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Menopause chat
continued from page 3
A: I'm sorry to hear about your problems and wish you every success with your treatment. Do see your GP, who can arrange blood tests to check if the hot flushes and night sweats are due to high levels of FSH, which occur at the menopause. Clomid can cause hot flushes itself, however, so possibly (fingers crossed) this is the cause of your symptoms. It is worth consulting a medical herbalist, as sometimes treatment with the herb agnus castus can help a cycle become regular and help you conceive. It must be stopped as soon as pregnancy is suspected, however. Treatment with the anti-diabetes drug, metformin, can be effective in achieving ovulation in women with PCOS - in a large analysis of published data, it was found that 46 per cent of women taking metformin start to ovulate again compared with only 26 per cent of those not taking metformin.
Clomiphene, is effective in triggering ovulation in at least 42 per cent of women with PCOS but does increase your chance of a multiple pregnancy - most commonly with twins. Clomiphene seems to work most effectively when prescribed together with metformin (ovulation rate increases to 76 per cent). The metformin must be stopped immediately if pregnancy occurs, however, as there is not yet enough information on how it might affect early pregnancy.
Stronger fertility drugs such as gonadotrophins will help up to 95 per cent of women ovulate, but significantly increase the risk of multiple pregnancy (14 to 36 per cent).
If drug treatment does not work, a laser beam may be used to literally drill holes in the surface of the ovaries. This is a quick procedure performed under general anaesthetic using keyhole (laparoscopic) surgery. Why it works is unknown.
Screening for gestational diabetes during pregnancy in a women known to have PCOS is a good idea as the additional strain of pregnancy combined with insulin resistance (which can occur in PCOS) may trigger the development of gestational diabetes.
When will my periods end?
Q: I started getting hot flushes between 41 and 42 years of age. Then, when I was 43 a scan showed that I had very large fibroids. My GP at the time informed me that if she were to send me to see a consultant, he would recommend a hysterectomy. Believing that I had started the menopause early, I declined both the visit to the specialist and the possibility of the operation.
Suddenly last year, my periods stopped without warning and I hoped that this was the end of them. However, eight months later I had a very light bleed, lasting four to five days. This was at the end of March, and since then there has been nothing again. I am taking phyto soya for the symptoms, but would appreciate any advice from you. I am now 50 years old and wondering if this could really be the end of them? kikixxx
A:It does sound as if you have reached the menopause. However, any bleeding that occurs more than six months after you thought your periods had stopped should be reported to your GP. It may be wise to arrange a few tests to ensure the bleeding was due to an additional period rather than to a problem with the womb lining. In addition to the phyto soya, you can add in black cohosh and/or sage leaf extracts, which are good for improving both hot flushes and night sweats. They are available singly or as a combination product.
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A: I'm sorry to hear about your problems and wish you every success with your treatment. Do see your GP, who can arrange blood tests to check if the hot flushes and night sweats are due to high levels of FSH, which occur at the menopause. Clomid can cause hot flushes itself, however, so possibly (fingers crossed) this is the cause of your symptoms. It is worth consulting a medical herbalist, as sometimes treatment with the herb agnus castus can help a cycle become regular and help you conceive. It must be stopped as soon as pregnancy is suspected, however. Treatment with the anti-diabetes drug, metformin, can be effective in achieving ovulation in women with PCOS - in a large analysis of published data, it was found that 46 per cent of women taking metformin start to ovulate again compared with only 26 per cent of those not taking metformin.
Clomiphene, is effective in triggering ovulation in at least 42 per cent of women with PCOS but does increase your chance of a multiple pregnancy - most commonly with twins. Clomiphene seems to work most effectively when prescribed together with metformin (ovulation rate increases to 76 per cent). The metformin must be stopped immediately if pregnancy occurs, however, as there is not yet enough information on how it might affect early pregnancy.
Stronger fertility drugs such as gonadotrophins will help up to 95 per cent of women ovulate, but significantly increase the risk of multiple pregnancy (14 to 36 per cent).
If drug treatment does not work, a laser beam may be used to literally drill holes in the surface of the ovaries. This is a quick procedure performed under general anaesthetic using keyhole (laparoscopic) surgery. Why it works is unknown.
Screening for gestational diabetes during pregnancy in a women known to have PCOS is a good idea as the additional strain of pregnancy combined with insulin resistance (which can occur in PCOS) may trigger the development of gestational diabetes.
When will my periods end?
Q: I started getting hot flushes between 41 and 42 years of age. Then, when I was 43 a scan showed that I had very large fibroids. My GP at the time informed me that if she were to send me to see a consultant, he would recommend a hysterectomy. Believing that I had started the menopause early, I declined both the visit to the specialist and the possibility of the operation.
Suddenly last year, my periods stopped without warning and I hoped that this was the end of them. However, eight months later I had a very light bleed, lasting four to five days. This was at the end of March, and since then there has been nothing again. I am taking phyto soya for the symptoms, but would appreciate any advice from you. I am now 50 years old and wondering if this could really be the end of them? kikixxx
A:It does sound as if you have reached the menopause. However, any bleeding that occurs more than six months after you thought your periods had stopped should be reported to your GP. It may be wise to arrange a few tests to ensure the bleeding was due to an additional period rather than to a problem with the womb lining. In addition to the phyto soya, you can add in black cohosh and/or sage leaf extracts, which are good for improving both hot flushes and night sweats. They are available singly or as a combination product.
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