MENOPAUSE

MENOPAUSE

What Is Menopause?

Menopause defines the time when a woman’s reproductive life comes to an end and is marked by the end of her menstrual periods.1 This is also known as ‘the change of life’.

The symptoms which many women suffer at menopause are primarily a result of oestrogen deficiency.1 They may be short-term (like hot flushes and night sweats) or long-term (like osteoporosis), psychological, general or more localised.1,2,3 Whatever their nature, doctors now seem to agree that menopausal symptoms justify treatment.3,4

Menopausal Symptoms

VASOMOTOR1,2

vasometer
Hot flushes
Night sweats

WEIGHT3,5

weight
Weight gain

BONE3,5

bone
Bone loss
Risk for
osteoporosis

GENITO-
URINARY1,2

Genito-Urinary
Irregular periods
Vaginal dryness
and itching
Painful intercourse

SKIN & HAIR5

skin and hair
Skin dryness and
thinning of scalp hair
Excessive hair
growth on the face

MOOD1,2

mood
Irritability
Anxiety
Depression
Sleep disturbances
Fatigue
quote
Menopausal
symptoms
can be both
physical and
psychological
in nature.1,2
quote

HEART4,5

heart
Higher risk of
heart disease
Palpitations

The Menopause
Guidebook

Our Menopause Guidebook is a comprehensive, valuable and educational resource for women. Inside you’ll find information regarding important topics such as menopause symptoms, sexuality, urinary incontinence, vaginal dryness, treatment options, medical conditions (such as osteoporosis and cancer), and advice for healthy living.

Treatment Options

Pharmaceutical MHT (Menopause Hormone Therapy) products usually contain hormones synthetically manufactured to be chemical duplicates of hormones produced by women’s own ovaries. These products are well-tested and have been approved by the pharmaceutical regulatory bodies such as our own Medicines Control Council or the FDA in the USA.3,6

Speak to your doctor about which type of MHT will be best suited to you. Different types of MHT products are available (e.g. tablets, skin patches and gels). All pharmaceutical hormone therapy choices effectively relieve the symptoms of menopause.1,3

Taking your medical history, type of symptoms and personal preferences into account, your doctor will advise you on which type of MHT will benefit you the most.

MENOPAUSE
PATCHES

Menopause Patches

Patches allow for a high concentration of active ingredient, embedded in microscopic pockets, to move to the skin surface in a continuous manner, resulting in sustained delivery of the active ingredients to the body.7

Patches effectively relieve menopausal symptoms and protect against bone loss, yet offer lower hormone doses vs. tablets.8,9 Technological advances in the way that patches are designed and hormones are delivered allow for smaller patches that are discreet and cosmetically acceptable.7 Patches tend to stick quite well and allergic reactions are rare.9 In a clinical trial, < 1 % of patches came loose or were lost, while 78 % of women experienced no redness, and > 95 % of women experienced no itchiness.7

Should you need more information on Menopause Hormone Therapy patches, speak to your doctor.

MENOPAUSE
HORMONE THERAPY
(MHT) TABLETS

Menopause Tablets

Different kinds of Menopause Hormone Therapy (MHT) tablets are available for the management of menopausal symptoms. Your doctor will help you choose the most appropriate option taking into account whether you still have a uterus or not, and whether you are perimenopausal or postmenopausal. Some women may still have menstrual bleeding when starting MHT.

It is important not to mistake MHT tablets for birth control tablets. Menopause Hormone Therapy does not provide protection against pregnancy.5

Should you need more information on Menopause Hormone Therapy tablets, please speak to your doctor.

MENOPAUSE
HORMONE THERAPY
(MHT) GEL

Menopause Gel

Oestrogen gel is another option used to relieve symptoms of menopause.10 It is applied as a thin layer on the arm from shoulder to wrist, once a day, at the same time every day.10

With hormones applied to the skin, care should be taken to avoid inadvertent transfer to children and animals.11 Do not allow anyone to touch the area where you have applied the gel for 1 hour after application.10 This also applies to applications of creams e.g. sunscreens.10

Should you require more information on oestrogen gel, speak to your doctor.

Frequently Asked Questions

Menopause defines the time when a woman’s reproductive life comes to an end and is marked by the end of her menstrual periods.1 This is also known as ‘the change of life’.

The symptoms which many women suffer at menopause are primarily a result of oestrogen deficiency.1

They may be short-term (like hot flushes and night sweats) or long-term (like osteoporosis), psychological, general or more localised.1,2,3 Whatever their nature, doctors now seem to agree that menopausal symptoms justify treatment.3,4

Speak to your doctor about which type of MHT will be best suited to you. Different types of MHT products are available (e.g. tablets, skin patches and gels). All pharmaceutical hormone therapy choices effectively relieve the symptoms of menopause.1,3

Taking your medical history, type of symptoms and personal preferences into account, your doctor will advise you on which type of MHT will benefit you the most.

The most recent consensus statements from local and international experts support this view, stating that women should rest assured that the possible increased risks of breast cancer associated with Menopause Hormone Therapy (MHT) are small and are similar to the increased risks associated with common lifestyle factors such as obesity and alcohol consumption.3,13,14

BREAST CANCER RISK IN WOMEN TAKING MENOPAUSE HORMONE THERAPY (MHT) 3,13,14

BREAST CANCER RISK IN WOMEN TAKING MENOPAUSE HORMONE THERAPY (MHT)3,13,14.Oestrogen-only Up to 13 years No increase in risk14.Combined oestrogen + progestogen < 1 additional case per 1 000 women per year13,14

Media will often report on the relative risk of breast cancer when talking about Menopause Hormone Therapy (MHT), without reporting on the real or ‘absolute’ risk.12 The table reports absolute increased risk, which is less than 0.1 % per year.13,14

The 5 steps of a breast self-examination15

Step 1 – Looking:

Begin by looking at your breasts in the mirror with your shoulders straight and your arms on your hips.

Here’s what you should look for:
  • Breasts that are their usual size, shape and colour
  • Breasts that are evenly shaped without visible distortion or swelling
If you see any of the following changes, bring them to your doctor’s attention:
  • Dimpling, puckering or bulging of the skin
  • A nipple that has changed position or an inverted nipple (pushed inward instead of sticking out)
  • Redness, soreness, rash or swelling

Step 2:

Now, raise your arms and look for the same changes.


Step 3:

While you are at the mirror, look for any signs of fluid coming out of one or both nipples (this could be a watery, milky or yellow fluid or blood).


Step 4 – Lying down:

Next, feel your breasts while you are lying down, using your right hand to feel your left breast and then your left hand to feel your right breast. Use a firm, smooth touch with the first few finger pads of your hand, keeping the fingers flat and together. Use a small circular motion to examine the entire breast from top to bottom, from side to side, from your collarbone to the top of your abdomen and from your armpit to your cleavage.


Step 5 – Shower:

Finally, feel your breasts while you are standing or sitting. Many women find that the easiest way to feel their breasts is when their skin is wet and slippery, so they like to do this step in the shower. Examine the entire breast, using the same hand movements as described in Step 4.

shower

Women often gain weight in their 40’s and 50’s, and they tend to attribute this weight gain to menopause. Although menopause may play a role, weight gain seems to mainly relate to aging and changes in lifestyle. Factors identified that have an influence on weight gain during menopause include a decrease in exercise, and an increase in food and alcohol consumption.5

As one grows older, muscle mass tends to decrease, while fat mass tends to increase. The distribution of fat also changes from the known pear-shape, with fat distribution around the hips and thighs, to an apple shape, where fat distribution is more around the abdomen and waist area. Being overweight increases the risk of heart disease.5

Despite a decline in fertility during perimenopause, and even if a few months have passed without a period, women are not totally protected from an unplanned pregnancy until menopause has been confirmed after 12 consecutive months without periods.5 Your doctor will advise you on an effective and appropriate method of birth control.

The Pap test screens for early warning signs of cancer of the cervix. After the age of 30, you should have a pap test every 3 years, but the timing will depend on your history and your doctor.16,17

The national policy on cervical screening in South Africa allows for three smears in a woman’s lifetime taken at 10 year intervals from 30 years of age.17

pap