FAQs Archive - Page 3 of 9 - Chelvey Menopause

Q: What are our bones and what do they do?

Our bones form our skeleton- literally the foundations upon which everything else in our body is hung and are critical to our health. Bones are a living part of our body and are filled with cells and blood vessels. They are dynamic- ever changing- constantly being broken down and reformed over time. Each small bit of bone is completely reformed around every 3-9 months. Our peak bone forming years are up until our early to mid-twenties after which our bone resorption equals bone loss, keeping a roughly steady state of bone density until a few years before the menopause. Around the time of the menopause, break down of bone overtakes bone formation and bones start to get thinner rapidly.

Q: Why do I need to think about this now? Im young, im sure my bones are fine…

Knowledge is power and a little bit of education about what affects bone development and function goes a long way towards understanding the importance of lifelong strategies to protect our bones from osteoporosis. As with so many things in medicine, prevention is better than cure and with life expectancy extending all the time, maintaining mobility and independence into our elderly years becomes ever more relevant. Every little helps and there’s no time like the present to start thinking about your bones.

Q: What can we do to help?

HRT Oestrogen will help to improve the symptoms of oestrogen deficiency that often interrupt sleep. Progesterone (if needed as part of HRT) has been shown to increase the amount of stage 3 (deep) sleep which will restore that ‘well rested’ feeling we all crave when we wake up and research has consistently shown that HRT can be hugely beneficial for improving sleep around the menopause. If you have tried everything you can do yourself at home and nothing has worked for you then it is unlikely that these measures will suddenly help you to start sleeping well. At Chelvey Menopause we have the option to book a ‘lifestyle’ consultation where one of our skilled clinician will be able to take a careful history and try to unpick the cause of your insomnia and talk through other techniques (such as Cognitive Behavioural Therapy) which are highly effective at transforming sleep and can easily be put into practice yourself at home.

Q: What happens to sleep at the Menopause?

There are different ways that sleep may be affected during the perimenopause and menopause- you may have difficulty getting to sleep, problems staying asleep with frequent waking through the night, early morning wakening or less restorative type (deep ) sleep. During the menopause we spend less time in stage 3 restorative sleep so a common complaint from women is that they suddenly seem to feel much less refreshed in the morning despite having seemingly slept most of the night. Mood disorders are well known to cause early morning wakening and anxiety can really interrupt our ability to shut off our minds and drift off to sleep.

Q: What is 'normal' sleep?

There are two types of sleep- Non REM and REM sleep and there are 4 stages of sleep which we cycle through several times throughout the night. 1.NREM stage 1- this is essentially dozing off and usually lasts around 5 or 10 minutes. The body hasn’t fully relaxed in this stage though the brain starts to slow down and there may be brief movements or twitches. It is easy to wake someone up from this stage of sleep. 2.NREM stage2- our bodies really start to relax and our temperature starts to drop, our heart rate and breathing slow down. This stage lasts for 10-25 minutes but each stage 2 that you experience through the night becomes progressively longer. 3.NREM stage 3- this is deep sleep and it is thought that this type of sleep is the most restorative and important sleep stage. It is when our brains remove waste and our cells repair themselves. We spend most of the time in deep sleep in the first half of the night and it is difficult to wake someone from this sleep stage. If they are woken there may be a period of disorientation lasting up to half an hour after waking. Each stage 3 lasts around 20-40 minutes but gets shorter though the night and more time is spent in REM sleep instead. REM sleep- during REM sleep brain activity actually increases but our muscles are paralysed with the exception of the eye and breathing muscles. This is the stage of sleep when we have the most vivid dreams and REM sleep is thought to be essential for cognition, memory and learning. It is when our brains re-energize! You don’t enter REM sleep until you have been asleep for around an hour and a half and the REM stages get longer through the night- the first REM sleep stage may only last a few minutes.

Q: Does HRT delay menopause?

No it does not. Menopause is an intrinsic process inside a woman's body that goes on behind the scenes whether you're taking HRT or not. HRT helps with the symptoms of the Menopause as well as offering the other benefits mentioned above but it does not change the overall process of a woman's ovaries winding down to retirement.

Q: Can you change from one regimen to the other?

Yes very easily. If a women starts on a sequential regimen we usually advise staying on this for a minimum of a year before trying to change over to a continuous type of HRT. If a woman changes to a continuous HRT and develops irregular bleeding it is sometimes necessary to change back to the sequential hormones for a length of time before trying the continuous again.

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