Menopause is the bridge between an ending and a beginning - here's how to survive the crossing. Article from YOU Pulse magazine.

“I became terribly forgetful and irritable – I was short tempered and would start crying for no reason.”

For women menopause is the bridge between an ending and a beginning – but the crossing is fraught with hot flushes, night sweats, mood swings and forgetfulness. Is help available? Is hormone therapy safe or dangerous? And what about the so-called male menopause? Here’s the low-down
By Mariëtte Crafford

I’m on fire!’’ my middle-aged neighbour complains at a mutual friend’s 50th birthday tea party. She fans herself with a magazine. ‘‘I can’t sleep. I toss and turn all night,’’ another joins in.

‘‘I jerk awake drenched in sweat,’’ says a third. ‘‘And my family has to watch out – I wake up happy but by lunchtime I’m miserable and cry for no reason. I don’t know what’s wrong with me.’’

Most of the women at the tea party are going through their menopause. Th e birthday girl however is as cool as a cucumber. ‘‘I can’t complain about menopause yet,’’ she says. ‘‘But my husband! It’s like living with a stranger. New car, new hairstyle, new clothes . . . but nothing new in bed!’’

The menopause affects everyone differently
The flood of complaints around me reminds me of what lies ahead. So I question an expert about the menopause. It’s not just that I want to be prepared; I also want to understand what my friends – female and male – are going through.,/p>

There’s much confusion about the various treatments and I have plenty to ask. In fact the words ‘‘menopause’’ and ‘‘hormone therapy’’ are words that can cause hot flushes by themselves. ‘‘Male menopause’’ (or andropause) is even more bewildering . . . And this is all because of a series of misconceptions, doctors say.

Dr Tobie de Villiers, gynaecologist and committee member of both the South African Menopause and International Menopause Societies, clears up some of the confusion.

Question: What’s the best treatment for the symptoms of menopause?

TdV: The only treatment that results in a dramatic improvement of all the symptoms is hormone therapy (HT). HT involves either only oestrogen hormone therapy (EHT) or a combination of oestrogen and progesterone therapy (EPT).

Women don’t all experience the same symptoms in the same way. However no woman should have to suffer because oestrogen therapy, whether on its own or with progesterone, really works.

Your hot flushes and night sweats (which are actually hot flushes at night) should stop within14 days after starting HT. You’ll also sleep better and be less moody and your quality of life will improve.

HT also reduces the possibilities of osteoporosis and heart disease if you start the therapy as soon as possible after menopause. Because hot flushes and the other unpleasant menopausal symptoms don’t usually last longer than five years your doctor will interrupt the treatment after that time to see if you still need it.

If HT is used to treat or prevent osteoporosis the treatment could last longer, with a specialist’s approval. But women older than 60 should preferably use a skin patch, which releases a lower dose.

If you’re a suitable candidate for EHT the sooner you start using it the more effective it’ll be. It’s available in pill form, as a patch and in gels.

Question: Should all menopausal women have HT?

TdV: No! Firstly only one or two in every five women experience symptoms so severe they need treatment. Secondly not all women are suitable candidates for EHT. It’s important to remember that while menopause can be uncomfortable it isn’t a disease. It’s a physiological reality all women go through. Many women say they feel more relaxed, wiser and more at peace with themselves once the uncomfortable bit is over.

In fact, menopause is an excellent opportunity for women to pay attention to their overall health. Take a look at your eating habits and weight. Get fitter and try to stress less. Go for the tests your doctor recommends, including cholesterol, blood glucose, thyroid function and bone density tests. Also have a mammogram done.

YOU Pulse: Why do doctors change their tune about HT every few years? Is the treatment safe or not?

TdV: Forget about researchers’ interpretations of the Women’s Health Initiative (WHI) findings. The WHI writers owe women and doctors around the world an apology for the confusion. They’ve exaggerated the dangers of HT. Hormone therapy is perfectly safe, provided it’s used correctly.