Dr Heather Currie
An Associate specialist gynaecologist specialising in menopause, trustee and past chair of the British Menopause Society and spokesperson for the Royal College of Obstetricians and Gynaecologists and MD Menopause Matters
17 years ago Dr Heather Currie created Menopause Matters. She explains some of the misunderstood issues around hormone replacement therapy (HRT).
www.menopausematters.co.uk was launched in January 2002 and the first Menopause Matters magazine was published in 2005.
Our mission is to provide information and support, and our vision is that all women are able to make informed decisions about management of their menopause.
Women need to understand the menopausal process, what diet and lifestyle factors they can change to reduce symptoms and improve later health and what treatment options are available.
Education is needed for healthcare professionals so that women are given accurate and consistent advice. The British Menopause Society (BMS) has many educational events and resources available and we are working hard to implement its vision for menopause care in the UK.
Menopause and HRT myths
HRT just delays menopausal symptoms
HRT controls symptoms while present. Choosing to stop HRT at a later date, means symptoms may or may not be present. For those who still experience symptoms when stopping HRT, it is believed that they would have had symptoms all along if HRT had not been taken. We now know the average duration of symptoms is 5-7 years and many women still have symptoms in their 60s or later, so HRT may be needed for symptom control for many years.
HRT can only be taken for 5 years
There are no arbitrary limits to the duration that HRT can be used. We cannot predict how long symptoms last so cannot predict how long HRT will be required for symptom control. The type of treatment used and duration is individual – we are all different. HRT can be used for as long or as little time that each woman feels the benefits outweigh the risks to her.
HRT causes breast cancer
The association of any HRT and breast risk is very small. Estrogen-only HRT is not thought to be associated with an increased risk of being diagnosed with breast cancer. Estrogen combined with progestogen may be associated with a small increased risk of being diagnosed if taken for more than 5 years after the age of 50, (approximately 4 extra cases per 1000 women aged 50-59 over 5 years) but these extra cases are thought to be due to HRT promoting the growth of cancer cells already present, not causing the cancer.
Some have worried about this risk and while important, it needs to be kept in perspective. Being overweight is a bigger risk!
- A blood test to measure hormone levels is usually NOT required to diagnose the menopause.
- Levels of hormones in saliva do NOT determine which level of hormones should be taken.
- Vaginal estrogen for treatment of menopausal vaginal dryness does NOT work immediately and should not be looked on as a single course of treatment. It may take 3 to 6 months to get the full benefit and should be continued long term; symptoms frequently return when treatment is stopped.
- High blood pressure is NOT a reason for HRT to be avoided, though if high blood pressure is found, it should be controlled before starting HRT.
- The combined contraceptive pill does NOT always have to be stopped after age 35. If you are a non-smoker and generally healthy, it can be continued up to age 50 and provides effective contraception and non-contraceptive benefits such as control of bleeding and menopausal symptoms.
- Antidepressants are NOT recommended for first-line treatment of menopausal symptoms such as flushes and low mood, yet are often offered by GPs. Some antidepressants can be used if HRT cannot be taken for medical reasons, but only after full discussion and after ruling out the use of HRT.
We will continue to support women across the UK and would love our magazine to be readily available in every branch of well-known stores and supermarkets!