Newsletter Sept 2020

September – a time for renewal & vision

I hope you’ve all had a lovely September thus far. The leaves on the trees are starting to turn colour as a nod to the beautiful colours that Autumn brings with it. We have had some beautiful blue skies here in Norfolk & bumper crops of blackberries on our hedgerows. Hasn’t it turned very autumnal the last few days!

Many of you will have school age children that may or may not be back in School, or you perhaps you are  home schooling. Some of you will have waved your child off to University and feeling very much the empty nest.

Some of you may have started a new job or a new course. Or you may have a  different focus now the new academic year has started.

Here at Victoria Health and Wellbeing there’s been a hive of activity (and I’m not referring to my neighbour’s honey bees). You won’t be surprised to learn that I have packed a lot of professional development in this month, as this is such a passion of mine, to assist in continuously improving the services that I provide to you.

We also had a focus on self care ( all available on Instagram if you missed it) and I will be collaborating with a lovely lady in October, to provide more on this very important topic!

Why? Because so so many women feel guilty for even thinking about looking after themselves, they feel selfish. Well, stick with us and you will learn how to adapt to a healthy approach to self care.

I had the absolute pleasure of having the wonderful Jane Lewis, author of My Menopausal Vagina join us for an interview (see below) who is such an advocate of women’s health, I hope you enjoy reading it. 

In response to the survey we are looking at Brain Fog, yes, it is indeed a real thing!

Happy reading everyone

This is a typical scene we see here in Norfolk at this time of year. I wanted to share with you because it says so much. It shows accomplishment, achievement, warmth, hope and renewal. These are just some of the elements we need to look out for with regards to self care.

Hi Jane
Welcome to Victoria Howell Health & Wellbeing as our September’s Special Guest, & a big thank you!

What is vulvovaginal atrophy now termed by medical professionals as GSM?

Vaginal dryness is the greatest taboo symptom of menopause yet so common. It is officially called Genitourinary syndrome of menopause (GSM), as it can cause far more symptoms than the word “dryness” implies.
Due to declining oestrogen that comes with perimenopause & then post menopause, when it is as good as all gone the vagina, vulva, bladder & pelvic floor can really suffer. It is a myth that GSM only starts in post menopause, it is also common in perimenopause just often not recognised by medics & women alike. My symptoms started at about the age of 40 but got exceptionally bad at 45 whilst still having regular monthly periods.

What are the symptoms of GSM?

The symptoms of GSM can be mild to moderate to awful. The vagina tightens, shortens and (the lining) becomes thinner & can cause vaginal dryness, painful sex, or smear tests. The vulva can burn & be sore & itchy, old episiotomy scars can become painful & even split at surface level. Other symptoms include repeated urine infections, which are quite common, needing the toilet numerous times a night, bladder leakage and a watery discharge. Wearing pants or trousers or sitting down for long periods of time can hurt or become impossible as can exercise also.

So, what do you recommend a woman do if she thinks she has GSM?

The most important thing is a woman does not self-treat, so she should see her GP as a first off.  The problem is symptoms often come before it can be seen & women can be fobbed off as having thrush unfortunately, an examination should be done but often a GP will say you look “fine”.

What treatments should a woman expect to receive from her GP?

Vaginal moisturisers, local oestrogen in the forms of cream, pessaries & a vaginal rings. All these go directly into the vagina & some can be used on the vulva also. There is also an oral tablet that is for vaginal dryness. Roughly 25% of women also need HRT as part of their treatment plan.
Laser treatment is also available, that some women respond well to, unfortunately currently is only available privately & thorough research should be done before deciding on having it done. (Victoria suggests seeing a consultant that is experienced and qualified in providing these procedures, if unsure the British Menopause Society can provide information).

What if women do not get the support from their GP’s?
It’s important women are not ignored or dismissed as having a “bit of dryness” they should expect to be examined & if symptoms persist then they may also have another vulva skin condition & should ask to be referred on if deemed necessary.

So, Jane, what you are saying is do not give up and keep going back to your GP until you feel you are being listened to and examined thoroughly to enable a correct diagnosis. What help can women get to help them prepare themselves for a GP consultation?

My support group is on Facebook & called Vaginal Atrophy we currently have 4.2k members, it is a very supportive group with lots of knowledgeable members enabling women to get the correct information to empower them to see their medical professional. I set it up 3 years ago as there are many groups for menopause but not just for vaginal dryness so it’s the only one that I am aware of, & women are very relieved when they find us.

Can you tell us a bit about your book? (The book that one lucky subscriber will win this month!)

My book Me & My Menopausal Vagina, although about my symptoms & GSM in general it was written by my middle daughter Penny. Many medics have now read it & I have recently been told that a nurse has completed a dissertation on GSM inspired by my book. The book is factual and real with humour, it has been written for all abilities whether you have a degree, which my daughter does, or you are dyslexic like me. Many ladies have given a copy to their GP. The front cover is very eye catching.

What message do you have for us all, whether we are health care professionals or not?
 
All health care professionals right up to the very top, need to know just how debilitating GSM can be. Very sadly, I know of ladies who have taken their own lives.  
Treatment should not stop start; it is for life. If treatment is stopped, symptoms return & is often more difficult to alleviate symptoms again.
GSM cannot be cured, it’s managed for life, & it’s safe for all women to use including those who have had oestrogen receptive breast cancer. Women who breast feed can also suffer from GSM & can use local oestrogen also.
 
Jane thank you so much for sharing your experience and knowledge with us. Your time is very much appreciated.

Jane joined us for a Instalive on 15 September, this is available to watch on @victoriahealthandwellbeing IGTV grid. This is packed with so much information and so many women have fed back to say what a fantastic session it was and how they do not feel alone with their symptoms anymore. Jane is paving the way to take the taboo out of GSM.

Does your head ever feel fuzzy or cloudy like the picture above?
Does it feel your thoughts are there but cannot quite make it to verbalisation?
Do you find your mind is saying what it needs to but the words don’t match?

It can be so frustrating. You find yourself describing something as simple as a spoon and the word completely escapes you, so you might say something along the lines of ‘that long thing that I use to do this’ (whilst gesticulating widely the actions of scooping with a spoon).

Does this sound familiar? You are so not alone ladies! 

Brain Fog, lack of concentration, & reduced memory are indeed symptoms of the peri menopause.

Not all of us will experience brain fog, our peri menopause journey varies from woman to woman. Some will experience mild brain fog whilst others experience it to the level of finding it frustrating & embarrassing & even impacting on work.

Some of us are unaware of this as a symptom of peri menopause, so when we start experiencing it, we can be concerned that we are starting with early onset dementia of some kind. We may be living super busy & stressful lives so also putting these symptoms down to the demands of modern life.

What can cause it?

When we start with peri menopause, we still have periods either for a few months or up to a decade or indeed longer. The cause of brain fog in addition to many other symptoms is the decline in oestrogen. We females also have a level of testosterone in our bodies and one of it’s jobs if you like, is to help with concentration and cognition. So when both these start to decline, this is when some women encounter brain fog. 

Other factors alongside the drop in hormone levels &  follicle stimulating hormone and luteinising hormone is sleep deprivation and stress. Anxiety about work, or hot flushes can cause waking during the night, and will contribute to brain fog. 

So, what can we do to help it?

Medical experts say that replacing the hormones is the safest and most efficient way to eliminate brain fog. This is the first line NICE guidelines recommendation for management.
The amount of oestrogen and progesterone provided in hormone replacement therapy is very low. It is much lower than the levels found in the contraceptive pill, and therefore the risks are far lower. Especially when taken transdermally. Women that experience other symptoms of peri menopause, also find that the other symptoms decrease or disappear completely too. 

For women who have survived breast cancer, your oncologist and menopause specialist will need to discuss together what the best treatment is for you.

Some herbal supplements such a Ginkgo Biloba is said to help with concentration ( always check with your pharmacist for contra indications to other medication you may be on).
When thinking of general lifestyle factors include omega oils, found in fish oils & hemp, chia seeds and really pay attention to how much vegetables you are actually consuming.
Try a food diary for a month, this is a superb visual tool to help monitor and evidence to you how much vegetables you consume, and can be something of a wake up call to many of us. Keep off sugary & refined foods too, where you can as these can contribute to brain fog.

Think about consuming fish, beans, pulses and nuts.

Follow sleep hygiene steps for a better night’s sleep

Drink enough water! When even slightly dehydrated, this will impact on the ability to concentrate.

Physical exercise – Aim for at least 2.5 hours a week, not just during perimenopause, we can look after ourselves throughout our lives by exercising. The exercise helps oxygen travel around the body, including your brain.

Brain exercise- Learning a new skill helps literally build new neuro-transmitters in our brains. Do what you enjoy though, is it undertaking a course? Joining a club? Learning a new skill? Puzzles, or cross words, sewing?

Avoid smoking as this affects your cardiovascular system and will reduce the efficacy of oxygen flowing through your body and to your brain.

Alcohol will also help make brain fog worse for you, so avoid where you can.

Let me know how you get on by engaging on Instagram. It is great having you as part of the community!

Guest interview with Jane Lewis of the acclaimed “Me and my menopausal vagina” book. 

If you are wondering what to get your friends for Christmas, why not buy Jane’s book? Available from her website & Amazon.

Every woman really should read this book!

The winner of Me & My Menopausal Vagina will be notified today.

What would you like to see?

So, that’s it for this month.

Coming up in October is Menopause Month & is International Menopause Day on the 18 October.

Look out on Instagram for what we are up to.

What would you like to see in October’s addition?
Email me at: [email protected] & let me know or message me on Instagram @victoriahealthandwellbeing

Keep safe everyone x