HRT helps so many, but I regret having it

TWeNTy years ago, at the age of 51, I published a book called Is It Me Or Is It Hot In Here? — a modern woman’s guide to the menopause. I’d been shocked as I went through the heavy bleeding, low mood and hot flushes of the perimenopause — the phase that leads to the end of menstruation when you become truly menopausal — at how much of a taboo the subject was and how little balanced information about the stage of life every woman will go through existed.

My aim was to explain what the menopause was and what our choices were in trying to deal with its worst excesses. I researched hormone replacement therapy (HRT), herbal alternatives, diet and exercise and the consequences of simply enduring it. I like to think I contributed to making the subject less of a taboo. It’s encouraging that it’s now talked about openly and some employers are making an effort to be helpful.

The key cutters Timpson are offering to pay for HRT prescriptions for employees and the online clothing firm Asos will make paid leave and flexible work available.

The first books I remember on the menopause were Wendy Cooper’s No Change and the gynaecologist Robert Wilson’s Feminine Forever. Both were very keen on HRT. Wendy’s was written from her own experience and informed my mother, whose menopause was horrific, that her GP might be persuaded to prescribe it. He did and she sailed through, staying on it into her early 70s.

ONly one problem. When she stopped, as evidence of a link with breast cancer was revealed, she had horrible menopausal symptoms for months. No fun at all in your eighth decade.

I hated Wilson’s book as he was so rude about menopausal women. ‘I have seen untreated women who have shrivelled into caricatures of their former selves,’ he wrote. Nevertheless, I suspect lots of us were seduced by his name and took HRT, ‘The youth Pill’.

I know I and several of my friends couldn’t wait to get on it, convinced the oestrogen we were replacing would give us beautiful skin and glorious hair. When I asked my GP for a blood test to confirm I was perimenopausal, she looked at the result and said: ‘Do you want pills or patches?’

I tried both. I stopped the patches when they repeatedly came off at night and stuck to my husband, but I continued with the combined oestrogen and progestogen pills for ten years, setting aside concerns about breast cancer because I felt so great.

Then, in 2006, came the first sign of the cancer, an inverted nipple. My oncologist asked immediately if I was taking HRT. I was. ‘Stop it. Now,’ he said. Mine was an oestrogen receptor cancer, he told me.

‘What’s the point,’ he said, ‘of replacing the oestrogen your body is getting rid of when it’s feeding your cancer cells?’ I know it helps millions, but five of the friends who’d loved HRT as much as I had were similarly diagnosed over the next couple of years.

The link between HRT and breast cancer has been downplayed, then emphasised so many times since I had those experiences all those years ago.

Maybe the quality of the medication has improved since I was in my 40s. Maybe there’s more knowledge about who might be most at risk, but it seems to me we still don’t know for sure what the link between HRT and breast cancer is. And it’s high time women did know for sure.

I would have preferred the hot flushes and feeling fed up for a bit to the fear of cancer spreading and the mutilation of my breast. No contest.