Coping with the menopause during lockdown

As everyone keeps saying, these are strange times.

If getting through the lockdown and coping with fears surrounding the coronavirus weren’t bad enough, dealing with the menopause can make things feel even worse. 

Experiencing menopausal symptoms while being cooped up with your nearest and dearest can make this a particularly challenging period.  Low mood, feeling anxious and poor concentration will all feel intensified when you can’t get out of the house and let off steam with your friends. Night sweats, hot flushes and difficulty sleeping will also exacerbate the mental pressure of being under lockdown. If you’re isolating alone, although you won't have anyone getting on your nerves, being cut off from your support network is tough 

It’s important to remember, help is at hand. Try these ideas to get through the next few weeks and months. 

Have a chat with a gynaecologist

One of the big concerns at the moment for doctors and patients, is that other health conditions are becoming neglected as the health service is understandably so focussed on the fight against Covid-19. Social distancing makes face to face consultations hard to facilitate. However, Mr Mike Savvas, a consultant gynaecologist at The London PMS & Menopause Clinic believes specialists can still practice by utilising the power of technology, be this by phone or video conferencing. ‘Face to face consultations will always be preferred of course, as they have the major advantage of being able to include scans, examinations, smear tests and other relevant diagnostic tests,' he says. ‘But in these difficult times, these full consultations can be delayed for a few months. We can still make adequate assessments for both new and follow up patients with arrangements put in place for tests to be done later. In the meantime, we can provide repeat prescriptions with any changes to the dose required based on the telephone or video assessment.’

Consider HRT to keep healthy

One of the notable features of Covid-19 is how it discriminates – for example, the older we get the more at risk we are. However, researchers have also been intrigued by another pattern in Covid-19’s infection rate – men are more risk than women of more serious illness and morbidity. In England, Wales and Northern Ireland around 70% of ICU patients are male, and a higher proportion of men than women have died. A study of more than 4000 Covid-19 patients in New York City, found that 62 per cent were male. Women generally do have better genetic immune response (which is damped down in pregnancy), but the medical establishment is asking is, ‘Could HRT keep Covid-19 at bay?’ Dr Sharon Nachman from Stony Brook University, US is researching oestrogen’s effect on those with Covid-19 to see if the hormone can reduce severity. The research, she says, was prompted because it’s rare to see a disease with this incredible predilection for men. A patch containing the hormone will be administered to patients for a week. Another trial at The Cedars-Sinai hospital in Los Angeles will look into the hormone progesterone’s anti-inflammatory properties. UK-based menopause expert Professor John Studd commented: ‘It is possible HRT has a protective effect. Good heath is often dependant on hormones, so there is some sense logic to this approach.’ 

Get your sunshine vitamin

Although the government has been fretting about the public taking advantage of the glorious weather during the lockdown, one thing experts in Covid-19 do agree on, is that Vitamin D is a very important for optimal good health. Sunshine is the best source of the vitamin – which is also categorised as a hormone. Deficiency has been linked at more severe cases of Covid-19. Doctors have observed low levels of vitamin D often correlate with obesity, diabetes and high blood pressure. The Covid-19 crisis has also underlined its importance in respiratory health because of its effects on lung development and structure, respiratory muscle strength, inflammation and immune response,  Research using pre-existing data on vitamin D levels from across 20 countries, found that the most vulnerable group of population for Covid-19 is also the one that was found to be the most deficit in vitamin D. As low Vitamin D levels are also linked to declining oestrogen during menopause, make sure you’re taking a good quality supplement and spending 20 minutes a day without sunscreen outside in the sunshine to get your daily dose of vitamin D. Include D-rich foods such as oily fish and eggs in your diet. Consultant gynaecologist Ms Beverley Benster comments, 'I always tell my patients, the right hormones are very important but don’t overlook good nutrition and healthy lifestyle.'

Make sleep a priority

Sleep disturbance is one of the most common symptoms of the menopause. According to consultant gynaecologist Mr Mike Savvas, although sleep quality declines with age, it tends to be worse for women transitioning through the menopause than after it, often due to hot flushes and night sweats. Lack of sleep has an adverse effect on general health and immunity and of course mood. It’s definitely worth prioritising whether you're looking to protect yourself against the coronavirus, or simply to survive your family and other mental challenges of lockdown! Mr Savvas says: ‘Treatments for insomnia during the menopause include learning better sleep hygiene – such as keeping your room dark and winding down before bed; cognitive behaviour therapy, or if these don't work, medications such as melatonin, anti depressants or sleeping tablets - as prescribed by your doctor. HRT can also be very helpful at this time.'

Mr Savvas explains: ‘Women taking HRT report Improved sleep quality, less difficulty getting off to sleep, reduced night time wakening and feeling more refreshed after a night’s sleep.’ 

Check your HRT is at the correct dosage

If your GP has been prescribing HRT, but you feel unhappy with its effects, it might be worth seeking a second opinion from a gynaecologist who specialises in the menopause, - getting the right balance of hormones for each individual can be a delicate art. A careful evaluation of the symptoms and the personal health requirements of each patient is essential - a generic, 'one-size-fits all' approach can lead to the wrong dosage of HRT.  Consultant gynaecologist Mr Neale Watson says: ‘As doctors, we need to be careful to separate out post-menopausal endocrine changes from those you would expect to see with the normal ageing process found in both men and women.’ He adds: ‘Treating the debilitating symptoms of menopause is extremely important. It is also key to understand and acknowledge the real physiological changes brought about by decreasing hormone levels that take place during and after the menopause. We must therefore be proactive in ensuring that women have access to the most expert care.'

Find out more about The London PMS & Menopause Clinic by visiting their website or call 020 7486 0497.