Never too late for HRT Carla McKay on the astonishing advances in hormone therapy

Old Age ain’t no place for sissies, as Bette Davis said It certainly ain’t for women. No sooner are the demanding child-bearing years over, than the mighty menopause comes along to whisk the wind out of your sails.

Literally. Say goodbye to your friendly hormones oestrogen, progesterone and testosterone (yes, women have that too) and say hello to what can be all the debilitating and long-term consequences of not having those hormones – ranging from symptoms like hot flushes and night sweats, to anxiety, depression, brain fog, poor memory, lack of energy and lack of libido.

All this would have been of no concern to the average new-born girl in 1841 – not expected to see her 43rd birthday. But it is of immense concern to women now, who still have a third or even half a life ahead of them post-menopause.

But I bring glad tidings! There is hope for us oldies who have been suffering in silence. While on holiday recently with some women friends, I was complaining about feelings of low mood and self-esteem, lack of energy and the way in which my joie de vivre seemed to be seeping away with every passing year. I was astonished when two of them revealed that they too had suffered similar symptoms but since taking HRT (Hormone Replacement Therapy) had felt much better.

But I’m far too old (at 71) to take HRT, I wailed. No, you’re not, they chorused. And so I discovered women’s medicine has moved on from the days when I was menopausal. It was possible to find enlightened doctors who would not only prescribe HRT for postmenopausal women but positively encouraged it.

However, it is still not nearly enough widely known. The understanding of women’s hormonal health is a woefully underfunded and under researched area of health, in spite of the fact that the greater part of an ageing society will primarily comprise women.

The medical treatment and care of post-menopausal women in the past have been seriously inadequate but there are signs that progress is being made at last.

HRT has always been controversial, largely due to the perceived breast cancer risk. However, recent research suggests the risk is now minimal; partly because HRT now uses regulated body identical hormones, as opposed to the synthetic ones used in my day; partly because we now know that the world, helps women to make an informed choice about HRT. It was born out of her frustration with women finding it difficult to access impartial information and treatment and being put off HRT through cancer scare headlines.

‘Alarm is a natural reaction when you hear the words ‘breast cancer’ in the same sentence as HRT,’ she says, ‘and my fear is that the headlines, rather than the drugs themselves, will impact negatively on women’s health’.

HRT is not just about breast cancer risk. Numerous studies have shown that women who take HRT have a lower risk of heart disease, osteoporosis, osteoarthritis, type 2 diabetes, depression, bowel cancer and dementia.

All these diseases increase in women who have gone through the menopause and have low hormone levels in their bodies. Women are seven times more likely to die from heart disease than breast cancer.

Dr Newson says, ‘The women I see at my clinic are constantly thanking me for “giving their lives back” after starting treatment. I have seen so many women who have been suicidal due to menopause whose depression has lifted after hormonal balance is restored.’ modifiable lifestyle factors, such as obesity, lack of exercise and smoking – not combined HRT – are the real risks for breast cancer.

A 2022 paper from the International Menopause Society says there is an urgent need for risk levels to be put in context and considered together with other factors: ‘Preventing a woman from the sound benefits of a properly instituted hormonal medication, just for the fear of rare side effects, is not satisfactory medicine.’

Leading GP and menopause specialist Dr Louise Newson is one of the loudest voices in this country to champion the benefits of HRT for women of any age and at any point in their lives. Her app, Balance, the largest dedicated menopause app in

One of her chief concerns is that healthcare professionals still have no mandatory menopause training and often misdiagnose patients: ‘They need to be given more confidence in prescribing body identical HRT which, for the large majority of women, is safe, effective and also cost-effective to the NHS and the economy from wasted referrals. We must empower women with the right information so that they can make the right choices.’

As she points out, the NICE (National institute for Health and Care Excellence) guidelines are clear that women can continue to take HRT as long as the benefits outweigh the risks.

For most healthy women, this is for ever.

For more information go to www.balance-menopause.com