HELP FOR MENOPAUSE AT STATE 11

51% of the UK's population is female, and each one of these women will enter into peri-menopause and menopause at some point in their lives. But despite this, many people have little or no knowledge of peri-menopause and menopause. 

​

What is peri-menopause and menopause? 

 

To understand peri-menopause and menopause, it's important to understand the hormones involved. 
As far as the NHS is concerned, there are two main hormones involved in peri-menopause and menopause, and they are progesterone and oestrogen (although science shows us that a third hormone, testosterone, is actually really important to many women, too). 

​

Peri-menopause is defined as the years before menopause, when progesterone and oestrogen levels start to change. It can start at different point in a woman's life, but a "rule of thumb" can be any time from mid-thirties onwards.

 

In peri-menopause, progesterone starts to decline, while oestrogen levels fluctuate up and down. This means that the ratio between progesterone and oestrogen changes. 

This change in the levels of progesterone and oestrogen can result in various symptoms such as night sweats, hot flushes, brittle nails, dry skin, mood swings and anxiety. Sadly, because most women associate menopause with periods stopping...and periods stopping is often one of the last symptoms to occur...many women don't realise that their anxiety, mood swings and other symptoms might actually be peri-menopause.

​

Instead, they think they are struggling with life, or work is becoming too difficult. They get mis-diagnosed with depression, anxiety, or (if they are struggling with aches and pains), conditions like fibromyalgia. They get given anti-depressants or painkillers, when really what they need is replacement hormones!

​

Why we care about peri-menopause and menopause at State 11 Soft Tissue Therapy

​

We see a lot of female clients, who come to see us with aches and pains. The decline of oestrogen in menopause (medically, menopause means the time after a women has gone one year and one day without a period) can lead to muscular and joint pain. Often clients will open up to us about difficulties in their emotional life or talk about how they didn't used to be anxious but now they are terribly worried, how they struggle with sleep or mood swings, how they can't seem to remember things like the used to. 

When Vic went into peri-menopause, struggling with a vast array of symptoms, there was little to no awareness from her local GP, who declared that it was far too early for her to be peri-menopausal, despite her being over 45. He offered no help, so Vic and Greg had to research and seek private medical assistance. She was put onto Hormone Replacement Therapy, and it helped resolve her symptoms and turned her life around. 

​

We're determined that no one else should have to go through this alone, so we studied and learnt about menopause so that we could help our clients from a position of knowledge rather than just personal experience. Both Vic and Greg have undertaken and passed the Newson / Fourteen Fish Confidence in Menopause training, as well as studying, reading and keeping up to date with the latest information and research. They are members of the Newson Health Menopause Society and the International Menopause Society.  

NHS Treatment of peri-menopause and menopause

​

Training in menopause is not compulsory for British GPs, and is not covered at many medical schools as a compulsory part of their training. So it is possible that your local GP may never have received formal training in recognising the menopause or peri-menopause. ​Some GP surgeries have a "menopause nurse", and again, there is no standard level of training, aptitude or ability. We have heard of very good menopause nurses, but also horrendously bad ones. 

​

Information and understanding about peri-menopause and menopause is changing all the time, but many GPs don't have the time (or perhaps the inclination) to keep up to date with the latest changes.

 

For instance, there is no reason for women to have to discontinue HRT after five years unless they are taking a combined oral HRT or oestrogen HRT tablet, but there are still GPs that think HRT must be discontinued after five years. 

​

Likewise, some GPs will tell patients that taking HRT increases breast cancer risks. Science is showing that the risk is very low, and varies depending on what type of HRT is taken - but this is rarely explained to patient. 

​

Most frighteningly of all, many GPs seem to be unaware of the difference between replacement progesterone (provided on the NHS as part of the HRT prescription as a tablet called Utrogestan) and progestogen (provided on the NHS as part of the HRT prescription as either the Merina Coil or combined progestogen and oestrogen patches). Progesterone and progestogen are quite different, and progesterone can come with a range of very unpleasant side effects - but this is rarely explained to women, or even worse, the differences are ignored and women are gaslit into being told they are imagining things. 

Having said all of this, there are official guidelines about how NHS GPs must treat women to come to see them with peri-menopause or menopause symptoms. These guidelines are called the NICE guidelines and we strongly recommend that any woman seeking NHS help for menopause studies this guidelines before going to see their GP and even prints them out to take them to their appointment so that they know what they should expect. You can find the NICE guidelines for menopause here - they are written in plain English and are quite easy to understand. 

​

At State 11, we can advise you about how to approach your GP for HRT treatment and talk to you about your different options. We don't need to squash everything into eight minutes, we listen to you and point you to where you can find out further information in your own time. 

Private treatment for menopause and peri-menopause

 

The NHS is not the only source of help for peri-menopause or menopause, and if like us you have a shockingly dreadful GP surgery, you may find that you need to seek private help instead. 

​

Financially this is a burden no woman should have to carry, but here we are anyway. 

​

Private options vary. Firstly, there are the big name clinics (the most well known are the Newson clinics and Livi), clinics provided by insurance companies such as BUPA, and independent clinics set up by GPs who either work entirely privately, or who work part time for the NHS and part time privately. Their services will normally involve an in-person or online appointment, and some will offer or require blood tests that can be obtained privately or maybe via the NHS. You'll need to buy your medication privately, using a private prescription that will be provided by the GP you see. 

​

Secondly, there are the more low cost subscription options. These services generally involve a shorter, online appointment and the cost of the medication and prescription is all bundled into one monthly cost. You're required to buy a subscription for a set period of time. Companies that offer this service include OnStella.com. 

​

Thirdly, there are the online prescribing services. These are most suitable for women who already have a diagnosis, perhaps have had HRT medication before, and involve no consultation with a GP. Instead, you select the medication you require, complete a form online which is reviewed by a GP or prescribing chemist, and if the person reviewing your medication feels that it is suitable for you, you'll pay the cost of your medication (the private price rather than the NHS fee) and it'll be sent to you in the post. 

The first two options will generally involve the company you're dealing with taking the details of your NHS GP surgery and writing to them to let them know what you have been prescribed. Once you are happy that the dosage is correct for you, you can consider approaching your GP and asking them to continue your prescription themselves, on the NHS. It is important to know that while many GPs will do this, they do not have to. 

​

Testosterone

 

Despite women producing a large amount of testosterone which can decline during peri-menopause and menopause, the NHS does not feel it is necessary for women as part of standard HRT. Lack of testosterone can be behind the distressing lack of libido that affects many women during menopause (although there are plenty of lifestyle factors here too), but low testosterone can also cause lack of energy, inability to concentrate and "brain fog". 

​

In the UK, NHS GPs can only prescribe testosterone for low libido. It should only be prescribed once oestrogen levels are optimised as otherwise the testosterone will be "converted" to oestrogen. The only form of testosterone available is gel that is packaged in doses for men, so women using it are required to titrate smaller doses themselves. 

There is a female preparation of testosterone available called Androfemme. This is only available via private prescription at around £90 a tube, which should last about 3 months. 

​

HRT isn't for everyone

 

We are big fans of HRT here at State 11, but we understand that it's not for everyone. 

Some women can't take it due to medical conditions. 

Some women don't want to take it, believing that this natural transition does not need medical intervention. There is certainly a discussion to be had here about the role of HRT in a woman's life, what it means in regards to aging and society's view of older women, but this can be somewhat academic if your symptoms mean you're not able to manage your life!

​

We can talk to you about your options in relation to non-HRT management of your peri-menopause and menopause symptoms, too. 

​

Get help with peri-menopause and menopause from State 11

​

At State 11, we offer free, additional appointment time so that you can discuss menopause and peri-menopause during your appointment. Simply tick the additional time box when you book your appointment.

​