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Most women experience symptoms like hot flushes, night sweats and brain fog. Many can cope with them but some women find it very hard to deal with them without help. There are number of ways you can be helped. The treatment options can be hormonal and non-hormonal. Most times you need a specialist help to tailor the treatment to your need. One needs to aim for physical, mental and emotional wellbeing and target the treatment accordingly.
Not all women choose to go on hormone replacement therapy but those who does, should have appropriate consultation and risk assessment.
Please contact to arrange a consultation.
The menopause is a permanent state once you stop having your periods. It happens when your ovaries stop releasing eggs or your ovaries have been removed. This is when the amount of oestrogen hormone in your body falls. Common age for menopause is between 45 and 55 years, with the average age being 51 years. If menopause occurs before the age of 40 years, it is known as premature menopause or premature ovarian insufficiency.
Perimenopause is the time (lasting from few months to few years) before menopause when gradual decline in oestrogen levels occur. Around half of all women notice physical and/or emotional symptoms during this time.
The symptoms vary from minimal to quite severe. Every woman experiences menopause differently. Most common symptoms are:
If you are over the age of 45, you do not need a blood test to diagnose menopause. Your symptoms are enough to diagnose it.
Not all women want to have treatment for their symptoms. Many women decide not to have any treatment. Treatment options are offered based on your symptoms and your preferences. There are lots of treatment options.
Simple lifestyle changes:
Not every woman chooses HRT for menopausal symptoms. This may be because of your own or family history, or because you have concerns about the safety or side effects of HRT. Herbal medicines plants or plant extracts, such as St John’s wort, black cohosh and isoflavones (soya products), can help reduce hot flushes and night sweats for some women.
Caution about herbal treatment:
Once again the results are variable. There is not much research about the results for such treatments. Therapies such as acupressure, acupuncture or homeopathy may help some women.
Commercially available ‘bioidentical’ hormones are not regulated or licensed in the UK owing to lack of evidence that they are effective or safe to use. One must exercise caution in using these treatments.
This is the commonest form of a prescribed medication to control menopausal symptoms. Please click here to have more information about HRT. There is a lot of fear about HRT because of information gathered from TV, from magazines or from what is heard from friends.
For most women there is a conundrum. On the one hand they may be suffering from very troublesome symptoms for which HRT seems to offer the most effective form of treatment. On the other hand, they are concerned whether the treatment is going to be safe and appropriate. This is where a trip to see your gynaecologist can be of great value. Your individual circumstances needs to be discussed. You need to know about the different options that are available to you. Once fully explained, you might find that how small the risks of HRT are, when compared with the benefits that can be provided. Breast cancer risk is always a concern, so it is reassuring to know that in the first few years of HRT most experts agree that there is no increased risk at all. Contact to make an appointment to have further information regarding your personalised risk analysis and discussion regarding available options.
Non-hormonal medical treatment:
There are medications that can be prescribed to control your symptoms like hot flushes, night sweats. These include clonidine or venlafaxine for hot flushes.
Cognitive behavioural therapy (CBT) is a type of psychological treatment that has shown beneficial effect on menopausal symptoms mainly low mood, anxiety and cognitive function.
Book an appointment for consultation:
Hormone replacement therapy (HRT) HRT is the most common form of prescribed treatment for menopausal symptoms. It helps to replace the hormone estrogen in your body, which decreases around your menopause. You may sometimes also need other hormones (such as progestogen and testosterone) that your body is no longer producing.
It depends on your individual circumstances. If you have a uterus (womb) then a combination of oestrogen and progestogen HRT (combined HRT) would be recommended to prevent thickening of the womb linning. Progestogen may be given in the form of tablets, patches or a hormone containing coil (Mirena Coil). For first two years of menopause, you need a cyclical HRT which gives you a regular, light period like bleeding. After that you can go on a bleed free HRT. If you have had a hysterectomy then you will be offered oestrogen only HRT. If you suffer with low sex drive, you may be offered a use of testosterone.
You can use tablets, gel, patches, injections, vagial ring, cream or pessary.
Benefits
Risks:
The effects of HRT have been studied worldwide and research shows that, for most women, HRT works and is safe. Most of the risks are dose and duration dependent.
If you have a history of breast cancer or deep vein thrombosis, please discuss your individual situation to know your own risk. HRT can still be an option.
You should know about available alternatives to HRT along with their benefits and risks.
If you want to discuss HRT or other alternatives for your menopausal symptoms, please contact us.
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Overactive Bladder (OAB) is a sudden and compelling need to relieve the bladder which is difficult to put off, often associated with the frequent need to go to the toilet during the night or the day, and may result in incontinence.
People experiencing these symptoms should not feel ashamed or embarrassed to talk to their doctor, because help is available. OAB can have a huge emotional and physical impact on people.
About 1 in 6 adults experience some symptoms of an overactive bladder. About 1 in 3 people with an overactive bladder have episodes of urge incontinence.
Normally, the bladder muscle stay relaxed as the bladder gradually fills up. However, in people with an overactive bladder, the bladder muscle seems to give wrong messages to the brain. The bladder may feel fuller than it actually is. The bladder contracts too early when it is not very full, and not when you want it to.
Untimely contractions lead to symptoms like Urgency where you cannot wait to go to urinate, increased frequency more than 7-8 times a day, Night time frequency (nocturia) of more than 1-2 times every night interfering with your sleep and Urinary leakage mainly happening on the way to the toilet or without any warning. You may pass quite small volumes of urine.
Try these top tips to help you control your symptoms:
Bladder training (sometimes called bladder drill)
Bladder training is a very simple but effective treatment. It works in up to half of cases and makes it important part of the treatment. The aim is to slowly stretch the bladder so that it can hold larger and larger volumes of urine. For more information see the “Bladder Drill” section on this website.
Medication
If there is not enough improvement with bladder training alone, medicines also help. There are number of medicines available. They work by blocking certain nerve impulses to the bladder, which relaxes the bladder muscle and so increases the bladder capacity. Medication improves symptoms in some cases, but not all. The amount of improvement varies from person to person. Click here to know about medication.
Posterior Tibial Nerve Stimulation
This treatment involves inserting a very fine needle (like acupuncture) into a specific point near the ankle. A specific kind of electrical impulse is delivered to the patient through the lead set. The electrical impulses travel along the tibial nerve to the nerves in the spine that control pelvic floor function. For more information on this treatment please look at the “Tibial nerve stimulation” section on this website.
Surgery
Surgery is used in very limited cases of overactive bladder where symptoms have not responded to above mentioned treatments and symptoms are too bothersome.
Treatment with botulinum toxin A
This is an alternative treatment to surgery if other treatments including bladder training and medication have not helped your symptoms. It has not been licensed (approved) for the treatment of overactive bladder syndrome in the UK. Make sure that you discuss this procedure fully with your doctor and understand all of its risks and benefits before you go ahead with it. Click below to know more about this treatment.
Further help and information
www.bladderproblem.co.uk provides accessible information on how you can help to manage bladder conditions.
If you have any further questions, to make an appointment please contact.