to use this World Menopause Day not only to raise awareness of the health issues faced by women, but to further educate them in the management of the menopause and their choice of treatment.
The menopause is the biological stage in a women’s life when her ovaries stop producing eggs and the amount of oestrogen hormone in the body drops. This usually happens between the ages of 45 and 55. The time before a woman’s last period, when her hormone levels are falling, is called the perimenopause, and can last from a few months to several years.
During this time, up to 80% of women experience physical and/or emotional symptoms, including hot flushes and night sweats, vaginal dryness, tiredness and sleep disturbance, mood swings, forgetfulness or lack of concentration, and loss of interest in having sex. Every woman experiences the menopause differently, but for some, the symptoms can be extremely debilitating and dramatically impact their health, work, relationships and quality of life. Despite this, the BMS survey found only half of women surveyed in Great Britain speak to a healthcare professional about their symptoms.
One of the biggest campaigns in my life, is to make sure my patients look after themselves when they reach this biological stage. Many women opt to manage their symptoms by using hormone replacement therapy (HRT), non-hormonal treatments (like clonidine), or non-pharmaceutical (for example cognitive behavioural therapy, relaxation techniques, exercise, isoflavones or black cohosh).
To manage symptoms including vaginal dryness, vaginal irritation, a frequent need to urinate and urinary tract infections, the NICE guideline recommends systemic or vaginal oestrogen. However, oestrogen alone might not be enough to manage vaginal dryness for some women, and the guideline suggests using vaginal moisturisers and lubricants in addition.
It is important women find out what treatment options work for them, as the risks and benefits are different for each woman depending on her medical history, family history and symptoms. Women must have access to the highest quality information and advice, so they can make a well informed decision about their health.
The RCOG’s Women’s Network has been developing an online hub for women, where accurate, evidence based, reliable information about the menopause can be found in one place. Information will not only be about the menopause, but also a range of other health conditions women may face during this time of their lives, such as osteoporosis and gynaecological cancers. The hub – which will be accessed on the RCOG website from next month - will link to a host of resources produced by the NHS and a range of expert organisations.