Q&A - The Menopause

Whatmedicine? magazine are pleased to introduce Dame Dr Shirley Bond who will be answering your questions on the menopause, female hormonal issues and other problems affecting women's health. If you have a question for Dr Bond, please write to: Dr Bond Q&A/Whatmedicine? magazine, 129a High Street, Lymington, Hampshire SO41 9AQ or email info@whatmedicine.co.uk.

Q I am in my late thirties and am wondering how to tell if I am starting the menopause. Although I am showing none of the well known symptoms such as hot flushes and irregular periods, I have become very absent minded and my thoughts are 'fogged' a lot of the time. This causes me to become very frustrated with simple tasks. A friend recently teased me that this was the first sign of the menopause - could she be right?

A From what you say I think it is most unlikely that you are starting the menopause. You are rather young for the menopause plus your periods are still quite regular and as you say you have none of the other indications. A hormone test would not be very helpful as it can only indicate what is happening in the cycle in which you have it done and if your periods are regular the odds are that your hormones will not show a menopausal picture. I suggest you have a good look at your health and life style in general. There are various conditions including stress that can produce the picture you describe.

Q I am in my early forties and have started the menopause. I am avoiding HRT owing to a family history of breast cancer, and so would like advice as to how I can achieve hormonal balance through diet. My mother had osteoporosis and so I have concerns in that department too.

A You are young to be starting the menopause. If this is indeed the case with your family history of osteoporosis you should consider having a bone mineral density screening. Also with a history of maternal breast cancer you should certainly avoid oestrogen and traditional HRT completely. There are many natural ways to deal with the problems of the menopause and I suggest that you consult the website www.nmas.org.uk where I have written some fact sheets.

Q I used the contraceptive pill throughout my teens and adult life, apart from when I planned my two pregnancies. I have now started the menopause at the very early age of 35. Could this be attributed to my constant use of the pill? Incidentally, my mother went through the menopause at 53, and I always understood that the rule of thumb was that you would probably go through the menopause at the same age as your own mother - is this true?

A Certainly the age at which your mother had her menopause is a good indication of the age at which you would have yours. However this is not a hard and fast rule as the chances are that your life style will have been very different. Taking the contraceptive pill long term can certainly throw the hormones out of balance but there does not as yet seem to be evidence that long term use causes an early menopause.You do not say how long it is since you stopped the contraceptive pill. In many women who take the pill long term if they stop the pill in their 30's it can take many month for the cycle to return. If hormone tests are done at this time when they are not ovulating the result is similar to menopause and they are then diagnosed, incorrectly, as early menopause. Patient attention to diet and life style, taking appropriate dietary supplements and herbs can often resolve the problem. Consult my fact sheet on early menopause on www.nmas.org.uk

Q Going through the menopause seems to have left my sex drive behind. Please can you tell me how to kick start those feelings again as my husband is considerably younger than me and his needs are pretty evident! I am always feeling tired, but really I have just gone off the whole idea, which is very alarming as only a couple of years ago I was very active. I have tried Maca, but this has done nothing so far.

A It is very common for the sexual drive to diminish at the menopause. As far as nature is concerned we have intercourse to produce babies not have fun. This does not mean that you have to accept this. There are herbal mixtures that can help and some people use natural progesterone or testosterone. What you have to realise is that if there are no physical problems, such as dryness, once one gets over the initial lack of interest the experience is as good as it ever was, If you are generally tired then you need to consider your life style and diet and ensure that you are not low on nutrients, especially iron.