Of the 2.5 million women currently going through the menopause in the UK, it is estimated that fewer than ten per cent opt for hormone replacement therapy, leaving many more suffering in silence. Following a 2002 study linking HRT to an increased risk of breast cancer, the number of women taking it more than halved, but it is now thought that the risks are outweighed by the benefits. Here, women share their views.
Alison, 61, is a marketing manager. She is divorced, has a daughter aged 25 and is in a relationship. I feel utterly cheated when it comes to HRT. I was never prescribed it
and, now I’m post-menopausal, my GP says it’s too late for me to take it. I feel I’ve missed out, especially on valuable bone protection.
My periods gradually stopped from my mid-40s onwards, but unlike some women I didn’t experience severe menopausal symptoms so it didn’t occur to me to consider HRT.
Last April I spent a week at a wellness clinic in Italy. The doctor there was astonished when she heard I wasn’t on HRT. She told me all Italian women of menopausal age are put on it, essentially for bone protection.
Back in the UK a bone scan showed I had osteoporosis (low bone density) in my hip and spine, and was at risk of fracture. I now have to take a drug to slow the development of this condition. If I had taken HRT, my bones would have been protected.
I have annual health check-ups through work – why did no one suggest a bone scan previously?
I recently asked about HRT for my libido, which has hit the floor. But the doctor said hormone therapy wouldn’t be appropriate post-menopause. He said a low libido is a normal part of the ‘arc of growing older’. In magazines, many celebrities swear by HRT. They say it has done wonders for their skin, hair and sex lives – although, of course, they also have money for nutritionists, personal trainers and expensive skin creams, so who knows?
My generation of women have the potential to live to a great age – 90 or even older. I want to stay as healthy as I can for as long as possible. I seem to have high energy levels, but I don’t want to end up frail and hump-backed or with a broken hip.
I believe that if you’re fairly healthy, you can get overlooked when it comes to HRT. When I was in my 50s, no one ever talked about it. Now everyone is saying how great it is, but it’s too late for me.
Lorraine Kelly, 58, TV presenter. ‘I was lucky because I had no hot flushes and never felt down, but it was still a difficult thing to go through and I had days when I felt dreadful. For me, HRT patches were the way forward and I would urge all women to find a solution to suit them. Why not have a bit of extra help when you need it?’
Hannah, 49, is married and has a daughter who is 24. She is a housekeeper and companion to elderly people. HRT didn’t work for me – I put on two stone in weight over six months. I started taking it in August 2016. I’d had a full hysterectomy because
I was in crippling pain from endometriosis. Three months after surgery, I went into the menopause.
It hit me like a brick wall. I had hot flushes; I was going all night without sleeping; I couldn’t concentrate, couldn’t hold a conversation. I was anxious and depressed. I was prescribed progesterone-only HRT – oestrogen would have caused the endometriosis to return. I stayed on it for six months but the weight gain knocked my confidence and it didn’t help with my hot flushes and depression.
Last July I started a programme of natural remedies, run by Maryon Stewart of the Natural Health Advisory Service. I feel much better, like a new woman.I take several supplements, including red clover, vitamin D and black cohosh. I’ve changed my diet, cutting out alcohol, caffeine and wheat, and eat a lot of soya, which helps with the hot flushes. I exercise at the gym five times a week, walk regularly and drink two litres of water a day. It’s also important to relax. My sleep is greatly improved and I only get the occasional hot flush.
I’ve lost the weight I gained, but have another two stone to lose to achieve my ideal weight. The programme is expensive – the supplements cost me about £150 a month – but it’s worth it.
Jenni Murray, 67, radio presenter. ‘The body naturally divests itself of excess oestrogen after the menopause, so it makes no sense to add it in the form of HRT to give any nasty cells an extra meal. The oestrogen is not a direct cause of cancer [Jenni had breast cancer after taking HRT] but it appears to foster an environment in which it can develop. If I had known then what I know now, would I have taken it? No.’
Ann, 53, is a teacher and single. I would like to take HRT but I’m scared. My mum was diagnosed with breast cancer at 64, which the doctors said was probably caused by HRT. Mum was put on hormone therapy because she had developed osteopenia, a loss of bone density that can lead to osteoporosis. Her mother had such bad osteoporosis that her spine crumbled. The GP thought Mum should take HRT in order to protect her bones. The breast cancer was caught early and treated, but she developed ovarian cancer when she was 75 and died 18 months ago. Of course, she might have got cancer anyway, but the doctors think there was a link to the HRT.
It is the night sweats that really get me down. I’m not sleeping well, which means I have trouble getting up in the mornings and lack energy during the day. I also have joint pain in my hands, feet and knees. I’m told this is arthritis, which the doctor says is exacerbated by menopause. I have regular scans and my bones are fine at the moment.
I did discuss HRT with my GP but he agreed that because of my mum’s history there was a risk and it would be better if I could manage without it. That was three years ago. The problem is I don’t know how much worse this will get. I’ve been told the symptoms could go on for years. I have tried natural supplements but they didn’t help.The irony is that my granny lived to 93 with osteoporosis, whereas my mum died at 79. I feel cheated of the time I might have had with her.
Nadira, 44, a make-up artist, is single and has a three-year-old son. My doctor said I should consider HRT but I’m sceptical about all the claims made for it. I’m not ruling it out, but I want to see if I can manage with natural remedies before popping a pill.
Earlier this year I was feeling fatigued like never before; it was as if my pilot light had gone out. I had brain fog and couldn’t concentrate. Then a few weeks ago, I started to get hot flushes, night and day. My joints have also begun to ache.
I’m waiting for the results of blood tests but I think I’m perimenopausal. My GP gave me some leaflets to read about HRT. I know some women who swear by it but I’m apprehensive of taking anything synthetic. I am already on medication for an underactive thyroid. Right now, I’m taking a supplement called Fema45+, which is designed to be taken by women during menopause, and it has helped with my fatigue. I also take a high-potency omega-3 supplement.I’ve cut down on alcohol and caffeine, which seem to make the hot flushes worse. Regular pilates is helping with my joints and yoga in the mornings gets me going. My diet is pretty good.
When it comes to HRT, I don’t feel as if I’ve been treated as an individual by my GP. All the information seems so generalised. I do worry about the potential risks. The pro-HRT people say, ‘Why should women suffer for eight or nine years?’ It’s true no one should suffer – but no one should automatically be put on HRT either.
Elizabeth Hurley, 52, actress. ‘Some people think research shows a risk that might not bode well with breast cancer but other doctors say it could be advantageous. It’s not my place to give advice, but I’ve chosen not to take HRT. It is an individual choice.’
Kate, 56, is a married TV producer.I’ve been on HRT for eight years and it has helped me enormously. I feel the same as I did when I was 40. I was interested in HRT partly because of our family history. My mother had terrible menopausal symptoms and HRT made a massive difference – she stayed on it for the rest of her life. Her own mother, my grandmother, had a breakdown during her menopause: I remember seeing her in bed weeping when I was a little girl. I certainly didn’t want to have an emotional breakdown. There is also arthritis and osteoporosis in the family, as well as cardiovascular disease, which I believe HRT can help keep at bay.
I had to lie to my GP to get HRT. When I first asked for it he said I would have to wait until six months after my last period. At this point I felt quite muddled and kept misremembering things, which you can’t do in my job. Also, my periods were going haywire – I wouldn’t have one for three months and I’d then get a massive one. In the end I simply told the GP my periods had stopped and he prescribed it. Immediately my periods became much lighter and I got my concentration back.
I married for the first time when I was 48. The vaginal dryness made sex very painful and I suffered repeated bladder infections. I had to have antibiotics almost every month. It was terrible – we would try to make love and I would be wincing with pain. This went on for two years.The HRT didn’t seem to help with this but during one bout of cystitis I was working away from home and went to see a lovely female GP who prescribed HRT vaginal pessaries. These changed everything – sex became much less painful and the cystitis stopped. Why had no one suggested pessaries earlier?
There is a lot of social disapproval of HRT, as though it’s cheating to use it. It seems that, when it comes to the menopause, women are expected to tough it out. But why should we? If you can’t sleep at night, have hot flushes at work, can’t have sex without pain? Life is hard enough as it is – why make it harder?
Rosemary Conley, 71, diet guru. ‘I lost my mojo when I was 53 and started taking HRT. I’ve never looked back. I’m on it for life. In my opinion, the risks are tiny, unless there is a history of breast cancer. Don’t let doctors talk you out of it.’
Gudrun, 70, is retired with two children and five grandchildren. I have been on HRT for 20 years. I use patches, which I was told may have less of a risk of breast cancer. I plan to stay on it until the day I die. I asked my doctor for it before getting menopausal symptoms out of vanity. I’m from Iceland where, at a certain age, HRT is the norm. My girlfriends back home were on it and they told me, ‘You should go on it to keep your skin nice and your weight down’. I think I look OK for 70. People ask me, ‘How do you look so good?’ I think it’s down to HRT. It also protects my bones. My grandmother died at 96 but she spent her last 16 years in bed with osteoporosis in her hips.
I’m aware of the risks but I’m not worried. I have regular mammograms. My son is a doctor and he thinks there’s nothing for me to be concerned about. There are so many other risks in life but this one seems to get all the publicity.
Cynthia, 64, is a retired events manager and has a daughter aged 29. HRT isn’t a miracle drug but it did take the edge off my depression, which developed in my late 40s. I hated the way I looked, the way I felt. I was getting very bad tempered. My doctor said this was all down to the menopause and I had a choice: either take HRT or antidepressants. I opted for HRT and was put on a low-dose combined pill. I don’t consider it a wonder drug but it did make the depression more bearable. I took it for ten years on and off. I was always
aware of the risks and every now and then would come off it. I always felt ambivalent about it.
I still get hot flushes and these are preceded by a bout of extreme anxiety. I wake up in a sweat, convinced something terrible is about to happen. The doctor has suggested natural progesterone, which you can order online. I don’t want to go back on to full-blown HRT.
Five years ago I discovered topical HRT cream, which helps with vaginal dryness. At one point, it was too painful to have my regular smear test and the GP said my vagina had ‘atrophied’, which is a terrible word. After a few weeks using the cream, I was able to have the smear taken. Also, I had a brief dalliance a few years back and found sex very difficult. The cream helped with that. I would use it again if I had another relationship.
Angela, 74, is a writer and has two adult children and two grandchildren. I only lasted on HRT for four months. This was in my late 40s when I felt I was being boiled alive by hot flushes and my energy levels plummeted. At that time HRT was just starting to become popular, but it gave me bad headaches and I felt generally unwell. Maybe at that time the hormone doses were higher than they are today. In the end, I decided to see if I could cope with the menopause by exercising and eating healthily.
Being physically active helped my mood enormously. I ate plenty of salad and fruit and cut down on caffeine and alcohol. I didn’t go for alternative remedies – I remember trying evening primrose oil, but it didn’t do the slightest good. I was quite glad I didn’t continue with HRT. I don’t like being on medication, especially hormonal drugs. We still don’t know enough about the downsides.I think exercise, getting enough sleep and eating well are key to feeling better during menopause – though nothing really helped with the hot flushes, which took about nine years to disappear completely.
I was certainly concerned about osteoporosis as I grew older, but I know weight-bearing exercise can help protect bones. I carry heavy shopping bags and walk upstairs very fast.
Plus I eat bags of spinach and other calcium-rich foods. Now I have that ‘post-menopausal zest’ – I feel full of energy and optimism.
Linda Barker, 56, TV presenter. ‘I started HRT because the symptoms were so bad. But when I went to repeat the prescription, I saw a different GP. She explained to me I’d need to come off it at some point because of the health risks. Did I want to suffer the same symptoms when I was older and would I find it even harder to cope? The jury is still out on HRT but I don’t like popping pills if I can help it, so I decided to get through the menopause my own way, without drugs.’