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There seem to be a few grey areas whehen it comes to the common issues surrounding menopause.

There is nothing worse, is there, especially with a health issue, when you can’t get a straight answer about something? So here are a few answers to some of those myths surrounding the menopause…


First up…diagnosis of the menopause…


  • Diagnosis of the menopause should be done by symptoms alone. The majority of women do not usually need a blood test (the follicle stimulating hormone (FSH) blood test) to diagnose menopause.  Why?… 
  • When women are going through menopausetheir hormones are fluctuating all over the place, with levels changing daily, which makes it very difficult to get an accurate reading. As a consequence ,the results of an FSH test can be very misleading.  
  • The problem in today’s society is that we want something ‘concrete’ to happen when we go to the GP, don’t we? It can take so long to actually get an appointment in the first place that you want to come away with either having had something done, or to be clutching a prescription! Whereas with menopause, it’s much better to go by the symptoms you are suffering from. 

The same goes for saliva tests: Please do not get drawn into thinking these are a good thing to go and get done with regards to checking hormone levels – they do not give accurate enough readings to decide which hormones you should be taking.  

Important note…don’t get swept along into paying for FSH and saliva tests to be done privately – save your money! * 


Next up…menopause starts in your 50s?

A large proportion of women start to experience symptoms in their early to mid40s as their reproductive hormones start to decline. There are a number of women who suffer from premature menopause, correctly known as premature ovarian insufficiency (POI), who are under the age of 45. It is important for any woman to see their GP if they are experiencing any changes to their menstrual cycle, and incredibly important for anyone with POI to get advice and treatment as soon as possible. This can help prevent long term symptoms from developing, such as osteoporosis or cardiovascular problems.  

1 in 100 women are under 40 

1 in 1000 women are under 30 

The challenging topic of HRT… 

Sensationalistic headlines and misinformation around the topic of HRT have created so much confusion for women and health care professionals. Let’s get a few facts straight… 

  • You do not need to be menopausal before you can be prescribed HRT. As explained in previous blogs, the most symptomatic stage of the female hormonal journey is the perimenopausal stage, when hormones are fluctuating all over the place. This is the ideal time to be prescribed HRT, if you require it, to replace those hormones and help with symptoms. 
  • If you start taking HRT, does it just delay your menopause? Whilst on HRT your body continues to developsimply putthe HRT is replacing those hormones, and so overriding the menopause. If you decide to come off HRT, you might experience some symptoms as your body adjusts to the changing hormone levels. It will, however, be different with every individual. 
  • HRT is too risky: The benefits of HRT outway the risks. Rememberall medication carries risks, and it’s incredible what people pop into their mouths without a second thought.  
  • HRT and breast cancer: To get things in perspective, the research says there are an extra 5 cases per 1000 women if using HRT for over 7.5 years. What most people don’t take into account are the other contributory factors for those women, such as lifestyle choices, smoking and weight gain. The risk of developing breast cancer is far greater if you drink too much alcohol, if you smoke or if you are overweight. 
  • Certain types of HRT carry less risk, with transdermal HRT being the safest route. There are many different combinations of HRT available; sometimes it’s a matter of persevering until you find the right combination for you. 
  • Ultimately, women need to be informed of every option available so they can make an informed, educated choice along with their Health Care Professional. 
  • Remember your prescription is only as good as your prescriber, so make sure you see someone who is experienced. 

Important note: only take recognised properly registered hormonal treatment. 

Vaginal oestrogen…


This can be taken in conjunction with systemic HRT, or on its own as a localised treatment. Be patient though…it can take between 3 and 6 months to work.

Oestrogen deficiency can affect urinary symptoms as well as vaginal ones. It can contribute to urinary and bladder problems such as cystitis and infections.


Contraception…don’t stop too soon!


Unless you want to hear the pitter patter of tiny feet, make sure you are covered contraception wise. Just because you aren’t having periods doesn’t mean to say there isn’t a slim chance you might become pregnant!

If you are 51 or under, make sure you are covered for at least 2 more years ,and if over 51, for at least 1 year.




  • These are not recommended as the first line of treatment for menopausal symptoms.
  • There has been a lot of over prescribing in this area in the past.
  • Some antidepressants can be used if HRT is unable to be taken for medical reasons but, as with any treatment, all options should be fully discussed prior to prescribing, so that an informed decision can be made.


So, there you have a few nuggets of information to help clear up those menopause myths!



All information is in line with the current NICE guidelines:


* The time when an FSH test can be useful is to test for POI or for fertility tests, so under the age of 45. You should be offered two tests 4-6 weeks apart, and the tests should be done preferably around day 3 of your cycle to maximise accuracy.

'As with any information developed for Fountain Retreats the information in this post is accurate at time of posting and is for information purposes only. It is not intended to replace or substitute the judgement of any medical professional you may come in contact with. You should always seek advice from your health care professional regarding a medical condition

About the author...

Ruth Devlin

Ruth Devlin

Author, Qualified Nurse

Ruth is a qualified nurse, gaining her registration and working at the Edinburgh Royal Infirmary.

She is passionate about providing women and employers with evidence based information and support, helping women to make informed decisions about how to manage their menopause and so improve their quality of life.

She has been asked to contribute on several occasions on various media platforms including, Radio 4s Woman’s hour, BBC Radio Scotland, Radio Borders, the BBC Insiders Guide to the Menopause documentary with Kirsty Wark and BBC breakfast.

Ruth is married with three children, three dogs and a cat, loves cycling, playing netball and tennis, spending time with family and friends and has a great sense of humour.

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