The Surrey Park Clinic
FEMALE HEALTH-GYNAECOLOGY-HORMONES01483 454 016
Stirling House, Stirling Road, Guildford, Surrey, GU2 7RF
When oestrogen production falls to a very low level the uterus stops responding, periods stop and this is called the menopause. For around ten years before and several years after the menopause, the amount of oestrogen produced from the female ovary declines; this decline varies a lot before the menopause and can result in very distressing symptoms as well as erratic or heavy menstrual bleeding.
Around three-quarters of women experience problems associated with the menopause. Symptoms relate to a low level of oestrogen and occasionally testosterone and depend which system in each individual is affected the most. It is not related to a 'state of mind' as the most determined and active women can be laid low and completely incapacitated by symptoms which may take them completely unawares.
HRT (Hormone Replacement Therapy) is a replacement for the oestrogen that was produced by the ovaries before the menopause. The level of oestrogen in HRT is designed to reduce or stop altogether the symptoms of the menopause outlined above such as hot flushes, night sweats, mood swings etc. It does not restore oestrogen levels to pre-menopause level.
Unlike the contraceptive pill, oestrogen replacement in HRT mimics the natural oestrogen molecule in a similar way to thyroid replacement. It is known that the contraceptive pill is 50 to 100 times stronger than HRT in all it's effects as unlike HRT it is synthetic, takes a long time to be cleared from the body and therefore stays in the body much longer.
Some women may have concerns about possible associated risks due to the bad and sometimes inaccurate publicity, resulting in poor understanding.
Recent concern about the effect of some HRT preparations increasing breast cancer risk means that for many the risks of HRT are not worth the benefits. However, most of the reliable studies have shown that oestrogen only users do not have a significantly increased risk of developing breast cancer although the addition of a progestogen (usually done to protect the uterus if still present) can increase the risk significantly. The risks of breast cancer may also be smaller than many women think. It is however always sensible to be breast aware and to have regular mammograms
There is no evidence that HRT causes cancer of the cervix or ovaries.
This will often mean prescribing the oestrogen and progestogen separately, building up the dose until the symptoms have disappeared. This way, the lowest dose required for each individual is given after which the blood levels are checked.
Some women find that natural treatments are adequate in obtaining symptom relief and some of them are also shown to provide some benefit in protecting the bone and heart.
We are great enthusiasts of these alternative treatments, which in some cases can also enhance the effect of standard or low dose HRT. They can also be used for example in conjunction with vaginal oestrogen local treatment where 'proper' HRT is not wanted but where bladder and vaginal symptoms or poor sensation or low libido problems exist.
The purpose of our clinic is to ensure that our patients obtain a good understanding of the menopause whilst tailoring and individualizing their treatment to ensure best quality of life without compromising safety. The benefit of attending a menopause clinic means that individual cases can be assessed and the HRT preparation altered according to the woman's response.
Our clinic offers screening for uterine, ovarian, cervical cancer, breast cancer and pre-cancer. Also bone density and cardiovascular screening where increased problems are observed after the menopause.
