The Pros And Cons Of Hormone Replacement Therapy (HRT) For The Menopause
If you are a woman approaching the menopause, it can be a frightening time. Watching your periods ebb away and beginning to experience unpleasant symptoms, you may not know where to turn.
There are all sorts of conflicting advice and scary headlines around concerning Hormone Replacement Therapy (HRT) that can create a lot of confusion. So is HRT right for you? One of the UK’s eminent gynaecologists and director of the prestigious The Gynae Centre, Dr Alex Eskander, gives a helpful overview.
What is Hormone Replacement Therapy?
During the menopause, as your periods cease, your hormone levels decrease. This fall in hormone levels creates unpleasant symptoms such as sleep disturbances, hot flashes, mood swings and vaginal dryness – and sometimes even problems such as osteoporosis.
Hormone Replacement Therapy (also known as HRT, oestrogen replacement therapy and menopausal hormone therapy) is the use of female hormones – progesterone and oestrogen – to treat the symptoms of the menopause. Hormone replacement therapy substitutes the hormones no longer naturally produced by your body.
What Are The Benefits Of HRT?
Decades of HRT prescription and research have shown HRT to be the most effective intervention for the symptoms of the menopause1. It helps to relieve uncomfortable and disrupting symptoms such as hot flashes, disturbed sleep, night sweats, mood swings, vaginal dryness and vaginal atrophy.
HRT can also help to guard against some of the other side effects from a loss of oestrogen, such as osteoporosis.
What Are The Risks Of HRT?
The data in relation to the risks of HRT is conflicting. In the early 2000s, two published studies appeared to show a link between the extended use of HRT and increased risk of breast cancer and heart disease. However, in the years following, further analysis found problems with the representativeness of the sample in one of the studies, making it difficult to apply the breast cancer findings to British women. What’s more, the reviews actually found a decrease in the likelihood of heart disease in the women who began taking HRT within 10 years of the onset of the menopause. Subsequently, a key Danish study found women starting HRT within this timeline actually had a reduced risk of heart disease2. However, a more recent study from the Institute of Cancer Research in London, found that in general, women using HRT had higher rates of breast cancer3.
The consensus? Speak to a doctor.
Why You Must Speak In Depth To A Doctor
Dr Eskander explains: “The truth is, no leaflet will ever be able to tell you enough to make the decision on whether and how to treat your menopause symptoms. What’s more, problems such as breast cancer have a great many other associated lifestyle and possible genetic factors far aside from the use of HRT. Nothing can substitute talking to an attentive gynaecologist, who can review your own medical history and family history.”
Sometimes making these choices is a balancing act, Dr Eskander says. “I have had patients whose menopause symptoms are affecting their quality of life to such an extent that they are set on HRT straight away, and some women don’t want to take any hormones at all. Some patients come in wanting HRT, but when I go through their medical history, I’ve suggested they reconsider. Remember that it’s your symptoms, your quality of life, your body. The right gynaecologist may be able to prescribe a combination of treatments to help your unique set of symptoms – for example a testosterone patch if a lowered libido is bothering you. There is no one-size-fits-all, and you need an expert gynaecologist to help you through it.”
The Gynae Centre is the UK’s foremost specialist gynaecological care clinic, offering gold standard care. We’ve helped countless women successfully navigate this important milestone in their lives.
To book an appointment with Dr Eskander, call 020 7580 8090.