Menopause
Available treatments
SAFE PRESCRIBING
Get started with the right treatment for you
Menopause key facts
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The menopause is a time in a woman’s life when her menstrual cycles and reproductive years end. During the menopause a woman will stop releasing eggs and her levels of estrogen and progesterone (the hormones responsible for menstruation and fertility) will also fall. Menopause normally occurs between the ages of 45 and 55, but this can vary from person to person.
Here, we will take a closer look at menopause, its causes, symptoms and treatment options available.
What is the perimenopause?
The phase in a woman’s life before the menopause, is called the perimenopause. During the perimenopause, less estrogen is produced by the ovaries, resulting in changes in the menstrual cycle and irregular periods. Other symptoms include mood swings, hot flashes, night sweats, difficulty sleeping, and vaginal dryness.
Hot flashes
Hot flashes (vasomotor symptoms) are the most common symptom of menopause. Hot flashes are often accompanied by sweating, hot flushes and a rapid heartbeat. Around three quarters of women experience hot flashes during the menopausal transition. Hot flashes may continue for around 2 years, but this may vary.
Other symptoms of menopause
Other symptoms may include irregular or missed periods, vaginal dryness, sore breasts, urinary incontinence, difficulty sleeping, mood changes, irritability, depression, tiredness, headaches, joint and muscle aches, weight gain, hair loss, vaginal atrophy and changes in sex drive.
When does menopause start?
When menopause starts is affected by factors, such as lifestyle, genetics, and other medical conditions. Underweight smokers tend to experience the menopause earlier, while women who are overweight may experience menopause later. Ethnicity does not however play a major role for the age of onset of menopause.
What is premature menopause and induced menopause?
Premature menopause is menopause that occurs before the age of 40, due to factors such as genetics, autoimmune diseases, medical treatments, or radiation therapy. Premature menopause may cause more severe symptoms needing treatment to manage any hormonal changes and potential health risks.
Induced menopause occurs when a woman has her ovaries surgically removed or receives treatment which damages the ovaries, causing a reduction in estrogen levels, triggering symptoms of menopause.
How to diagnose menopause
Diagnosis of menopause takes into consideration age, symptoms, and changes in the menstrual cycle. Blood tests can be used to measure hormone levels, such as the follicle-stimulating hormone (FSH) and estradiol. FSH increases as a woman approaches menopause, while estradiol levels decrease.
How to manage menopause symptoms
Lifestyle changes to alleviate symptoms
- Maintain a balanced diet containing calcium, vitamin D, and soy-based foods
- Regular exercise to reduce the risk of osteoporosis and heart disease
- Reduction of stress using yoga or meditation
- Managing changes in body temperature by wearing light clothing
- Avoiding caffeine, alcohol, and spicy foods
- Staying mentally active to promote good cognitive health
Hormone therapy
Hormone therapy may be used for women with severe menopause symptoms. This uses estrogen and sometimes progesterone, in the form of a patch, pill, cream, vaginal ring, gel or spray, to replace hormones no longer produced by the body. Oral contraception can also be used to help manage the symptoms of menopause.
Hormone therapy is not necessarily suitable for everyone, and women with a history of breast cancer or cardiovascular disease, may require alternative treatment.
Non-hormonal medications and alternative treatments
Non-hormonal medications such as paroxetine, venlafaxine, gabapentin and clonidine are effective in reducing hot flashes and sleep disturbances. Acupuncture is another potential option for the management of menopause symptoms.
Frequently asked questions
When does menopause occur?
Menopause occurs from the age of 45 to 55, but this can vary depending on genetics, general health, and other medical conditions. Menopause that occurs before the age of 45 is called early menopause.
Can a hysterectomy cause menopause?
If a woman has her uterus removed (hysterectomy) while keeping her ovaries, she will not experience the menopause immediately. However, her menstrual periods will stop, and she will not be able to conceive. If a woman has a hysterectomy and has both ovaries removed, menopause will occur immediately, as the ovaries are responsible for the production of hormones.
Can menopause affect bone health?
Estrogen helps to maintain bone density. A reduction in estrogen levels during menopause increases the risk of osteoporosis. To promote healthy bones:
- Exercise using weights
- Maintain a diet containing dairy products, leafy greens, and fortified foods, and consider calcium and vitamin D supplements
- Avoid smoking
Does menopause affect heart health?
Women may be at an increased risk of cardiovascular diseases, such as heart attacks after menopause. Prioritize your heart health by:
- Monitoring your blood pressure and cholesterol levels
- Eating a balanced diet, exercising regularly, managing your stress levels, avoiding smoking or excessive alcohol consumption
How will menopause affect my sexual health?
Menopause can cause vaginal dryness, causing discomfort during intercourse. Menopause can also reduce your sex drive. Treatment options include:
- Discussing your concerns with your partner and healthcare provider
- Using over-the-counter lubricants and moisturizers
- Using hormonal therapies
Does menopause affect sleep?
Yes. Sleep disturbance is common during menopause. Symptoms include night sweats and disrupted sleep patterns. Try the following:
- Keep your bedroom cool, dark, and quiet. Use breathable bedding and consider using a fan or air conditioning
- Develop a relaxing routine before bed, such as a warm bath or reading a book
- Limit caffeine and alcohol close to bedtime
How long does the menopause last?
The transition to menopause can last around 7 years. However, this may vary and some women may experience symptoms for a longer or shorter period of time. Postmenopause is defined as when your last period was over 12 months ago.
Can menopause affect my mental health?
Hormonal changes during menopause can cause mood swings, irritability, and changes to your mental well-being. Consider the following:
- Connect with friends, family, or support groups to receive emotional support
- Engage in activities that help you relax
- Consult a mental health professional if your symptoms affect your daily life or continue for long periods
Conclusion
Menopause is a natural process of life for every woman. By having a healthy lifestyle, staying connected to support groups and healthcare providers, and understanding menopause you can manage your symptoms with greater ease.
Sources
Service Guide
Everything you need to know about Getting Treated Privately
What does the Get Treated Privately service do?
The Get Treated Privately service is a private prescribing service which is designed for adults aged 18 years and over, who are experiencing health issues and who would like to receive a fast-track assessment and if applicable, a treatment plan from a qualified prescribing clinician. Treatments are dispensed and delivered to your home or workplace from our regulated online pharmacy.
Is this a safe service?
Yes. Our formulary of medications prescribed and conditions treated are controlled, governed, and continuously risk-assessed by our Medical Director, Dr. Aseel Hamoud. Unlike other prescribing services which operate using faceless questionnaires, our service is conducted through remote video consultations, also known as synchronous consultations. This builds patient safety and prescribing appropriateness into our service, ensuring our prescribing clinicians can be satisfied with who and what they are treating. There is no guarantee of supply of medications, and any prescriptions supplied are at the sole discretion of our clinician prescriber. There is no charge for the consultation.
What is a prescribing clinician and is it safe for me to use them on the NowPatient platform?
Our prescribing clinicians are board-certified pharmacists, nurses, or doctors who can also prescribe any medicine for any medical condition, subject to accepted accreditation and good clinical practice. They are all registered with their respective regulatory bodies. For example, a pharmacist independent prescriber is registered with the General Pharmaceutical Council (GPhC). Each prescribing clinician undergoes an extensive background check including a disclosure and barring service check (DBS). In addition, they undergo a rigorous license verification process. When you book an appointment with our prescribing clinicians you will see their full name, license number, and any specialized credentials they have.
Is the service available worldwide?
Yes, the Get Treated Privately service is available worldwide.
Do I need to pay for this service?
Yes. This is a private service. You do not need to pay for the consultation. You only pay for the cost of the medication you are prescribed.
How do I book a consultation?
Once you have logged into your account, you will need to navigate to the Get Treated Privately service card which is located as a service item on the dashboard.
Using the action button on the service card, you can select one of the following – ‘Search Treatments’ or ‘Search Conditions’.
Depending on the search type and the product/condition that you would like to get treated, you will be taken to a consultation booking screen. Follow the simple steps to complete your booking. During the booking confirmation, you will be able to select a date and time that is convenient for you, along with the preferred language and gender of the prescribing clinician you wish to choose. You will then see a list of all available expert clinicians who are trained to assess the medication or condition chosen. Once you have confirmed your booking, you will see a summary of the appointment including preliminary information about the consultation. At this point, you will also be able to add a reminder to your calendar. Always ensure your account health profile is up to date before any consultation. This ensures that our clinicians have the most up-to-date information about your current health status and anything that may influence their prescribing decisions. You will receive a push notification, SMS notification and email reminding you of your consultation, 30 minutes before the virtual consultation is due to start.
Depending on certain medications which require our clinicians to have your up-to-date blood pressure readings, you may be required to submit a virtual blood pressure check, using your smartphone or device. We will provide you with full instructions, when this is required.
What happens during the remote video consultation?
During the consultation, the clinician will ask you a series of questions that will allow the clinician to assess your condition and potential treatment options. At the end of the consultation, the clinician will decide if a treatment is a safe and suitable option for you. If it is, the clinician will discuss the various treatment options that may be available, so that you can jointly agree on the option that is most suited to you. Once you have jointly agreed on a treatment plan, the clinician will issue a prescription order which will be available in your Cart at the end of the consultation.
Also, with your consent, the clinician may wish to inform your doctor of the treatment that was prescribed. We recommend that you agree to this since your doctor is responsible for your overall care and they should have a record of this consultation and medication prescribed. In addition, our clinician may take the opportunity to advise you on your overall health including advice on healthy living or stop smoking.
What happens at the end of the consultation?
At the end of the consultation, you will receive a notification which will summarise the outcome. It will also advise you if any referrals were made to your doctor, along with any other advice that was given to you by the clinician.
If a referral letter was issued to your doctor, you will be able to view a copy of this in the ‘Documents’ section of the dashboard. If you were prescribed a treatment, it will now be available in your Cart.
When you go to your Cart, you will be able to select the treatment, checkout and make payment. Once the checkout is complete, your prescription order will be sent to our regulated online pharmacy for processing.
What if the prescriber does not prescribe what I want?
We operate a safe prescribing service. This means that our prescribing clinicians always exercise their clinical judgment when prescribing. Unfortunately, we do not operate a self select service where you can choose a medication and simply buy. If the clinician that sees you does not prescribe anything, then you will not be charged.
Will I get status updates for my order?
Yes. When your treatment is approved, and after you have checked out and paid for your order, we will keep you fully updated with the status of your order. Every time the status of your order changes, you will be notified immediately. These notifications will appear in the ‘Notification Feed’ section on the dashboard.
How will my order be delivered?
All orders are shipped in discreet and unmarked packaging. This means it is suitable for delivery wherever you require (home, work, or a neighbour).
For thermo-sensitive orders (e.g. Insulin or weight loss injections) we use cold chain-validated packaging. Your parcel will normally receive an estimated delivery window from the courier on the day of delivery.
For your protection and safety, your first order can only be delivered to the address that is registered with NowPatient. Future orders can be delivered to any other address, for example, your workplace.
Do you ship cold-chain or temperature sensitive products?
Yes. We use a specialist courier service for all thermo-sensitive deliveries. This is to ensure that cold chain integrity is always maintained and thus the product quality, safety and efficacy.
Learn more about how we handle the delivery of temperature sensitive products.
Where do you deliver?
We currently deliver to all postcodes/zipcodes worldwide. Some postcodes in rural areas may have a slightly longer delivery time.
When will my order arrive?
We aim to ship all orders placed Monday – Friday before 3pm on the same day. Orders placed outside these times will be shipped the next working day. All deliveries are shipped by Royal Mail, which delivers Monday through Saturday in the UK. For deliveries outside of the UK, please check with your national postal service for accurate delivery days.
Our delivery options have the following delivery times:
- UK – Royal Mail Tracked 24 & Signed for Delivery – Next day delivery
- Europe – Royal Mail Tracked – Typical delivery of 3-5 working days
- Worldwide – Royal Mail – Typical delivery of 5-7 working days. If a tracked option is available for your country via Royal Mail, this service will be applied.
What should I do if my order has not arrived?
Delivery is normally made promptly after your dispatch notification is received. You can check the tracking details of your order in the ‘Notification Feed’ section of the dashboard, at any point after dispatch.
Unfortunately, packages can sometimes get lost in the delivery system. If after 10 days you have not received your delivery, please contact us and we will do all we can to resolve the problem.
Can you prescribe GLP-1 weight loss injections?
Yes. However, with GLP-1 weight loss medications, the license requires that there are support resources put in place as part of the plan including coaching for a healthy lifestyle, exercise, and diet. Our clinicians will discuss this with you, if you are prescribed this type of treatment.
You can learn more on our Weight Loss Programs feature page.
What’s included with my order?
If you are ordering prescription medication, your order will contain your medication only.
If you are ordering weight loss injections, your order will contain:
- Your prescription of pre-filled weight loss injection pens
- Needles
- Sharps bin for safe disposal of needles (if ordered as part of the bundle)
Can I reorder my medication, if I have already been prescribed a course?
Yes. However, as a responsible prescribing service, we do not issue more than one monthly cycle of medication at a time. This means that, if you would like to reorder, you will need to rebook a consultation.
This is important, because it allows our clinicians to keep track on the progress of your treatment plan and ensure that the medication remains safe and effective for you.
What is the earliest I can reorder my medication or treatment?
14 days after you have received your first monthly supply, we will send you a notification to advise you that you are eligible to reorder your medication. To ensure that we are able to safely prescribe the next supply, you will need to rebook a consultation.
This ensures that our clinician can check in on your treatment plan and ensure it is working as intended and continues to be safe, suitable and appropriate for you.
How do I reorder my medication?
When you are eligible to reorder your next medication, we will send you a notification reminder. This notification reminder will request that you book a consultation with a NowPatient Clinician.
You should book a suitable time and date for the consultation.
At the end of the consultation, the clinician may advise you to either
- Stop the treatment
- Stay on the current dose
- Increase the dose
If our clinician deems it safe for you to continue taking the medication, the medication will be added to your cart, from where you can checkout.
Delivery will be made in line with our delivery timescales.
As a responsible prescribing service, we will always monitor your treatment plan to ensure that it remains safe, effective and suitable for you.
How do I reorder weight loss medication?
Our weight loss programs are built to closely monitor treatment progress and safety. Please refer to the Weight Loss Programs Service Guide that explains how you can reorder or step edit your dose.
About Telehealth
Everything you need to know about video consultations
Are remote video consultations right for me?
How do I know if the remote video consultation service is safe?
Do I need to verify my identity during the remote video consultation?
Can I have a chaperone (carer, friend, family member) join a remote video consultation?
How can I be sure that you are handling and protecting my data securely?
How is my data stored?
Are my consultations confidential?
Can I select which clinician I have my consultation with?
Will my doctor be informed of any consultations I have through the app?
Do remote video consultations save money for health systems?
Are remote video consultations safer than online questionnaires?
What quality of care can I expect to receive from a remote video consultation?
Why am I being asked to provide my Blood Pressure reading?
If I don’t have a Blood Pressure monitor, how can I provide my readings?
Is the remote blood pressure monitor safe and medically accurate?
How does the remote blood pressure monitor actually work?
When and how is my remote blood pressure reading taken?
What devices does the remote Blood Pressure monitor work on?
Why do my results keep failing when using the remote blood pressure monitor service?
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