Don’t sweat it
HRT stocks are running low but Lisa Salmon learns there are alternatives that could help women through menopause
HORMONE replacement therapy has long been a source of relief to women going through the menopause. But with demand doubling in the last five years, stocks are running low.
That is causing anxiety for thousands of people who count on HRT to keep hot flushes, night sweats, sleep problems and mood swings under control.
The British Menopause Society (thebms.org.uk) says more than 75 per cent 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.
One manufacturer of a commonly used hormone replacement gel has reported supply problems. The BMS expects the shortage to be shortterm, but if you’re struggling with a lack of medication, 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.
There are various ways to take HRT, including 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, with thousands of women suffering unnecessarily, as they rely heavily on this to get by in their everyday life.”
Dr Paula Briggs, right, a consultant in sexual and reproductive health and, says the HRT shortage “is undoubtedly causing problems”, but stresses women should be given the right information about how they manage their menopause, and it doesn’t have to be with HRT.
She explains: “HRT replaces the hormone women’s ovaries are no longer producing regularly or reliably, so it tends to be the most effective way of managing the menopause transition. But there are other ways of doing that – whether that’s with lifestyle changes or using prescribable alternatives, some of which are antidepressants. It depends on the woman’s background, and medical and family history.” So, what are the risks and
benefits of HRT?
Benefits
“The main benefits of HRT are symptom control,” says Dr Briggs. “It’s the best way of controlling hot flushes, night sweats and difficulty sleeping. “Longer-term treatment maintains bone mineral density, too. Osteoporitic fractures are a major cause of ill health, so anything that reduces that risk is good – but it’s got to be in the right dose, in the right patient.” Dr Newson says: “Taking HRT vastly improves your symptoms, and helps protect against longterm health risks or hormone deficiency. Even low levels of HRT can have benefits in your body and improve symptoms of the menopause.”
Risks
The NHS 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 it’s started before the age of 60 it may, in fact, reduce the danger.
“The main things are cancer and cardiovascular risk,” says Dr Briggs.
“But for otherwise healthy women below the age of 60, the benefits outweigh the risks.”