Health

"Health MENOPAUSE: TAKING BACK CONTROL Menopause is no longer a whispered word; a secretive stage of life; something just to be put up with thank goodness. But how does it affect you if you have arthritis? Words: Louise Parfitt S OESTROGEN AND ARTHRITIS Versus Arthritis is funding a study into the impact that gender, the menopause and sex hormones can have on the duration and severity of hand osteoarthritis. Oestrogen appears to help keep joints better lubricated and less inflamed, Dr Bajekal says. While HRT is not prescribed usually just to prevent arthritis or manage arthritis in the absence of other physical symptoms, there is some evidence to suggest HRT can slow progression of osteoarthritis. arah Stanyer, Helpline Advisor at Versus Arthritis, developed menopausal symptoms around the age of 48. It is difficult to pinpoint the exact time, she says, because she had been struggling to manage the pain caused by long-term osteochondritis a joint condition affecting bone and cartilage osteoarthritis of the shoulders, hands, knees and lower back, and fibromyalgia, where the nervous system cannot process pain signals from other parts of the body, causing pain and tenderness all over the body. I had about a year of on-and-off night sweats, mood swings and increased discomfort, Sarah explains. I just wanted to get the pain under control I wasnt thinking about the menopause. Dr Nitu Bajekal, consultant gynaecologist and International Board of Lifestyle Medicine physician, says that as women transition to the menopause (perimenopause) and then go through menopause, those living with arthritis may find symptoms of joint tenderness, pain and stiffness intensify. Joint pain and stiffness can get worse in the menopausal phase, even in the absence of pre-existing arthritis, she says. It is not just the high-impact joints, such as hips and knees, that are affected, but also those in the hands and fingers. Body weight, sedentary lifestyle, depression and a positive family history are some other risk factors, as well as age. Help from HRT After several GP visits during which she was offered counselling and antidepressants, and referred to a rheumatologist Sarah saw a different doctor, who asked if anyone had spoken to her about the menopause. We had a fantastic conversation, and she suggested I start on HRT [hormone replacement therapy usually a combination of oestrogen and progesterone]. Gradually, I noticed my mood lift, and this helped me to manage my pain better. Dr Bajekal says it could be useful to talk to your doctor about HRT if you are experiencing additional symptoms or increased levels of pain. It may be worth a trial of the appropriate HRT after a detailed discussion with your doctor, she adds. Although many drugs that are used to treat arthritis are not compatible with taking HRT, your doctor will guide you, taking into consideration your individual situation. Take control MORE SUPPORT If you would like to talk to someone, you can call the free Versus Arthritis helpline on 0800 5200 520. You can also chat to people who share the same everyday experiences, and exchange challenges and solutions, at community. versusarthritis.org. Read more about Sarahs story at versusarthritis.org/sarahand-menopause Although HRT is a common treatment for managing menopausal symptoms, Sarah and Dr Bajekal believe that lifestyle and mental wellbeing also play a big part. Moving your body regularly can help keep muscles and joints supple, says Dr Bajekal. Try to walk in nature in daylight, especially when the sun is shining, to boost mood and get some vitamin D. Weight-strengthening exercises can help prevent sarcopenia [age-related muscle wasting and loss of muscle function], keep your joints more mobile and prevent bone loss [osteoporosis]. Carrying excess weight makes arthritis and menopausal symptoms worse, so try to maintain a healthy body weight. Focus on a colourful, varied diet that includes plenty of vegetables, fruit, wholegrains, beans, lentils, soya, nuts, seeds, and herbs and spices, such as turmeric, which may help with joint pain, says Dr Bajekal. Ensure your diet is supplemented with vitamin D3 unless your levels are checked regularly and remember, it is never too late to make changes. Sarah agrees. She says that she spent too much time trying to push on through the pain and not giving herself the attention that her body and mind needed. Exercising and trying some alternative and holistic therapies has been really helpful for me, she says. It is important to talk about your arthritis and menopause symptoms, because you are not alone. Once you talk, you can take back some control, gain more understanding and become empowered to live your life, not just exist and make do. Now, a year on from starting HRT, my relationships are much better in all areas because of the improvement in my moods. I still live with daily pain and fatigue, but meditation and self-care is now my priority. COMMON MENOPAUSE SYMPTOMS Changes to the normal pattern of your periods Hot flushes and night sweats Reduced sex drive and vaginal dryness/pain Headaches Issues with memory and concentration Joint stiffness, aches and pains Reduced muscle mass Palpitations Recurrent urinary tract infections