Menopause, which is defined as the permanent cessation of menstruation, normally occurs in a woman’s life between the mid-forties and mid-fifties; so most women will now live at least a third of their lives after menopause.

Beginning some years before menopause there is a slow and usually (but not always) steady decline in the secretion of the female hormones – oestrogen and progesterone.

These hormones have an influence on mood, appetite, skin appearance, body weight and shape, bladder and sexual functions, and blood vessels and bones. Not surprisingly, therefore, many women face menopause with some degree of apprehension; and with the knowledge (indeed the hope, despite the possible problems), that this post-menopausal time might last for many years.

It seems reasonable that replacing the diminishing levels of hormones would also replace the protective effects against disease that these hormones previously provided. However, the Women’s Health Initiative (WHI) Study, which involved over 160,000 post-menopausal women, showed that there could also be significant risks.

So, taking hormone replacement (HRT) is a balance between risk and benefit. The decision whether to take HRT, and if so, the form, the dose and duration, will depend on just what symptoms are most troublesome and their severity. As women age their risk of some adverse events will increase; and the balance of risks and benefits will change. Nevertheless, non-smoking women in their 50s are likely to experience only small absolute increases in risk.

There are various types of HRT and various methods of delivery. Oral treatment is convenient, inexpensive and usually well tolerated, while transdermal therapy (by patch or gel) allows for a smaller dose of oestrogen and thus fewer adverse effects; although skin irritation with both patches and gel can occur in a minority of cases. Topical vaginal therapy may be more suitable for women whose symptoms are predominantly urogenital – urinary frequency or vaginal dryness.

HRT is certainly a valuable therapy. A number of uncomfortable symptoms and disease risks are reduced by HRT. So, in many women HRT is suitable for the short term relief of moderate to severe menopausal symptoms. For long term use and for women with mild symptoms the risks appear to outweigh the benefits – treatment is generally recommended for no more than five years.

There is also interest in so-called natural alternatives to HRT. These ‘complementary’ medicines are perceived to be safe but there is little real evidence for benefit. And, in any event, some are associated with side effects and toxicity concerns.

Whether or not HRT is chosen for short or longer term treatment of symptoms, and whether or not an alternative therapy is chosen, most women will definitely benefit from lifestyle modifications.

If a smoker, a woman should stop smoking. Hot drinks, spicy foods, alcohol and caffeine are often triggers for hot flushes; so these triggers should be avoided or at least intake reduced. Adequate sleep, relaxation techniques, pelvic floor exercise (and regular exercise as well) can all help; as can a balanced diet including a daily intake of 1300mg calcium and 400-800 IU vitamin D.

More evidence-based information is provided on the Menopause fact card which is available from pharmacies around Australia providing the Pharmaceutical Society’s (PSA) Self Care health information. You can find the nearest location from the PSA website www.psa.org.au/selfcare.

There are some related cards, too, which will be helpful – Fat and Cholesterol, Osteoporosis, Relaxation Techniques, Bladder and Urine Control .

©2009 Pharmaceutical Society of Australia

Most often the word is used to describe that time in life when there is a decrease in the ability to reproduce – in women leading to the menopause.

For some women, managing the menopause is quite a challenge. Unpleasant symptoms include breast tenderness, hot flushes, night sweats, mood swings and depression. No surprise then that hormone replacement therapy (HRT) which can control these symptoms became so popular – popular that is, until 2002 when result s from the Women’s Health Initiative (WHI) study suggested that there could be serious side effects from HRT.

However, now researchers have had another look at the results of the WHI study, the news is not all that bad. In fact the news is pretty good.

According to Professor Amos Pines, Chair of the International Menopause Society (IMS), women in the early stages of menopause should not worry about taking HRT medicines. And IMS President Dr David Sturdee said that common “misconceptions” surrounding HRT have resulted in many women having difficulty with menopause symptoms. Women should take HRT he said “for as long as they need to be on it”.

A summary of the scientific evidence and common perceptions relating to the menopause can be found on the IMS website.

Of course men’s bodies gradually undergo change as well. By the time we get to our 40s and 50s our bodies may begin to show signs of wear and tear. Regular ‘check-ups’ and ‘maintenance’ procedures, which women are so used to having carried out, will be able to prevent serious illness or at least allow for early diagnosis and effective treatment. So it should be for men.

Even if no health problems are apparent, from the age of 50 onwards men should attend their GP for a check up at least every two years – and if men have the occasion to visit the doctor, say for the treatment of an injury, or perhaps travel vaccinations, they should take the opportunity to have blood pressure and blood sugar levels checked. Conditions such as high blood pressure and diabetes can occur with few symptoms and little or no warning.

During their lifetime, women may have a few more specific health problems than men; however, for those conditions which are likely to affect both men and women, men are often at greater risk.

Probably because of lifestyle issues, such as diet, lack of exercise, smoking and drinking habits and the tendency to be overweight, men are more likely to suffer from heart disease and certain cancers.

There are of course some special health issues for men and these are covered in the Men’s Health fact card available from pharmacies around Australia providing the Pharmaceutical Society’s Self Care health information.

There are other relevant topics in the Self Care fact card range as well. They include Weight and Health, Exercise and the Heart, Sleeping Problems, Heartburn and Indigestion and Gout. Each card offers information about signs and symptoms, self help procedures and when to seek further advice. The week beginning June 9 is International Men’s Health Week – perhaps a time to pause and reflect on men’s health issues – by both men and women.

Meanwhile, you can get those fact cards all year round form a Self Care Pharmacy. Phone 1300 369 772 or check out the Pharmaceutical Society’s website.

©2008 Pharmaceutical Society of Australia