We receive a lot of questions from readers about HRT and the menopause, so we are delighted to have Dr Marilyn Glenville answer many of those questions.
In this video we cover:
What is HRT?
What are the risks associated with HRT?
What are the benefits of HRT?
How should you assess the risks when deciding if HRT is right for you?
How long should you take HRT?
What happens when you stop HRT?
What are bio-identical hormones?
Enjoy the video. As always, do share with those you feel will benefit, and feel free to post your questions in the comments below.
Transcript of HRT and Menopause video interview:
Ceri: Hi, Marilyn. Thank you for joining us today. For those of you who don’t know Marilyn, Marilyn, in fact, you’re the UK’s leading women’s health nutritionist. So, thank you, Marilyn, for taking the time out.
Marilyn: You’re welcome, Ceri.
Ceri: And we’re talking about the menopause, aren’t we?
Marilyn: We are.
Ceri: HRT. I mean, that is such a contentious issue. I mean, there are people who seem to be very much pro-HRT, and people who are against HRT. But, from your perspective, what is HRT, and what are the benefits and risks of considering it today?
Marilyn: Well, we’re talking hormone replacement therapy. And, for me, I view the menopause as a natural stage in our lives.
Ceri: Yep. Mm-hm.
Marilyn: That we’re going to go through the menopause and come out the other side. And we can live 30 to 50 years past the menopause now, as a woman. And so, hormone replacement therapy is suggesting we replace the hormones that are naturally declining at this stage in our life. And that’s where the risks are, because we’re putting hormones back at that point, and we’re almost saying, “Well, nature’s got this wrong.” It is very different if a woman goes through an early menopause, or premature menopause, before the age of 40, and she needs those hormones replacing to protect her bone health.
Marilyn: But, through a natural menopause, the risks are there because we’re putting these hormones in when actually, they’re reducing in our bodies naturally. And the biggest risk is the risk of breast cancer. There are other risks like the risk of strokes, heart disease. And it is a woman weighing up those risks. She may have a family history of breast cancer and actually now she shouldn’t be taking it, or had had thrombosis in a pregnancy. So, there are individual risks as well . . . . . . that make it worse. But, there are risks of breast cancer even with no family history risk. And it’s weighing up all the time, benefits versus the risk with the medication. And some medications, definitely the benefits are there. But, I think, around this time in our life, which is a natural stage and not a medical problem, that we’re adding in a medication that can give us the risk of something like breast cancer, when actually this is only a transition of us moving from this one stage, through the menopause, and out the other side.
Ceri: Yet, there are women who feel there is no option other than taking HRT, and it’s being prescribed for them. Is there an optimum period of time? Because there are women, who certainly have written in to us, who said that they had been on HRT for up to 10 years. And, they really don’t know what to do, coming off that. Now, would it then trigger the menopause later? Are they just delaying the problem? Or, now would they never be able to come off it?
Marilyn: They’re not delaying the menopause, because the clock on the menopause ticks away underneath. So, they’re not delaying the menopause, and they won’t come off at 60 and get their periods back.
Marilyn: But, they can, their body can get used to a much higher level of those hormones. And the difficulty, if women are just told, “Well, stop it,” they can actually feel certain symptoms come back. Some women won’t. I have written a book called Natural Solutions to the Menopause, which talks about weaning themselves off of HRT.
Hormones should be gradually reducing
And I think that’s the best way to do it, is gradually reduce those hormones. A bit like when we go through the menopause. The hormones should be gradually reducing. Though now, the Committee on the Safety of Medicines is now saying there are a maximum of five years, and then women should come off it, because the risks of the breast cancer are going to be much higher after that because we’re also older as well. So, really, if a woman is going to take it, it should be for the shortest possible length of time, and the lowest dose possible. And my advice would be to try the natural remedies first, and use the HRT as the last resort . . . if they need to use it.
Ceri: what we will do is we will give people the link to your book, if they want to have more in depth information . And I’ve read that book, an excellent book.
Marilyn: Thank you.
Ceri: . . . my perspective, I learned a lot. So, hopefully we can give people a link. And if they’re not sure of the points that comes out of our discussion, then they know where to go for the information.
Marilyn: And I think one other one that we ought to mention are the bioidentical hormones.
Because some women feel that the bioidentical hormones would be a natural way to go instead of going for the usual prescription HRT.
But to be really clear, the natural side of it only means that they’re chemically identical to the hormones that we would produce in our body naturally.
Marilyn: But they are still a drug. They’re still made in the same way, in the lab, as HRT would be. But, also, it’s still hormone replacement therapy. And they still carry the risk of breast cancer. So, women need to be really clear that whether they’re doing it in a bioidentical form or the form on prescription in the UK, they are still replacing hormones that basically, shouldn’t be there at that stage in a woman’s life. And still, they have to come off them, or else the question is, are they going to stay on them for the rest of their life?
That’s the question. When do you come off these hormones?
Ceri: Absolutely. Especially if we’re looking at possibly even 30 to 50 years beyond.
Marilyn: Yes, and it’s a long time. And if women are taking them with the perception they use them, especially the bioidentical ones, for sex drive or prevention of osteoporosis, when our risk of hip fractures is in around the age of 75 or 80, you’d have to stay on them for life.
More information can be found in Marilyn’s book Natural Solutions to Menopause: How to stay healthy before, during and beyond the menopause
Other videos in this series: