Menopause And Hrt

For most women the menopause starts between the ages of 45 and 55 when the ovaries begin to produce less oestrogen.   For some women this hormonal imbalance can result in symptoms such as hot flushes, irritability, anxiety and poor concentration.  The menopause is a normal stage in a woman’s life and it isn’t an illness, having said that we all know for a fact and through personal experience, that some women do have very real problems and need help, whilst others get through the changes easily.

Nevertheless many women who complain to their doctors of distressing menopausal symptoms don’t, or won’t take Hormone Replacement Therapy, even though they have been told by their doctor it could help them alleviate their symptoms.   They feel it will do them more harm than good, since reports indicate that there is a slight risk of thrombosis, asthma, endometrial cancer, and psychological problems.   Most worrying is the slighter greater risk of developing breast cancer (2.3% per year) in women on HRT.

Women, who have had an early menopause (a surgical menopause) as of the result of a hysterectomy, are often offered HRT, especially if their ovaries have been removed.  HRT works by replacing the oestrogen no longer produced by the ovaries.   HRT is also recommended for women who have a family history of osteoporosis.

It’s important to discuss fully the health implication of taking HRT long term and it is understandable that many women are suspicious of the claims and confused about the side effects of taking HRT.  Women need to be confident of the ways in which they manage their menopause and post menopause.   It is now well known that HRT does lower the risk of osteoporosis and it relieves hot flushes and night sweats, encouraging a better night’s sleep.

HRT comes in several forms.   The original type contained just oestrogen, but it was thought to have increased the risk of cancer in the lining of the womb.   Nowadays it is only prescribed for women who have had a hysterectomy, no longer have a womb, and who therefore are not at risk.

Other forms of HRT use both the oestrogen and progesterone as replacement hormones.  During the first half of the monthly cycle the patient takes just the oestrogen, but the progesterone is added during the second half of the cycle, and causes a monthly bleed, not unlike a period.

Another form of HRT contains a combination of oestrogen and progesterone.   This type is usually given to women who have ceased to have a natural period.   There is still protection against cancer of the womb lining, but no inconvenient monthly bleeding.

Your doctor must prescribe HRT, but you may prefer to consider the natural approach as an alternative.   Plant forms of oestrogens and progesterones can be found in foodstuffs such as the Mexican yam, tofu (Soya bean curd), French beans, green lentils, miso (fermented Soya paste) and rye bread.   The amounts of hormone balancing properties will of course vary a great deal, and may not be constant enough to treat some women, especially those who have had their ovaries removed.   Other women will find these natural alternatives helpful and more acceptable.   Bananas, figs, dates, citrus fruits, sprouted seeds and grains, citrus fruits, seaweed, fennel and garlic are all foods containing hormone balancing properties which are claimed to help alleviate menopausal problems. Medicinal herbs such as hops and sage are rich sources of plant-oestrogens and from recent tests red Clover is proving beneficial to some women who cannot or will not take HRT.

Speaking from personal experience I believe taking regular exercise is also important during this time.   Not only will the weight bearing exercises boost and build stronger bones, but aerobic exercise will strengthen our hearts and lungs.   Most moderate exercise will help improve energy levels, overcome depression and anxiety, and relax our bodies enabling us to sleep more soundly.

However, some gynaecologists and doctors with menopausal patients are concerned that although health supplements and homeopathic medicine can be useful, they are not alternatives to HRT.   Many point out that women lose their oestrogen supply after hysterectomy and removal of ovaries, and need immediate HRT and claim that taking alternatives puts their menopausal patients at risk.  The point they make is that nothing else relieves menopausal symptoms and osteoporosis at the same time.

Recent results of long term trials of HRT have further confused women contemplating taking the drug. As responsible mature women we must make our own individual and informed choice, and take whichever course of action we consider suitable for our well being.

CONTACT

The National Osteoporosis Society