HRT in the spotlight
LISA SALMON looks at hormone replacement therapy as stocks run low
STOCKS of hormone replacement therapy (HRT) medication are running low, and Health Secretary Sajid Javid has appointed Madelaine Mcternan as head of a new taskforce to tackle the problem.
The British Menopause Society (BMS, thebms.org.uk) says more than 75% of women, usually in their late 40s or early 50s, have menopausal symptoms, and an increasing number are taking HRT to help deal with it. Figures suggest HRT prescriptions in the UK have more than doubled in the last five years, but stocks are running low, with one hormone replacement gel manufacturer reporting supply problems.
As a result, many women are worried they may not be able to get their HRT, and might have to endure debilitating symptoms – including hot flushes, night sweats, sleep problems and mood swings.
The BMS expects the shortage to be a short-term issue, but if you’re struggling with a lack of medication – or menopause symptoms in general – speak to your GP for advice.
According to the NHS, HRT “replaces the hormones that a woman’s body no longer produces because of the menopause”.
The two main types are oestrogen and progesterone – medication tends to be split into combined HRT (taking both hormones) and oestrogen-only HRT, taken via tablets, skin patches, gels and implants.
Dr Louise Newson, founder of The Menopause Charity (themenopausecharity.org) and Newson Health Research and Education (newsonhealth.co.uk), says: “We’ve reached an extremely worrying point with regards to HRT supply in the UK, with thousands of women suffering unnecessarily, as they rely heavily on this to get by in their everyday life.”
Dr Paula Briggs, a consultant in sexual and reproductive health and chair elect of the BMS, says the HRT shortage “is undoubtedly causing problems”, but stresses women should be given information to make an informed decision about how they manage their menopause, and it doesn’t have to be with HRT.
So, what are the risks and benefits of HRT?
Benefits of HRT
“The main benefits of HRT are symptom control,” says Dr Briggs. “It’s the best way of controlling common menopausal symptoms like hot flushes, night sweats and difficulty sleeping.” She adds: “Longer-term treatment maintains bone mineral density, too. Osteoporitic fractures are a major cause of morbidity and ill health, so anything that reduces that risk is good – but it’s got to be in the right dose, and in the right patient.”
Dr Newson believes: “Taking HRT vastly improves your symptoms, and helps protect against long-term health risks or hormone deficiency.
“Even low levels of HRT can have benefits in your body and improve symptoms of the menopause.”
Risks of HRT
The NHS says the risks from taking HRT are very small – it depends on the type you take, how long you take it for and if you have any existing health conditions.
It says there’s little or no change in the risk of breast cancer if you take oestrogen-only HRT, and combined HRT can be associated with a small increase in the risk of breast cancer, related to how long you take
the medication for.
This risk falls after you stop taking it. Experts stress because of this increased risk, it’s especially important to attend all breast cancer screening appointments.
The NHS says there’s no increased risk of blood clots from HRT patches or gels, but a small increase from taking HRT tablets.
HRT doesn’t significantly raise the risk of cardiovascular disease (including heart disease and strokes), and when started before age 60 it may, reduce the danger.
“The main things are cancer and cardiovascular risk,” says Dr Briggs. “But for otherwise healthy women who are below the age of 60, the benefits outweigh the risks.”
She suggests hype around HRT supply problems is creating panic, saying: “Don’t panic, don’t use anybody else’s medication, and make contact with your GP about a reasonable alternative. The shortage should be resolved by June.”
WHEN it comes to feeling your best, Aljaz Skorjanec knows there’s nothing more important than good sleep.
“The first thing I did that really helped me change my sleep pattern for the better, was changing when and how I eat,” says the dancer, who leaves a good “couple of hours” between eating and going to bed.
And judging by Aljaz’s glowing energy while we chat something is working for him.
At the end of March, Aljaz announced that after nine years, he was leaving Strictly Come Dancing – and while “forever grateful” for the BBC show which made him a household name, he has “lots of exciting things planned”. We’ve already seen him release a cookbook with his sister Lara, filled with family-friendly recipes and memories from growing up in Slovenia.
Aljaz is currently touring the UK with his wife, Cuban-american presenter and fellow professional dancer Janette Manrara, in Remembering The Oscars, which runs until May 7.
The couple met in 2010, when Janette performed alongside the Strictly pros in live dance show Burn The Floor, and tied the knot in 2017.
Aljaz also recently started opening up about his experiences with psoriasis – the chronic skin condition that causes red, crusty patches, which can become painful and itchy. Experts believe it’s an autoimmune disorder, where someone’s own immune system attacks healthy cells.
It’s not contagious, but it does sometimes run in families.
“I was always aware psoriasis was in my family,” the 32-year-old recalls – but it wasn’t until he was 18 and had moved to Australia for his first job, that he started to get patches on his elbows and knees. “The good thing was, because I was in the Gold Coast, surfers’ paradise, I was able to go in the ocean and the salt water is really helpful, it calmed it down.”
After leaving Australia his psoriasis got worse. Aljaz remembers trying all sorts of treatments: “At one point I had about 50 creams from different countries. I was kind of testing what works best.
“When I started doing Strictly, my stress levels increased a bit – I’m not complaining, it was just significantly more responsibility that comes with the job – and that’s when my psoriasis started flaring up way more,” he adds. “It wasn’t just a couple of little patches, it started appearing more in different parts of my body, my arms, legs and my back.”
It wasn’t just a visual thing – the psoriasis was physically uncomfortable and sore, too. At this point, Aljaz started steroid treatments.
Eventually though, he found himself in a vicious cycle. While often effective in the short-term, longterm use of strong steroid treatments can be associated with side-effects, and some people report that it leaves them with worse skin problems. “Steroid cream works – but it got rid of it for a couple of days or weeks, then it came back with a vengeance, not just in that same spot, but the areas
around the affected area. So I was in this vicious cycle,” he explains.
“There was one year on Strictly – when he was partnered with Daisy Lowe in 2016 – when I could only pretty much wear turtlenecks, because my psoriasis was so bad.”
Deciding to speak up about his health battle on BBC1’S Morning Live 18 months ago proved a turning point. Aljaz was contacted by Medovie, a new skincare range producing creams and capsules targeting skin issues.
Now, his skin is in “the most manageable and best condition” it’s been for years – and breaking free from the “vicious cycle” has been a “massive relief”. He’s so pleased with the results, he’s now a brand ambassador. “I was never going to endorse something that I don’t believe works,” says Aljaz. “We all need different things to treat our problems, but for me, Medovie really worked.” Talking publicly about his psoriasis has also been an eyeopener.
“The response from people – how many people contacted me and sent me photos – touched me quite a bit. That’s when I decided I want to relate myself to something I truly believe in,” he explains. “Being a teenager and then in your 20s, especially how the world is – it’s all about your appearance, the way you look. And on television and the dance industry, it’s all about expressing yourself through your body. And then if your body is covered in psoriasis... It was tough. It was hard on my mental health, and I was really self-conscious.
“I feel I’m very much at peace with who I am and what I look like, but when you’re growing up, and God forbid you’re in an environment where people think they’re going to get it if they touch you.
“I’ve gone through so many moments like that and it’s not pleasant. I feel for everybody that ever has to go through it.” Managing psoriasis is about overall lifestyle too, with Aljaz avoiding his individual triggers and taking steps to de-stress.
He also avoids too much of certain foods after discovering he was intolerant, including dairy – “and the worst thing for my skin is spicy chilli, then grapes” – and uses a UV light machine for a few minutes a day while at home. “And what really works for me as well, is those bags of Dead Sea salt, or non-fragranced bath salt,” he adds.
He says he likes to switch off watching movies and TV with Janette whenever they can. “We’ve always had that outlet,” he says. “And we go for a walk or just go into nature. Where I grew up in Slovenia was so beautiful, so I missed that tremendously living in a big city like London.
“But you need to find your roots again, even if that’s five minutes standing outside on your balcony or in your garden,” says Aljaz. “Just to give yourself a little peace.”
There was one year on Strictly when I could only pretty much wear turtlenecks because my psoriasis was so bad
Always consult your doctor before making any changes to your skincare or treatment regime