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effective treatment for most symptoms.
It’s oestrogen from the ovaries that you’re
lacking, so taking oestrogen tablets makes
you feel better. Result! However (isn’t there
always a however?), taking oestrogen alone
was found to cause problems – thickening
of the lining of the womb, polyps, bleeding
and even cancer of the womb. The answer, to
protect the womb, is to add a progesterone
type hormone for at least some of the month,
but progesterone is the stuff that rises in your
body before a period, so some people feels
irritable and ‘premenstrual’ when they take it.
Women who have had a hysterectomy
in the past don’t need to worry about their
womb, so they can take oestrogen only.
This also applies if you have a Mirena coil
(intrauterine system), making HRT more
straightforward and lower in side effects.
There are lots of different combined
preparations available though so if you do get
side effects with one, try a different brand.
But wasn’t there a downside? Yes.
The main concern is breast cancer. Because,
in taking HRT, you are exposing your body
to hormones for longer than nature intended,
you are slightly more likely to develop breast
cancer when on it for five years or more past
the natural age of the menopause (51, 52). So
if you go through a premature menopause at
say 36, you are not at any increased risk at all
until the age of 56ish. That doesn’t guarantee
you won’t get breast cancer. It just means
you are no more likely than anyone else of the
same age.
For everyone, as with anything else, you
need to carefully weigh up the pros and
cons. Someone with a strong family history
of breast cancer might be a bit wary of
increasing their risk even by a small amount.
HRT does have beneficial effects on bone
density though (preventing bone thinning)
so if you have a strong family history of
osteoporosis this might sway you to try it.
The other thing to mention is
contraception. It wouldn’t be the first time
someone has missed a few periods, decided
they were menopausal and were horrified
to find out they were pregnant at 50! Your
ovaries are determined wee things and
struggle to produce eggs until they can go
on no longer. Occasionally they succeed
and a ‘change of life baby’ is the result. So
you do need to continue to take adequate
contraception until around age 54. Talk to
your doctor about what is suitable for older
(NB: not OLD just ‘in your prime’) women.
If you can’t (or decide not to) take HRT
for whatever reason there are a few nonhormonal
alternatives. Things like Sage, Red
Clover, Black Cohosh and some other herbal
stuff might help and some women swear
by them. Magnets in your pants? Not sure
about the science behind that but I can’t
imagine it could do any harm! Some beta
blocker medications can help with flushes
and antidepressants (Prozac or Venlafaxine)
can help with flushes as well as anxiety/mood
disturbances.
For a balanced, sensible and informative
review of HRT and the menopause look up:
nice.org.uk/guidance/ng23. It’s quite a
detailed paper but if you’re struggling to
make up your mind, all the info is there.
Right, I’m off for a cocktail by the pool.