By Dr Louise Newson
Ever wonder why HRT is so controversial? Following the Women’s Health Initiative study in 2002, which showed risks of cancer, heart disease, and stroke for women, prescriptions for HRT fell by nearly 80%. Many doctors then changed their practices and training of new doctors began to overlook menopause care. However, the data in the report has been reanalysed and the original study was shown to be statistically insignificant. Examples like this highlight a long history of misinformation about HRT – so what’s the truth?
MYTH #1: HRT causes breast cancer and heart disease
FACT: HRT with oestrogen alone is not associated with an increased risk of breast cancer. Combined HRT (oestrogen and a progestogen) can be associated with small increased risk of breast cancer in some women, however, this reduces once treatment stops as it’s related to treatment duration. Young women (under 45 years) who take any form of HRT do not have an increased risk of breast cancer. If HRT is started before the age of 60, there is a lower future risk of heart attacks. Taking HRT can also lower your cholesterol.
MYTH #2: HRT causes weight gain
FACT: There is no significant evidence that HRT causes weight gain. Weight gain is a common symptom of menopause and aging in general, but it is not linked to HRT.
MYTH #3: HRT causes blood clots
FACT: There is only a very small risk of blood clots associated with the oral tablet HRT. This risk is higher if you have a history of blood clots or if you are overweight or obese. There is no such risk if the oestrogen is given as patches and gels.
MYTH #4: You have to stop HRT after 5 years
FACT: How long a woman should be on HRT varies between women and should be assessed by a doctor individually, depending on personal risks and dosage amount. Low dosages of HRT can be taken for a longer time and there is no upper age limit. Women who begin HRT under the age of 51 should take it until they are at least 51, regardless of when it was started.
MYTH #5: HRT delays your menopause
FACT: HRT manages symptoms of menopause, it does not delay it to a later time. If you stop taking HRT, symptoms will arise as if you were not taking HRT at that time.
MYTH #6: I can’t get pregnant while taking HRT
FACT: HRT is not a contraceptive. If you are still releasing eggs when taking HRT, then you can still get pregnant.
MYTH #7: You have to wait until you have horrible symptoms before taking HRT
FACT: You can take HRT even to relieve mild symptoms. If you would like immediate relief now, there is no reason to delay taking HRT. Research has shown that the earlier a woman starts taking HRT, the lower her future risk of heart disease and osteoporosis.
MYTH #8: Natural treatments for menopause are always safer
FACT: Just because it’s natural, doesn’t mean it’s safe. There is not a lot of strong scientific evidence supporting many natural remedies for menopause, and you should give it a lot of care and attention if you’re considering these as alternatives.
Many risks of HRT have been exaggerated over the years. The facts show that HRT is a low-risk treatment for the menopause. However, if you’re still unsure, it’s best to talk to your doctor about your options, as the right treatment for menopause depends on your individual medical history, family history, lifestyle, and more!
For more from The Menopause Doctor Louise Newson, visit her website here.