HRT, to take, or not to take? That is the question.


Is Hormone Replacement Therapy Safe?

“It’s the ultimate bottom line, women want to know, is this medication going to kill me? And the answer appears to be no.” (September 2017).” said Dr JoAnn Mason, preventive medicine chief at Boston’s Brigham and Women’s hospital and  lead author of the report written about the largest follow-up study looking at the safety of HRT.

In the 80s and 90s,Hormone Replacement Therapy (HRT) was the treatment of choice for dealing with menopause mayhem and misery. By the early noughties, prescriptions of HRT nosedived in the fallout from two studies: The Women’s Health Initiative and The Million Women Study, both linking HRT with a small increase in the risk of breast cancer, heart disease and blood clots. Doctors stopped prescribing HRT and women refused to take it, as they responded to the fear-inducing headlines.

What are the benefits of HRT?

Recently, HRT has enjoyed a revival. Many women’s health experts now believe that the benefits outweigh the risks.

After going through a surgical menopause, journalist and presenter, Kirsty Wark, developed a deep mistrust of HRT and fearing that breast cancer could develop, took herself off the medication. In her BBC programme, ‘The Menopause and Me’, she talks about ‘coping’ over the following 12 years, with the disturbed sleep and night sweats that only improved when she started taking a small dose of HRT once more.

What do the experts say about HRT?

Today’s menopausal women have a lot more living, loving and working to do. They need to get on top of the physical, emotional and physical signs of menopause. So, if HRT can help them along, should they take it? What do the experts say about HRT?

•    Mr Edward Morris, Vice President for Clinical Quality for the Royal College of Obstetricians and Gynaecologists (RCOG): “While not every woman requires HRT, all should have access to accurate information about the consequences of menopause and treatment options, and the reassurance that HRT remains a low risk and beneficial treatment for most women.”

•    Dr Karen Morton, a gynaecologist & obstetrician who Hot Flush consult, says that it is ‘absolutely clear’ that the risks of taking HRT are ‘very, very minimal’. Acknowledging that there is a risk, she says that it is low, in comparison to the potential relief of debilitating menopause symptoms.

•    Dr Heather Currie, ex-chair of The British Menopause Society says that these studies which generated headline-grabbing fears linking HRT with the risk of breast cancer, ‘did not show any statistically significant increased risk’. 

•    Kathy Abernethy, chair of The British Menopause Society: “Hormone replacement therapy (HRT) is absolutely the best treatment for hot flushes and sweats that affect daily life. It can also help sleep disturbance caused by night sweats and is one of several strategies to keep bones strong.”

Who can and can’t take HRT?

Dr Morton told Hot Flush that there are very few women who can’t take HRT to deal with the debilitating effects of menopause. For her, HRT is a woman’s choice. Women who have diagnosed gynaecological problems will need to talk to their doctor about how suitable HRT would be for them, check the chances of pain and bleeding increasing as a side effect and find out which specific type of HRT they should take. Where women choose to start taking HRT, it’s worth bearing in mind that it can take at least 3 months to see any benefits and to get used to any side effects. It’s not uncommon for the HRT prescription to be changed at the 3-month review to find the best method and dose.

How long can you take HRT?

Dr Morton says that there’s no limit on how long HRT can be taken. Essentially women are postponing the inevitable symptoms that will occur for 3 in 4 women at the point when their oestrogen stops flowing. Whilst you may have no choice about going through this transition, HRT allows you to delay it so that you get the best out of your life now. Of course, making changes to your diet and lifestyle could have a really positive impact on your emotional well-being, self-esteem and physical health meaning that you won’t need to take HRT.

When to see your doctor about HRT?

If you’re a woman in your late 30’s onwards and think that unexplained changes to body and mind are impacting on your well-being and your ability to get on with life it could be time to talk to your doctor about which options, including HRT, could work for you. Have your voice heard and make an informed choice.

CatchDr Karen Morton & Hot Flush in conversation here:

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