The following ‘Ask the Experts’ questions were sent in to The Menopause Exchange by our members, the answers were provided by our ‘Ask the Experts’ panel and included in issue 98 (Autumn 2023) of The Menopause Exchange newsletter.

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I work in HR and have been asked to organise help for all of our employees going through the perimenopause and menopause. What should I be doing?

You need to see what information and advice (such as a menopause policy) is already available at your workplace. Think about how working in the company could affect perimenopausal and menopausal women, such as the office environment (in relation to hot flushes). Consider a flexible working policy for people who experience night sweats, which can lead to insomnia and then fatigue during the working day. Is there an occupational health department or an Employee Assistance Programme in the workplace? What well-researched impartial, practical menopause information is already available, and is there any internal communication about the menopause between line managers, employers and employees. Could your workplace set up a menopause café? Information could be provided via the intranet, newsletter or weekly bulletin if you have any of these. Contact The Menopause Exchange for help.

My menopause symptoms are quite severe so my GP will be giving me a prescription for HRT. How long will it take to work and will this depend on the type and form of HRT?

The type of HRT you’ll be prescribed will depend on whether you’re perimenopausal or postmenopausal. You should see some benefit with symptom control within a few days to a week. The form shouldn’t really affect how long the HRT takes to work, but women have individual responses. When starting on HRT, initial side effects, such as breast tenderness, can take up to three to four months to settle. Women who are perimenopausal are usually prescribed an HRT regimen that causes monthly bleeds. With these, it can also take three to four months to settle, so keep a bleed diary to discuss at your review appointment. Some women will be offered an oestrogen with the Mirena intra-uterine system as their HRT preparation as this can help with bleed control during the perimenopause. Women who are postmenopausal (who have not had a menstrual period for over a year) can be prescribed a monthly bleed HRT or started on a formulation that means they stay bleed free. It can take up to six months to settle on bleed-free HRT. Various HRT formulations are available, offering women a choice. A change in HRT regimen may be offered if women don’t settle as expected on their HRT preparation. It’s important to use the HRT correctly.

I’m 48 and am going through the menopause. I’m worrying about everything and suffering from anxiety. I’m finding it difficult to cope with work, a daughter who has just changed schools, and a widowed mother who finds it difficult to look after herself. Do you have any advice for me?

It’s understandable to feel anxious and overwhelmed when faced with so many changes and responsibilities, simultaneously. juggling what our bodies are experiencing and what’s going on in our minds. Eating a balanced diet with plenty of fruit and vegetables, avoiding alcohol, reducing caffeine intake, and getting daily activity in the fresh air alongside adequate sleep are important ingredients for good mental health. Deep breathing techniques, guided visualisations and meditations (both found on the internet) and acupuncture reportedly help with relaxation. Writing down nervous thoughts can clear the mind, but preferably don’t do this just before sleep when it’s more calming to remember the good happenings of the day. An as-often-as-practical pamper, big or small, and talking and laughing with friends and family can also help to reduce anxiety. But if these measures prove to be insufficient, seeking out the advice of a healthcare professional may be the way forward.

I’m an acupuncturist. A few patients in the age group of the menopause complain of generalised itching: a feeling of ants crawling over the skin. Is this a menopausal symptom and, if so, why does it occur at this time of life?

General itching isn’t uncommon during the perimenopause. It’s called formication and can be very uncomfortable. Sometimes it’s described as a crawling sensation. Research suggests that hormone fluctuations can trigger sensitive skin during the perimenopause, including this itching sensation. Skin dryness also increases at this time of life, so moisturising your skin more regularly may help, as well as wearing looser clothing. Antihistamines, especially when taken at night, may help to combat the itch. You can buy suitable antihistamines over the counter, but speak to a healthcare professional before you take them. These are usually a short-term solution. If the itching is part of a cluster of menopausal symptoms, you may find that HRT helps.

Created Autumn 2023
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Tags: acupuncturist, Antihistamines, anxiety, Deep breathing techniques, Employee Assistance Programme, formication, HR, HRT, itching, menopause, Menopause Cafe, Mirena intra-uterine system, perimenopause, symptoms