Managing the menopause: Lifestyle changes and innovative treatment options

Nowadays, women no longer need to suffer in silence with troublesome symptoms of the menopause thanks to innovative and effective treatment options. We invited leading consultant obstetrician and gynaecologist Miss Nataly Atalla to detail the modern therapies currently used to treat hormone imbalances which occur during the menopause and how they can be complemented by key lifestyle changes.

What lifestyle changes can people make to help with hormonal changes?

There are a number of lifestyle changes women going through the menopause can make to improve their wellbeing and reduce their risk of complications. The most important is to cut out smoking and alcohol consumption. One or two occasional glasses of wine at the weekend are okay but anything in excess of this can be particularly harmful to women experiencing hormonal changes. Alcohol can cause weight gain, making you more prone to heart problems and increasing your likelihood of being affected by diabetes.

The next crucial thing is exercise. With regards to fitness, merely being generally active and mobile is not sufficient and your weekly exercise should exceed daily dog walks. I strongly recommend building up a routine of visiting the gym for a good hour around three times a week for classes that combine weight bearing and cardio. Weight bearing actually has a positive effect on the body’s management of hormones which continues for more than twenty four hours after doing exercise. Maintaining a routine like this will keep you fit and will also help you to avoid weight gain. Vitally, it will also make hormones, which the body has in far lower dosage during the menopause, more effective. This reduces unpleasant menopausal symptoms as excessive body fat can cause hormones to become lost.

What treatments are available for conditions associated with hormonal changes?

In terms of diet, sugars and carbs should be avoided as much as possible. Focusing on foods rich in protein, fruits and vegetables is very important, as is ensuring that you drink plenty of water. A good balanced diet lowers the risk of future complications and also maximises the body’s response to hormones which improves general function and reduces resistance to insulin.

I would also stress the importance of good quality sleep during the menopause. As deep sleep only happens at night, I advise against catching up on sleep during the day. Allowing for plenty of time to sleep well - at least seven or eight hours, starting early in the evening - gives your body time to effectively recover.

How are hormonal changes monitored?

When treating hormonal change, it’s essential that hormone levels are meticulously checked over time as they fluctuate and there is no one solution which treats everyone. There are several different hormones we monitor, including luteinizing hormone (LH) and follicle-stimulating hormone (FSH), as well as oestrogen and testosterone.

Testosterone is the male hormone released from the ovaries which lowers and runs out during this time of hormonal change. It is responsible for libido, brain fogginess and sleep so it is very important. Oestrogen, which the ovaries also stop producing, is a really beneficial hormone. Therefore, as part of hormone therapy for the menopause, we replace lost oestrogen with supplements. This treatment does pose a risk as oestrogen can make the lining of the womb overgrow, which can lead to polyps or in some very rare cases, the development of some types of cancer.

To combat this effectively, progesterone is always prescribed along with oestrogen. Many people are unaware that we also prescribe testosterone for women to replace their lost supply. Depending on the age of the woman and her progression through the menopause, we may prescribe a combination of hormone replacements to effectively treat her symptoms. The combination of treatments may change around once a year throughout the different stages of the menopause to best suit the fluctuating needs of the patient. This tailoring is informed by regular hormone check-ups, gynaecological exams and consultation with a specialist gynaecologist.

What supplements can support women’s health during the menopause?

As well as prescribed hormone replacements, it’s also very useful to use nutritional and dietary supplements to ensure suitably high doses of vitamin D3, CoQ10, fish oil and Omega-3. This is important as the immune system is compromised as a result of the hormone change. Further to this, supplements of vitamins D and B as well as zinc and antioxidants are very helpful for women going through the menopause. Women in this stage also typically tend to be very low in iron which can cause hair loss so supplementing this can combat this issue.

What alternative treatments are available for conditions associated with hormonal changes?

In recent years, radiofrequency treatment for menopause has been found to be a very successful complementary form of therapy. First of all, we treat the patient with hormone replacement therapy and once that is optimised, the body is then able to respond to radiofrequency sessions. This form of treatment is non-invasive and non-surgical and it can help with many menopausal symptoms including:

• vaginal pain
• discomfort during sex
• lacking sexual desire and libido
• prolapse
• urinary incontinence

This type of treatment is administered through a probe inserted into the vagina. This is done in outpatient clinic without anaesthetic and usually takes about twenty minutes. The probe transmits radiofrequency waves that promote collagen under the skin to build up. This form of treatment is exactly like those used in aesthetic and cosmetic treatments to improve skin firmness. The successful building up of collagen strengthens and restores the integrity of the vaginal walls and bladder and vaginal support. This is an increasingly popular form of treatment and I’ve seen very good results in my own practice.

How have treatments for menopause developed in recent years?

Women have previously suffered greatly during the menopause due to poor quality treatment, where hormone levels haven’t been monitored effectively and correct tailoring of therapies hasn’t taken place. In the past, hormone replacement medication originated from horse urine and was given in the form of tablets but this has long been outdated. Nowadays, we use natural remedies extracted from plants which mimic our own hormones. It has been established that when given orally, hormone replacements have more side effects and associated risks. Therefore, they are now administered through the skin by patches and gels and also in pessary form. The world of hormone replacement therapy has completely changed and is now healthier, safer and more effective.

If you are seeking treatment for menopausal symptoms, you can book a consultation with Miss Atalla by visiting her Top Doctors profile.