Menopause with a stoma

Menopause and living with a stoma are both important life events which individually bring about significant changes to a woman’s body and lifestyle. When these experiences coincide, the challenges can be even more complex. Understanding how menopause and stoma care affect an individual and how they can overlap and intertwine is essential for managing physical and emotional health during this phase of life.

If you are struggling with menopause symptoms, seek advice from your GP. The Practice Nurse at your GP surgery may also run a menopause clinic in which they will provide a safe space to discuss your symptoms and any treatment options.

Understanding Menopause:

Menopause marks the end of a woman’s menstrual cycles.  It is diagnosed after 12 consecutive months without a period. It typically occurs between ages 45 and 55 years of age, though it can happen earlier or later. The transition to menopause, called perimenopause, can last several years and is characterised by a decrease in oestrogen and progesterone production.

Common symptoms of menopause include:

• Hot flashes
• Night sweats
• Vaginal dryness
• Mood swings and irritability
• Sleep disturbances
• Brain fog
• Decreased libido
• Weight gain and slowed metabolism

Navigating menopause with a stoma:

How to navigate menopause while managing a stoma can present unique challenges. Both conditions involve significant bodily changes and require careful attention to health and wellbeing. Here are key areas where menopause and stoma care overlap:

1. Skin health and stoma care

Menopause can cause skin to become thinner, drier, and more prone to irritation due to decreased oestrogen levels. This can exacerbate issues around the stoma, where the skin is already sensitive.

Tips:

• Use skin-friendly stoma products to minimize irritation around your stoma.
• Keep the skin around the stoma clean and dry
• Talk to your Stoma Care Nurse for advice and support with any skin issues

2. Hormonal Changes and Digestive Health

Hormonal fluctuations during menopause can impact digestive health, affecting the speed in which the food passes through the gut. This can result in bloating and pain leading to changes in bowel habits, such as increased constipation or diarrhoea.

Tips with managing these changes:

• Monitoring dietary intake to maintain consistent stoma output
• Noting any foods which cause any gastric issues
• Staying hydrated to prevent dehydration, which can be more common during menopause.

3. Emotional and psychological wellbeing

Both menopause and living with a stoma can affect mental health. Women may experience feelings of anxiety, depression, or lowered self-esteem. Others may feel mood swings, anger and irritability which they didn’t feel before. It is important to take time to adjust to both the physical and emotional changes your body is going through. Give yourself the time and space you need, to understand and accept the changes you are experiencing.

Support strategies for well-being include:

• Taking time out for you every day, whether this is a phone call to a friend, a dog walk or even a long soak in a bath. This time is, yours giving you time and space for reflection
• Joining support groups for women going through menopause or support groups for those with stomas
• Seek counselling or talking therapy to address emotional challenges you may feel you cannot deal with alone
• If you have had the all clear from your stoma surgeon, engaging in regular, gentle physical activity such as walking, Pilates, yoga or swimming can really boost your mood and overall wellbeing
• Don’t be alone – reach out for help and support

4. Sexual health and intimacy

Menopause can lead to vaginal dryness and decreased libido, while having a stoma can affect body image and sexual confidence.

To address these issues:

• Use lubricants, vaginal moisturizers or oestrogen pessaries to alleviate dryness
• Communicate openly with partners about concerns and preferences
• Explore different intimate positions that may be more comfortable with having a stoma

5. Nutritional needs

Nutritional needs may change during menopause, as certain foods can impact stoma function. Maintaining a balanced diet that supports overall health and manages menopausal symptoms is crucial.

Tips include:

• Incorporating foods rich in calcium and vitamin D to support bone health.
• Eating fibre-rich foods to manage bowel function and gut health, but be aware these should be consumed in moderation so that you avoid stoma blockages or diarrhoea
• Avoid foods that cause gas or odour, which can be more noticeable with a stoma
• You may find that your tolerance to alcohol has changed due to menopause and having a stoma. Try to limit your alcohol intake and look at ways of staying hydrated.

6. Exercising during the menopause

Exercise is so important for our physical and mental health at all stages in life and has been found to have huge benefits during menopause for our general wellbeing, bone health, to destress and aid sleep. It is also beneficial for those with a stoma to build core strength and help with the prevention of a hernia. Try focussing on low-impact activities such as walking, swimming, and yoga to enhance cardiovascular health, muscle strength, and flexibility. Core exercises, like gentle Pilates, can improve stoma support without straining. Always check you are ready to start exercising during the recovery phase of a stoma and use appropriate stoma support garments, start slowly, gradually increasing intensity.

7. HRT (Hormone Replacement Therapy)

Managing medication and hormone replacement therapy (HRT) with a stoma requires careful consideration. Some medications may affect stoma output or absorption. HRT can alleviate menopausal symptoms like hot flashes and mood swings but must be tailored to individual needs. Consulting your GP is crucial to ensure the safe integration of medications and HRT with stoma care. They can adjust dosages, suggest alternative forms of medication, and monitor for potential interactions or side effects.