#1 - Get clued up around Hormone Replacement Therapy

This year’s World Menopause Day theme focuses in on menopause hormone therapy. Last year, Hormone Replacement Therapy (HRT) was made available through prescription prepayment certificates (PPCs) which mean those who experience symptoms can now access a year’s worth of HRT products for just £19.80 – a saving of hundreds of pounds per year. This means that, if you purchase more than 2 prescription items in a 12 month timeframe, you can make a saving.

In our recent training session with Jacqui McBurnie, Menopause Lead for the NENC ICB and founded of the NHS England Menopause Network, dialled down into the potential benefits of HRT, while also dispelling some of the myths.

Nowadays, HRT comes in different shapes and sizes, and can be in the form of patches, tablets, gels and more. If you have a uterus (you have not had a hysterectomy), you’ll need both estrogen and progesterone. If you have had a hysterectomy, you’ll need estrogen. For some, testosterone can can also be of use. For more on the benefits and risks of HRT, you can always tune into this video by Kathy Abernethy of the British Menopause Society.

For many who experience menopause, the HRT journey unfortunately might not be as straightforward as it should be. The best way to ensure the smoothest road possible is to ensure you’re getting the most out of appointments with your GP. For some of us, this might mean we have to arm ourselves with information to share with GPs. Useful resources for doing so can be seen below.

• Henpicked’s 5-minute guide to talking to a GP about menopause
• The British Menopause Society’s info sheet on all types of HRT
• NICE guidance on the benefits and risks of HRT
• British Menopause Society information on testosterone replacement in menopause

#2 - Expand your knowledge

The easiest way to expand your knowledge around menopause, whether for your own benefit or that of those around you, is to try find 30-60 minutes to sit down and engage in some of the learning opportunities available to you.

As mentioned above, we recently benefitted from the time of Jacqui McBurnie who delivered a couple of menopause champions training sessions. Within, Jacqui covered a host of different topics including common symptoms of menopause and perimenopause, misconceptions around the topic, the close link between menopause and mental health, diet and menopause and more, as well as advice for those who are looking to support those experiencing symptoms.

One of these sessions was captured and has been uploaded to YouTube, where colleagues can now tune in at any time. The session itself lasts around 30 minutes, although there is a lot of value in tuning in for the additional half an hour of questions following the session, too. This is an ideal resource for team meetings, and particularly in the understanding that we don’t need to be experiencing menopause to help build a supportive culture for those who are.

Elsewhere, NHS England also have a free 30-minute eLearning package focusing in on menopause awareness, providing an overview of what menopause is, common symptoms associated with it and including practical scenarios which can help you better understand how to support yourself and/or others. To register for the course, just visit the eLearning for Healthcare Hub.

Also just released is another eLearning package, this time from Wellbeing of Women. Created in partnership with NHS England, the course aims to help equip you to provide better support and contribute to creating a working environment where all can thrive. To register free for this 30-minute course, visit Wellbeing of Women.

#3 - Understand the symptoms

Some might associate menopause with symptoms like hot flushes, amongst women and amongst those who are between 45-55. The reality however is far more broad, and while that might well be the experience for one person, it is very often more complex and varied for those who experience symptoms.

Menopause is a stage in life where menstruation stops and the reproductive life ends. It is generally defined as the consecutive 12-month period where there has not been a period – but that is only for those who reach menopause naturally.

There is also early menopause or Premature Ovarian Insufficiency (POI) for example, diagnosed in people under 40. Causes can include anything from genetics, to surgery and treatments to lifestyle choices and more, and this is generally diagnosed on a timeframe of 4 months or longer without a period and following two blood samples to evaluate hormone levels.

It’s also a misconception that menopause can only impact women. Trans women undertaking HRT are likely to take this for life, and may experience menopausal-like symptoms, while trans men who don’t undertake hormone therapy and retain ovaries are likely to experience an age-related menopause process. Non-binary people and intersex people may also experience menopause, depending on a variety of factors. For more information on LGBTQ+ and menopause, we recommend visiting sites such as Menopause Care, Queer Menopause and LGBT Health and Wellbeing.

Continuing along the theme, while hot flushes are one symptom, they’re only one of around 35 common symptoms. The most common do include hot flushes, but also potentially more problematic symptoms such as lack of sleep, anxiety and depression, fatigue, changes in bleeding pattern and an impact on concentration. Of course, many of these more common issues probably interlink – serving only to worsen their impact.

Around 4 in 5 NHS colleagues who experience symptoms of menopause say they impact them at work, with 1 in 4 reporting severe symptoms. 7 in 10 experience anxiety and depression, while some 85% have trouble sleeping.

For advice on sleep hygiene and menopause, we suggest giving the National Institute of Aging’s item for some good tips for a better night’s sleep. Elsewhere, a good starting place for understanding perimenopausal depression is this interview with Professor Pauline Maki, hosted by the International Menopause Society. Mental wellbeing support & resources can be accessed through your GP, but many more are available to find through our mental wellbeing area.

#4 - Connect with others

The Menopause Warriors are a peer support group kindly led by our Head of Research & Development, Alison Harvey, here at Gateshead Health. Today, Alison is in The Hub on-site at the QE Hospital between 10:00am – 2:00pm where she’s free for a chat, discussion, to share tips and tricks, advice and guidance around all things menopause and perimenopause.

If you can’t make today, you can always join The Menopause Warriors! Meeting on a monthly basis both in-person and via Microsoft Teams, the Menopause Warriors provides a dedicated time and place for those who are experiencing symptoms of menopause and perimenopause to gather, share their experiences, challenges and success stories. As well as meeting via Teams, a WhatsApp group is also up and running, so if you’d like to join this just drop a line to [email protected] with your name and number and we’ll pass the request on.

Also available through the Warriors is our Menopause Buddy system, providing similar peer support on a more personal and private basis if preferred.

And while we’re always keen to promote connecting with peers for support, we’d also encourage those who are experiencing symptoms to consider how they might be able to raise this with their line manager. One way to facilitate this is through the Menopause Passport, a dedicated document which you can complete and present to a line manager to help provide them with a better understanding of how your symptoms might impact you at work – and prompt them to consider what adjustments they might be able to make at work to support you in staying well.

#5 - Adapt for others

As already stressed, symptoms can vary both in their presence and severity for those who experience menopause.

It’s also worth noting that personal characteristics can also shape experiences of menopause. As already touched on, gender is one of these – but there are also other factors such as race, ethnicity, religion, long-term conditions and more which can alter how we experience menopause.

Demonstrating this, because there are differences in biological and hormonal changes in women of different races and ethnicity, black women typically start menopause earlier than white women. Early onset of menopause increases the likelihood of developing heart disease, putting this group at higher risk of other postmenopausal health risks like diabetes. There is however a wealth of information and support available for black women, including that available through Black Women in Menopause, the British Menopause Society and more.

Similarly, Ramadan is the ninth month of the Islamic calendar and for Muslim women, this can have implications on HRT, hydration and managing menopause symptoms. A useful resource for Muslim women is the Muslim Women Network, where forums & groups as well as useful resources can be accessed freely.

Those who are neurodiverse or who have learning disabilities and/or long-term conditions can also find menopause to be a challenging time. Those who are neurodivergent may experience new challenges or even find other traits are intensified throughout menopause. Those with ADHD can experience a significant impact on emotional regulation and so on. For more exampels like these and tips on how to cope, visit Positive Pause.