Norfolk Menopause

Exercising outdoors during menopause offers so many health benefits.

Outdoor activities help regulate hormones, reduce symptoms like hot flashes and mood swings, and strengthen bones to combat osteoporosis. It improves cardiovascular health, aids in weight management, and enhances mental well-being through endorphin release and sunlight exposure, which boosts vitamin D production. Nature reduces stress and improves sleep quality by regulating circadian rhythms. Overall, outdoor exercise provides a holistic approach to managing menopausal symptoms and promoting physical and mental health.

So get outside and take a healthy approach to your menopause journey!

Earlier this week, we were back at Fitter Bodies to try out one of Nadine’s sessions. Great fun and a great atmosphere, and boy are we going to ache tomorrow. Will try Nadines’s tip of plenty of water and protein today...

Here are some reasons why building and maintaining muscle is so important in midlife…

- Strong muscles help to build strong bones. When your muscles pull on your bones it gives them work to do and your bones will respond by renewing themselves. Having strong muscles and using them therefore helps to positively remodel bone.

- Building muscle helps you burn fat. We all know that body composition changes in mid life. Spare tyre anyone? But to shift this stubborn fat and improve body composition focus on building muscle rather than losing fat. Muscle is metabolically active and building lean muscle will mean you lay down less fat and lose extra fat.

- Building and then maintaining muscle in mid life delays frailty. Life is not an inevitable spectrum from vitality to frailty, and what we do in midlife has a huge impact. Think of muscle as a protective armour for your body, it keeps you moving and cushions you if you do fall. Let’s think about our healthspan and try to prolong it as much as possible.

Lots more tips to follow!

Why is it so hard for some women to get the help they need in perimenopause? Time and time again we hear the frustrations of women who have struggled to get a diagnosis and support.

This seems to be due to a combination of a lack of knowledge (in the population in general and health professionals) and the huge variability of symptoms. We want to do our bit to help change this by working with women and sharing our knowledge with local health professionals.

Do look at our social media posts for regular updates and education events.

Here’s a recap from Emily’s video on using transdermal (skin based) patches in hot weather. She saw a lady in clinic earlier this week who had just come back from Greece and started having issues on holiday as her patches did not stick as well as normal.

Most women don’t have problems with patch adhesion, but hot sweaty skin and suncream could both potentially make patches less likely to stick well. Stick to the general rules of applying patches to cool, clean, dry skin. So don’t change a patch when you’ve just come in from the sun, and are hot and sweaty with residual sun cream or after sun on. Do it after a cool shower to a clean area of skin. Rub gently for 20-30 seconds to encourage adhesion.

Take a few extra patches with you just in case, the last thing you need on holiday is to run out. If a patch falls off, just apply a new one. Each one will last up to 4 days and gives a steady release of hormones during that time so you won’t get higher levels from applying sooner than usual.

If anyone has their own tips on using HRT in very hot weather please do share.

In this video Emily talks about using transdermal (skin based) patches in hot weather. She saw a lady in clinic earlier this week who had just come back from Greece and started having issues on holiday as her patches did not stick as well as normal.

Most women don’t have problems with patch adhesion, but hot sweaty skin and suncream could both potentially make patches less likely to stick well. Stick to the general rules of applying patches to cool, clean, dry skin. So don’t change a patch when you’ve just come in from the sun, and are hot and sweaty with residual sun cream or after sun on. Do it after a cool shower to a clean area of skin. Rub gently for 20-30 seconds to encourage adhesion.

Take a few extra patches with you just in case, the last thing you need on holiday is to run out. If a patch falls off, just apply a new one. Each one will last up to 4 days but gives a steady release of hormones during that time so you won’t get higher levels from applying sooner than usual.

If anyone has their own tips on using HRT in very hot weather please do share.

Here are some top tips which were brought up in discussions at the Fitter Body event earlier this month.

Thanks Nadine for organising such a fun evening. And to all the ladies for your questions and for sharing your experiences. I could write an essay on the discussions, but ‘top tips’:

- Perimenopause is a CLINICAL diagnosis, there is no blood test for it. A ‘normal’ FSH/hormone test does NOT mean your symptoms are not due to perimenopause.

- Menopausal symptoms can be especially tough after ‘induced’ menopause from surgery or other medical treatment, all women in this situation need support
Remember HRT has huge benefits to our bones and cardiovascular health when it is taken in the right way and started within 10 years of natural menopause.

- There is no arbitrary limit as to how long HRT can be used for, the small risks increase over time but the benefits are also cumulative. This decision needs to be individualised.

- Good menopause management is NOT JUST ABOUT HRT. Some women can’t or don’t want to use hormonal management

- Peri/menopause should be seen as an opportunity to think about our longterm health and wellbeing. We need to prioritise ourselves (for once!).

- If you want to try herbal remedies look for the THR logo to make sure they are regulated and do your research. AboutHerbs App (from Memorial Sloan Kettering cancer centre in USA) is free and gives great information. Black Cohosh, Red Clover and Ashwagandha are worth a look.

- WEIGHT TRAINING - thanks Nadine, we are looking forward to coming for a session and seeing what you are all about!

Finally a shout to Little Lifts for all the work they do, ticket sales from this event have been donated to them.

Soak up some sunshine this summer (as and when the weather allows!) and boost your ability to cope with menopause symptoms…

This post is for women who might have been told they can’t have HRT as they could not have the pill.

Though both combined HRT and the combined pill contain oestrogen and progestogen there are key differences that mean this is usually NOT the case:

- The combined pill uses high doses of synthetic oestrogen. HRT has much lower doses of natural oestrogen and can be delivered through the skin to reduce clot risks

- The progestogen in HRT can be the natural body identical Utrogestan which is better tolerate for most women who find progestogens hard to get on with.

SO the majority of women who have been advised against the pill or who have not got on with it can use HRT should they wish to. HRT is all about tailoring to the individual.

It’s not all about HRT!

We are very aware that HRT is just ONE facet of menopause management, and is not available for everyone.

We want all women to have good advice about a multi-layered menopause toolbox they can access.

With this in mind, Emily is looking to develop a series of leaflets about non-hormonal management of menopause, and management of symptoms for women who have had breast cancer.

She started by looking at the management of GSM (Genito-urinary syndrome) of menopause and thinking about vaginal oestrogen use in these women.

Her top tips are
• non-hormonal management is always going to be the first line.
• but vaginal oestrogen can certainly be considered if needed EXCEPT IN WOMEN CURRENTLY ON AN AROMATASE INHIBITOR.
• An Oestriol rather than Oestradiol-based vaginal oestrogen makes sense.
• BLISSEL GEL or IMVAGGIS PESSARIES are both ultra-low dose Oestriol preparations that would be suitable.
• Your prescriber should liaise with your breast oncologist or at least let them know.

Much more info to come in the leaflet!