Should women use HRT for the menopause?

Taking pills
Taking pills
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Columnist Jenny Logan talks about the pros and cons of Hormone Replacement Therapy

I write a lot of articles which focus on natural and alternative remedies. However, recently I was asked to write a piece on HRT, outlining the risks and benefits associated with this medication, and why some women may look for alternative to a medication which has largely been successful at helping women deal with uncomfortable menopausal symptoms.
It was such an interesting exercise for me, that I thought I would share it with my Post readers as well.

Read more: Information talk on menopause at Preston Marriott Hotel

What is HRT?
HRT stands for Hormone Replacement Therapy. Menopausal symptoms are often caused by falling hormone levels, and the idea is that taking HRT will replace the hormones your body is no longer producing, and therefore put a stop to uncomfortable symptoms. For many women, this can feel like a lifeline – but what are the risks and benefits associated with this medication?


The benefits of HRT
For some women the onset of menopause causes little or no problem, and for these lucky souls there is no need to use any medications. For other women, however, falling hormone levels can lead to a number of symptoms including:
Hot flushes;
Night sweats;
Low mood;
Mood swings;
Vaginal dryness;
Reduced libido.
Because it replaces lost hormones, HRT can usually relieve most of these symptoms and, therefore, improve quality of life. These benefits last for as long as you are on HRT, but it is worth noting that some women do report a return of symptoms when they stop HRT. This can usually be minimised by withdrawing from the medicine slowly.

The side effects of HRT
As with all medications there are some common side effects associated with starting on HRT – this is largely due to the fact that it changes your hormonal balance. These can include:
Breast tenderness;
Headaches;
Nausea;
Indigestion;
Stomach pains;
Vaginal bleeding.
These symptoms are generally only noticeable for the first three months of taking the medication and should subside.

The risks associated with HRT
Most women, especially those who still have a womb, are prescribed an HRT which combines the two important hormones of the female menstrual cycle – oestrogen and progesterone. This is commonly known as combined HRT. Taking a combined HRT has been associated with certain health risks including:
Increased risk of blood clots;
Increased risk of breast cancer;
The increased risk of blood clots.
Taking HRT tablets can increase the risk of developing blood clots. This can be a serious problem as blood clots could become lodged in a blood vessel and block blood flow.
Generally, this risk is regarded as quite small. However, those women who are deemed ‘at risk’ of developing a blood clot, or those who have already had a blood clot, may be advised to seek an alternative solution for menopausal symptoms.

The increased risk of breast cancer
There is quite a lot of evidence that HRT can increase the risk of breast cancer. In a study carried out by Cancer Research UK, it was concluded that women who take combined HRT have double the risk of developing breast cancer, when compared to non-users. In women who have taken HRT for more than 10 years, that risk is even greater.
The risks do decrease again, once HRT has been discontinued, but it does take 4-5 years to completely return to normal.
It is important to note that whilst this may be concerning to many women, it is still a small risk factor when compared to the potential impact of diet and lifestyle. According to Brown et al; reporting in the British Journal of Cancer in 2018:

Minimising HRT could prevent 1,400 cases of cancer each year;
Keeping a healthy weight could prevent 13,200 cases of cancer each year;
Stopping smoking could prevent 22,000 cases of cancer each year.

In conclusion
It is important to remember that, for many women, HRT can improve quality of life and help to control uncomfortable and unpleasant menopausal symptoms. However, there are risks and it is just one of many different approaches which could be used to help, including natural and complementary remedies, dietary and lifestyle changes as well as other medications available from the GP. So, seek advice, talk to other women, look at the alternatives which are available and then decide, which is the best way forward for you.