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 99 (Winter 2023-24) of The Menopause Exchange newsletter.
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What impact can HRT have on thyroid medicines? Does this apply to all forms of HRT?
The relationship between HRT and thyroid medicines varies, depending on the specific hormones involved and your medical condition. Oestrogen may influence your production and metabolism of thyroid hormones and enhance their effects on your body. The impact of this can depend on the specific oestrogen being used in HRT; oral oestrogen may have more impact than transdermal oestrogen (e.g. skin patches), for example. Progesterone may have a more subtle effect on thyroid function than oestrogen, but it can influence how well your thyroid gland responds to thyroid-stimulating hormone. As with oestrogen, these effects may vary depending on the form of progesterone in HRT. Close monitoring by a healthcare professional is essential to assess your hormone levels, adjust the doses of your medicines and address any potential interactions.
What are the positive effects of the menopause?
Sometimes we only hear negative things about the menopause. In fact, this time of life can mean freedom for many women; freedom from periods, from premenstrual symptoms, from cyclical ups and down, and from the need for contraception (but don’t stop too soon!). When it comes to midlife, the usual time of the menopause, many women say that this prompts them to get fitter and healthier as they look towards maintaining good health for the future. This has an emotional impact, too. Some women say the post-menopause stage can be a time of renewed confidence as well as a time to set and fulfil new goals. Some of this increased inner strength doesn’t come directly from hormonal changes but from increasing age and experience, often coinciding with the time of the menopause.
I get cystitis-like symptoms after I’ve had sex. Is there anything I can take or use to stop this happening?
As a preventative measure, you could take cranberry juice or sachets such as Cymalon and Cystopurin, which you can buy from your local pharmacy. You can also buy cranberry supplements in convenient tablet and capsule formulations (e.g. Cranberry Extract, Cysticare and CranProbio). Go to the loo frequently to reduce bacteria, and wash with warm water after sex. Abstain from sex until any infection clears up. Painkillers such as paracetamol will ease any discomfort. Avoid drinks such as fruit juices, coffee and alcohol, which will irritate your bladder. Speak to your local pharmacist to discuss precautionary measures and medicines specific to your needs to avoid recurrent infections.
Can you provide any information for post-menopausal women experiencing irregular bleeding? Vaginal bleeding after the menopause (i.e. more than 12 months without any bleeding), however slight, should be discussed with your GP or nurse practitioner. This is because it could be an early sign of endometrial (womb) cancer and is usually treated as an urgent hospital referral for further investigations. Irregular bleeding while taking HRT is a different matter, as this can be a normal side-effect, but should be discussed with a healthcare professional as well. You may benefit from having a physical examination to exclude a cause for the bleeding, such as a polyp on your cervix, or a transvaginal pelvic ultrasound to rule out any problems with your uterus, such as an abnormally thickened lining. Both problems would need further hospital treatment and possibly a change in HRT or stopping HRT.
What’s the difference between kefir (fermented yoghurt) and prebiotics and probiotics? Which is the best to have for optimum microbiome health?
Probiotics (also known as ‘good’ bacteria) are live bacteria and yeasts believed to have various health benefits. They’re usually added to yoghurts or taken as supplements and are thought to help restore the natural balance of bacteria in the gut and therefore confer a wide array of health benefits. Prebiotics are a non-digestible food ingredient, usually fibre, that selectively stimulates the growth and/or activity of one or a limited number of good bacteria in the colon. It can be thought of as a food to encourage good bacteria activity. To increase your prebiotic intake, have more fibre in your diet or take a prebiotic supplement. Kefir is an example of a probiotic. This is a drink made from the fermented milk of a cow, goat or sheep. It’s made by adding kefir grains, which contain yeast and probiotics, to the milky liquid and allowing it to ferment to form the yoghurt-like drink. Kefir contains many species of probiotics that are thought to improve gut health and has other health benefits associated with probiotics.
Created Winter 2023-24
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