Some women experience a big deterioration in their wellbeing when they pass through menopause whilst other women seem to sail through it with calm waters. This is somewhat mysterious and has not been explained in medical text books.

The most common problems are –

  • Poor sleep
  • Hot flushes and sweats
  • Aches and pains
  • A fuzzy brain which does not work as well as it did before menopause
  • Loss of sex drive
  • Dryness of the vagina and uncomfortable sex
  • Bladder problems such as incontinence and urgency and increased urinary tract infections
  • Weight gain

Does not sound like much fun right?

I see a lot of women who need relief of these symptoms and yet find it hard to get the balance right. They are often given forms of Hormone Replacement Therapy such as patches or the tablet Livial (also known as tibolone). The patches contain the oestrogen called Oestradiol and a synthetic progesterone and provide relief for some women. The hormone tibolone is a synthetic hormone with actions that emulate oestrogen, progesterone and testosterone but is far removed in its chemical structure from our natural hormones. Furthermore tibolone can cause weight gain and an increased risk of blood clots, so I am not a fan of this treatment in the long term.

Hot flushes and disturbed sleep can be improved by the use of bio-identical hormones which I first prescribe in the form of creams. I often use a progesterone cream which is rubbed into the inner upper arm once a day. I will combine this with another separate cream containing oestrogen and a small amount of testosterone and this is rubbed into the vulva once daily. This vulval cream relieves vaginal dryness, improves bladder function and restores sex drive. The creams enable small doses of hormones to be used to effectively relieve symptoms. Like the patches, the creams deliver their hormones via the skin, thus avoiding the liver metabolism of the hormones before they get to have their effect in the body. Not all doctors prescribe bio-identical hormones, as they are not considered main stream medicine and are not promoted by drug companies. Thus it can be hard for women to obtain bio-identical hormones.

For poor sleep and anxiety natural herbs can be used such as withania, rhemania and valerian. I also find that a magnesium supplement promotes relaxation and better sleep.

Many women with aches and pains are low in vitamin D and will get relief with supplements of vitamin D 3 and fish oil.

Hot flushes and sweats will often be relieved well with bio-identical oestrogen but if your liver is fatty your flushes will be worse and you will tend to overheat. A sluggish or toxic liver is an overworked liver and will generate excessive heat. To help your liver check your diet – you may be eating excess carbohydrates such as sugary foods and lots of bread. A high carbohydrate diet will lead to a fatty liver unless you are doing a lot of regular and aerobic exercise. So cut the carbs, take a good liver tonic and eat more green leafy vegetables, avocadoes, citrus fruits and free range eggs. Your liver will improve, you will cool down and sleep better; this also helps you to lose weight!

For more information see my book titled HRT – The Real Truth and my video at