February 9, 2021

Frequently Asked Questions

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1. What is the difference between Body Identical and Bio Identical HRT?

Body Identical is licensed and regulated HRT products available from your GP for the usual prescription charge, if you pay for prescriptions. These will also be prescribed by both NHS and private British Menopause Society registered menopause specialists. Bio Identical is not licensed or regulated and only available from private practitioners who are not necessarily menopause specialists. These products are made up individually in compounding pharmacies and can be very expensive, safety concerns have also been raised over these.


2. Can your GP refer you to a menopause specialist on the NHS? What if they refuse?

Yes, they can refer you and if they refuse they should have a good reason why, you can always seek a second opinion from another GP in the same practice. Details of clinics can be found on the British Menopause Society website.


3. Is anxiety a symptom and what if my doctor offers me anti depressants?

Anxiety is a very common symptom of perimenopause and anti depressants are not the first line treatment for menopausal anxiety as detailed in the NICE menopause guidelines.


4. My doctor said that I can’t have HRT as I am still having periods, is this true?

No, you can start HRT as soon as your symptoms become troublesome.


5. My GP has said I have to come off my HRT after 5 years, is this true?

No, this is outdated information; there is no time limit on HRT use.


6. I am overweight and have been told I can’t have HRT; is this right?

No, you can have HRT but it should be offered as either a patch, gel or spray.


7. My skin feels very itchy and like I have insects crawling on me, is this a symptom and what should I do?

Yes, this can be a symptom for some women, formication, as it is known, is caused by a lack of oestrogen and HRT can help to resolve this.


8. I’ve just picked up my HRT patches/gel/tablets and Utrogestan, when can I start?

If you have been prescribed then your GP should advise, it is likely that they would expect to you start straight away but always check if in any doubt.


9. Vaginal atrophy- is it possible to have this without symptoms and what are the symptoms?

The most common symptoms of vaginal atrophy are vaginal dryness, soreness, irritation or burning and repeated urinary tract infections. However, some women can be shocked by the appearance of their labia or clitoris, particularly if they are not used to checking and they have not experienced any of the symptoms.


10. Can menopause cause changes to your hair? e.g. hair loss, drying, change to texture?

Yes, women have oestrogen receptors all over their bodies and hormone fluctuations can result in different symptoms for different women.


11. I have been referred to a gynaecologist instead of a Menopause specialist but they know all about menopause don’t they?

Unfortunately gynaecologists do not all receive mandatory menopause training so you need to see a doctor who specialises in menopause.


12. Can I use Vagifem alongside my HRT? Is it safe to use both?

Yes, you can use Vagifem at the same time as your systemic HRT.


13. Is restless legs a symptom and what can I take for it?

Yes, restless limbs can be a symptom for some women, HRT and/or a magnesium supplement can be useful.


14. Magnesium-What does it do and what types are available, can it help with muscle aches and pains?

Magnesium is one of the most abundant minerals in our body, needed for literally hundreds of different chemical processes. Low levels of magnesium can interfere with your sleep; contribute to low mood and brain fog, fatigue, muscle and joint aches and pains as well as headaches. Magnesium is available in many synthetic forms as a supplement but can be found naturally in nuts and seeds, whole grains, dark green veg and avocados. If you are looking for a supplement, look for a chelated Magnesium (sometimes the label will simply say chelated magnesium) such as Magnesium Citrate. This is easily absorbed and therefore more likely to work more quickly and least likely to cause any digestive problems. Magnesium citrate is good for calmness and relaxation and can be taken in the morning to help with anxiety or at night to help with sleep. Magnesium glycinate is also absorbed very easily and with a more potent calming effect can be useful to take in the evening (an hour before bed) to help with very disrupted sleep. At higher doses, magnesium can have a laxative effect and if you already suffer with a sensitive gut (such as IBS) be particularly mindful of starting with a low dose (100-200mg) and do not exceed 400mg without consulting a qualified practitioner. Alternatively, adding Epsom salts (that contain Magnesium sulphate) to a warm bath can be good for relaxing muscles and achy joints, as can using a Magnesium ‘oil’ spray directly to sooth the affected areas.


15. What are the official figures for cancer risks for HRT?

It very much depends which piece of research you choose to read but the overall risks of taking HRT are very low and for the vast majority the benefits outweigh any risks. Your doctor should discuss up to date statistics with you when prescribing.


16. Can my GP prescribe Testosterone?

In theory they can as the NICE guidelines say that in some circumstances testosterone should be considered but many doctors do not feel confident to prescribe and some are told not to by their practice.


17. What are the official contra-indications to HRT?

This is very much assessed on a patient by patient basis and should always be assessed taking in to account the individual woman’s quality of life.


18. What is Testosterone used for?

Testosterone is often prescribed to women who report a continued reduction in libido even once established on HRT it must be considered for those women in a surgical menopause. Testosterone lso has a part to play in bone, muscle and skin health and has a significant effect on cognitive function and confidence.


19. Does HRT cause weight gain?

No, menopause causes weight gain, when oestrogen levels being to fluctuate the amount and type of the hormone oestrogen changes and this can cause body shape and weight distribution changes.


20. I have a family history of breast cancer, does that mean I can’t have HRT?

No, not necessarily, if you GP tells you that you can’t consider HRT but your symptoms are having an impact on your quality of life ask to be referred to a menopause specialist clinic. Further information can be found on this site or via the following resources:
www.menopausedoctor.co.uk
www.womens-health-concern.org

 

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