For many women over the age of 50, pain has become an unavoidable part of life.
But Dr Ginni Mansberg, an Australian general practitioner and expert in perimenopause, says this doesn’t have to be the case. She has had countless patients report living with debilitating symptoms for up to 10 years – only to realise after a single consultation that there are treatment options available.
The transition to menopause has long be associated with irregular periods and hot flashes, but beyond these ‘official’ symptoms, there are issues such as weight gain, painful joints, migraines and even insomnia that are rarely discussed in medical literature, but Dr Mansberg encounters often in her Sydney clinic.
‘It can be devastating and no two people have the same symptoms,’ she told FEMAIL.
She says it breaks her heart to see women lose their confidence, struggle with relationships and even abandon their careers because of the pain of perimenopause – with many failing to even realise their symptoms are related to ‘The Change’.
Every year, medical research links more and more painful symptoms to the hormonal changes that come with the natural end of the reproductive stage of your life. And, believe it or not, your ethnic background can determine what symptoms you get.
‘Many women have migraines. The research linking this to perimenopause is new but I see it in my clinic all the time,’ Dr Mansberg, 56, said.
‘It’s the same with joint pain. Seventy-five per cent of women from an Asian background will get very sore joints. Out of them, 10 per cent will continue to have pain for the rest of their lives. Seventy-five per cent of non-Asian women will get hot flashes. Again, for one in ten of these women it will be a permanent issue.’
For many women over the age of 50, pain has become an unavoidable part of life. But Dr Ginni Mansberg, an Australian general practitioner and expert in perimenopause, says this doesn’t have to be the case
But, advises Dr Mansberg, the majority of the side effects of perimenopause do not have to be debilitating, or indeed long-term.
‘Women need to know everything they are experiencing is hormone-related, from the brain fog to the rage to the aches and pains and weight gain and the painful sex,’ she said.
The most obvious treatment option is hormone replacement therapy, or HRT, which supplements the hormones estrogen and progesterone that are lost to menopause.
But, in Dr Mansberg’s experience, this isn’t always necessary: ‘Most of the time, they don’t need to go on HRT. They can try a variety of treatments.’
HRT typically involves replacing the feminine hormones, but in some cases a more appropriate treatment for perimenopause symptoms can be testosterone – the primary male hormone.
This can be effective if the patient is experiencing symptoms like low libido, fatigue or a decrease in overall energy that are not fully relieved by estrogen therapy alone.
One alternative treatment is dietary supplements. However, these will vary in effectiveness and should be taken after consultation with a doctor to ensure it’s the right option and does not interact with other medicines or have side effects.
Some studies suggest black cohosh, widely available in pharmacies and health stores, can reduce the severity of hot flashes and night sweats. Red clover extract, Vitamin E and soy isoflavones (plant-based estrogens) are also said to help.
Magnesium may assist with disturbed sleep, cramps and mood swings.
In addition to HRT, testosterone and daily supplements, Dr Mansberg says ‘diet can also be a factor with symptoms’. She finds people who are overweight generally experience more symptoms, so a weight-loss program may be advisable.
While a consultation with a doctor should always be the first port of call, in terms of general advice – not Dr Mansberg’s specifically – the following dietary changes may help with symptoms:
- Hot flashes and night sweats: Eat more plant-based foods because they are rich in compounds known as phytoestrogens that mimic estrogen in the body. Avoid spicy foods, caffeine, and alcohol, which are known triggers.
- Bone and joint pain: Dairy, leafy greens and fatty fish that bolster your calcium and vitamin D and help maintain bone density that can naturally decline. Avoid salty foods which can lead to calcium loss from bones.
- Disturbed sleep: Magnesium-rich foods such as leafy greens, nuts, and seeds can be good for sleep. An obvious no-no is caffeine, as well as a heavy meal late at night.
Treatments range from hormone replacement therapy to testosterone and daily supplements, depending on the severity of the symptoms. Diet can also be a factor
Surprisingly, your class and education can have an impact, too, with Dr Mansberg finding symptoms tend to be worse for women of a lower socioeconomic status.
‘There’s fairly good evidence which points to these demographics when it comes to more severe symptoms. The more educated you are, the less likely you are to suffer as much,’ she said.
Dr Mansberg says women often feel conflicted after finally going to a doctor and seeing positive results – because they realise just how long they spent living with pain that had been treatable all along.
‘It can take some people a long time before they think to go to a doctor,’ she said.
Heading to the doctor after years of fighting symptoms, only to find themselves ‘come back’ in weeks is a difficult experience for many women.
‘They carry that shame. But if more people could recognise it and make the choice to see a doctor, then we would have fewer women having terrible symptoms,’ she added.
‘Women also might forgive themselves a bit more. They might not feel as horrific and ashamed.’
The main takeaway message for Dr Mansberg is that perimenopause symptoms that affect women in their forties and fifties should not be dismissed as a normal part of growing older.
It is this attitude that puts women off seeking help – when there are actually a multitude of options available to them.
