An expert guide to menopause


Dr Elise Dallas of The London General Practice on how HRT, lifestyle modifications and personalised care can alleviate the symptoms of menopause

In simple terms, what is the menopause?
Menopause is a natural biological process that marks the end of a woman's reproductive years. It typically occurs between the ages of 45 and 55, with the average age of onset being around 51.

Perimenopause, often referred to as the ‘menopausal transition’, is the stage that precedes menopause. It can start several years before menopause and is characterised by hormonal fluctuations and irregular menstrual cycles.

What are the main symptoms?
Women may experience a number of different symptoms during perimenopause, as well as during menopause itself, and these can vary from woman to woman. Common symptoms include hot flushes, night sweats, mood swings, vaginal dryness, decreased libido, irregular periods, and sleep disturbances, all of which can significantly impact a woman’s physical and emotional well-being.

How can these symptoms be alleviated?
One widely used treatment option for managing menopause symptoms is hormone replacement therapy (HRT). HRT involves the supplementation of declining hormone levels in the body, specifically oestrogen, progesterone and – in some cases – testosterone. It is important to account for individual considerations and medical history, as HRT is not suitable for everyone. However, in most cases, if started before the age of 60, the benefits of HRT outweigh the risks.

Dr Elise Dallas of The London General Practice

Dr Elise Dallas of The London General Practice

Can lifestyle modifications also have an impact?
Nutrition plays a crucial role in supporting overall health during this transitional phase. A well-balanced diet consisting of fruits, vegetables, whole grains, lean proteins and healthy fats can provide essential nutrients and promote hormonal balance. Avoiding excessive consumption of caffeine, alcohol and spicy foods may also help alleviate hot flushes and other symptoms.

Regular exercise is also beneficial. Engaging in activities such as walking, swimming, yoga or strength training can improve mood, reduce stress, promote better sleep and help maintain a healthy weight.

Quality sleep is vital for overall wellbeing and can have a positive impact on menopause symptoms. Establishing a comfortable sleep environment, practicing relaxation techniques before bedtime, and following a consistent sleep routine can promote better sleep quality.

Emotional wellbeing is equally important. Engaging in stress-reducing activities such as meditation, mindfulness, or seeking support through counselling or support groups can help manage mood swings, anxiety, and depression that may arise during this time.

What impact can menopause have on heart and bone health and how can this be managed?
Oestrogen plays a protective role in maintaining cardiovascular health and bone density, making HRT an essential consideration. Adopting heart-healthy habits, such as regular exercise, maintaining a healthy weight, managing blood pressure and cholesterol levels and avoiding smoking can contribute to overall wellbeing. Adequate calcium and vitamin D intake and weight-bearing exercises are recommended to support bone health.

How would you sum up you approach to menopause?
Menopause is a natural transition experienced by all women, and though it may present challenges, it is a manageable phase of life. While HRT can effectively manage symptoms and improve heart and bone health, lifestyle factors such as nutrition, exercise, sleep, and emotional wellbeing also play key roles. At The London General Practice, we specialise in personalised assessment and care plans tailored to your needs, ensuring optimal bone and heart health and improving comfort, well-being, and quality of life during menopause.