‘There is a greater understanding of the menopause now’

Dr Isabelle Cullen / title page
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I think there is a greater understanding of menopausal issues than ever before but there is still some confusion about the place of HRT and indeed its safety, writes Dr Isabelle Cullen. 

GPs are well-placed to advise patients if they are struggling with symptoms.

I would usually have several consultations dealing with such problems every week in my Hyndland Road practice.

In general I find that my patients in the West End are well-informed but have often come across conflicting information.

The menopause is the time when the ovaries stop working. This means a woman no longer ovulates or has periods. 

For many women they will have months or years leading up to this point when they are perimenopausal as the ovaries are gradually becoming less effective. 

Menopausal and perimenopausal symptoms are caused by two main factors: lack of oestrogen – the female sex hormone – and resultant high levels of the hormones which stimulate the ovaries – FSH & LH. 

We now have clear evidence that HRT is safe for most women particularly under 60.

Most people are well aware of the classic hot flushes and sweats which are common at this time. 

Glasgow GP Dr Isabelle Cullen writes about family health matters in a new blog.
‘My patients are generally well-informed but have often come across conflicting information’

There are many other symptoms however which can have an impact on a woman’s wellbeing – e.g. anxiety, sleep disturbance, fatigue as well as physical symptoms like muscle and joint pains.

It’s important to consider menopause and perimenopausal as a possible cause for many symptoms in women in their 40s and 50s. 

HRT can be life-transforming for many women. A small dose of oestrogen, usually combined with progesterone, will make a huge difference.

Some argue that the menopause is a natural process and some women are not keen on HRT, preferring to deal with the process without taking hormones. 

For a small number of women HRT will not be an option because of medical conditions.

‘Menopausal and perimenopausal symptoms are caused by two main factors: lack of oestrogen – the female sex hormone – and resultant high levels of the hormones which stimulate the ovaries’

Dr Isabelle Cullen

In general though, we treat all other hormone deficiencies – e.g thyroid disease, type 1 diabetes. 

In recent history, women’s life expectancy was significantly lower which meant women did not live for long after the menopause. 

Now women can expect to live a significant proportion of their lives post-menopausal and HRT can help to keep them healthy – e.g. in preventing osteoporosis – the bone thinning that leads to so many fractures in older women.

The important thing to remember is that there is not a one-size-fits-all answer for every woman. 

It is well worth discussing any concerns you have with your GP to get an idea of your options and decide together.


Dr Isabelle Cullen is a general practitioner based at 130 Hyndland Road. You can follow the surgery on Twitter @DrCullenSurgery or visit the website cullensurgery.gp.scot

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