By Dr Radhika Vohra - NHS & Private General Practitioner in Surrey, Educator & Medical Trustee to The Menopause Charity Thankfully, everyone is talking about menopause! If you know you are suffering with symptoms such as hot flushes, sweats, brain fog, tiredness or anxiety, you may be wondering where to start when trying to get some help. Many women suffer for years with perimenopause and believe they just have to put up with the 40-odd symptoms of menopause. NO, NO, NO! Please don’t wait until you are desperate and at breaking point as it usually makes the process more frustrating. I work as an NHS and Private GP, so I very much understand the challenges GP surgeries are facing and the struggles that patients are having. So, I’m going to share some advice and tips that will allow you to get the most from your consultation with your health professional. Who to speak to? It’s not essential that you always speak to a GP about perimenopause or menopause. GP surgeries are changing, so practice teams are made up of multiple health professionals including: nurses, paramedic practitioners, nurse practitioners and junior doctors.  Non-GPs are dealing with all sorts of problems, so it’s important to try and speak to the right person… I hear you sigh in exasperation… please wait! There are lots of ways to find this right person: have a look at the practice website – does anyone have a special interest in women’s health? look at the practice social media and pop a query there if you feel comfortable most practices are offering e-consults (usually called Footfall), where you can fill out an online query form in detail and this is passed onto the appropriate health professional – this will save you and the reception A LOT of time speak to the receptionist – it’s a good idea to avoid the busy times such as morning and early afternoon consider seeing a doctor who is training; most training practices will have GP trainees. This will be a qualified doctor who is on a 3-year training programme to become a GP. Menopause education is a HOT TOPIC so quite often they will be interested in learning more through patients and will have longer appointment times. Making an appointment? So now that you know who to see, bear these tips in mind when making an appointment: try to get a ROUTINE appointment rather than urgent, either on-line or by phone. try to book a double appointment as this will give the health professional more time to spend with you. be prepared to try a few times as most surgeries release staggered appointments every few weeks to cope with demand. do your research before making a private appointment with a menopause specialist. Taking a look at testimonials, motivations and professional credentials will be reassuring for you and will often work out better in the long run. Homework before an appointment? If you have not already done so, download the FREE Balance App (balance-app.com). It will provide you with a symptom tracker, information and group chats that provide immense support. You can download the Health Report from the app which will be a summary of your symptoms and also your periods (if relevant). Many women find this alone is hugely empowering and gives them control. Preparation in the run-up to your appointment is ESSENTIAL. No one will know your history or health like you. Periods: What are your periods doing? Have you missed any? Are they getting longer or shorter? Do you regularly feel unwell at certain days of the month? Contraception: What contraception are you currently using? Is it making you feel worse? For example, many women on the progesterone-only pill find that vaginal dryness or mood maybe worse. Past medical history: Have you had any fertility care? What hormones have you had in the past either as treatment or contraception? Family history: What is your family history? If you don’t know, ask! It is important as it clears up the unknown. Pay particular attention to any history of heart disease, clots, breast cancer, ovarian cancer or dementia. If you have anyone with a family history of breast cancer, find out three things: the age they were diagnosed, type of breast cancer and their oestrogen receptor status (they can find all of this at the top of a hospital letter, usually in bold) Look at your lifestyle? Your lifestyle has an impact on your entire health – from your mind to your body! Take this opportunity to have a CLEAN UP! do you smoke? do you drink above the recommended amount of 14 units/week (1.5 bottles of wine)? do you exercise regularly? how much caffeine per day? Decaffeinated and green tea still contain caffeine!  Going to the appointment? Go in calmly and, if you have done all the above, you should be brilliantly prepared and the time should be used to focus on YOUR NEEDS. It is not supposed to be a battle but a shared conversation of risk and benefits for your health. For example, if you don’t exercise, drink 3+ coffees and 7 units of alcohol a day, then expect lifestyle changes to be a crucial part of your consultation. However, if you’ve learnt all of this from the Balance App and made changes beforehand, the conversation should be much more comfortably focused on treatment options, including hormone replacement therapy (HRT). Being self-aware about your own health and lifestyle is CRUCIAL and if you make healthy lifestyle changes, they will benefit you in all areas. If you start HRT, don’t forget/be forgotten – make sure you follow up? Once you start to take HRT, it is important to: not miss doses – ensure you have plenty prescribed and ask for a 3-month supply keep a bleeding or side-effect log stick with it! It usually takes around 3 months to get a good idea of how it suits you. have a REVIEW at 3-6 months. Menopause and perimenopause are the consequences of HORMONE DEFICIENCY. We have plenty of evidence that replacing the hormones using body identical HRT (available on the NHS) is SAFE and BENEFITS most women. I hope this information helps you to find and consult the best health professional for you.

One of the frontrunners in cutting-edge skincare science, peptides are proven to be truly powerful in targeting many different skin concerns. Peptides are a key area of research and innovation at Medik8, so let’s take a deep dive into the science...

The first most beauty fans heard about peptides was in 2006 when, in a subsequently much spoofed Olay TV ad, celebrity beauty editor Nadine Baggott told viewers “Right now, I think the hottest anti-ageing ingredients around are pentapeptides.” Back then most of us didn’t know what a peptide was or what it could do, but in fact, peptides had been floating around in the world of skincare since the 1970s. (If you’re still none the wiser, it’s basically a small protein, composed of two or more amino acids, which are the building blocks of proteins. A pentapeptide is a peptide made up of five amino acids, while a dipeptide is made up of two, and a tripetide from three).

What advice do you have for people prone to sensitivity or Rosacea when it comes to SPF? Ultrasun is formulated for people with sensitive skin. The Lamellar technology means that your skin can breathe and your pores are not clogged. If you have conditions such as Rosacea we would recommend our Face Fluid SPF50+ as it’s particularly important to use a higher level of protection.   Are there ingredients you should avoid if your skin is generally sensitive? 1. Fragrance. Fragrance can be difficult for the skin to cope with and has the potential to aggravate sensitive skin. To add perfume to your skin when you are already exposing it to the sun’s UVA & UVB rays is something to be avoided if at all possible. 2. Emulsifiers. These are the compounds that bring products together that wouldn’t naturally combine, so the product doesn’t split or separate. Emulsifiers can be incredibly drying and dehydrated skin should avoid exposure to the sun. We frequently talk about the health of the skin being linked to moisture levels and this should include the formulation of your chosen sun protection product. 3. MI. (Methylisothiazolinone). A commonly used preservative found in sunscreen, which is a known skin irritant and can cause a reaction in sensitive skins.   What sort of sun protection is best for naturally dry skin? Look for added skincare actives that hydrate and allow the skin to breathe. The Ultrasun Face SPF30 & Family SPF30 for the body are both recommended by Dermatologists as they are non-comedogenic and contain vitamin E, squalane and GSP-T (grape seed extract) for additional moisture.   Prickly heat: A fragrance-free, hypoallergenic, non-comedogenic formula that allows the skin to breathe and prevents irritation. The addition of soothing ingredients and a potent coolant are a plus. Formulas such as Ultrasun’s lamellar structure allow the skin to breathe by being absorbed just below the skin’s surface. In this case, products such as our Family 30 and Extreme 50+ are ideal. In an aftersun, Superoxide dismutase is a strong coolant, which is present in our aftersun gel.   What sort of sun protection is best for oily skin? Lamellar gel structures have a high affinity with the natural structure of ceramides found in the skin, and products are absorbed subcutaneously rather than sitting on the skin’s surface, blocking pores and potentially leading to break outs. We would particularly recommend our Face 30 and 50+ for those with oily skin.

Choosing the right SPF is really important and a number of factors should be taken into account – your skin type, the sun conditions and the amount of time you plan to be out. Skin that is not used to the sun is less able to protect itself so a higher SPF should be chosen. Under the influence of UV rays, the skin begins to thicken and starts producing melanin. This process can take 10-20 days, so use extra protection while your skin is adjusting to the sun. Be aware that there’s a difference between SPF 50 and SPF 50+. An SPF 50 is tested to be exactly that but a 50+ must achieve at least an SPF 60 to get that all important "+" sign.

If you’re a woman of a certain age, then your introduction to acids in skincare was probably that infamous episode of Sex And The City when Samantha Jones tries a “freshening chemical peel” and ends up with a raw, red face that genuinely frightens children and causes Carrie to compare the results to “beef carpaccio”.