The Menopause

The menopause is the name given to the time when a woman’s periods stop, the end of menstruation.  It is also sometimes referred to as ‘the change of life’. This happens because the ovaries stop producing hormones and ovulation (egg production) stops. Surgical removal of the ovaries also causes the menopause. A woman is said to have reached the menopause once she has not had a period for one year. After this point, she can be described as ‘post-menopausal’. The time leading up to the menopause is known as the ‘peri-menopause’. The average age of the natural menopause is around 50-51 years. Menopause before the age of 45 years is regarded as early.

What are the symptoms of the Menopause?

Some women will not get any symptoms but most women will get a few symptoms. The range of symptoms that are experienced are due to the changing hormone levels.

The commonest symptom as the menopause approaches is a change in the menstrual cycle – sometimes the periods get closer together and sometimes they get less frequent.

Other common symptoms are:

• Hot Flushes
• Night Sweats
• Vaginal Dryness
• Joint Aches & Pains
• Sleep Disturbance
• Mood Changes
• Bladder Irritability

What can you do to help yourself manage the Menopause?

Lifestyle changes can make a difference!

There are several simple things that you can do to help yourself.  The menopause is the perfect time to look at your diet and lifestyle and aim to make some positive changes which may ease some menopause symptoms.

• Eat a balanced diet with plenty of calcium and vitamin D
• Increase your intake of fruit, vegetables and fibre and try to cut back on saturated fats and caffeine
• Take weight bearing physical activity such as walking and aim for a minimum of 30 minutes a day at least five times a week
• Keep within a healthy weight range
• Stop smoking! Stopping will improve the health of your heart and your bones
• Keep within recommended alcohol intakes – not more than 14 units per week for women
• Get your blood pressure checked out to make sure it is within safe limits

For further information download   Menopause, The Facts from www.nhs.uk/Livewell/menopause

Hormone Replacement Therapy (HRT)

Hormone Replacement Therapy (HRT) replaces the hormones that the ovaries stop making. It is usually given as tablets or a patch. HRT is not necessary for every woman it is important that you have the necessary information to help you make a choice.  HRT can be discussed in more detail with your GP, Practice Nurse or at the Menopause clinic if you have been referred by your GP.

Alternative Therapies

Some people have found that alternative medicines have helped their menopause symptoms. However care must be taken when using some herbal remedies as they can cause side effects and may interact with prescribed medicines. If you suffer from any medical condition, you should consult your GP or Practice Nurse for advice before commencing any alternative medicines. For further information check out www.menopausematters.co.uk

Other things to consider!

• Contraception.Women continue to be fertile after their periods have stopped, so it is important to use contraception, as an unwanted pregnancy would be distressing. Contraception should be continued until at least 2 years after the last natural period if under 50yrs and 1 year past the last natural period if over 50yrs
• Cervical screening. Smear tests are offered every 5 years from the age of 50yrs until age 64yrs. It is important to continue to attend for this even after your periods have stopped.
• Breast screening. Women from the age of 50yrs are offered breast screening every 3 years, you should attend for this.  It is important to learn how to check your breasts for lumps and irregularities, check out www.breakthrough.org.uk ( about breasts-cancer/touch-look-check)

If you would like to discuss any symptoms of the menopause, you could speak to your GP or Practice Nurse or ask your GP to refer you to the menopause clinic which is run by the Sexual Health Department at The Gatehouse, Irvine.

Further Information

Menopause matters – www.menopausematters.co.uk

Menopause NHS Choices – www.nhs.uk/Livewell/menopause/

Women’s Health Concern Ltd – www.womens-health-concern.org

National Osteoporosis Society – www.nos.org.uk

Checking your breasts – www.breakthrough.org.uk/about-breasts

How do I tell if I have an STI?

Some infections don’t have any symptoms, so if you have had unprotected sex (i.e. you didn’t use a condom or the condom burst) and are worried about it you may want to get a check up.
Signs of an infection may include the following:

• Any unusual discharge (either vaginal or back passage)
• Pain or burning when you pee
• Pain or bleeding during sex
• Itches, rashes, sores, lumps or blisters on genitals or near the back passage
• Bleeding between periods
• Any unusual pain in your pelvic area

If you have any of these symptoms, its important to get them checked out, If you are phoning for an appointment at the Sexual Health Clinic just tell us you have symptoms and we will try to see you as soon as possible. You don’t need to tell us on the phone what the symptoms are if you don’t want to.

PAINFUL PERIODS AND PRE-MENSTRUAL SYNDROME (PMS)

Some women suffer from painful periods and some may suffer from PMS. For further information on PMS and period pains, you can download a recently updated leaflet on PMS and period pains from www.healthscotland.com/documents/4218.aspx. Use the search facility and search for pre menstrual syndrome to access the leaflet on PMS and Painful Periods.

• breast awareness
• smear tests
• pregnancy
• menopause

https://www.lothiansexualhealth.scot.nhs.uk/MultiMedia/Video/New_IUDS_VideoMP4.mp4
(acknowledgment to NHS Lothian)

What is it?

A small T-shaped plastic device which is put into the uterus. It contains the hormone Levonorgestrel (progestogen). 

How does the Intrauterine System (IUS) work?

The hormone is the IUS works  by preventing  fertilisation ( joining of sperm and egg)  and preventing implantation of any fertilsed eggs in the uterus. An IUS does not cause an abortion.

How to use the Intrauterine System (IUS)

The IUS is put into the uterus by a doctor or nurse, once it is in place you do not need to do anything.  There are 2 types, which can last up to 3  or 5 years before you need a replacement.

How effective is the Intrauterine System (IUS)?

An intrauterine system is over 99% effective.

What are the advantages of the Intrauterine System (IUS)? 

It can stay in place for up to 5 years. You don’t have to think about contraception for as long as it remains in place and fertility returns to normal on removal. Your periods usually become lighter or completely stop. If fitted after 45yrs of age it can stay in place until after the menopause. It is not affected by other medications. It can be used if you are breastfeeding.

What are the disadvantages of the Intrauterine System (IUS)?

Insertion can be uncomfortable; you will need an internal examination to have an IUS fitted. There is a small risk of uterine perforation, pelvic infection, expulsion of the IUS but these risks will be fully explained by the health professional.  You require another small procedure to have the IUS removed. An IUS cannot be used as a method of emergency contraception.

Does the Intrauterine System (IUS) protect against Sexually Transmitted Infections?

No, condoms are the only form of contraception which gives protection against some infections.

After You’ve Had a Coil Fitted

(aknowledgement to NHS Lothian)

What is it?

A small plastic and copper device which is put into the uterus. It does not contain any hormones. 

How does the Intrauterine Device (IUD) work?

The presence of the device stops sperm reaching an egg and helps prevent implantation of a fertilised egg in the uterus. An IUD does not cause an abortion.

How to use the Intrauterine Device (IUD)

The device is put into the uterus by a doctor or nurse, once it is in place you do not need to do anything, it can last from 5 – 10years before it needs replaced.

How effective is the Intrauterine Device (IUD)?

It is over 99% effective.

What are the advantages of the Intrauterine Device (IUD)?

It works as soon as it is put in. It can be used as an effective method of emergency contraception. No hormonal side effects. It can stay in place for 5-10 years depending on type used. You don’t have to think about contraception for as long as it remains in place and fertility returns to normal on removal. If fitted after 40yrs of age it can stay in place until after the menopause. It is not affected by other medications. It can be used if you are breastfeeding.

What are the disadvantages of the Intrauterine Device (IUD)?

Insertion can be uncomfortable; you will need an internal examination to have an IUD fitted. There is a small risk of uterine perforation, pelvic infection, expulsion of the IUD but these risks will be fully explained by the health professional. Periods may be a bit heavier or longer. You require another small procedure to have the IUD removed.

Does the Intrauterine Device (IUD) protect against Sexually Transmitted Infections?

No, condoms are the only form of contraception which gives protection against some infections.

After You’ve had a Coil Fitted

By being familiar with how your breasts normally look and feel, you will be able to identify any changes quickly.

• Know what is normal for you
• Know what changes to look and feel for
• Look and feel your breasts regularly, e.g. at the same time every month
• Report any changes to your GP or Practice Nurse
• Attend for routine breast screening if you are aged 50 or over

These are some of the changes to be aware of:

• Size – If one breast becomes larger or sits lower
• Nipples – If a nipple becomes inverted (pulled inwards) or changes position or shape
• Rashes – on or around the nipple
• Discharge – from one or both nipples
• Skin changes – Puckering or dimpling or skin like orange peel
• Swelling – Under the armpit or around the collarbone
• Pain – Continuous, in one part of the breast or armpit
• Lump or thickening – different to the rest of the breast tissue

WHAT TO DO IF YOU NOTICE A CHANGE

If you notice a change in one or both of your breasts arrange to see your GP or Practice Nurse. Remember that most breast changes are not cancer, even if they need further investigation.

For further information:
http://coppafeel.org

http://nhsinform.co.uk/Cancer/scotland/dce/breastcancer

http://www.youtube.com/embed/yNKbmif0M6c

THE RIGHT BRA

Wearing the correct bra is important to support your breasts, especially during puberty, pregnancy and as you get older. Many women are wearing the wrong sized bra, which can cause pain and discomfort, sagging breasts and bulges around your bra. Many shops offer a bra fitting service which can be helpful but you should still try before you buy, to ensure the bra is a comfortable fit for you. You should get re-measured if you have lost or gained weight, had a baby or after the menopause.