My daughter has been suffering from perimenopause, help! Dr Zoe Williams answers your health questions

DO you care enough for your digestive health? Particularly if you are among the one in three who suffers symptoms such as constipation, bloating or wind.

Tomorrow is World Digestive Health Day and we could use a reminder that the digestive system – which includes the giant tube that runs from the mouth to the anus, the liver, gallbladder and pancreas – needs looking after.

Dr Zoe Williams shares her top tips for anyone struggling to get a GP appointment

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Dr Zoe Williams shares her top tips for anyone struggling to get a GP appointmentCredit: Olivia West

For a more comfortable tummy, don’t rush food, skip meals or have large meals before bed.

Excess weight, smoking and binge drinking can all increase the chances of acid reflux and heartburn.

And de-stress! Stress can either slow down or speed up digestion, and lead to unwanted symptoms.

If you feel overwhelmed, breathe in for a four-count, then slowly breathe out until you have no breath left.

Most of us do not eat enough fibre.

Easy ways to add it include having a large helping of fruit or veg with every meal, adding a can of beans or lentils to dinner, and choosing the brown versions of starchy foods, such as pasta or bread.

Here is a selection of what readers have asked this week.

BRUTAL FLARE-UPS

Q: I HAVE been suffering from diverticulitis for ten years. I’ve had two serious bouts that left me in hospital.

Is there anything I can do to help myself when I feel this ­coming on? It normally lasts for up to two weeks at a time, but it can be brutal.

A: Diverticulosis is a condition that affects the large intestine, known as the bowel.

Davina McCall on what you should know about menopause

It is when people have little pouches in the wall of the intestine, called diverticulas, and if they become inflamed or infected it causes diverticulosis.

Symptoms can include diarrhoea, bloating, constipation and tummy pain that gets worse after you eat but improves after you pass wind or have a bowel movement.

The pain tends to be at the left lower area of the abdomen and sometimes people have blood in their stools.

Treatment includes painkillers, ­laxatives, medicines for stomach cramps, and antibiotics if there is an infection.

You don’t mention your weight or whether you smoke but the condition can be made worse with excess body weight or smoking.

So what can you do? We know that consuming a diet high in ultra-processed items – think packaged foods or anything that is not in its raw, original state – can exacerbate the symptoms.

In fact, some studies suggest it’s a condition caused by Western diets. So try to avoid too much heavily processed food and eat plenty of fruit, vegetables and whole foods.

A high-fibre diet has been shown to reduce episodes of diverticulitis too, so foods such as avocados, broccoli, almonds and lentils can help.

A word of warning, though. While raising our fibre intake is something that most of us will benefit from in the long run, it’s important to increase it slowly and gradually, or else it can cause tummy discomfort, bloating and other unpleasant­ ­symptoms.

What is the menopause and how does it affect women?

The menopause is a transitional period all women go through in mid-life.

Hormones related to the reproductive system deplete namely oestrogen, over a period of time. 

This doesn’t just cause periods to stop. Sex hormones act all over the body, from the brain, skin, vagina and more.

Therefore, dozens of symptoms affect all areas of the body, to varying degrees.

Women’s experiences of menopause vary greatly. While some breeze through it, others’ lives are significantly impacted. It can feel as though it lasts a couple of years, or for decades.

It cannot be predicted how each woman will fare. 

When is menopause?

Perimenopause is when symptoms start but periods have not yet stopped, although they will be irregular. This can start in the early 40s.

Menopause is when periods have completely stopped for a year. The average age this happens is 51, but it can be any time from 45 to 55, according to the NHS. 

The term ‘menopause’ is used to describe the experience overall.

Menopause before the age of 45 is called early menopause, affecting five per cent of women. Menopause before the age of 40 is called premature menopause, affecting one per cent of women before 40 and 0.1 per cent of women under 30.

This may happen for no clear reason, but also as a result of surgery, genetics or medications. 

A year after that the final period, a woman is considered to be entering the post-menopausal stage. 

How does it impact a woman’s life?

The menopause can be an extremely testing time in a woman’s life and for those around her.

The body is going through a significant change, and the symptoms that come with it can feel alien, with women sometimes describing a loss of sense of self.

Physical symptoms include hot flushes (a sudden feeling of heat in the face, neck and chest), difficulty sleeping, night sweats, heart palpitations, headaches, muscle and joint aches, weight skin, skin changes, reduced libido, vaginal dryness and more.

Symptoms affecting mental health or cognition include brain fog, memory loss, low mood, anxiety, low self-esteem and irritation.

There are ways to manage symptoms and cope with menopause – and women need to know that they are not alone in facing it.

Medication, such as HRT or oestrogen gel, can help attack the symptoms.

However, experts often say it needs a rounded approach incorporating good lifestyle habits, such as a balanced diet and less alcohol. 

Many women report that their life began after menopause after it drew them to a healthier way of living.

However, the huge burden it can have – on work, family life and more – is important for society to recognise, as adapting policies at work, for example, can make it easier for women to stick with their job.

Read more about menopause on The Sun’s Fabulous Menopause Matters campaign.

Q: MY daughter is 39 and has been suffering from perimenopausal symptoms for the past year.

As well as night and daytime sweats, she has forgetfulness, mood swings, painful periods, poor sleep and has lost interest in sex.

Dr Zoe helps a reader suffering with night and daytime sweats

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Dr Zoe helps a reader suffering with night and daytime sweatsCredit: Getty

She has seen several doctors and they basically say, “It’s one of those things” or, “She’s too young to be going through these things”.

I’m sure my daughter is not the only one suffering like this. She has tried herbal remedies to no avail.

She’s a busy working mum and generally healthy, but I can see the change in her over the last year.

Do you have any advice?

A: It’s not uncommon for women in their late 30s and early 40s to begin experiencing symptoms of perimenopause, which for many, can last four to eight years.

The average age of menopause (one year after your last period) is 51, but around five per cent of women, experience it by the age of 45.

What age did you reach menopause? Numerous studies show genetics play a strong role in determining the age of menopause.

Women who are black or Asian reach menopause earlier, on average, than white women, according to a huge US study.

Given the severity of her symptoms and the impact on her quality of life, your daughter needs to find a doctor or nurse who takes her concerns seriously and offers appropriate support and treatment options.

It’s also important to rule out other conditions such as abnormal thyroid function, anaemia, B12 deficiency and hypertension, if this hasn’t been done already.

Get her to ask if the practice has a doctor or nurse who has a special interest in women’s health.

She can submit an e-consult online if she’s reluctant to return.

Of course, she could see a private menopause specialist if financially possible.

If HRT or other medication is commenced, she could ask her NHS GP to take over the prescribing.

It’s important we all advocate for ourselves during medical appointments and it’s easier to do this if we have done some prior research.

Good resources include nhs.uk, patient.info and for menopause- related issues, thebms.org.uk.

Take a written list of symptoms and be prepared to give a timeline of how and when they started, and how they affect everyday life.

High BMI is thwarting son’s hip op

Q: FOUR years ago my son had an accident at work and broke his hip. He is 42.

After a scan, the surgeon said his BMI of 35 was too high for a hip replacement. He stated it needs to be 30.

And Dr Zoe also helps another reader who broke his hip

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And Dr Zoe also helps another reader who broke his hipCredit: Getty

My son is struggling to lose weight as he cannot exercise or move around very easily. He went back to his GP who further advised him to “starve”. What would your advice be?

A: This is a really difficult position for your son to be in. NICE guidance on arthritis states that BMI should not be used to exclude people from referral to surgery – but restrictive policies are still in use in some regions.

In your son’s case, it sounds as though the problem is due to a hip fracture, rather than arthritis per se.

While we know hip replacements work well when they have less weight to bear, it does seem unfair to me that a person would be excluded without being offered professional support to lose weight.

In some areas, surgical teams delay ­surgery but provide a weight-loss-support programme.

My advice is to return to the GP and see what support is available for your son.

If he tries this and still has a BMI of 35 then I think you are well within your rights to seek a second opinion with another surgeon, possibly at a different hospital.

You can check the average wait time to be seen at different hospitals at myplannedcare.nhs.uk.

In the meantime, a few dietary tips for him: He needs fibre, fluid and whole foods and to avoid white processed carbohydrates as much as possible.

Oatmeal, peanut butter on wholemeal toast or eggs are great breakfast ideas, and roasted vegetable salad or soup (with protein) are good for lunch.

Dinner should be lean proteins Such as chicken breast with lots of salad or veg.

Drink water rather than fizzy drinks and, over time, ditch sugar in tea and coffee.

Some evidence suggests eating all meals in an eight-hour window can support weight loss, too.

Tip of the week

PRESCRIPTION costs rose again recently, to £9.90 an item. But many people can get theirs for free, including those over 59 or some people who have, or live with someone, on benefit support.

Find out if you are eligible at this website: check-for-help-paying-nhs-costs.nhsbsa.nhs.uk.

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