Revelations that Nicola Bulley stopped taking hormone replacement therapy (HRT) because of the side effects have put both the drugs and early menopause in the spotlight.
Lancashire Police today claimed the 45-year-old mother had “a history of a number of significant drinking problems caused by her ongoing struggle with menopause”.
Ms Bulley’s family said that while she suffered from classic menopausal symptoms such as brain fog and restless sleep, she stopped taking HRT because the drug caused her severe headaches.
Here MailOnline answers your questions about premature menopause and the possible side effects of HRT.
Missing mother-of-two Nicola Bulley (pictured) is struggling with post-menopausal drinking problems, investigators revealed yesterday
What side effects can HRT have?
HRT replaces the hormones that a woman’s body stops making as a result of menopause, such as estrogen and progestin.
Like any drug, it carries a risk of side effects that vary in rarity and severity.
These can include bloating, tender or swollen breasts, nausea, cramps, headaches, indigestion, vaginal bleeding, depression and acne.
The NHS advises people with side effects to try to keep it off for three months if possible, as they may stop as the body adapts to the drug.
However, women should contact their GP if they experience “severe” side effects or if they last longer than three months.
Studies have also linked HRT to a slightly higher risk of breast cancer. But the risk drops once a woman stops taking the medication.
Do the risks outweigh the benefits?
For most women struggling with menopausal symptoms, the answer is yes.
HRT has been considered life-changing by millions of women who say it has enabled them to regain energy and lead active lives.
Others called quitting “hell” for medical reasons when menopausal symptoms return.
The frequency of side effects of HRT may depend on the dose and route of administration.
In addition to HRT, women experiencing menopausal symptoms may also be offered cognitive behavioral therapy—a type of talk therapy—for those struggling with mental symptoms, trouble sleeping, and hot flashes.
There are also vaginal moisturizers and lubricants to help relieve dryness.
Menopause is the point at which a woman has not had a period for 12 consecutive months. This is a normal part of aging and occurs because the ovaries stop producing eggs, meaning that a woman can no longer conceive naturally. As a result, the levels of the hormones estrogen (pictured), progesterone and testosterone produced by the ovaries drop.
How many women take the medication?
Almost 2 million women in England are prescribed HRT, which can be available as a patch, gel or tablet
Police have been criticized for leaving Nicola Bulley’s family in a “horrible place” after they “fueled speculation” with their “deeply disturbing” handling of the case and then revealed the missing mother had a drinking problem when she struggled with menopause.
Lancashire Police sparked anger and heartbreak after detectives revealed mum-of-two Nicola Bulley, 45 (pictured with her partner Paul) struggled with drink problems caused by ongoing struggles with menopause
And HRT use has risen 35 percent in the past year as women flock to seek prescriptions to ease their symptoms.
In a change last September, a low-dose form of HRT, given as vaginal estrogen, became available to buy without a prescription.
What classes as early menopause?
About 1 in 20 women will experience early menopause if they stop menstruating before the age of 45.
Symptoms may include irregular menstrual cycles for several years, spotting between periods and changes in vaginal bleeding.
Early menopause can increase your risk of osteoporosis (weak bones), heart disease, depression, dementia and Parkinson’s disease. Sufferers also tend to experience the symptoms of menopause worse.
It can occur as a result of a chromosomal abnormality, an autoimmune disease or infection, or a side effect of cancer treatments.
But in 90 percent of cases, the reason for premature menopause is unknown.
For those experiencing premature menopause, hormone therapy is offered to replace the hormones that are normally produced. Doctors advise patients to take it at least until the average age of menopause.
Early menopause is different from premature menopause, which is the term when a woman’s menstrual periods stop before the age of 40. It affects about one percent of women.
What causes “the change”?
Menopause is the point at which a woman has not had a period for 12 consecutive months.
It usually occurs between the ages of 45 and 55, with 51 being the UK average.
This is a normal part of aging and occurs because the ovaries stop producing eggs, meaning that a woman can no longer conceive naturally.
As a result, the levels of the hormones produced by the ovaries—estrogen, progesterone, and testosterone—decline.
Besides hot flashes, what are the other symptoms of menopause?
Almost nine out of ten women will experience menopause-related symptoms regardless of when “the change” begins.
Mental health symptoms include mood changes such as anxiety, mood swings and low self-esteem, as well as problems with memory or concentration.
Hot flashes, insomnia, palpitations, headaches, muscle and joint pain are some of the physical symptoms.
As well as body shape changes, weight gain, decreased sex drive, vaginal dryness and recurrent urinary tract infections.
It can last months or years and change over time.
And symptoms usually start months or years before menopause officially begins, when periods become irregular. This is called perimenopause.
The NHS warns symptoms can have a “huge impact”, including on relationships, social life, family life and work.
Getting enough rest, eating a healthy diet, exercising and engaging in recreational activities are recommended to help manage mood swings and bad moods.
Kate Rowe-Ham, founder of Owning Your Menopause, an app designed to help women going through menopause get fit, said: “A lot of women go through menopause.
“Due to a lack of education, many are unaware that the myriad of symptoms they experience could be due to perimenopause and unfortunately often do not receive the much-needed diagnosis.”
It’s a “myth” that the main symptoms of menopause are hot flashes and sweats, as increased anxiety, shortness of breath, heart palpitations and feeling “a little less like yourself” are all symptoms, she said.
Ms Rowe-Ham said: “Adding that on top of sleepless nights it can be very overwhelming at a time when many are juggling elderly or ill parents, teenagers, work and homes.
“Awareness of menopause has grown, but there is still work to be done.”
She added, “The recent update about Nicola Bulley has made me feel very uncomfortable and I find the speculation very disturbing and my heart goes out to her family and friends.”
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Crystal Leahy is an author and health journalist who writes for The Fashion Vibes. With a background in health and wellness, Crystal has a passion for helping people live their best lives through healthy habits and lifestyles.
