Kiveton Pharmacy

Mon – Fri 09:00 – 18:00

Saturday and Sunday – CLOSED
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Old Colliery Offices

Kiveton Park, South Yorkshire

S26 6LR

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Menopause Symptoms and Treatments

 

Key facts

 

The average age of menopause diagnosis in the UK is 51 years although this varies by ethnicity
It is estimated that 20 per cent of UK women have had a hysterectomy and, although the ovaries may be preserved, the menopause is often earlier than normal in these cases
Menopausal symptoms typically last from five to seven years, but some women continue to experience them for up to 10-15 years
Hot flushes and night sweats are the most commonly reported symptoms of the menopause
Hot flushes can be related to drugs that affect vascular reactivity, such as some antihypertensives, and to antidepressants when prescribed at high doses

 

Recognising the menopause

 

The menopause occurs when a woman stops menstruating permanently due to the loss of ovarian follicular activity and is diagnosed after a woman has had 12 months without periods (amenorrhoea), which typically occurs between 45-55 years of age. The average age of menopause diagnosis in the UK is 51 years, although this varies by ethnicity.

The menopause is preceded by the peri-menopause when the ovaries gradually stop functioning, oestrogen and progesterone levels fall, and women experience altered and irregular menstrual cycles. Some may start to experience these symptoms from their late 30s onwards.

Around one in 10 women have an early menopause between 40-45 years of age. Menopause before the age of 40 years is categorised as premature ovarian insufficiency and occurs in around 4 per cent of women. If early or premature menopause is suspected, referral to a GP is necessary as investigation and HRT is usually indicated.

Although the menopause is usually a natural event, it is important not to forget women who have had surgical removal of the ovaries, usually occurring at the time of a hysterectomy. It is estimated that 20 per cent of women in the UK have had a hysterectomy, most commonly between the age of 40 and 50 years. Although the ovaries may be preserved, the menopause in these women often occurs earlier than normal.

Sometimes chemotherapy or radiotherapy treatment for cancer can cause ovarian failure. Sudden cessation of ovarian function due to surgery or treatment can lead to severe menopausal symptoms and HRT is often indicated as a result.

 

Period irregularity and cessation

 

Most women experience irregularities in their menstrual cycle in the years leading to the menopause, which typically last for up to four years (the perimenopause). The cycle may shorten to two to three weeks or lengthen with many weeks or even months between periods. Only about one in 10 women’s periods will stop abruptly. Perimenopause is usually diagnosed based on irregular periods and the presence of vasomotor symptoms such as hot flushes.

 

Duration of symptoms

 

The duration and severity of symptoms experienced in the menopause vary markedly. Menopausal symptoms typically last for five to seven years, but some women continue to experience them for up to 10-15 years.

 

Hot flushes and night sweats

 

Vasomotor effects are the most commonly experienced menopausal symptoms. Together with irregular periods, they may be the first sign of ‘the change’. Hot flushes are often described as a sudden sensation of heat in the chest, face and head followed by flushing, perspiration and sometimes chills. Headaches and palpitations are other common vasomotor symptoms.

 

Urogenital symptoms

 

Urinary and genital symptoms occur due to the effects of diminishing oestrogen levels, which cause thinning and shrinking of the tissues of the vulva, vagina, urethra and bladder.

Multiple symptoms can result including vaginal dryness and irritation, and urinary symptoms such as a frequent need to urinate and also urinary tract infections.

Loss of oestrogen changes the urethral and vaginal bacterial flora, resulting in a higher (more alkaline) pH, predisposing both to infection.

As women age, a loss of muscular tone in the pelvic floor muscles together with thinning of vaginal and urethral tissue can lead to urinary incontinence. There may be insufficient vaginal secretions for comfortable sexual activity, so discomfort or pain on intercourse (dyspareunia) may be experienced.

Vaginal dryness and urinary symptoms tend to increase in severity over time and in some women may not present until five to 10 years after the menopause.

 

Musculoskeletal symptoms

 

Joint, bone and muscle pain may be experienced and are commonly reported.

 

Altered sexual function

 

Some women experience lower libido (sex drive) during and after the perimenopause partly due to diminishing levels of oestrogen and testosterone. Vaginal dryness leading to discomfort or pain during intercourse may further reduce libido. Some women experience higher libido once they no longer need to use contraception and are no longer worried about the risk of pregnancy.

 

Sleep disturbance and fatigue

 

Some women notice disturbed sleep during the menopause in association with irritability, poor concentration and depression. Night sweats can further cause or aggravate disturbed sleep. Sleep deprivation can lead to fatigue during the day and difficulty concentrating on tasks at work or home.

 

Mood disorders

 

It is common for women to experience loss of confidence, low mood, irritability, forgetfulness, difficulty in concentrating, panic attacks, anxiety and depression at the time of the menopause.

 

Hair and nail changes

 

Many women notice that their hair grows more slowly and becomes thinner. Nails can become brittle. These problems can add to their distress.

 

Practical guidance

 

There is some evidence that hot flushes and night sweats can be helped by weight loss (if applicable), by stopping smoking and by exercising regularly.

Practical measures such as wearing lighter clothing and/or dressing in layers, turning down central heating, sleeping in a cooler room and using fans may help. Some women find that symptoms are triggered by spicy foods, caffeine and alcohol, so these could be avoided.

Pelvic floor muscle training is an effective intervention for urinary symptoms, particularly for stress and mixed incontinence related to the menopause. This is perhaps best guided by a therapist but women who wish to try it themselves can access information from resources such as the Squeezy NHS Pelvic Floor app.

 

Complementary therapies

 

There is some evidence that black cohosh, isoflavones (in red clover) and St John’s wort may relieve vasomotor symptoms during the menopause, but the constituents, quality, purity and safety of the products may not be known.

Women sometimes take these supplements expecting them to be safer than prescribed medicines but in many instances their safety may be worse or unquantified. There are potential interactions between St John’s wort and tamoxifen, anticoagulants and anticonvulsants, for example. Black cohosh may inhibit CYP3A4 and so could potentially increase the risk of adverse effects with drugs metabolised by this enzyme.

Some complementary therapies such as red clover contain constituents with oestrogen-like properties (phytoestrogens), and these are also found in food such as soya. There are many studies looking at the effectiveness of these food substances, but the results are variable and generally show little value. They should not be used in patients with a history of breast cancer.

Bioidentical hormones are offered by private clinics in a mix of plant-derived oestrogens, often together with progesterone and testosterone in quantities based on the results of saliva and/or blood tests. They are formulated as creams, lozenges and vaginal preparations. NICE points out that “the efficacy and safety of unregulated compounded bioidentical hormones are unknown” as they are not subject to the usual regulatory processes for medicines.

 

If you would like to trial some of these complimentary therapies we at Kiveton Delivery Pharmacy can order the relevant product from reputable suppliers for you. Please get in touch.

or try from our website ;

Vitabiotics Menopace 30 Tablets

 

 

Talking therapies, exercises and relaxation

 

Cognitive behavioural therapy (CBT) can be considered for low mood and anxiety associated with the menopause (a NICE recommendation). There are online resources for CBT but it is generally advised that it should be initiated by a psychological therapist.

Breathing exercises and structured relaxation may be helpful – for example, click here

Mindfulness may be another method to reduce stress and help with relaxation. There are a number of online apps such as Headspace. Also visit the Be Mindful and NHS websites.

Pelvic floor exercises
Exercise can also reduce stress, anxiety and the likelihood of depression. For some general advice on suitable activities to signpost or recommend, see the NHS website.

 

When you should see your GP:

 

Premature or early menopause suspected
Unexplained vaginal bleeding
Significant upset with vasomotor symptoms which may require HRT
Suspected depression
Significant urogenital symptoms

 

Blog date 06/06/2022

Terms and Conditions of Sale

1 These Terms and Conditions of Sale

1.1 What these terms cover. These are the terms and conditions on which we supply products to you, whether these are goods or services on the www.kivetonpharmacy.com website.

1.2 Why you should read them. Please read these terms carefully before you submit your order to us. These terms tell you who we are, how we will provide products and to you, how you and we may change or end the contract, what to do if there is a problem and other important information. If you think that there is a mistake in these terms, please contact us to discuss.

2 Information about us and how to contact us

2.1 Who we are. We are OTC direct services ltd a company registered in England and Wales under the trading name of Kiveon deliver pharmacy. Our company registration number is 12239643 and our registered office address is: 43 Forthill road Sheffield S9 1BA, United Kingdom. Our registered VAT number is GB373807574.

2.2 How to contact us. You can contact us using the following email address pharmacy.fq716@nhs.net or by telephone using the following number 0114 698 0161.

2.3 How we may contact you. If we have to contact you we will do so by telephone or by writing to you at the email address or postal address you provided to us in your order.

3 Our contract with you

3.1 How we will accept your order. Our acceptance of your order will take place when we email you to accept it, at which point a contract will come into existence between you and us.

3.2 If we cannot accept your order. If we are unable to accept your order, we will inform you of this and will not charge you for the product. This might be because the product is out of stock, because of unexpected limits on our resources which we could not reasonably plan for, because it may not be clinically appropriate to supply the product you have ordered, because we have identified an error in the price or description of the product or because we are unable to meet a delivery deadline.

3.3 Your order number. We will assign an order number to your order and tell you what it is when we accept your order. It will help us if you can tell us the order number whenever you contact us about your order.

3.4 We only sell to the UK and EU. Our website is solely for the sale or supply of our products in the UK and EU. Unfortunately, we do not deliver to addresses outside the UK or EU.

3.5 English Language. We only provide treatment and advice in English and it will be your responsibility to ensure that you fully understand our advice.

3.6 Emergencies. You must not use our website or services for emergencies. In emergencies, you should consult your local doctor or the emergency department of your nearest hospital.

4 Our products

4.1 Product packaging may vary. The packaging of the product may vary from that shown in images on our website.

5 Your right to make changes

If you wish to make a change to the product you have ordered please contact us. We will let you know if the change is possible. If it is possible we will let you know about any changes to the price of the product, the timing of supply or anything else which would be necessary as a result of your requested change and ask you to confirm whether you wish to go ahead with the change. If we cannot make the change or the consequences of making the change are unacceptable to you, you may want to end the contract (please refer to clause 8).

6 Our right to make changes

Changes to the products and/or services . We may change the product or our services offered on the website at any time which may include amendments required to reflect changes in relevant laws and regulatory requirements.

7 Providing the products

7.1 Delivery costs. The costs of delivery will be as displayed to you on our website.

7.2 When we will provide the products. We will deliver the products that are the subject of your order as soon as reasonably possible and in any event within 30 days after the day on which we accept your order.

7.3 We are not responsible for delays outside our control. If our supply of the products is delayed by an event outside our control then we will contact you as soon as possible to let you know and we will take steps to minimise the effect of the delay. Provided we do this we will not be liable for delays caused by the event, but if there is a risk of substantial delay you may contact us to end the contract and receive a refund for any products you have paid for but not received.

7.4 If you are not at home when the product is delivered. If no one is available at your address to take delivery, our delivery company will leave you a note informing you of how to rearrange delivery or collect the products from a local depot. We will only post the products through the letterbox without the need for a signature where you have specifically selected this option during the ordering process.

7.5 If you do not re-arrange delivery. After a failed delivery to you and you do not re-arrange delivery or collect them from a delivery depot we will contact you for further instructions. If, despite our reasonable efforts, we are unable to contact you or re-arrange delivery or collection we may end the contract.

7.6 Automatic delivery upgrades. In some instances, we may have to automatically upgrade your delivery method; if the shipment does not comply with the size constraints of your chosen delivery method or your chosen delivery method does not have adequate insurances. In these instances, we will not charge you any more for the upgrade.

7.7 Combination of orders. In the event that two or more orders are placed to the same address by the same account on the same day, we may combine the orders into one single delivery. This decision is ultimately at the discretion of the pharmacist on duty. You will not be charged any extra fees, nor will you be re-reimbursed for the cost of the delivery.

7.8 When you become responsible for the goods. The products which we deliver to you will be your responsibility from the time we deliver the product to the address you gave us.

7.9 When you own goods. You own a product which is goods once we have received payment in full.

7.10 What will happen if you do not give required information to us . We may need certain information from you so that we can supply the products to you, for example, the information you are asked to give us for the medical assessment prior to placing your order with us. If we require additional information, we will contact you to ask for this information. We will not be responsible for liability arising out of supplying the products late or not supplying any part of them if this is caused by you not giving us the information we need within a reasonable time of us asking for it. We will also not be responsible for liability arising as a result of any incorrect or misleading information you have given us.

7.11 Reasons we may suspend the supply of products to you. We may have to suspend the supply of a product after an order has been accepted by us due to a change in relevant laws and regulatory requirements or where the supply of the product would not be clinically appropriate.

7.12 Your rights if we suspend the supply of products. We will contact you in advance to tell you we will be suspending supply of the product if we have already accepted your order. You may contact us to end the contract for a product if we suspend it and we will refund any sums you have paid in advance for the products that have not been supplied to you.

7.13 No right of re-supply. You agree that you will not sell, supply or make available the products we have supplied to you to any other person.

7.14 Mental Capacity Act 2005. You confirm that consent to care and treatment from our website has not been sought in line with the Mental Capacity Act 2005.

7.15 Testing Kits. In relation to any testing kit purchased through our website, you acknowledge that neither we nor the manufacturer of the test kits or the supplier of the testing services are able to guarantee the absolute effectiveness or accuracy of the test kit. Therefore, you acknowledge and accept that there may be instances where results obtained from a test kit may be inaccurate including the occurrence of a false positive or false negative result. Subject to the provisions in clause 12, we will not be liable for any inaccurate or other information arising from the results of a test kit and that you should seek medical advice from an appropriate healthcare professional if you think you may be suffering from a medical condition or have any specific queries on medical matters.

8 Your rights to end the contract

8.1 Ending the contract because of something we have done . You may be able to end a contract for a reason set out at (a) to (c) below. Where you decide to end the contract, the contract will end immediately and we will refund you in full for any products which have not been provided. The reasons are:

(a) we have told you about an upcoming change to the product (please refer to clause 6);

(b) we have told you about an error in the price or description of the product you have ordered and you do not wish to proceed;

(c) there is a risk that supply of the products may be significantly delayed because of events outside our control.

8.2 When you don’t have the right to change your mind. You will not be able to return any medicines which you have ordered if the return is not for any of the reasons set out in clause 8.1 above. Please note that the Consumer contracts (Information, Cancellation and Additional Charges) Regulations 2013 do not apply to the sale of medicinal products under a prescription.

8.3 How we will refund you. If you are exercising your right to end a contract based on the reasons set out in clause 8.1, we will refund you the price you paid for any products which have not been despatched to you, by the method you used for payment.

9 Our rights to end the contract

9.1 We may end the contract if you break it . We may end the contract for a product at any time by writing to you if:

(a) you do not, within a reasonable time of us asking for it, provide us with information that is necessary for us to provide the products;

(b) you do not, within a reasonable time, allow us to deliver the products to you.

10 If there is a problem with the product

10.1 How to tell us about problems. If you have any questions or complaints about the product, please contact us.

10.2 Summary of your legal rights . We are under a legal duty to supply products that are in conformity with this contract. Nothing in these terms will affect your legal rights.

11 Price and payment

11.1 Where to find the price for the product. The price of the product (which includes VAT) will be the price indicated on the order pages when you placed your order. We take all reasonable care to ensure that the price of the product advised to you is correct. However please see clause 11.3 for what happens if we discover an error in the price of the product you order.

11.2 We will pass on changes in the rate of VAT. If the rate of VAT changes between your order date and the date we supply the product, we will adjust the rate of VAT that you pay, unless you have already paid for the product in full before the change in the rate of VAT takes effect.

11.3 What happens if we got the price wrong . It is always possible that, despite our best efforts, some of the products we sell may be incorrectly priced. We will normally check prices before accepting your order so that, where the product’s correct price at your order date is less than our stated price at your order date, we will charge the lower amount. If the product’s correct price at your order date is higher than the price stated to you, we will contact you for your instructions before we accept your order.

11.4 When you must pay and how you must pay . We accept payment with Visa, Mastercard and American Express credit and debit cards. You must pay for the products before we dispatch them. We will not charge your credit or debit card until we dispatch the products to you.

12 Our responsibility for loss or damage suffered by you

12.1 We are responsible to you for foreseeable loss and damage caused by us . If we fail to comply with these terms, we are responsible for loss or damage you suffer that is a foreseeable result of our breaking this contract or our failing to use reasonable care and skill, but we are not responsible for any loss or damage that is not foreseeable. Loss or damage is foreseeable if either it is obvious that it will happen or if, at the time the contract was made, both we and you knew it might happen, for example, if you discussed it with us during the sales process.

12.2 We do not exclude or limit in any way our liability to you where it would be unlawful to do so . This includes liability for death or personal injury caused by our negligence or the negligence of our employees, agents or subcontractors; for fraud or fraudulent misrepresentation; for breach of your legal rights in relation to the products.

12.3 We are not liable for business losses. We only supply the products for domestic and private use. If you use the products for any commercial, business or re-sale purpose we will have no liability to you for any loss of profit, loss of business, loss of sales, loss of revenue, business interruption, business interruption, loss of business opportunity or for any indirect or consequential loss or damage.

13 How we may use your personal information

13.1 How we will use your personal information. We will use the personal information you provide to us:

(a) to supply the products to you;

(b) to process your payment for the products; and

(c) in accordance with our Privacy Policy and/or any other consents for information that you have given us.

14 Other important terms

14.1 We may transfer this agreement to someone else. We may transfer our rights and obligations under these terms to another organisation.

14.2 Nobody else has any rights under this contract. This contract is between you and us. No other person shall have any rights to enforce any of its terms.

14.3 If a court finds part of this contract illegal, the rest will continue in force . Each of the paragraphs of these terms operates separately. If any court or relevant authority decides that any of them are unlawful, the remaining paragraphs will remain in full force and effect.

14.4 Even if we delay in enforcing this contract, we can still enforce it later . If we do not insist immediately that you do anything you are required to do under these terms, or if we delay in taking steps against you in respect of your breaking this contract, that will not mean that you do not have to do those things and it will not prevent us taking steps against you at a later date.

14.5 Which laws apply to this contract and where you may bring legal proceedings . These terms are governed by English law and you can bring legal proceedings in respect of the products in the English courts. If you are a consumer and not resident in the UK, you may in some circumstances be permitted to bring proceedings in the EU member state in which you reside. If you are a business customer, then you agree to the exclusive jurisdiction of the English courts.