Menopause care
It is not an illness, and it is not something to be endured in silence either.
A stage of life, not a loss
Menopause is confirmed after twelve consecutive months without periods. The years leading up to it — perimenopause — are often the most disorienting: irregular cycles, unpredictable bleeding, hot flushes appearing while periods are still present.
Symptoms vary enormously from one woman to another. Hot flushes and night sweats, broken sleep, irritability, joint pain, vaginal dryness and discomfort during sex, loss of desire, urinary problems: some women scarcely notice any of it, others see their daily life come apart for years. None of these situations is to be brushed aside.
Care is discussed case by case. It may be local or general, hormonal or not, and it takes account of your personal and family history — breast and cardiovascular history in particular — of how much the symptoms trouble you, and of what you want. Hormone therapy has precise indications and equally precise contraindications: it is neither to be offered as a matter of course, nor ruled out on principle.
This stage of life also shifts what needs watching: bone health, cardiovascular balance, breast screening, and investigation of any bleeding occurring after menopause — that one is never simply monitored, it is investigated.
Questions about menopause
When does menopause actually begin?
After twelve consecutive months without periods, once other causes have been ruled out. The preceding years, known as perimenopause, often bring irregular cycles and the first symptoms.
Is hormone therapy necessary?
Not as a matter of course. It comes up for discussion when symptoms genuinely affect daily life, and after your medical history has been reviewed. It has precise indications and equally precise contraindications: it is a shared decision, not an automatic prescription.
Should I keep consulting after menopause?
Yes. Follow-up does not stop when periods do: cervical and breast screening, bone health, cardiovascular prevention, and investigation of any new symptom.
Is bleeding after menopause normal?
No, never. Any bleeding after menopause has been confirmed must be investigated without delay, even if it is slight and happens only once. The cause is usually harmless — all the more reason to find it straight away.
Other consultations
Care after menopause draws on these areas of practice.
Talking it through
A consultation of its own makes room to take stock, rather than address one symptom.