Every woman is an individual and of course, the answers to these questions and others need to be given in that context; a one to one appointment with a doctor who is up to date and in touch with the realities of the perimenopause and postmenopausal life is just what is needed. However, there are some common themes and some myths which can be dispelled for everyone’s benefit.
The safety of HRT largely depends on age and healthy women under 60 should have very few concerns about the safety of HRT; the potential benefits are many and the risks very few when it is started within a few years of menopause.
What are the benefits of HRT?
It will, without doubt, control your menopausal symptoms: the most troublesome of these being hot flushes, disturbed sleep and vaginal dryness.
It will maintain the density of your bones and reduce your fracture risk although these benefits stop once your HRT stops.
There is some evidence that it may improve muscle mass and strength
It has been said over the years that HRT should be taken for only ……. years; insert any number you like, at some point in the last decade you will be correct! In fact, there is NO arbitrary limit. As long as the benefits of symptoms control and improvement in quality of life outweigh the risks, then carry on.
What are those risks?
If just one hormone, oestrogen, is taken when your womb is still present then there is a risk of cancer of the lining of the womb. Doctors prevent this by prescribing a second hormone, progestogen, alongside oestrogen in this situation. This is most effective at preventing womb cancer when it is prescribed every day.
There is a small risk of blood clots forming in your leg or lung: this is still very low. If 1000 women over 50 took HRT tablets for 7 and a half years then 1.7 women would have a blood clot of this type. ( a statistical concept!)
If you have just oestrogen ( because you have had a hysterectomy) prescribed as a patch then you have no more risk than a woman not on HRT.
There is NO increased risk of heart disease or stroke in women under 60 on HRT of any sort
Breast cancer is feared, and naturally so but the risks are small. It is a common disease; over a woman’s lifetime, there is a 1 in 11 risk of developing breast cancer. On a combined HRT ( oestrogen and progesterone together) if 1000 women over 50 took this HRT for 7 and a half years then only 5 more women would have breast cancer compared with the same group not on HRT . And for those 5 women the risk of dying of breast cancer is not increased. Once HRT is stopped the risk returns to the baseline risk for all women.
MORE importantly, being obese after the menopause ( which is the case for almost a third of British women) or drinking 2 or more units of alcohol a day ( 1 large glass of wine) each carries a greater risk of breast cancer than 5 years of combined HRT.
This sort of information is written for Mrs Average and each of us is unique, with our own journey through menopause to negotiate. Nothing beats a personal assessment with one of our doctors, to work out what would help you manage this season of your life. Appointments are available by calling 01268 833680.