Can this woman REALLY wean you off HRT? ( and make you slimmer and happier! )
For five years CLAUDIA CONNELL swore by HRT tablets and gels. Now, as millions panic over shortages, she meets the expert behind a natural alternative to beating the menopause
As if being menopausal wasn’t challenging enough, for those taking hormone replacement therapy, it’s an even more worrying time.
Production problems mean there is a national, and worsening, shortage of HRT, with some women trying to source their medication overseas at a huge cost, and the Government imposing an export ban on the stuff.
scarier still, those health scares just won’t go away. Earlier this year, a new study, published in The Lancet medical journal, suggested the risk of users contracting breast cancer could be double what was previously thought. i started taking HRT aged 48. One freezing January morning on my way to work, a particularly bad hot flush led me to open a window on the bus.
When a fellow passenger closed it, i launched a torrent of hot, sweaty abuse at the poor fellow. At the time, i decided i had two choices: take HRT or face a jail term for GBH. Although it hugely alleviated my symptoms, by the age of 53, i was worried about how dependent i was on it. Every time my GP suggested coming off it, i’d have a mild panic attack.
so, when i read that one pioneering menopause expert had compiled a programme for women who wanted a more natural approach to getting through the menopause, with a view to eschewing or coming off HRT, i sat up and listened.
Dr Wendy sweet started out as an
People are intrinsically incomprehensible — don’t try to understand them NOVELIST LOUIS DE BERNIERES
intensive care nurse in New Zealand before training and lecturing in sport, health and nutrition. She was doing a doctorate on women’s healthy ageing when her own menopausal symptoms kicked in.
‘I kept reading all these stories about being “fabulous at 50” and thinking: “why am I not fabulous at 50?!”’ she told me, when she was over in London delivering a lecture.
‘ Despite upping my exercise regime, I had piled on weight, my knees hurt, I couldn’t sleep and I felt and looked awful.’
wendy’s research led her to conclude that no one was joining the dots when it came to women’s menopausal symptoms and their lifestyles. No one was linking diet to hot flushes, exercise to lack of sleep, poor sleep to weight gain, and coming up with a solution.
She devised a 12- week online programme, My Menopause Transformation, after years of research into what she calls ‘untangling the menopause mayhem jigsaw’.
My Menopause Transformation, or MyMT, offers two plans: there’s a ‘circuit breaker’ programme for symptom relief, and then there’s a plan for women like me, who’ve piled on the pounds in middle age, called ‘Transform Me’.
The plan meant a total diet overhaul, early bedtimes and exercise, during which, if I was brave enough, I would attempt to wean myself off my HRT medication.
It all starts in the bedroom because, as far as wendy is concerned, no menopause transformation can take place unless we get a good night’s sleep.
Before menopause I could sleep like the dead and, while HRT stopped the night sweats, it didn’t stop me waking in the middle of the night with a wildly racing heart.
I’ve always gone to bed late (typically 1am) and get up at least once in the night to use the loo. wendy’s sleep programme aimed to turn around my body’s circadian rhythm (our natural sleep/wake cycle) and I quickly learned that my 1am bedtime was far too late.
OUR bodies are designed to be in their deepest sleep at 2am (when I was still looking at my phone screen).
we also start to secrete melatonin (the sleep hormone) at 9pm and our bodies need darkness to do this efficiently — not, like me, to be in front of the TV with a main light on.
A poor night’s sleep fires up our stress hormone cortisol, which fires up our appetite, and my 35in waist was the result.
on wendy’s plan, I quit my box-set binge habit and headed to bed at 10pm. As mammals, our bodies and hormones are programmed to love routine. My phone was left downstairs and replaced with an alarm clock, as the ‘blue light’ generated by smart phones interferes with our melatonin production.
Meat was also banned from my evening meal. our bodies have to work harder to break down meat proteins, leading to a rise in blood pressure, temperature and heart rate — not things a menopausal lady needs to be encouraging at bedtime.
wendy believes uninterrupted sleep is key, meaning those 4am trips to the loo had to stop, so I stopped drinking liquids from 8pm.
when I woke in the night with a racing heart, I practised a deepbreathing technique called ‘diaphragmatic breathing’.
This method is said to lower heart rate, get you quickly back to sleep and train the body out of thinking your bladder needs emptying.
After three months I can report, I’ve become an early-night convert and find my body springs into life naturally at around 6am.
we’re allowed one lie-in a week, which helps with nights out, but even if I meet friends for dinner I am usually in bed by midnight.
In the first six weeks, I still needed the loo in the night and the menopausal heart palpitations lingered, but for the past six weeks I’ve slept through soundly.
The thing I’ll never get used to is the cold showers. Yes, that’s right, like some archaic boarding school ritual, the programme calls for cold showers before bed.
If we can keep our body core temperature low at bedtime, it means our thyroid and pituitary glands don’t have to leap into action during a hot flush — yet another thing that tampers with the production of melatonin.
WHEN I started my cold showers, I only managed five seconds. Now I’ve built up to 15 and have to report that ne’er a hot sweat has troubled my cotton sheets in two months.
Another reason for the early nights is that, on the programme, we are encouraged to start every day with a walk. The melatonin we need to sleep well is stimulated via sunlight hitting our retinas, which means my habit of swanning around in sunglasses like some B-list movie star wasn’t doing me any good.
It’s important to leave sunglasses off for about 15 minutes in morning light, and even if it’s not sunny, natural light will still stimulate melatonin production.
Getting up at 6am gives me an hour before I need to get ready for work. I aim for 20 minutes of brisk (sunglasses-free) walking, but I admit I only do it in the pouring rain at weekends. wendy encourages participants to aim for at least an 80/20 rule on her programme — if you’re following the rules 80 per cent of the time, you’re not doing badly.
During the 12-week programme, exercise is gentle (with walking, cycling and swimming recommended) and designed to be ‘healing and not harming’.
It’s not a problem I was ever likely to have, but menopausal women who follow punishing workout regimes could be making their symptoms worse. A gruelling workout can result in cortisol levels soaring, leading to a bad night’s sleep and no chance of recovery for those poor, overworked muscles.
while changing my bedtime routine and going for walks took adjustment, it was always the diet overhaul that was going to test me.
You may question why anyone needs to change what they eat in menopause, but few realise that oestrogen is the most powerful antiinflammatory in a woman’s body.
when oestrogen levels decline, it results in deep tissue inflammation from higher cortisol levels, that in turn spikes insulin which makes us crave sugary and starchy food.
when devising her food plan, wendy studied the diets of women living in so called ‘Blue Zones’ — areas in the world where people live longer and suffer fewer medical conditions.
A study of women’s ageing in Blue Zones found that many reported a symptomless menopause and they certainly weren’t taking HRT, so
Cold showers. No milky tea. And 10pm bedtimes. Her step-bystep guide is simple. But every time I think about coming off HRT I have a panic attack . . .
what was their secret? The thing the women all had in common was that their diets were very similar — they featured little meat and dairy, no processed foods and an abundance of fruit and vegetables.
Wendy based her diet plan on the Mediterranean diet, but with a few tweaks for menopausal women.
A study by the American Journal of Clinic Nutrition discovered that those who followed the Mediterranean diet experienced a 20 per cent reduction in hot flushes.
In other words, the foods she advocates have a low glycaemic level as well as being low acidity.
These foods slow the release of insulin and sustain energy levels.
Our bodies strive constantly to maintain a state of homeostasis — the perfect balance of hormones — and a healthy diet goes a long way towards aiding that.
As the programme I followed aimed to help me shift weight, it incorporated a liver cleanse. Oestrogen decline makes our livers less efficient, which means we don’t metabolise fats and proteins well, leading to the dreaded middle-aged bloating.
I started the diet overhaul with gusto by throwing all sugary and processed foods into a bin bag.
Out went the breakfast cereals, the crisps, the wine gums and the Diet Coke. I also binned dried penne and a half- eaten loaf of bread, since I was to eliminate wheat for six weeks. The reason for this is that wheat inflames the small intestine and reduces the amount of vitamins and minerals that are absorbed from food.
Wendy also wanted me to cut out beef, which is reported to make the body more acidic. Osteoporosis is linked to highly acidic diets.
As a tea guzzler, the bad news was that dairy was out, too. Dairy contains oestrogen-mimicking substances which push up insulin levels and will add another spare tyre to the one I was carrying.
Lower progesterone levels lead to water retention, so the diet plan called for two litres of water a day. It may sound counterintuitive, but water retention is due to the body panicking and holding on to liquids when dehydrated, so taking in more liquid alleviates the dehydration and the problem. Wendy prefers mineral water, but I went for the good old tap variety.
The golden rule was that I had to start every day with the juice of one fresh lemon to cleanse the liver, which may sound daft when you’re trying to reduce acid, but lemons turn alkaline when they enter the body.
Included in the programme is a long list of foods to eat: rarely, moderately, regularly and often.
In order to not get overwhelmed, I whittled that down to my own shortlist of food I liked and made my choices from there.
Many women on the programme start their day with a green juice, but I knew that juicing would be a road to failure. Just as Shirley Conran famously once said that ‘life’s too short to stuff a mushroom’, I believe it’s also too short to peel and blend a kiwi.
Juicing is a faff, washing the juicer afterwards is a headache. I’ve thrown away £150 juicers because I’m too lazy to wash them, so I settled on a solid food diet. Besides, I was already following a toddler’s bedtime routine — I didn’t want their diet as well.
I start most days with either mixed berries or porridge and a bucket of coffee with a dash of oat milk. Now coffee does trigger hot flushes. But I don’t care, I can’t give it up. But I rarely have tea just because no non- dairy milk goes with it.
I eat my biggest meal at lunchtime, which usually features either chicken or fish and vegetables or salad. When I’m working, Pret a Manger’s salmon with red cabbage and avocado salad box has been my life-saver.
AND you know those infuriating people who batch cook a load of healthy food at the weekend and then eat it during the week? I’ve become one of them. My go-to recipes are a Quorn chili con carne, an aubergine and cannellini bean stew and a chicken and ginger stir fry with vegetables. And it gets worse: I also carry little bags of nuts and dried fruit around with me to snack on.
When it comes to alcohol, I’ll have a white wine when the mood takes me, but I can happily go days without drinking.
After six weeks of no wheat, I introduced bread again and one round of toast resulted in a bloated belly rarely seen outside the world of professional darts.
Now I don’t eat bread or pasta at all, and my sugar cravings are firmly under control. When my train was subject to delays at victoria Station recently, I stressbought a packet of wine gums, but instead of scoffing the whole lot, I ate two and binned the rest.
But the big question is whether following the programme made me feel brave enough to come off my HrT? After seven weeks of dithering on the programme, I bit the bullet and consulted my GP about tapering off it.
At the start of the programme, I was using two pumps of oestrogen gel, rubbed into my arm daily. And for 12 days a month I took progesterone tablets.
I felt great doing the programme, but how did I know that it wasn’t still the HrT that was keeping the menopause’s worst symptoms at bay? There was only one way to find out. On my doctor’s advice, I reduced my oestrogen gel to one pump a day, then one every other day until finally, after two weeks, I stopped altogether. I felt genuinely anxious and requested another prescription ‘just in case’.
After a week, I noticed hot flushes creeping back, but with nothing like the ferocious intensity I had experienced pre-HrT.
When I get them they are usually triggered by caffeine and last a few seconds. The night sweats have not returned — thank goodness all those cold showers weren’t in vain!
And now the big news: after three months on the diet, my stomach has deflated like you wouldn’t believe. I’ve lost nearly five inches around my middle and 18lb (over a stone!) in weight.
I’m about to enter my fourth HrT- free week and, so far, I haven’t needed to break into my emergency supply.
I’ve never been anti-HrT — I’ve recommended it to many friends — but, like a stale relationship, it felt as though the time was right for us to go our separate ways. I’m pleasantly surprised it wasn’t the painful break I was expecting.