Menopause and Hormone Replacement Therapy (HRT) - what you need to know
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Menopause and Hormone Replacement Therapy (HRT) – what you need to know
It’s a fact that every woman will go through menopause and for
many of them it will be a difficult, anxious time accompanied by
physical changes and unwelcome symptoms. Nine out of ten
women say that menopause has had a negative impact on their
working life.
It need not be this way. There is now a range of personalised
hormone replacement therapy treatments available that can
dramatically alleviate the symptoms. Whatever your symptoms,
the Gynaecare Clinic can offer a supportive service, expert
advice and specific solutions, but it’s always a good idea to
educate yourself first, so please read on to find out more about
menopause and what HRT can do to lessen its impact.
2
What is the menopause?
Menopause is due to a change in hormone levels. During a woman’s fertile years,
her ability to produce an egg each month is associated with the release of oestrogen.
As she ages, her egg store reduces, and less oestrogen is produced. This gradual
reduction is usually referred to as the peri-menopause, when most women will start
to notice and feel changes, like irregular periods. Menopause finally happens when
there are no more monthly cycles and ovulations, or pregnancies.
You can find out more information about menopause on our website.
Statistics
Women represent 51% of the UK’s population and at some stage, 100% will go
through menopause. The average age for women starting is 51 in the UK , but it
varies because every woman is different. A small number start menopause before
they are 40, and others may have had a medically induced menopause due to surgery
or ill health.
If you are reading this article, you are probably a woman over 40, possibly peri-
menopausal or experiencing menopausal symptoms, and if that is the case, it’s likely
to be affecting your quality of life. It’s estimated that at least 90% of UK women will
experience some menopausal symptoms , which vary in severity.
HRT treatments have been proven to alleviate many of these symptoms and they can
also have wider longer-term health benefits; yet here are two more sobering statistics.
Out of the 13 million menopausal women in the UK, 1 in 3 do not seek help from their
GP, and only 12% of them are on HRT.
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What happens to women during menopause?
The menopause is a deeply personal experience, but with so many women
experiencing symptoms, the loss of oestrogen obviously makes a big difference to
overall well-being, and some women will need to seek medical help.
The most common symptoms; hot flushes, affect three in every four women. Others
include night sweats, insomnia, aching joints, skin and hair changes, urinary tract
infections, vaginal dryness, loss of libido and skin irritation.
Menopause can also affect a woman’s mental health; ‘brain fog’, low mood, confusion,
and increased anxiety are all regularly reported symptoms. A serious longer-term
health concern is the impact oestrogen reduction can have on bone density and
strength, with menopause linked to the onset of osteoporosis, and recent studies
suggest a link to increased risks of coronary heart disease, strokes and Alzheimer’s.
So, it is quite remarkable that more women aren’t seeking out HRT treatment, when
something that they will all experience can carry so much risk to their health. It is even
more shocking when you remember that women make up half of the population.
Negativity
You could also be forgiven for asking at this point why any woman would put up with
this when there is a possible solution in the form of HRT. It’s true, women should not
have to put up with something that can, for many, be debilitating.
The explanation for this is complex, but it’s partly to do with cultural attitudes. Until
recently, menopausal women expected to ‘just get on with it’ and suffer in silence.
Thankfully there are now celebrity campaigners like Davina McCall, raising awareness,
breaking taboos and urging women to seek help. High-profile women like Oprah and
Michelle Obama have also spoken out about their experiences.
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Another reason has been the attitude of the medical profession. Davina McCall’s
Channel 4 documentary shown in May 2021, highlighted the lack of training and
resources available to GPs to support menopausal women seeking their help.
The most significant contribution to the stigmatisation of HRT though were 2 pieces
of research released respectively in 2002 and 2003, linking HRT to increased risk of
breast cancer, stroke and heart disease. You can read more about the history here.
These studies caused considerable panic, and almost immediately 50% of women
stopped their HRT treatment.
In fact, the studies were flawed and focused on the wrong age range – with results
from women in their 60s and 70s included. Post-menopausal women are more at risk
of these conditions because they are older, and in the US study, some were obese,
which further increased their risk; yet women of all ages were included in the study
results.
The positives
Ignoring ‘women’s problems’ and shrouding them in secrecy is now, thankfully, a thing
of the past. The hormone deficiency that causes so many women to suffer is taken
seriously by the medical and research professions, and treatments and research into
menopause have advanced significantly.
Ignoring ‘women’s There are risks associated with taking any medication,
problems’ and but recent studies have shown that oestrogen-only HRT
shrouding them treatments can actually reduce the risk of breast cancer.
in secrecy is now, It’s worth saying this again, but every woman is different,
so the type of treatment available can now be tailored to
thankfully, a thing the individual, taking into account medical history, weight,
of the past. and other risk factors such as smoking and diet.
There are now 50 types of HRT treatment available to women, that can be taken in
various forms. A good doctor will do a full assessment of the patient and find the
right one . Other hormones such as progesterone and testosterone may also be
considered, or various combinations depending on individual needs and symptoms.
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Gynaecare’s approach
Our practice is led by Mr David Ogutu, a highly
experienced obstetrician and gynaecology consultant, who
will take your overall health into account when considering
your HRT treatment. Patient management is at the heart
of our practice, and we aim to provide comprehensive care
of the highest standard for all our patients.
Gynaecare takes a person-centred approach and works with you to understand what
you need to safely and effectively restore your physical and mental well-being during
menopause.
In our practice HRT transdermal patches, gels or implants are more frequently
prescribed as first line, compared to the oral tablets, because they are associated with
fewer risks.
Where testosterone supplementation is required to improve the symptoms of loss of
energy and loss of interest in sexual relationships, this is available as gels or implants.
We also stay abreast of the latest developments, studies and research to continue
improving our patient care.
Be the change
To use an old term, you may be ‘on the change’ but you can change the way it
affects you. And HRT can be the game-changer. Do your research; there are now
plenty of resources and information about HRT online; we’ve listed a few below to
help you, and if you are thinking of taking the next step, please contact us to start a
conversation about how we can help.
Resources
Women’s Health Concern – the patient’s section of the British Menopause society –
lots of factsheets and useful resources.
The Royal College of Obstetricians and Gynaecologists has a comprehensive list of
further information sources too.
Menopause Matters – set up by a female gynaecologist to help more women
understand what happens during menopause, and where to seek help.
The Menopause Charity – a charity with high profile ambassadors that aims to
educate and campaign on the need for better menopause care.
1 Davina McCall: Sex, Myths and Menopause – Channel 4 documentary, first broadcast 12 May 2021
2 Gov.uk – Male and female populations
3 NHS UK – menopause
4 The Menopause Charity
5 Davina McCall: Sex, Myths and Menopause – Channel 4 documentary, first broadcast 12 May 2021
6 Davina McCall: Sex, Myths and Menopause – Channel 4 documentary, first broadcast 12 May 2021
7 Women’s Health Concern
6For more information, contact: Ruth Blissett Secretary to: Mr David Ogutu MBChB, MRCOG, DFSRH Consultant Gynaecologist and Fertility Specialist Tel: 07838 171641 info@gynaecare.uk.com gynaecare.uk.com
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