THE PHYSICAL IMPACT OF MENOPAUSE Dr K. McKinney Department of - PowerPoint PPT Presentation

THE PHYSICAL IMPACT OF MENOPAUSE Dr K. McKinney Department of Obstetrics & Gynaecology, Daisy Hill Hospital

What is Menopause?  Menopause is the last menstrual period  Perimenopause: beginning of menopausal symptoms to the postmenopause  Postmenopause: is after the last period

Menopause - when? Average age of natural menopause is 51 years

Effect of menopause on daily life Home Social 36% of women said their 50% of women said their menopause symptoms affected menopause symptoms affected their social life their home life Work Sex 36% of women 50% of women said their menopause said their menopause symptoms symptoms affected their work life affected their sex life

Menopause and work This police officer considered leaving her job because of the menopause

New menopause policy for PSNI considered  Over a third of the PSNI workforce are women  70% thought there should be a menopause policy “Menopause can impact some individuals adversely at work” Assistant Chief Constable Barbara Gray 26th April 2018

Menopause and work  In NI women make up 50.5% of the workforce  In SHSCT - workforce is approximately 86.8% female  56% of women over 50 are in employment  Menopause at work will affect more women as they continue to work longer

Liz Jones Daily Mail May 2018

Early Menopausal Symptoms • Periods changing • Palpitations • Vasomotor 2-5yrs • Connective tissue • Insomnia • Skin/hair • Tiredness, irritability, poor • Joint aches concentration • Cognitive function • Mood swings • (Weight gain) • ‘foggy head’ • Headaches • Low self esteem • More emotional

Hot flushes/ night sweats  60-85% of women experience symptoms  20% so severe that they affect quality of life  Previous belief- 2 to 3 years  10%, symptoms can continue for more than 15 years  So no arbitrary limits for treatment

Lifestyle Modification Core body temperature • Lower air temperature reduces hot flushes • Keep cool / cold food • Avoid thermally hot food/drinks

Hot flushes

Hot flushes

Lifestyle Modification  Exercise  High BMI predisposes to more severe hot flushes  Non-smokers fewer hot flushes Risk increases with cigs smoked

Lifestyle Modification Relaxation Techniques

Non prescription remedies

Prescribable Non-HRT  Clonidine /Dixarit  SSRI DRUGS (Selective Serotonin Reuptake Inhibitors) Venlafaxine, Fluoxetine, and Paroxetine  Gabapentin

HRT  Sequential combined  Continuous combined  Oral vs transdermal

Vaginal Problems  Vaginal dryness  Vaginal discomfort  Pain during sex  Vaginal itching /burning  Vaginal or urinary infections  Lack of bladder control

The French approach to menopause

Treatment

Treatment

Treatment

Osteoporosis

HRT: When to be referred  Persistent side effects  Poor symptom control  Bleeding problems  Complex medical history  Individual request  History of hormone dependant cancer

Different women…..different risks Individual women need individual assessment and Individual treatment

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