Menopause hysterectomy and high cholesterol

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Hi,

I am a 47 years old female with average build up. I am 5 feet and weigh 8 stones. I don't know whether these details are relevant. But what I meant to, was to give a short description about my health. Recently, I started getting hot flashes, continually and many times a day. Even though they occur at times, they are quite bearable and not too severe. My last period was about 40 days before, in January itself. I have been taking a healthy diet because of high cholesterol level and used to do regular exercises also. I also try to take foods with high calcium levels also. Is there anything, I should do, to attain menopause? I have heard of HRT and am worried about its side effects, even if I don’t know whether I need it or not. How to find whether it is needed or not? Should I consult with my GP for checking hormone levels or take some tests? I have had IVF twice and also could not have children. When I was at my twenties, I used to be on pills regularly. Recently I underwent hysterectomy and removed endometrial polyp which was benign. I also used to have recurring polyps before, in cervix. My Gynecologist thinks that I might have had endometriosis before but haven’t suggested anything special for that. And the reason for my infertility was due to some problems with husband. In my mid-thirties, I had IVF done. Before that, I became pregnant once, when I was 23, and had a TOP at 8/52. I read some magazines and they left me with nothing but confusion about having HRT. In those magazines, it says that, almost all wives of doctors perform this and that made me think that there is something which they rely on. I would also like to know whether there are any relationships with heart problems, breast cancer and osteoporosis.I used to work with a gynecologist as a PA. She was specializing in cancers and knew about ovarian cancer and drugs. I use to take Citalopram for severe and panic attacks. I also use Seretide50 inhaler.

Submitted: 4 Days
Category: Sexologist

Expert:  Dr. John Monheit replied 4 Days.

Thank you for consulting with Doctor spring. It is good to see you are well informed about the options for your health issues. Your age and symptoms suggest that you may be going in for menopause. Although the fact that your periods have been delayed, it does not mean that you will menstruate no more. Usually, your periods space out more, reduce in quantity to completely stop over a period of 6 months to a year. Regarding HRT, it is not routinely recommended currently for all women going into menopause. The U.S. Food and Drug Administration (FDA) now recommends that women with moderate to severe menopausal symptoms who want to try menopausal hormone therapy for relief use it for the shortest time needed and at the lowest effective dose. Like most women, your hot flashes or night sweats will likely go away over time. Considering the fact that your hot flushes are bearable, I don’t think you will need HRT. I recommend that you get your cholesterol levels rechecked because the beneficial effect of estrogen and progesterone is lost after menopause leading to worsening of your cholesterol levels. It would be good to add in some weight bearing exercises to maintain your bone density in addition to your routine exercise schedule.

Hormonal levels for testing the onset of menopause are not required. Its onset is diagnosed with symptoms and age alone.  Yes there is an established increased risk of heart disease and osteoporosis. But they can be put off with wise eating choices, regular exercise and work ups. As far as breast cancer is concerned, although the risk does increase with menopause, your GP should be able to chart out a schedule for mammography depending on your other risk factors. Regular breast self examinations and pap smears are not to be forgotten.

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