Periods and Menopause

Question 1

Period pain lifestyle advice

Answer 1

Warm baths and showers
Hot water bottle
Massaging tummy and back
Gentle exercise like yoga, swimming, cycling, walking
Stop smoking

Question 2

Period pain referral

Answer 2

Prolonged after new contraceptive
Irregular period
Spotting
Pain during sex
OTC painkillers not helping

Question 3

Symptoms of period pain

Answer 3

Sharp pain or dull ache in lower stomach just before or during period.
Can spread to back and thighs

Question 4

Causes of missed or late periods

Answer 4

Pregnancy
Stress
Menopause
PCOS
Anorexia/weight loss/excessive exercise
Overweight
Contraceptive pill

Question 5

Missed period referral

Answer 5

Chance of pregnancy
Missed 3x in a row
Periods haven’t started by age of 16
Other symptoms such as weight gain/loss, fatigue, excessive hair growth, dry/oily skin.

Question 6

Heavy periods referral

Answer 6

Affecting day-to-day life
Occurs for a few months
Pain during periods
Spotting
Pain during sex or going to toilet

Question 7

Symptoms of PMS

Answer 7

Bloating
Breast tenderness
Mood swings
Irritable
Acne
Low libido

Question 8

PMS lifestyle advice

Answer 8

Exercise regularly
Avoid smoking and alcohol
Eat healthy balanced diet
Eat smaller frequent meals every 2-3 hours rather than 3 larger meals
Get at least 7 hours of sleep
Reduce stress with yoga and meditation
Keep a diary of symptoms to take to the GP

Question 9

What is menopause?

Answer 9

Loss of ovarian sensitivity to LH and FSH results in a reduction of cirulating oestrogen, which causes a loss of periods.

Question 10

At what age does menopause usually occur?

Answer 10

45-55, but can happen earlier

Question 11

What is perimenopause?

Answer 11

When women experience menopause symptoms but period haven’t stopped.

Question 12

What are symptoms of (peri)menopause?

Answer 12

Anxiety
Mood swings
Brain fog
Hot flushes
Reduced sex drive
Vaginal dryness and pain
Night sweats and difficulty sleeping
Headaches and migraines

Question 13

Menopause lifestyle advice

Answer 13

Keep regular sleep routine
Eat a healthy diet
Risk of osteoporosis so eat calcium-rich food to keep bones healthy
Avoid smoking or excessive drinking
Exercise regularly and do meditation/yoga
Take a cool shower or use a fan if hot
Lose weight

Question 14

OTC treatment/advice for vaginal dryness

Answer 14

Vaginal moisturisers and pessaries
Water-based lubricants for sex

Don’t use oil-based lubricants
Avoid creams or moisturisers not intended for vaginal use

Question 15

What is HRT?

Answer 15

Oestrogen and progesterone replacement in the form of:
Oestrogen: patches, gel, spray, implants, tablets
Progesterone: patches, IUD, tablets

Question 16

Benefits of HRT

Answer 16

Improves hot flushes, brain fog, joint pain, mood swings and vaginal dryness.
Also reduces risk of osteoporosis and heart disease

Question 17

Treatment of loss of libido in menopause

Answer 17

1. HRT
2. • testosterone gel.

Question 18

Side effects of testosterone gel

Answer 18

Acne
Unwanted hair growth

Question 19

HRT side effects

Answer 19

Headaches
Breast tenderness
Vaginal bleeding

Question 20

How to take HRT?

Answer 20

Tablets - 1 od

Patches - start between days 1-5 of menstrual cycle if still getting periods, if not any time. Stick just below the waist (thigh or bum). Change once or twice a week.

Gel - once a day at same time. Wait 5 mins to dry and don’t get area wet for 1 hour. Wash hands after applying.

Sprat - 1-3 sprays od at same time. Wait 2 mins to dry and don’t get area wet for 1 hour.

Question 21

How long does HRT continue for?

Answer 21

2-5 years

Question 22

Advice for postmenopausal bleeding

Answer 22

Refer, even if its only happened once. Could indicate blood.