Let’s Demystify HRT.
Misinformation, misogyny in society and within the medical and pharmaceutical industries, and an ongoing lack of education amongst front line health workers are the three main reasons for women’s mistrust of HRT. These three things combined have bred trepidation and uncertainty amongst women for years, causing many to shun HRT because of their concerns about what it may do to them. Instead, despite huge medical advances, they go on like generations of women before them, suffering in silence.
“Is it safe?”
“Does it cause cancer?”
“Should I only take it for five years?”
“My friends are on a gel. Is that better?”
“Will it make me put on weight?”
Just some of the many questions women ask about hormone replacement therapy, or HRT as it’s commonly known. Most of these women would, in all likelihood, have no issue taking statins, antidepressants, or medication to reduce high blood pressure. They probably wouldn’t question the side effects or long-term implications, but when it comes to HRT, there is still great deal of confusion and fear.
Needless suffering
Thousands of studies have looked at HRT now, and all have come to the exact same conclusion: it is safe, completely safe. And more than that, taking it has been shown to improve long-term health by protecting the brain, heart, and bones.
Of course, it is a little more complicated than that, and in this case, there is no smoke without a little fire. That fire is this: all the studies show that there is one issue within HRT, something that does increase (but only slightly) the risk of cancer, clots, and strokes and that is synthetic progestogen. This man-made chemical mimics real progesterone – the body’s anti-anxiety, anti-inflammatory, and anti-depressant hormone. It’s produced by drug companies and therefore is more lucrative than real progesterone. But and this is an absolutely massive BUT, thanks to the thousands of studies into HRT, the NICE (National Institute for Clinical Excellence) guidelines, and the British Menopause Society’s recommendations, synthetic progestogen is no longer the first line treatment. Instead, women are given real progesterone – otherwise known as body or bio-identical progesterone – which replicates exactly the hormones the body itself makes. This has been proven time and time again to be completely safe and to even reduce a woman’s risk of getting breast cancer by 40 per cent.
That’s progesterone, but there’s another crucial hormone within HRT and that’s oestrogen. Oestrogen starts to decline in women later than progesterone, at menopause. Again, all the research into oestrogen – and there’s a lot of it - shows that replacing the depleted hormone in women does not cause cancer, and that taking it actually reduces the risk of developing heart disease, osteoporosis, and dementia by FIFTY per cent.
So why the confusion?
It all goes back to a huge study of HRT in American back in 2002 which claimed that there was an increased risk of breast cancer, heart attacks, and strokes for women taking it. Not surprisingly, this made headlines around the world, but the truth behind these headlines barely got a mention.
Taking HRT for just a year may raise risk of dementia, warns shock study.
Experts stressed the study involving 60k women was merely observational.
Headlines have been, are, and will continue to be, a huge part of the problem, breeding fear and confusion amongst millions of women the world over.
Just last month this was printed. Look at the language, ‘just a year’, ‘warns’, ‘shock study’… and then, in much smaller text, the qualifying statement, that the study was observational, its results questioned by experts. What do most women, particularly those on HRT focus on? The headline of course. And this is repeated day after day, year after year. Statistics interpreted in sensationalist ways, when there is, almost always, another, largely unreported side to the story. In this case that HRT actually reduces the risk of dementia if body identical progesterone is used.
Misogyny in medicine
Of course, we can’t lay the blame solely at the hands of the press. For years, medical studies have focused on men, and so there is a huge void of information about women’s health. Take statins for example. Almost all the studies into statins have been conducted on men, there’s a lack of evidence to show they are beneficial for women, and yet, women are still regularly prescribed them to lower cholesterol. Add to this the inbred societal view that women should just ‘put up’ with pain and you start to see why they have suffered in silence for so long, never considering HRT to be an option.
Patch or tablet?
And so, we come onto the third issue which, together with misinformation and misogyny, has led to a real lack of trust in HRT and that’s the frankly alarming lack of education amongst many front line health workers about women’s health issues and how best to treat them. For years, the British Menopause Society and NICE said that HRT should be used for a maximum of five years. This advice was flawed and changed in 2015 and yet, still to this day, doctors are telling women this. Similarly, health professionals often say that oestrogen gel or patches are safer than tablets. They are absolutely not. Both are equally safe and in fact, recent studies have found tablets to be far more beneficial when it comes to protecting women against high cholesterol.
That’s not all, we are still seeing women repeatedly turned away by their GP, or given antidepressants or the oral contraceptive pill which, in most cases, only serves to worsen symptoms. We hear daily from women who have been prescribed oestrogen when blood tests show they absolutely don’t need it and, we often watch women recount horror stories having needlessly been given hysterectomies or invasive surgery when all they needed was replacement hormones. All of this because of a lack of knowledge and understanding and a resistance amongst some in the medical profession to change.
Time for change
Thankfully though, times are changing, thanks in part to a brigade of influential women on a mission to educate, empower, and inform women with the facts. And a less well-known brigade of women’s health doctors and advocates working tirelessly behind the scenes to arm all women with the truth about HRT. That, above all else, it is perfectly safe and can make a huge difference to the way we live as we approach and go through menopause.
