Menopause and Migraines

What are migraines?

Migraines are severe and recurrent headaches which can have a significant impact on a person’s quality of life. They are often accompanied by other symptoms such as visual disturbances, nausea and vomiting, sensitivity to light and sound, irritability, fatigue and malaise.  

What how can menopause affect migraines?

From the early 40s, the menstrual cycle can become more erratic, with fluctuations in oestrogen levels, leading to more frequent migraines. As these fluctuations lessen in the run up to the menopause and beyond, some women may find that their migraine improves after the menopause. 

What are the options for migraine treatment during menopause?

Here are 7 possible treatments for migraine sufferers during the menopause.

• Hormone Replacement Therapy (HRT): Some menopausal women may benefit from HRT, which can help stabilise hormonal fluctuations and reduce the frequency and severity of migraines. If you have migraines with aura (changes to your vision) it is often advised to use oestrogen which is delivered through the skin, as there is no increased risk of blood clots when it is given this way. Your doctor will be able to discuss and individualised treatment approach with you.  
• Lifestyle Modifications: Lifestyle changes can play a crucial role in migraine management. This includes maintaining a regular sleep schedule, staying hydrated, managing stress, and avoiding trigger factors (for you) like certain foods, alcohol, and excessive caffeine. 
• Medications: Your healthcare provider may recommend migraine-specific medications, such as triptans, nonsteroidal anti-inflammatory drugs (NSAIDs), or preventive medications like beta-blockers, calcium channel blockers, or antiepileptic drugs. The choice of medication depends on the frequency and severity of your migraines and of course, your preference.  
• Complementary Therapies: Some women find relief through complementary therapies like acupuncture, chiropractic care, or herbal supplements. Be sure to consult with a healthcare professional before trying these approaches. 
• Dietary Changes: Maintaining a healthy diet and identifying and avoiding trigger foods can be helpful. Common migraine triggers include aged cheeses, processed meats, and foods with artificial additives. Alcohol again can be a trigger for some.  
• Exercise: Regular physical activity can help reduce the frequency and severity of migraines. However, it’s essential to find an exercise routine that suits your individual needs and doesn’t trigger migraines. 
• Tracking Migraines: Keeping a migraine diary can help identify patterns and triggers, which can inform your treatment plan. 

Menopause Symptoms

What menopause symptoms might I have?

No two women are the same when it comes to menopause symptoms. However, we do know that we have oestrogen receptors in every cell of our body so it is possible that the fluctuating levels of oestrogen can provoke a wide variety of menopause symptoms.

Not all women will experience all of these menopause symptoms, but common ones include:

• Hot flushes
• Night sweats
• Insomnia
• Low mood
• Panic attacks or anxiety
• Feeling tense or nervous
• Heart beating quickly or strongly
• Loss of feeling in hands and feet
• Breathing difficulties
• Vaginal dryness and itching with painful intercourse
• Wanting to pass urine often
• Hair loss
• Formication (a feeling of insects crawling on your skin)
• Crying spells
• Loss of interest in most things
• Irritability
• Feeling dizzy or faint
• Parts of the body feeling numb or tingling
• Joint pains and muscle aches
• Loss of interest in sex
• Muscle and joint pains
• Headaches including worsening migraines
• Poor concentration
• Feeling tired or lacking in energy
• Urinary urgency
• Hair and skin changes
• Dry eyes/dry mouth
• Weight gain

Genitourinary Syndrome of the Menopause (GSM)

What is Genitourinary Syndrome of Menopause (GSM)

Genitourinary Syndrome of Menopause (GSM), formerly known as Vulvovaginal Atrophy (VVA) or atrophic vaginitis, is a condition that affects many perimenopausal and post-menopausal women. It is a group of symptoms and physical changes in the genital and urinary tract areas, primarily caused by the hormonal changes associated with menopause, particularly the decline in oestrogen levels.  

What are The Symptoms of Genitourinary Syndrome of Menopause (GSM)

GSM symptoms encompasses a range of symptoms and can significantly impact a woman’s quality of life. Common genitourinary syndrome of menopause symptoms and manifestations of GSM include: 

• Vaginal Dryness: A decrease in oestrogen levels leads to reduced vaginal lubrication, resulting in dryness and discomfort. 
• Vaginal Itching and Burning: The thinning and drying of the vaginal tissues can cause itching and a burning sensation. 
• Dyspareunia: Painful sexual intercourse is a common symptom of GSM due to vaginal dryness and thinning of the vaginal walls. 
• Vaginal Discharge: Changes in the vaginal tissues can lead to altered vaginal discharge. 
• Urinary Symptoms: GSM can affect the lower urinary tract, leading to symptoms like urinary urgency, frequency, and an increased risk of urinary tract infections. 
• Urinary Incontinence: The weakening of pelvic floor muscles and changes in the urinary tract can contribute to urinary incontinence. 
• Recurrent Urinary Tract Infections: Thinning of the urethral tissues can make women more prone to urinary tract infections. 
• Pain or Burning During Urination: Urinary symptoms may also include pain or a burning sensation during urination. 

What are The Treatment Options for Symptoms of Genitourinary Syndrome of Menopause (GSM)

GSM symptoms can have a substantial impact on a woman’s sexual function and overall well-being. However, there are various effective treatments  and management options for GSM symptoms: 

• Local Oestrogen Therapy: Low-dose estrogen creams, vaginal tablets, or vaginal rings may be prescribed to deliver estrogen directly to the vaginal tissues. These are very safe and can be used alongside hormone replacement therapy if needed.  
• Non-Hormonal Moisturisers and Lubricants: Over-the-counter or prescription moisturisers and lubricants can provide relief from vaginal dryness and discomfort. 
• Pelvic Floor Physical Therapy: This type of therapy can be helpful in managing urinary incontinence and improving pelvic floor muscle tone. 
• Lifestyle Changes: Staying well-hydrated, maintaining a healthy diet, and practicing stress reduction techniques can contribute to overall vaginal and urinary health. 

It’s essential for women experiencing GSM to consult with a doctor to discuss their symptoms and explore appropriate treatment options. With proper management, many women can find relief from the discomfort and distress associated with this condition.  If you would like to book in with a menopause specialist, click here.

Menopause: When to Stop Contraception

The decision of when to stop contraception during menopause can vary depending on your individual circumstances and preferences. Menopause is defined as the cessation of menstruation for 12 consecutive months and is technically one day in time. It is important to understand that pregnancy can still occur during the perimenopausal transition, as ovulation can be irregular.

• If you are over 50 and your periods have naturally stopped for 12 months or more, you can usually stop contraception. This only applies if you are not using additional hormonal medication.
• If you are under 50 you can stop using contraception if your periods have naturally stopped for 2 years. Again, this advice only applies if you are not taking additional hormones or using the Mirena coil.
• At the age of 55 you can usually stop using contraception as natural conception at this time is very rare.

If you are using the combined contraceptive pill and you have withdrawal bleeds these are occurring because of these hormones rather than your own cycle. Because these methods give an ‘artificial bleed’, you are not able to tell where you are in the menopause transition or if your periods have naturally stopped.

Some women using the progesterone only pill, progesterone implant or hormone-containing coil may not have regular bleeds which can make it difficult to know when the menopause happens.

If this is the case, your doctor can carry out a blood test to check your follicle stimulating hormone (FSH) level. This blood test can be useful in helping you work out when to stop using contraception. Speak to a doctor to arrange this, and for advice on how to interpret the results.  If you would like to discuss menopause or when to stop contraception with one of our menopause specialists, click here,

Can HRT Be Used For Contraception?

A common question is whether hormone replacement therapy (HRT) can be used as a contraceptive. HRT is used as a treatment for the symptoms of the perimenopause and post menopause. It contains very low doses of hormones and as a result it cannot be used as a contraceptive. It is worth remembering that you can still get pregnant in the perimenopause, so it is important to discuss a method of contraception with your doctor.

If you are using HRT and depending on the type you are using, the progesterone only pill or the Mirena coil can be used safely.

Menopause Diagnosis: Is There a Menopause Blood Test

Is there a test for the menopause?

Most women will not require a blood test to diagnose the perimenopause or menopause. For most, the menopause diagnosis will be based on your symptoms, your age and your period history.

Blood tests can be helpful in younger women where the perimenopause is questioned, and of course some blood tests can be helpful to look at in order to gauge a picture of your overall health. These tests can be discussed with your doctor.  

Menopause and Weight Gain

Does menopause cause weight gain?

Many women find it harder to control their weight as they enter the peri/menopause. Weight gain is complicated and due to a variety of factors:  

• Fluctuating levels of hormones: As oestrogen levels decline the way the body stores fat changes. Fat is more likely to be stored around the abdomen and thighs and is less evenly distributed compared to perimenopauslly. This can then lead to a change in your body shape even if your weight actually remains the same.  
• Women’s metabolic rate: (the rate at which you burn calories) slows down. Women often require fewer calories as they transition through this phase meaning that eating the same way as you have done before may cause weight gain.  
• Muscle mass: We lose muscle mass as we age (known as sarcopenia) and muscle helps to burn calories, less muscle mass means burning fewer calories leading to weight gain.  
• Symptoms: The menopause symptoms experienced as we transition through this time can be hard to manage – lack of sleep, lack of energy, fatigue, low mood to name a few. This can leave us reaching for the higher energy, less healthy snacks.  These symptoms can also reduce our desire to exercise which can lead to weight gain.  
• Many of us are juggling relationships, work, and our menopause symptoms and we forget to take time to self-care. The stress hormone cortisol can be triggered which also causes us to gain weight 

How to manage weight changes in the peri/menopause?

• Maintain a Healthy Diet: Focus on a balanced diet rich in fruits, vegetables, eat more protein, and whole grains. Fat is not your enemy – focus on eating good fats like avocados, oily fish, nuts and seeds. In short, eat the rainbow! 
• Regular Exercise: Engage in regular physical activity to help maintain muscle mass and boost metabolism. A combination of cardiovascular exercise and strength training can be effective. 
• Stress Management: Practice stress-reduction techniques, such as yoga, meditation, or deep breathing exercises, to manage stress and emotional eating. 
• Adequate Sleep: Prioritise good sleep hygiene to ensure you get enough rest each night. 
• Hormone Replacement Therapy (HRT): HRT is an excellent treatment option for managing menopausal symptoms. Discuss the benefits and risks of HRT with your healthcare provider. 
• Consult a Healthcare Provider: If you are struggling with significant weight gain during menopause, consider consulting a healthcare provider or a registered dietitian or nutritionist. They can provide personalised advice and recommendations.

At London Gynaecology, we have specialist menopause clinicians and nutritional therapists to support you through the menopause, if you would like to book a personalised menopause consultation, click here.

Menopause and Anxiety

Does menopause cause anxiety?

Anxiety is a common perimenopause symptom and can often be one of the first symptoms that you might notice. For some women, this is the first time they have experienced anxiety whilst for others, they may have experienced it before, and their anxiety has worsened. Anxiety can manifest as a feeling of fear, panic, feeling overwhelmed or a general feeling of worry.  

Hormone fluctuations and our stress responses can make the anxiety worse, so it is important to take the time to look after yourself and manage your stress levels wherever possible. Yoga, mindfulness and relaxation therapies can help and there are various apps which can support you through some meditation practices.  

Hormone replacement therapy may be used if it is felt that hormone fluctuations are contributing to your anxiety. It is also worth noting that some anti-anxiety medications can be extremely helpful too.  

Cognitive behavioral therapy (CBT) can also be beneficial in the peri/menopause and is based around talking therapy. There is lots of evidence that it can be helpful in managing hot flushes too.  

A holistic approach is key.  

Our New Harley Street Clinic Is Open

Step into a world of exceptional healthcare at our brand-new location in the heart of London ‘s medical district at 145 Harley Street, W1G 6BJ.  We are delighted to welcome all patients seeking excellent medical care in a luxurious setting.

Our state-of-the-art clinic, where advanced diagnostics and comprehensive services meet elegance, is equipped with cutting-edge medical diagnostic technology has been carefully designed to provide patients with the utmost comfort and convenience in a luxurious and relaxed setting.

Your journey to exceptional women’s health begins at 145 Harley Street.

 

 

What to Expect in a Private GP Appointment?

If you have never visited a private GP before, you may be unsure of what to expect.  Below outlines what a private GP consultation typically comprises of:

1. Medical history: We will begin by taking a detailed medical history, which includes information about any pre-existing medical conditions, allergies, medications, and previous surgeries.

2. Physical examination: We will carry out a thorough physical examination, which may include checking your observations, such as blood pressure, temperature, and pulse. We may also examine your ears, nose, and throat, listen to your heart and lungs, and check your reflexes.

3. Health concerns: You will have the opportunity to discuss any current health concerns or symptoms that you are experiencing. We will ask you questions to help determine the underlying cause of your symptoms.

4. Diagnosis and treatment plan: Based on your medical history, physical examination, and symptoms, we will diagnose your condition and develop a customised treatment plan. This may include prescribing medication, recommending lifestyle changes, or referring you to a specialist for further investigation or treatment.

5. Follow-up care: We may schedule follow-up appointments to monitor your progress and adjust your treatment plan, if necessary.

6. Additional services: We offer additional services, such as health screenings, diagnostic tests, and vaccinations, which can be arranged during your consultation or at a later date.