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In a recent segment on BBC Morning Live, Dr. Xand van Tulleken highlighted a crucial point for individuals over 45 who are grappling with sleep issues: consult your GP about menopause-related concerns. This advice came in response to a viewer’s question about her struggles with sleep during menopause.
Menopause, as defined by the NHS, marks the end of menstrual cycles due to decreased hormone levels, typically impacting women between 45 and 55, though it can occur earlier. Dr. Xand emphasized the complexity of menopause, noting that its extensive array of symptoms can often complicate diagnosis and treatment.
Addressing the viewer’s query, Dr. Xand remarked, “Menopause significantly impacts sleep, making it a challenging issue due to its myriad symptoms that might obscure other health concerns. Unfortunately, these symptoms can sometimes be overlooked, leading to under-treatment. That’s why it’s essential to have an open dialogue with your GP about menopause and its effects.”
One important aspect Dr. Xand brought to light was the viewer’s lack of information regarding Hormone Replacement Therapy (HRT). HRT is a critical treatment option aimed at mitigating menopause symptoms by replenishing diminishing levels of oestrogen and progesterone as menopause approaches.
Some menopause symptoms that HRT can help alleviate include:
Menopause symptoms HRT can help to treat include:
- sleep problems
- hot flushes
- night sweats
- mood swings
- anxiety and low mood
- vaginal dryness
Talking about HRT, he noted that you could try it and if it is not for you, to come off it. He explained: “That might be something to discuss, even if it was for a short period of time, it doesn’t have to be forever. I think sometimes the health dangers of HRT have been really exaggerated, particularly for doctors of my generation.”
The NHS have said people can usually take HRT if they are having menopause symptoms. However it may not be suitable if you:
- have a history of breast cancer, ovarian cancer or womb cancer
- have a history of blood clots – you may need to use patches or gels rather than tablets
- have untreated high blood pressure – your blood pressure will need to be controlled before you can start HRT
- have liver disease
- are pregnant – it’s still possible to get pregnant while taking HRT, so it’s important to use contraception until 2 years after your last period if you’re under 50, or for 1 year after the age of 50
The viewer also mentioned fibromyalgia. This is a long-term condition that causes pain all over the body. As well as widespread pain, other symptoms of fibromyalgia include:
- difficulty getting to sleep or staying asleep, which can make you feel very tired (fatigue)
- problems with mental processes (known as “fibro-fog”), such as difficulty concentrating or remembering things
- headaches
- increased sensitivity to pain
- muscle stiffness
- irritable bowel syndrome (IBS), a digestive condition that causes stomach pain and bloating
- feelings of frustration, worry or low mood
Discussing this chronic condition, the doctor explained that it is a greatly “misunderstood” health issue that can significantly disrupt sleep. Acknowledging that it can be “very, very difficult for people to manage,” he encouraged people to seek help and ask whether they can be referred to a sleep clinic. In the meantime, while waiting for support from a clinic, GP or other specialist, he reminded people that, according to the NHS, maintaining a regular bedtime and ensuring your bedroom is cool and dark are essential. He also emphasised avoiding caffeine and alcohol at night to help the body unwind.
He also pointed out that having a “regular wake-up time can make a big difference as well.” Additionally, if possible, aim for 150 minutes of aerobic activity each week. This doesn’t need to be strenuous—activities like “briskly mowing the lawn” or other forms of light movement count, too. He advised that you should “try and keep an eye on how much you’re doing as it can make a big difference to your sleep.”
Symptoms of iron deficiency anaemia – something he noted could also be causing your sleep issues – can include:
- tiredness and lack of energy
- shortness of breath
- noticeable heartbeats (heart palpitations)
- paler than usual skin
- headaches
Less common symptoms of iron deficiency anaemia (that are not usually connected to pregnancy) include:
- hearing ringing, buzzing or hissing noises inside your head (tinnitus)
- food tasting strange
- feeling itchy
- a sore tongue
- hair loss – you notice more hair coming out when brushing or washing it
- wanting to eat non-food items, such as paper or ice (pica)
- finding it hard to swallow (dysphagia)
- painful open sores (ulcers) in the corners of your mouth
- nail changes, such as spoon-shaped nails
- restless legs syndrome
Concluding his advice, he said: “Your GP should be looking at other causes of exhaustion and tiredness like iron deficiency anaemia and thyroid problems. Distinguishing between tiredness and sleepiness is key.”
