Expert FAQ On Menopause, Perimenopause & HRT

Many clients have questions about the menopause, perimenopause and HRT. 

The May Wellness Centre is delighted to be offering the services of Tracy-Louise Appleyard is a Consultant Obstetrician and Gynaecologist, an authority on the subject of women’s health.

In this video, Dr John Quinn asks a series of common questions for Tracy-Louise Appleyard to give her expertise.

Menopause, Perimenopause and HRT FAQ

How would I know that I am in the menopause?

Tracy-Louise Appleyard explains:

“So the menopause is is their last menstrual period that you have and so women can have menopause because they’ve had a surgery to remove a uterus or they can find menopause because they’ve got to the right age and the ovaries have just stopped working.

“So for us medics, the actual definition of menopause is one year after your last menstrual period, but a lot of the issues that ladies have is round about the perimenopause, so when their periods are still not finished, but they’re just messing about, becoming quite irregular and symptoms that are associated with that are quite similar sometimes to the menopause.”

What are the benefits of HRT hormone replacement therapy

“So it’s hormone replacement therapies combination either oestrogen or progesterone and progesterone type products, but what they aim to do is try to minimize the sort of bad side effects of menopause, such as increased cardiovascular disease. So we know that taking HRT as long as there’s no contraindications has a positive effect on that. We know that it does not – particularly if it’s oestrogen alone – actually increase your background risk of breast cancer, which is a fear that many women have. There is some association with the combined preparation, but that I can talk about later.

“We know that it can help your mental well-being and there’s big studies showing that the highest chance of somebody feeling para-suicidal, suicidal actually, the ages are between sort of 51 to 54 at the time of the menopause; so it can be helpful for that.

“And HRT should be considered by doctors when dealing with women in the perimenopause who has got any symptoms of anxiety and depression rather than giving them antidepressants. “

What about breast cancer and HRT?

“I think it’s a really real fear and the biggest issue, but we did put on the Instagram this week a sort of an informatic, so just lots of pictures which show the risk and actually the biggest risk for breast cancer in women is being obese and overweight and that increases your risk hugely.

So if you were to exercise for more than 150 minutes a week then that reduces your chance of breast cancer. If you don’t smoke, if you’ve got an optimal BMI… and so then the risk of the breast cancer if it’s oestrogen only and people take that because they’ve had a hysterectomy, then there is no increased risk of breast cancer. There is a slight increased risk when taking the oestrogen progesterone formulation, and on some of the information people liken it a bit to taking the combined oral contraceptive pill – there is an increased risk with that, but that doesn’t stop people taking that pill. What we have noticed is, there is no studies confirming an increased risk of death from breast cancer from HRT.”

Does HRT make you fat?

“So people always assume that if you take hormones you will get fat, but actually many women find they lose weight because they’ve got more joie de vivre, they’ve got more get-up-and-go, they feel better in themselves. And so actually there there is no association with increased weight.”

How is HRT actually administered?

“So there’s many different formulations.

“If you talk about oestrogen because you’ve got a combined preparation oestrogen can be delivered either by a patch or by a gel and actually many of us within the menopause trade think that’s preferential because that has bypasses the liver, so that’s just got the health benefits about it. Does not increase your risk of a clot in your leg or your lung.

“But you can take it as a tablet. There’s also a ring which you can put into the vagina and that delivers local oestrogen to the vagina. So we can also deliver local oestrogen to the vagina through tablets and there is a new tablet which is not a classical HRT, it’s not an oestrogen preparation, but that also helps with that aspect.

“With progesterone it’s very similar, it can be combined in a patch, you can use a tablet, you can also put that tablet into the vagina at night, which is although off-licence lots of women like that.

“Some people talk about using bioidentical and more bespoke; again that’s not recommended, we think that some of those are particularly not safe because they’ve not been tested so we would recommend the prescribed route.”

Consultant Gynaecologist, Bristol

Dr John Quinn trained as a GP and practised for many years. He explains how much he values Tracy’s expertise within the team at The May Wellness Centre:

“There are a lot of so-called experts – doctors who do what I do, who go on a short course and suddenly become medical specialists

“I worked for as a GP for over a decade and certainly wouldn’t consider myself an approaching an expert in that at all. So when when I wanted to introduce it into the practice, this is why we have a consultant gynecologist.

“…there’s so much information out there, with increasingly, sadly, social media becomes where people learn about everything and actually there’s no substitute for really good advice.”

Contact The May Wellness Centre

If you'd like to speak to someone about treatment with one of our professionals, please get in touch:

• Tel 0117 924 4592
• Email info@maywellnesscentre.co.uk
• Address 4 Redland Court Road, Bristol, BS6 7EE