Jenni Should I go back on HRT at 71 to ward off dementia? Murray

FOR so many years I’ve been afraid of HRT and have often cautioned others about taking great care before going on it. I was sitting in front of my breast cancer consultant in 2006 when I heard the words, ‘Are you taking HRT?’

‘Yes,’ I replied, ‘I’ve been taking it for ten years. I was 46 and perimenopausal when I began.’

‘Stop it,’ he said immediately. ‘Your cancer is an oestrogen receptor so it’s not safe for you to take it.’

I’m now 71 and have been reading everything about the research described in Davina McCall’s latest documentary: Sex, Mind And The Menopause that aired on Channel 4 earlier this week.

Most interesting was the link that’s been found between HRT and the prevention of the conditions that frighten my age group most: Alzheimer’s, dementia and other neurodegenerative diseases such as Parkinson’s.

Research carried out in America showed that women who took HRT for six years or more were 79 per cent less likely to develop

Alzheimer’s and 77 per cent less likely to develop dementia, multiple sclerosis and Parkinson’s — the disease which destroyed the last few years of my mother’s life and caused her death at the age of 80.

Right, I thought, maybe it’s not too late for me to return to the drug that had stopped the hot flushes, made my skin look fresh and healthy, my hair thick and shiny and had me bouncing with endless energy.

I was not, of course, going to insist on a prescription without research of my own. Studies such as the one above, carried out on almost 400,000 US women, cannot be completely trustworthy. Maybe the women who’d been able to afford HRT on the costly American health service had been well off, well-fed and healthy.

EQUALLY, I’ve never been entirely trusting of research programmes such as those carried out in New York and Arizona which argued that the menopausal brain could be better protected if HRT were prescribed earlier than is common practice. I would want to know exactly who had funded the research. Could the drug companies have been involved, seeing huge profits to be made if every woman went mad for HRT?

First, I spoke to the Mail’s brilliant GP columnist Dr Martin Scurr, whose experience has made him rather keen on HRT as he’s seen the improvements in the lives of many of his patients. He saw no reason why a woman in her 70s should be denied the medication and reminded me that Barbara Cartland had done extremely well on it up to her death at the age of 98. Age he felt should be no barrier, but…breast cancer? Given it’s 16 years since my mastectomy with no recurrence, he thought it might be safe, but I should speak to my own doctor first.

My own GP was not available (surprise, surprise!) so I contacted the gynaecologist and founder of Menopause Matters, Heather Currie. Her analysis was that starting HRT early may be beneficial in relation to Alzheimer’s, but the evidence is not strong enough to recommend taking HRT just for this reason.

‘The indications for taking HRT remain the same as before… symptoms due to early menopause or premature ovarian insufficiency or for treatment or prevention of osteoporosis. In addition, it is still controversial to take HRT after breast cancer,’ she told me.

Third, I called Professor Nigel Bundred, the surgeon who had nursed me through my diagnosis, mastectomy and subsequent treatment of breast cancer. His view was I should stay away from oestrogen-only HRT because I still had my uterus. Even though I had been free of breast cancer for years, there was a significant risk of endometrial cancer.

Patches of combined HRT might be OK, but still carried risk. He did not encourage me to take the easy way out and protect my brain by popping a pill or a patch.

‘If I remember rightly,’ he said, ‘there is absolutely nothing wrong with your brain and the best way for you to fight off Alzheimer’s is to carry on as you are.

‘Keep the weight down, avoid too much red meat, try fasting on a low-calorie diet from time to time and make sure you exercise. Most importantly, keep the brain active. Use it, don’t lose it.

There’s nothing against older women taking HRT, but not if breast cancer has been in the picture. No point in going through all that again.’

He’s right. Maybe having taken HRT for ten years before the cancer, I gave my brain a chance to be protected, but dismissing the risk of the drug being connected with breast cancer is ridiculous and potentially dangerous.

There’s no doubt there should be no age limit on prescription of HRT. Baby boomers who feel they would benefit should argue their case with their doctor.

But, please, think about it carefully. A mastectomy is no fun at all. So, that’s me taking good, old-fashioned doctor’s advice: diet, exercise and keep the brain in gear. Fingers crossed.