Access frequently asked questions and answers about the symptoms of menopause and the treatment options available.
How will I know if I am in my menopause?
Menopause defines the time when a woman’s reproductive life comes to an end and is marked by the end of her menstrual periods. This is also known as ‘the change of life’. The symptoms which many women suffer from menopause are primarily a result of oestrogen deficiency.1
They may be short-term (like hot flushes and night sweats) or long-term (like osteoporosis), psychological, general or more localised.1-3 Whatever their nature, doctors now seem to agree that menopausal symptoms justify treatment.3-5
How will I know which treatment option is best for me?
Speak to your doctor about which type of MHT will be best suited to you. Different types of MHT products are available (e.g. tablets, skin patches and gels). All pharmaceutical hormone therapy choices effectively relieve the symptoms of menopause.1,3
Taking your medical history, type of symptoms and personal preferences into account, your doctor will advise you on which type of MHT will benefit you the most.
What are the risks of breast cancer with hormone therapy?
One of the biggest concerns of women considering Menopause Hormone Therapy (MHT) is the potential increased risk of breast cancer.9 Long-term clinical studies have suggested an increased risk of breast cancer while on Menopause Hormone Therapy (MHT).9 However, the risks are relatively small and only became apparent after 5 years or more of Menopause Hormone Therapy (MHT).10
The most recent consensus statements from local and international experts support this view, stating that women should rest assured that the possible increased risks of breast cancer associated with Menopause Hormone Therapy (MHT) are small and are similar to the increased risks associated with common lifestyle factors such as obesity and alcohol consumption.10
Breast cancer risk in women taking Menopause Hormone Therapy (MHT) 3,5,10
Media usually reports on the relative risk of breast cancer in regard to Menopause Hormone Therapy (MHT), without reporting on the absolute risk.9 The table reports absolute increased risk, which is less than 0.1 % per year.10
How will I know if there is a change in my breasts?
Step 1 – Looking:
Begin by looking at your breasts in the mirror with your shoulders straight and your arms on your hips.
Here’s what you should look for:
- Breasts that are their usual size, shape and colour
- Breasts that are evenly shaped without visible distortion or swelling
If you see any of the following changes, bring them to your doctor’s attention:
- Dimpling, puckering or bulging of the skin
- A nipple that has changed position or an inverted nipple (pushed inward instead of sticking out)
- Redness, soreness, rash or swelling
Now, raise your arms and look for the same changes.
While you are at the mirror, look for any signs of fluid coming out of one or both nipples (this could be a watery, milky or yellow fluid or blood).
Step 4 – Lying down:
Next, feel your breasts while you are lying down, using your right hand to feel your left breast and then your left hand to feel your right breast. Use a firm, smooth touch with the first few finger pads of your hand, keeping the fingers flat and together. Use a small circular motion to examine the entire breast from top to bottom, from side to side, from your collarbone to the top of your abdomen and from your armpit to your cleavage.
Step 5 – Shower:
Finally, feel your breasts while you are standing or sitting. Many women find that the easiest way to feel their breasts is when their skin is wet and slippery, so they like to do this step in the shower. Examine the entire breast, using the same hand movements as described in Step 4.
What about weight gain and menopause?
Women often gain weight in their 40’s and 50’s, and they tend to attribute this weight gain to menopause. Although menopause may play a role, weight gain seems to mainly relate to aging and changes in lifestyle. Factors identified that have an influence on weight gain during menopause include a decrease in exercise, and an increase in food and alcohol consumption.6
As one grows older, muscle mass tends to decrease, while fat mass tends to increase. The distribution of fat also changes from the known pear-shape, with fat distribution around the hips and thighs, to an apple shape, where fat distribution is more around the abdomen and waist area. Being overweight increases the risk of heart disease.6
If I am in my menopause, do I still need to worry about contraception?
Despite a decline in fertility during perimenopause, and even if a few months have passed without a period, women are not totally protected from an unplanned pregnancy until menopause has been confirmed after 12 consecutive months without periods.6
How often should I have a Pap test?
A pap test aims at detecting cervical cancer, which can be present without any symptoms. It is recommended that all
South African women should initiate cervical screening at the age of 25 years (earliest). Thereafter, a 3-yearly pap test to
look for abnormal cells is recommended, up to the age of 65 years (or up to a hysterectomy). A test, which is not yet widely available or widely used, is called an HPV screening-test. This test looks for certain types of the Human Papilloma virus, which may cause cervical cancer. These HPV-tests only need to be done every 5 years.14