Have common HRT myths put you off looking into treatment? Leading Menopause Expert Dr Louise Newson is here to set the record straight
There are 13 million women in the UK going through the menopause right now.
However, the menopause – like a lot of women’s health – has long been a taboo subject.
Older women tended to suffer in silence and didn’t discuss it with their daughters, it wasn’t a subject that was taught in schools and even to this day medical students are not always taught about it.
This means that often women may not recognise the tell-tale signs of menopause and struggle on for years with symptoms, and doctors may not always know the most appropriate treatment to offer their patients.
13 million women in the UK going through the menopause right now
During menopause and perimenopause (the time leading up to menopause), our bodies start to produce less of the key hormones oestrogen, progesterone and testosterone.
We need these hormones to keep our bodies in good working order – in fact we have oestrogen receptors on every cell throughout our bodies, from our brains to our bones and our reproductive organs.
When levels of these hormones decline it can trigger some really debilitating symptoms like hot flushes, mood changes, brain fog, joint pains and vaginal dryness to name but a few.
What is HRT?
HRT stands for hormone replacement therapy. It contains oestrogen and often progesterone (this is known as combined HRT) and sometimes testosterone.
The menopause should be seen as a long-term hormone deficiency and HRT replaces the hormones that the body makes much less of during the menopause.
However, only around one in ten UK women who would stand to benefit from HRT are actually taking it.
HRT isn’t a one-size-fits-all treatment. It comes in a variety of doses and methods, including skin patches, gels and sprays and a cream specifically to help with vaginal dryness.
It should be prescribed after a conversation with a healthcare professional about your individual medical history and also your personal preferences.
one in ten UK women who would stand to benefit from HRT are actually taking it
HRT has two key benefits. First by replacing the missing hormones, it eases symptoms. Secondly it helps to protect a woman’s long-term health.
For example, a lack of oestrogen puts women at greater risk of osteoporosis (a condition where the bones become fragile and are prone to breaking) and cardiovascular disease, including heart attack, stroke and also dementia.
Therefore, replacing these hormones via HRT can lower the future risk of developing these conditions.
Here are 5 common myths most people believe when it comes to HRT treatment…
Myth #1 You have to stop taking HRT after five years
There is no minimum or maximum length of time for which you can take HRT.
It is an individualised treatment and how long you want to take it for depends on your own health, symptoms, and personal wishes.
Some women may want to take it forever – I have a patient in her nineties who still takes HRT.
Myth #2 HRT ‘delays’ your menopause
If you have menopausal symptoms after stopping HRT, this means you would still be having symptoms even if you had never taken HRT.
Myth #3 You can only take HRT once your periods have stopped
The menopause is officially 12 months after your last period.
But during the perimenopause you can still suffer from menopausal symptoms while still having periods, because of the fluctuating hormones.
You don’t have to wait for your periods to stop before starting HRT. Your first step should be talking to a health professional about the options available to you.
The menopause is officially 12 months after your last period
Don’t wait until symptoms become unmanageable before you seek advice. The most health benefits from taking HRT are in women who start taking HRT within ten years of their menopause.
Myth #4 HRT causes breast cancer
For the majority of women who take HRT, the benefits outweigh any risks.
Taking combined HRT (oestrogen and progestogen), may be associated with a small risk of developing breast cancer however some studies show this risk is reduced by taking a type of progesterone called micronised progesterone.
The risk of breast cancer with any type of HRT is low; for comparison, the risk of breast cancer is greater in a woman who is obese or who drinks a moderate amount of alcohol.
In addition, women taking oestrogen only HRT actually have been shown to have a lower future risk of developing breast cancer.
risk of breast cancer is greater in a woman who is obese or who drinks a moderate amount of alcohol
A lot of concerns about HRT and breast cancer stem from the findings of a study published back in 2002 that pointed to concerns about an increased risk of breast cancer in some women who took combined HRT.
However, in this study, women used an oral oestrogen and an older type of synthetic progesterone.
This increased risk was not statistically significant and a long term follow up of this study has shown that women who take HRT have a lower risk of developing heart disease, osteoporosis, type 2 diabetes, clinical depression and dementia.
Myth #5 HRT causes blood clots
Again, for the majority of women who start taking HRT under 60, the benefits outweigh the risks.
If a woman has a history of blood clots or migraine, there is a small risk of a clotting if taking the tablet form of oestrogen, but taking it through the skin as a patch, gel or spray does not have these risks so is safe for these women.
What can help?
If your symptoms are affecting your everyday life, make an appointment to see a health professional (your GP surgery is usually the first port of call).
My free app, balance, contains many different articles about HRT, and also allows you to track your symptoms and create an individualised health report that you can take along to medical appointments.
If you are thinking about HRT, talk to your friends, family and colleagues who are taking it.
We are starting to see a societal shift where women are feeling more confident about talking about their menopause, which is fantastic.
Talking helps to dispel some myths and help you decide which treatment is right for you, your health and your lifestyle.
Dr Louise Newson is a leading menopause specialist and the founder of the free balance menopause app www.balance-menopause.com