HRT (hormone replacement therapy)

Over the last 100 years we have seen life expectancy rise dramatically, with women typically surviving into their 80’s. One of the problems that arise is that women will suffer the menopause and be ‘post menopausal’ for many years. Normally mammals (including humans) die around the menopause so the problem is a relatively new challenge for us. While there are many scare stories in the media it is important to take a few moments to ascertain the facts and decide what is best for you and your symptoms.

Is HRT right for me?

The menopause is different for every woman, so the goal is try and maintain an excellent quality of life with the minimum of intervention. For some women the menopause causes little problem and any minor symptoms can be addressed with supportive therapy and occasionally low dose local estrogen. For the majority the menopause will result in significant symptoms; while the woman can cope if necessary the quality of her life will generally greatly improve with the addition of HRT. For some women the menopause is a crushing, debilitating experience and without estrogen replacement the quality of life declines dramatically. Remember if you are in any doubt if HR will be of benefit you can always try oestrogen for a couple of months and assess the benefit for your self, without having to commit to long term therapy.

Do I need Progesterone?

The majority of women feel much better taking estrogen. If they have a uterus or womb they must also take a progestagen, which protects the womb from developing cancer (women with no uterus do not need to take a progestagen). While women greatly enjoy estrogen they often find the progestagen gives them unpleasant pre menstrual type side effects. Getting the right regime is very important in ensuring a woman gets all the benefits of HRT, with the minimum amount of side effects.

How can I take HRT?

HRT can be taken as a tablet, a patch, gel or an implant. Just as finding the right does of HRT is important the route of administration can also make a big difference to your experience. Ideally HRT is not taken as a tablet but for some women this is the best choice. We can discuss the best route for you of you decide to try HRT.

Do I need Testosterone?

Every woman makes a small amount of Testosterone, just as every man makes a small amount of oestrogen. For some women it is Testosterone that gives them their energy and libido. If HRT does not relieve all your symptoms a trial of Testosterone is worthwhile to see if you are one of the Testosterone tribe.

Will I get breast cancer?

This is a contentious issue because different studies produce different results, making it difficult to be categorical. Studies reported in the early 2000s, where combined (oestrogen/progesterone) HRT was prescribed to women in their 60’s (who did not have HRT before) showed an increase in breast cancer as well as a small increase in the risk of heart attack and stroke. This naturally led to great concern and led women to stop taking HRT. More recent studies suggest that the story is very different for a woman taking HRT from the time of he menopause. The ‘Danish’ study in 2012 reported that after taking 10 years of HRT (from the menopause, typically from 50 – 60 years) there was no increase in the risk of breast cancer and there was a 50% reduction in the incidence of heart attack and stroke. This study more accurately reflects how most women take HRT. While less than 5% of women die from breast cancer every year, over 35% die from heart attack and stroke.

What are the advantages of HRT?

Many women feel very happy about using HRT.
HRT can:

• – Control hot flushes and night sweats
• – Relieve vaginal soreness by reducing dryness
• – Maintain energy levels
• – Keeps the mind alert, reducing forgetfulness
• – Helps with depression
• – Helps their sex drive
• – Helps with muscular and joint pain
• – Reduce post menopausal bone loss for as long as treatment is being taken
• – Probably reduce heart disease and stroke

What are the disadvantages of HRT?

HRT can:

• – Produce unpleasant or unacceptable side effects. Altering dosage or the route of administration can often help, but not in every case
• – Increase the risk of breast cancer (from 5.2% to 5.5% risk after 5 years of HRT). No more women die from breast cancer, on or off HRT
• – Inflammation or itching when skin patches are used
• – Inflammation or itching when skin patches are used
• – May continue with periods

If you wish to consider taking HRT or want more information please contact Mr Harrington’s secretary on 02073870022