In many cultures menopause is referred to as ‘the change of life’

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Literally speaking, menopause means, the last period.

On average, it happens at about age fifty-one. For most women however their very last period is not the main issue. For most women it is the effects of changing hormone levels that impact on their quality of life.

The following may all become problems, to a greater or lesser degree:

  • Hot flushes
  • Sleeplessness
  • Headaches and / or “fuzzy thinking”
  • Lack of libido
  • Vaginal dryness

An easier transition is possible with:

  • Regular exercise
  • A good diet
  • Avoiding refined sugars and stimulants like caffeine
  • Hormone replacement / supplements

A Brief guide to HRT and Supplements

The Hormones:

The two important female hormones are progesterone and estrogen, from the ovaries. With menopause, the ovaries produce very small amounts of these hormones.


  • The hormones estrogen and progesterone can be given in different ways and come in different preparations
  • If non hormonal remedies have failed, there are prescription medications available
  • Despite the bad press in recent years, there is still a place for hormone replacement therapy
  • Different preparations are metabolized differently and have different side effect profiles
  • Choice of medication will depend on individual medical risk, symptoms, previous hysterectomy and personal choice

Potential risks: increased blood pressure, increased risks of developing blood clots, and breast cancer


Estrogen – The dominant female hormone:

  • Keeps skin soft, boosts libido, protects bones from osteoporosis but can cause excessive menstrual bleeding
  • Lack of estrogen causes the “menopausal” symptoms of headaches, hot flushes
  • Replacement is available in tablets, patches implants, creams, vaginal applications and “Bio identical” cream or troche

Progesterone – The other female hormone:

  • Estrogen replacement alone in women with a uterus increases the risk of endometrial cancer
  • Progesterone is crucial for stabilizing and protecting the endometrium and therefore is necessary as part of HRT in women with a uterus
  • Progesterone replacement is available as tablets (synthetic and “natural/bio identical”) or  as an intrauterine device (Mirena intrauterine system)
  • Progesterone creams are not well absorbed and are unreliable

Bio identical hormones

  • Pharmaceutical conversion of plant hormone molecules to be almost exactly like the hormone molecules produced by our bodies
  • These hormones cannot be patented, as they are identical to those made by our own bodies
  • They are manufactured and sold by compounding pharmacies
  • As a patient you need to know that the Australasian Menopause Society does not support the use of “bio-identical” hormones.


  • Synthetic progesterone like hormones given as medication


  • The dominant male hormone
  • Occasionally given to women, as a cream or oil, in low doses to boost libido


  • Hormone Replacement Therapy
  • Usually understood to be synthetic estrogen and progesterone available in a variety of preparations


  • A wafer like tablet, which contains a hormone preparation and is sucked rather than swallowed

Natural hormone therapy

A misused term which can mean many things; from plant hormones in their unchanged natural state to manufactured hormones that are identical to our own.

  • Black Cohosh:  a herb known to help up to 50% of women suffering from hot flushes and lack of sleep
  • Omega-3 and 6 fatty acids: often combined in a health supplement for women, may provide symptom relief and protect against cardiac disease
  • Soy: as a food may also be beneficial

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