Q. My family has a big history of breast cancer. My grandmother died of it, my mother has had a partial mastectomy, her sister has had a full mastectomy, my younger sister has had a double mastectomy. On my fathers side my cousin died of breast cancer, therefore I am aware that HRT will never be an option for me. What are my alternatives should I have a difficult time with menopause? I am 52 and at present am only experiencing mild symptoms which I am able to cope with at present.

I’m sorry to hear of your family’s experience with breast cancer. Although there is no evidence of an increase in breast cancer risk in women how take HRT for less than 5 years, your’s an unusually strong family history and I would therefore be reluctant to prescribe HRT for you, unless your symptoms were unbearable. Hopefully you will be one of the 80% of women who do not suffer severe menopausal symptoms. Taking care of yourself with regards to stress management and limiting caffeine and alcohol is worthwhile. If your symptoms did increase markedly you could try one of the antidepressant medications that have been shown to reduce hot flushes such as Venlafaxine, Paroxetine or Fluoxetine, or possibly a hormonal medication called Tibolone.  You could also seek advice from a naturopath experienced in menopause management regarding black cohosh.

Q. I suffer from regular heart palpitations which seemed to appear around the same time as menopause. Is this a common symptom? And is it something that I should be concerned about?
Q. Should periodic episodes of palpitations, sometimes quite alarming, be treated and are they related to menopause/perimenopause?

Heart palpitations are not a common menopausal symptom and usually not a sign of anything dangerous, but should be checked with your doctor. Take note of whether the palpitations are regular or irregular and whether you feel short of breath. You can try avoiding caffeine and alcohol.

Q. Is it normal during peri-menopause to have constant light bleeding if I have fibroids?

It is not normal during peri-menopause to have constant light bleeding if you have fibroids, this should be checked out with your doctor.

Q. Can the hormonal changes of menopause contribute to vaginal irritation similar to thrush?

The hormonal changes of menopause can contribute to vaginal irritation similar to thrush.  It is not ‘thrush’ (a fungal infection with candida) but an irritation due to low oestrogen.  Avoiding soap, using a good lubricant with sex, and possibly a vaginal oestrogen treatment will help.

Q. I have not had a period for 8 months and now they have started again. Is this a normal part of peri-menopause?

It is a normal part of peri-menopause to not have a period for eight months and then to start again. Periods can be erratic for several years before finally ceasing at the menopause.

Q. I have extremely sore nipples...could this be thrush or could it be hormone related? There has been no trauma involved!

Extremely sore nipples are unlikely to be thrush unless you are breast feeding or have diabetes.  Take note if it occurs in relation to your periods and discuss with your health practitioner.

Q. I had a hysterectomy about 16 months just before I turned 57 years of age. In the past 12 months I have had severe hot flushes along with wild mood swings. However in the last month or two the hot flushes have subsided and my mood is much better. I am nearly 58, can I expect that the severe hot flushes and mood swings are now a thing of the past.

If hot flushes and wild mood swings experienced for 12 months have recently subsided they may be a thing of the past. In 80% of women the symptoms of menopause last less than 5 years. If they persist see your doctor for advice re HRT.

Q. What can I do to reduce breast tenderness and headaches? These are the most severe symptoms I am experiencing, usually for 3 out of 4 weeks prior to my period.

Severe breast tenderness and headaches prior to period can sometimes be helped by Vitamin B6. Sometimes the oral contraceptive pill or one of the SSRI family of antidepressants are advised.

Q. Is memory loss/failing memory associated with menopause?

Memory loss can possibly be associated with menopause especially if associated with poor sleep, or stress. If it is a significant loss consult your doctor.

Q. Dry skin, dry eyes, sore neck, sore back, aching bones.....is this all menopausal?

Dry skin and eyes, sore neck and back and aching bones are highly likely to be related to menopause.

Q. What can be done for women who have very heavy periods at this time .

There are a number of very successful options including a medication called tranexaemic acid, the oral contraceptive pill, other hormone treatments, Mirena IUD, endometrial ablation, or if severe, a hysterectomy.  Remember to check your iron levels as well as thyroid function.

Q. I am 48. 5years ago I started spotting mid cycle for a few days. This is accompanied by a pain in my head which also lasts for a few days. Could this be my oestrogen levels dropping? Is this a part of perimenopause?

Spotting mid cycle for a few days might be due to a fluctuation in hormone levels and part of per-menopause.  It is important to keep a written record of the spotting and of periods, and if it persists, or is irregular, see your doctor.

Q. I am married with 3 children 45yrs and am having to pluck my chin every day my medication is zoloft 25mg for anxiety my period has been irregular for 1 yr and over the last fortnight I have been waking up hot and sweaty which I have never experienced before what can I take to reduce the hair growth
Q. why do we often have more hair growth on the face during and after menopause?

Hair growth may be due to hormonal changes as oestrogen levels decrease/fluctuate in perimenopause. It would be important to have an assessment of the extent of the hair growth and any other male pattern changes. Usually a bit of facial hair is just one of the changes that may happen as we get older. Plucking, waxing or laser electrolysis are all reasonable options.

Q. l am 44 taking remiefemin which givcs relief to pre-menopause symptoms, but how do l get rid of the crawling skin.
Q. How to relieve the skin crawling symptoms and what causes it?

Remifemin helps some women with some menopausal symptoms.  Make sure you do not get dry skin (avoid soap, use a moisturizer).  If the crawling bothers you then HRT would help.  Crawling skin, called formication, is one of the well recognised symptoms of menopause.  

Q. Is there anything that can relieve memory problems/forgetfulness in menopause?

To relieve memory loss/forgetfulness in menopause keeping the mind active is important as well as relaxation.  Many women find memory is improved with taking HRT.

Q. I am 54 and have missed my period, and been irregular for the past 3 or 4 months........about 12 months ago I had a few "hot flushes" ....do you think I have moved in or past menopause??

The symptoms you mention suggest you are in the perimenopausal phase. It is likely your periods will be infrequent and then cease altogether within a year or so.

Q. You mentioned that menopause lasts 5-10 years, so does that mean that minor symptoms of anxiety, memory loss, joint soreness will get better or go back to eariler levels?
Q. What signs and smptoms may continue in later years eg.loss of libido, tendancy to put on weight?

Symptoms of menopause vary and usually last a few years and then disappear.  However some changes are not purely due to menopause and therefore may persist, or require a different treatment approach.  Weight gain is probably associated with getting older, may be due to being less active, rather than a hormonal menopausal issue. Libido is dependant on  many different factors including how we feel about ourselves, how we feel about our partner, what’s going on in our lives, as well as what’s happening with our hormones. Specifically, relating to menopause, some women have decrease vaginal lubrication and sex can be painful – a good quality lubricant can help this.

Q. I am 52 and just gone off the pill for the last two months. Till this time I have had a period every month. My periods have now stopped for the last two months. How do I know whether I have been through menopause. Is there a hormone test that will clarify this for me or is it a matter of waiting to see whether my period returns? I have no severe symptoms but do experience some night flushes.

Whilst on the pill periods continue due to the effect of the hormones in the pill. Sometimes measuring FSH is helpful if trying to work out if contraception is still needed, but usually it is better to just “wait and see” if periods return. The average age of menopause is 51 so you may well have had your last period.

Q. If menopause is the last period, how long after the last period will symptoms continue?
Q. How long can symptoms (hot flushes) continue after the last period? I am still getting lots of flushes and it has been 1 year since my last period.

For 80% of women symptoms will last for less than 5 years.  For the other 20% symptoms may last 10, 20 or even 30 years.

Q. Could it be menopause if I am feeling anxious, nervous and forgetting things, but I'm still getting my period?

It is possible for a woman, usually in her forties or early fifties, to have menopausal symptoms even if she still has a regular period. Some women experience mood symptoms, like anxiety and depression, for several months to several years before periods actually cease. This is due to gradual changes in the ovaries and fluctuating oestrogen levels. This transition time, which averages 4-6 years before menopause, is called perimenopause. 

Q. I've heard lots about hot flushes but what about being constantly hot?

Some women notice they are just hotter and don't feel the cold. Other women may have distinct episodes of hot flushes. If you are constantly hot, then being able to wear lighter clothes may be helpful.

Q. I am 42 and have been having symptoms for at least a year. My periods are irregular sometimes I only have 4 days between and other times I miss a month or two, some are light but more recently I have been experiencing really heavy long periods with clots and a lot of pain. Although this is hard it is my hot flushes that have been the most worrying. As of three weeks ago I have been experiencing not just slight confusion and fogging but spells of uncontrollable confusion that I have been told by the people around me that leaves me rambling and not functional. They always seem to happen when I have a hot flush. Does this sound like menopausal symptom or should I get tests done.

The perimenopause can be a time when symptoms are complex. You should see your doctor and have some tests done to sort out what is happening. There may be other reasons for your symptoms, other than menopause.

Q. I have suffered from a lot more headaches (up to four days out of a week) since my periods stopped. This is just pain around the eyes and nose (not migraines) but it is very hard to live with. They used to be just hormonal coming at ovulation and at end of period - I hoped they'd improve but they got a lot worse. HR has helped a lot. Is this unusual?

Some women get headaches due to higher levels of oestrogen and others when the oestrogen levels fall around menopause. In some women going on to HRT may help, but you should have your doctor check you for other causes of headache.

Q. I have terrible internal shaking. When I mention this to my doctor, she does not know what I am talking about. Is this a common menopausal symptom?

Internal shaking as you describe it is not a symptom I have heard discussed as associated with the menopause. However some women develop anxiety symptoms in the perimenopause where shaking and tightness may be symptoms.

Q. Is light headedness a symptom? I have been experiencing this 3 - 4 hrs after food, even though I'm not diabetic.

This is not a menopausal symptom. You should see your doctor to discuss your symptoms.

Content Updated April 30, 2008