Why ARE so many of us put on happy pills instead of HRT?

She’s the straight-talking expert on the menopause. Now, in a refreshingly honest new book, DR MARION GLUCK bemoans the uncaring way women are treated and asks...

MARION Gluck has been on the frontline of HRT medicine for more than 15 years — a self- described ‘pioneer and firebrand’ whose fierce advocacy of ‘bio-identical’ hormones has drawn critical flak and admiration in equal measure.

at 69, she still sees patients every day in the central london clinic she founded in 2007, the first in the uk to offer bio-identical HRT (BHRT).

‘I’m not retiring any time soon. I’m still interested in life and travel, and I still like men,’ she says, laughing. ‘My main mission is the same as it’s always been, which is to give women a fair chance and a choice about how to treat themselves.’

In some ways, mainstream medicine has embraced her early evangelism. In the often deeply confusing world of hormone therapies, bioidentical HRT consists of hormones sourced from plants (soya or the Mexican yam) processed so that they’re identical in molecular structure to the hormones produced naturally in our bodies. conventional or synthetic HRT, meanwhile — which Gluck unceremoniously calls ‘fake’ — is derived from other substances with different chemical structures. no longer viewed with the outright suspicion it first attracted, BHRT is increasingly available to women in some forms, although not always on the NHS.

Yet Gluck remains a controversial figure. Her method of compounding the hormones, or making a bespoke medicine for each patient at a cost of £1,000 or more, is still dismissed in some quarters

A lot of people are afraid to say what they want. That’s why they don’t get what they want

MADONNA

as a form of ‘alternative medicine’. The British menopause society, for example, says that compounded HRT isn’t regulated, doesn’t necessarily work and might even carry additional risks.

Gluck dismisses the critics as simply failing to understand her practice. ‘ The compounding element is basically old-fashioned pharmacy, the kind of work doctors used to do in the past.

‘everyone is unique, which is why off-the-shelf medicine has a different effect on everyone. especially hormones, which all women know are very powerful things. you have to be incredibly gentle when you’re prescribing hormones and it’s where experience really comes in.’

Her NEW book, It’s Not my Head, It’s my Hormones, provides not only a guide through the HRT thicket, but describes in typically outspoken fashion what she sees as a systemic, societal failure to take women’s hormonal health seriously.

Alongside Caroline Criado Perez’s Invisible Women and Gabrielle Jackson’s Pain And Prejudice, it’s a powerful contribution to the growing body of literature describing a gender bias in medicine.

‘Women’s hormones have always been regarded as a joke,’ she says. ‘Oh, she’s in a bad mood because it’s her time of the month, or look at her, she’s menopausal and impossible! We’ve been treated in such a derogatory way.’

The reality is anything but funny. ‘Over and over again I’ve seen women in midlife who feel sad and exhausted and with a low libido and they don’t understand what’s happening to them, and their doctors don’t understand it either, and they’re just not speaking the same language.

‘ Women get told they’re just getting older and to accept it, or they’re handed antidepressants. But hormones affect your brain function. When they’re balanced, they have a calming, normalising effect on you and when they’re not, you can feel like you’re out of control.

‘my message to women is that they’re not going crazy. you can’t help it. Nor can you help it if people around you don’t understand.’

Here, in an exclusive extract from her new book, she focuses her considerable firepower on doctors who dismiss the symptoms of anxious and overwhelmed midlife women . . .

WOMEN MISDIAGNOSED WITH DEPRESSION

A WOmAN’s risk of being diagnosed with depression is 14 times higher during perimenopause than at any other time of her life.

Let’s just pause to consider that statistic, published in The American Journal Of Psychiatry. Is it a coincidence? Clearly not.

In my experience, the perimenopause, that stage of a woman’s life at which her body begins to end its reproductive capacity, lasting anything from two to eight years, is the most challenging time for both patient and doctor. In their 40s and 50s, women’s lives are often exhausting and stressful. They are mothers, wives, daughters, professionals and workers. many fulfil all these roles and have the responsibility of satisfying multiple demands at once.

yet can it really be true that depressive illness and menopause go hand-in-hand so often?

It’s what the data appears to say. study after study claims to show that women are twice as likely to suffer from depression, anxiety and other mood disorders as men.

Women who complain of feeling low or irritable or tired in midlife are routinely prescribed antidepressants by their doctors.

Indeed, a similar message comes from no less a body than the World Health Organisation, which concludes that the ‘female gender is a significant predictor of being prescribed mood- altering psychotropic drugs’ and ‘depression is not only the most common women’s mental health problem, but is more persistent in women than men’.

This is quite an indictment, and certainly a handicap for women to carry with them on their journey to a healthy, fulfilled life. Why should being female mean that many of us may need to take mind-altering drugs, specifically antidepressants?

Being female is not a medical condition; perimenopause and menopause itself are not generally medical conditions, so why does being a midlife woman carry with it such an apparent blight on our mental wellbeing?

Could it be that we are missing something here? That what is being diagnosed as depression — and treated with anti-depressants — is not in fact a depressive illness but a hormonal imbalance that we are still all too often ignoring?

I was a child of the sixties, when women’s liberation was bursting onto the scene. Women and their wellbeing became my raison d’être. I wanted to empower women, through knowledge, to take responsibility for their own health.

And what seemed strange to me, and to young female doctors like me even then, was the number of midlife women who were being prescribed tranquillisers like valium or other benzodiazepines.

Back then, we were just starting to talk about women’s lives and bodies in new, more open ways and when we looked around we couldn’t help but wonder why on earth so many women in their 40s and 50s were apparently having ‘nervous breakdowns’ that required such heavy-duty drugs.

What has changed? In some ways, everything; in others, not much at all. Women in perimenopause still

Women’s hormones have always been regarded as a joke. We’ve been treated in such a derogatory way