The following ‘Ask the Experts’ questions were sent into The Menopause Exchange by our members, the answers were provided by our ‘Ask the Experts’ panel and included in issue 104 (Spring 2025) of The Menopause Exchange newsletter.
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Is there a test I can have to find out if I’m going through the menopause?
If you’re under 40 and think you may be going through an early menopause, it’s important to speak to your doctor and start investigations. If you’re aged 40 to 45 and think you’re menopausal, a hormone test may be misleading. So if you have a change in periods and menopausal symptoms, your doctor may make a diagnosis without blood tests. If the diagnosis is unclear, your doctor may suggest an FSH test, but you may need more than one over a couple of months. If you’re over 45, your hormones will be fluctuating so a test isn’t needed or helpful. Your body will be letting you know these changes are happening to you with typical menopause symptoms and a change in periods. Since a blood test may be misleading as a diagnosis, it’s better to listen to your body.
I’m a nurse working in a GP practice. Can you tell me about new HRT products?
Generic natural progesterone or Gepretix are new capsules containing 100 mg natural progesterone, similar to Utrogestan. Natural progesterone, Utrogestan or Gepretix can be prescribed with oestrogen to make up the HRT and can be taken as a monthly-bleed or no-bleed formulation. Lenzetto is a new oestrogen spray used with a cap attached to the spray mechanism to deliver an accurate oestrogen dose. New vaginal oestrogen products include Blissel vaginal gel, a clear water-based oestriol gel that dries quickly. Blissel is inserted directly into the vagina using an applicator or can be applied lightly on the outer area of the vagina. It can be used safely with latex condoms or a diaphragm for contraception. Imvaggis offers another choice and is available as a pessary. It may damage latex condoms.
What’s the difference between cognitive behavioural therapy (CBT) and mindfulness for the menopause?
CBT is a structured, goal-oriented therapy. It’s about actively noting, challenging and reframing unhelpful thought patterns with the help of a professional, who acts like a personal trainer for your brain. Mindfulness is more like yoga for your mind and body. It’s a set of learned skills that can be practised solo, based on focusing your full attention on the present moment. Each time your mind wanders from, for example, mindfully observing your breath – and inevitably it will – the aim is to return your attention back each time without negative judgement. At the menopause, mindfulness supports your body by activating and calming the part of your nervous system that boosts emotional resilience. CBT and mindfulness are evidence-based ways to help you to navigate the menopause and heal from stress.
I’m 54 and my periods stopped two years ago. I’ve noticed over the last year that my memory isn’t as good as it was. Are there any supplements I can take to improve it?
At 54, and having gone through the menopause, it’s understandable to notice changes in your memory. One important point is whether you’re on menopausal hormone therapy (MHT). MHT has been shown to be one of the most effective approaches for improving brain function at this time of life. If you’re not on MHT, and have no clinical contraindication such as a personal history of oestrogen receptor positive breast cancer, MHT might be worth discussing with a healthcare professional. If MHT isn’t an option for you, there’s some evidence that certain supplements may help. Magnesium, lion’s mane (a type of mushroom), and various vitamins (such as B vitamins, vitamin D and antioxidants) have been mentioned in the context of supporting brain health. It’s also important to adopt a holistic approach regarding sleep, exercise and diet. Changes in memory can sometimes be related to other underlying conditions. So it’s important to discuss this with a healthcare professional to rule out other potential causes and to create a personalised plan that best suits your needs.
I’ve lost nearly all of my sense of smell and taste. I’ve had Covid three times in the last two years. Can you help?
There are many causes of a loss or change in the senses of smell and/or taste. It could be due to viruses (such as Covid-19), sinus infections, allergies, growths in the nose or sinuses (called polyps), medicines (e.g. thyroid medicines), hormone problems such as Cushing’s syndrome, a severe head injury or stroke, dental or mouth problems, cigarette smoking, exposure to certain chemicals such as benzene, or radiotherapy to the head or neck. Usually, it’s the change in smell that affects the sensation of taste. A true taste disorder is quite rare. I suggest you speak to your GP, as a referral to an ENT (ear, nose and throat) specialist may be needed to find out what’s wrong if your symptoms have been present for more than two to three months. However, in most cases, your senses will return to normal, although it might take many months for this to happen.
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