Scottish Daily Mail
Stopping HRT plunged me back into the menopause. I wish I hadn’t taken it at all – I’d have coped with the symptoms better’ far in my 50s
suffer needlessly. ‘Most women don’t want to come off HRT because they feel great on it,’ she says.
‘And it’s not just about helping women feel great, it’s about making their bones strong, their brains and their hearts work better, because the longer we have low hormones in our bodies, the higher the risk of heart disease, osteoporosis, diabetes and dementia.
‘Women taking HRT are also less likely to go back and forth to their doctors and drain NHS resources, which is crucial at this time when resources are so limited.
‘Before starting HRT some of my patients have been at their GP surgeries most weeks with headaches, palpitations, urinary symptoms, joint pains, low mood. Often they get referred for investigations into these various symptoms, which all costs money and takes resources from the NHS.
‘Because menopause affects around half the population, that’s a heck of a lot of women who are just draining the NHS every single day, whose symptoms could be eased with HRT.’
And, according to Dr Newson, these afflictions can go on for far longer than many of us realise, flooding back as soon as we stop hormone replacement therapy, as they did with Jill.
‘Some symptoms can last a few years, others can last decades,’ says Dr Newson. ‘And symptoms change as well. Sometimes people start having hot flushes, then they get anxiety, then poor sleep, then muscle pains.’
And while GPs have got much better at identifying the menopause in midlife women, ‘a lot of the time older women don’t even recognise that their symptoms are due to low hormones.
‘They are often misdiagnosed with arthritis, fibromyalgia or chronic fatigue, and even sometimes long Covid’.
Dr Marion Gluck, one of Britain’s leading hormone experts, says she regularly sees women in their 70s, and a few in their 80s, at her London-based clinic. Some women come to her because they’ve tried to get HRT but ‘some NHS doctors don’t like prescribing HRT for more than five or ten years,’ says Dr Gluck.
‘The majority of women who come off HRT later in life will experience menopausal symptoms. This is not the menopause, but hormone withdrawal symptoms,’ she explains.
‘These could be anything from hot flushes, fatigue and depression to brain fog or just suddenly feeling very old. It’s very tough — like going from a full battery to a flat battery.
‘It’s really important that we talk more about this,’ says Dr Gluck. ‘If older women don’t understand that they’re going through menopausal symptoms when they come off HRT, this can lead to even greater anxiety.
‘If more women understood what they were going through, they’d worry far less.’
Rosemarie Webster, 82, from Windsor in Berkshire, went on HRT aged 35 following a full hysterectomy due to uterine cysts. After the removal of her womb, she would have inevitably experienced symptoms of a premature menopause, so happily took the oestrogen-only pills for the next 25 years, avoiding hot flushes, mood swings, energy dips and brain fog.
However, aged 60, Rosemarie was advised by a new GP that she needed to stop taking them.
The doctor suggested that she should have only been on them for five years, due to now largely discredited concerns about an increased risk of breast cancer. Within two days, all of Rosemarie’s unwanted symptoms came back.
‘I was having headaches and hot flushes and felt quite confused,’ says Rosemarie. ‘I kept forgetting things — including routes I’d taken in my car for years — and even questioned if I was fit to drive. It was awful and I knew it was because I’d suddenly lost all those lovely hormones that had helped me feel so good.
‘It was embarrassing having hot flushes in public in my 60s and would have been easier having them a decade earlier, at the same time as my contemporaries.
‘I struggled on with these symptoms for two years, but my doctor was adamant it was too risky for me to go back on HRT.’
Rosemarie, a retired lab technician, raised her four children alone, after divorcing in her 30s, and had always prided herself on her boundless energy. However, for two years after coming off HRT, it took huge effort just to get through the days.
Gradually, as her body adjusted to the lack of oestrogen, her vitality returned and, now in her 80s, she still drives long distances to visit family in Wales.
But she would rather have remained on HRT than come off it, she says. ‘I’m only sad that my GP back then didn’t know it would have been safe for me to stay on some form of hormone therapy indefinitely.’
For some women, like Rae Radford, 59, from Kent, it is a personal choice to come off HRT.
After being on it for six years, she decided to stop taking it in August, convinced it was the cause of her 2st weight gain, and hopeful that she had ‘come out the other side’ of the menopause and no longer needed it.
However, within a week, the hot sweats were back — and so were the rages.
‘I remember getting ready in my bedroom for a meal out with friends in September, and I felt a million dollars in my pale blue Phase Eight dress,’ recalls Rae.
‘By the time I got to the bottom of the stairs I was so drenched in sweat I looked like I’d walked through a running shower. I felt so sad and frustrated that I could have quite happily told my partner, Shaun — who hates being late for anything — to go without me.’
Four months after coming off the Elleste Duet tablets, which contain both oestrogen and progesterone — Rae decided to go back to a smaller dose of HRT.
She still suffers hot sweats, but now twice weekly rather than daily. The Vagifem pessaries she uses contain a small amount of oestrogen and reduce the vaginal dryness, burning and itching associated with menopause.
Dr Radhika Vohra, a GP and menopause expert, says it’s difficult to predict which women will find themselves coping with menopausal side-effects after coming off HRT in later life as some, who have never been on it, can continue experiencing symptoms for decades.
She agrees with Dr Newson that, providing they have annual health checks, most women can, and should, stay on HRT for life.
‘There’s no arbitrary cut-off of when to stop HRT,’ says Dr Vohra. ‘But it needs an evaluation or review, weighing up the risks and benefits to the individual woman.’
Part of the problem is the lack of open debate and discussion around those suffering from menopausal symptoms later in life.
‘I definitely think there are more people out there who will have had similar experiences but won’t want to discuss it,’ says Rosemarie.
‘I’ve been talking about this for years, and as a result I’ve had a few friends who’ve said they’d also had a similar experience when they were told to come off HRT by doctors.
‘After about a year, the hot flushes and night sweats started to come back. And they wished they’d kept taking it. But the fact is the menopause is definitely still a taboo in my generation.’
‘It’s very tough, like going from a full battery to a f lat battery’
‘I kept forgetting things, even questioning if I was fit to drive’ JILL SLATER