Last week, one of my patients announced that she had just cancelled the facelift operation she was due to have. Delighted, she told me of her reduction in wrinkles, her youthful energy and injection of confidence.
The reason? A three-month course of the NHS treatment commonly prescribed to menopausal women – hormone replacement therapy.
And it’s not just my patients who are reaping the benefits. Several high-profile women over 50, including Davina McCall, Joanna Lumley and Kim Cattrall, have spoken of the life-changing effects of HRT.
Several high-profile women over 50, including Davina McCall and Kim Cattrall, have spoken of the life-changing effects of HRT
As a GP specialising in the menopause, I am inundated with cases of women laid low by debilitating joint pains, memory loss, migraines and depression. Many are forced to give up work due to the symptoms.
Most frustrating is that they are suffering needlessly, given the effective relief usually offered by HRT medication, which is a combination of the sex hormones oestrogen and progesterone (and sometimes testosterone).
Yet just ten per cent of those who stand to benefit are currently prescribed HRT, despite it being the gold-standard treatment recommended by the NHS watchdog, the National Institute for Health and Care Excellence (NICE).
Why? Patients say they’ve been scared by stories linking the treatment with cancer, blood clots and early death – stories that are inaccurate. So what is the truth? Here, I explain why I believe that more women should trust in HRT…
NOT TAKING HRT INCREASES YOUR BREAST CANCER RISK
Reports last year of a slight increased risk of breast cancer linked to taking oestrogen and progesterone HRT sparked concern.
Scientists believe this was due to exposure to a type of progesterone hormone which may encourage the development and growth of tumours. But the risk is still not much greater than normal.
Some studies have shown that the risk is eliminated when patients take a new form of progesterone, available on the NHS, that is chemically identical to the type occurring naturally in the body.
Joanna Lumley attends the Virgin TV BAFTA Television Awards at The Royal Festival Hall on May 14
In fact, many other factors pose more of a risk for developing breast cancer than HRT: being overweight, not exercising and drinking a moderate amount of alcohol, for example.
I see many women who become overweight due to energy-zapping menopause symptoms that stop them exercising. In these cases, not taking HRT is more likely to increase the risk of breast cancer.
There are several circumstances in which the increased risk of breast cancer doesn’t apply, such as women taking oestrogen-only HRT after a hysterectomy, and those under the age of 45. In younger women, the HRT is simply replacing the hormones that their bodies would otherwise produce.
OESTROGEN PATCH AVOIDS CHANCES OF BLOOD CLOTS
HRT is available in many different forms, including gels, patches, tablets and implants.
It is most commonly prescribed in the form of an oral pill, which evidence suggests can accelerate clotting proteins in the blood. So I offer patients the gel or patch, which does not carry a risk of blood clots as the oestrogen is absorbed through the skin, rather than affecting the liver.
The gel is rubbed daily on to the arms or legs, while the patch is stuck on to the bottom or thigh, and changed twice a week.
THE MENOPAUSE WON’T KICK IN WHEN YOU COME OFF IT
Some women believe HRT will delay their menopause and the moment they stop the treatment, they’ll experience every symptom at once. It’s not true. The HRT effectively balances the hormones at the time of treatment and won’t change the natural time-frame of the menopause. When a woman comes off HRT, symptoms will present as though she had not taken HRT.
FIGHTS OFF HEART DISEASE…
As oestrogen levels drop during the perimenopause (the period leading up to the menopause) and menopause, there is less oestrogen to protect both the lining of the blood vessels and the arteries, therefore increasing the risk of heart disease.
ITV presenter Lorraine Kelly, pictured, started taking HRT in 2012. The 57-year-old, who is married to cameraman Steve Smith, says: ‘I’d felt flat, anxious and I really wasn’t myself. The perimenopause sucked all the joy out of me
Research shows that low oestrogen levels can upset the balance of good and bad cholesterol, and increase the risk of diabetes, which could lead to heart disease. Several large-scale studies have shown that starting oestrogen treatment under 60 years old lowers this risk.
…AND OSTEOPOROSIS
Shockingly, half of women over the age of 50 suffer from bone fractures or bone thinning, which leads to osteoporosis – a condition in which bone density is lost at a faster rate than normal. This is likely to be a result of a loss of oestrogen, which leads to the bones becoming weaker, given that oestrogen is vital for protecting against breakages.
About ten per cent of a woman’s bone mass is lost in the first five years of the menopause, but HRT can protect against this because added oestrogen aids the re-uptake of vitamins and minerals within the bone.
HRT CAN HELP TO EASE DEPRESSION
A reduction in serotonin commonly leads to depression or anxiety but oestrogen is responsible for blocking the breakdown of the so-called happy hormone.
Some 70 per cent of women I meet for the first time have been offered antidepressants to treat anxiety. But there may be no need as replacing oestrogen via HRT has been shown to improve low mood.
BEATS ANTI-AGEING CREAM
Oestrogen works to build collagen, a connective protein found in the skin. The hormone is also important for maintaining blood supply to the skin and keeping it well hydrated and elastic. A lack of oestrogen can cause dry, itchy skin and increase wrinkles.
Loss of oestrogen can also result in brittle hair and nails. Taking HRT can help.
TAKE IT IN YOUR 90s
It is often thought that women must stop taking HRT five years after the menopause kicks in, due to the perceived risk of breast cancer. There is no set length of time you should take it. My eldest HRT patient is 91.
Menopause guidelines both at home and abroad clearly state that HRT may be taken for as long as necessary, although the dose of oestrogen usually decreases with age as the body requires less.
Some women decide to take HRT for much longer, as they find they have more energy and concentration and are generally happier.
SIDE EFFECTS ARE MINIMAL
Some mild side effects may occur at first, including tender breasts, nausea and bloating. However, these effects are more likely to occur if women are prescribed synthetic forms of progesterone.
Ask your doctor for a natural progesterone, sourced from the root vegetable yam.
Irregular bleeding is common with oestrogen treatment as it stimulates the lining of the womb, and may occur during the first three to six months. Oestrogen doses can be altered by the GP if bleeding becomes troublesome.
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