The non-HRT menopause treatment

Anyone who suffers symptoms of menopause will know it can cause havoc in your everyday life. From sleep-deprivation due to hot flushes and night sweats, to snapping at your partner.

When menopause hits…

Navigating your way through this hormonal rollercoaster can be anything but easy, with most women experiencing a number of unpleasant side-effects, from anxiety and mood swings to physical problems like vaginal dryness.

And although we might tell ourselves that this is a natural part of ageing, as the levels of the main female hormone oestrogen begin to drop in our 40s and periods eventually stop, usually by our early 50s, symptoms can drag on for years.

Don’t suffer symptoms of menopause in silence

You’ll be relieved to know there are treatments for menopause.  Many women think there’s nothing they can do except stay quiet and learn how to put up and bear it.

While others are too embarrassed to talk to their doctor about the more private effects, such as vaginal dryness which can cause general discomfort, itchiness, inflammation, and pain and bleeding during exercise and sex.

Instead of suffering in silence you should speak to a doctor who specialises in this area, such as a gynaecologist or clinical nutritionist with expertise in menopausal care.

Popular treatments for menopause

To help ease symptoms and get you feeling back in peak psychological and physical wellness, gynaecologists can create an individual, bespoke treatment plan for each woman, offering treatments such as a complete overhaul of your diet, as well as advice on diet and lifestyle.

Hormone replacement therapies (HRT), are often the go-to treatment for menopausal symptoms, to replace the hormones that have been depleted. These are usually prescribed as combination hormones, and come in many forms – topical creams, gels, skin patches and tablets, but they’re not suitable for everyone.

When HRT isn’t suitable

For some HRT isn’t the answer. You may have tried hormone therapy and been among those who instead of finding a remedy, have experienced side-effects, only adding to your menopause misery.  

It could be you have a medical reason for not taking hormone therapy, such as a family history of breast or ovarian cancer, or have had cancer yourself.  Studies show that oestrogen feeds some cancers and can cause them to grow.  There may be some non-drug strategies you can try. However, not all of these will work for every symptom - vaginal dryness or Geniturinary Syndrome of Menopause for example.

This is the predicament that Philippa Henderson* found herself in after being diagnosed with breast cancer while preparing to have a hysterectomy.

“I was Mr Francis Gardner’s patient in 2015 at an NHS hospital. Initially, I was referred to him because I had abnormal smears. My smear tests kept coming back with pre-cancerous cells, so he said we would try treatment. I’d had a colposcopy and LLETZ treatment on the cells, but after another six months, the pre-cancerous cells could still be found on the neck of the cervix.”

Mr Gardner recommended a hysterectomy that left her ovaries intact and then to go on HRT.  But there was bad news to come.

“A week before the operation, I found a lump in my breast,” recalls Philippa. “The doctors were very concerned and said there was an 80% chance of breast cancer. 

“Naturally, I was very anxious – the results would normally have been given a week later, but my hysterectomy was booked in for that day. In the event, Mr Gardner managed to look up the results for me before the operation.”

Mr Gardner confirmed that not only was it breast cancer, but it was the oestrogen-receptive variety, which meant Philippa would need a more radical hysterectomy to remove her ovaries too, to cut off the supply of oestrogen.

Philippa had to make a decision fast. “I decided to have an oophorectomy to remove my ovaries.”

She needed further surgery to remove the lump in her breast, but thankfully the cancer hadn’t spread. However, she was put on an aromatase inhibitor medication for five years - designed to inhibit oestrogen even further.

Finding an alternative to HRT

Philippa suddenly found herself in the midst of menopausal symptoms after having to undergo a surgical menopause.

“The obvious symptom is the hot flushes, which are frequent and extreme. But I wasn’t prepared for the vaginal dryness,” she confides.

“At first, I was extremely alarmed. I’d gone out for a run and I felt a bit uncomfortable. When I jumped in the shower after my run, I noticed I was spotting blood. My vagina was so dry, that the friction of running was making me bleed. If I had sex, the same thing happened. It was frightening.”

An alternative solution to treating vaginal dryness without hormones has been made possible by an innovative treatment that’s available privately.  The MonaLisa Touch (MLT) is a laser treatment that’s quick, minimally invasive and virtually pain free.

Mr Gardner is a leading authority on office gynaecological techniques, such as the MonaLisa Touch, where a special carbon dioxide (CO2) laser is used to administer treatment to the vaginal wall in tiny dots, so only a small percentage of tissue is directly affected by the laser at any time.

This triggers the production of new collagen, helping restore moisture to the vaginal wall. As well as adding lubrication, this treatment also has the benefit of toning tissue, which helps with mild incontinence and vaginal laxity. A session can be completed in as little as 5 minutes, and there is no downtime required, so you can walk out of the clinic afterwards and go about your normal day.

Seeing results after MonaLisa Touch treatment

“I decided to book in for a MonaLisa Touch course, and visited a Harley Street clinic for my three treatments,” says Philippa.

“Did it hurt? Not really. A slight sensation, but it wasn’t painful. It only took minutes. Each visit is spaced out by six weeks. During my third treatment Dr Gardner increased the laser settings and I did feel a little tenderness, but it was very manageable.

“Most importantly, I noticed a difference - even after my first two treatments. I could run without spotting. I could have sex without discomfort and bleeding.

“The MonaLisa Touch has been brilliant for me. So much so, that just three months on from my final treatment and I don’t even think about the vaginal dryness, bleeding, and general uncomfortableness.

“This means that sex is again something to be enjoyed rather than feeling trepidation as to if it’s going to hurt or make me bleed. I’m also able to run and exercise without any issues - something which I feel is essential for my continued good health and also my state of mind.”

* Name changed.

Mr Francis Gardner is a Consultant Gynaecologist and Clinical Director of Gynaecology at Queen Alexandra Hospital Portsmouth.