Menopause should be treated before it ‘reshapes brain’, say experts

NHS ‘regionalisation’ is preventing distribution of drugs, says MP as she calls for a nationwide solution

‘Menopause is like a renovation project on the brain, restructuring, rewiring’

MENOPAUSE “reshapes the brain”, researchers have found, as they called for “protective” HRT to be prescribed to women earlier, before changes become irreversible.

Women experience a sharp decline in oestrogen during the menopause, which can cause symptoms including hot flushes, brain fog and mood changes. But academics at Weill Cornell Medical College, New York, and the University of Arizona found the transition also has a significant impact on the brain, including a reduction in grey matter and changes in blood flow. Dr

Roberta Diaz Brinton, the co-author of the study published in Nature Scientific Reports, said taking HRT as soon as menopause symptoms start could have significant protective benefits.

The findings are set to be highlighted in a documentary presented by Davina Mccall, which will be broadcast tonight on Channel 4.

It comes after HRT was subject to emergency rationing in the UK owing to supply shortages. Prescriptions of key products, including Oestrogel manufactured by Besins Healthcare Ltd, have been limited to three months.

The Daily Telegraph previously revealed women were turning to the “black market” to secure their medication, including swapping bottles or paying significantly higher prices online.

Sajid Javid, the Health Secretary, has appointed an HRT tsar, Madeleine Mcternan, the head of the vaccines taskforce, to resolve the issues.

On Thursday, Mr Javid and Ms Mcternan will meet manufacturers to discuss the shortages.

Some drug companies have argued that if NHS red tape is cut to allow substitute HRT medications to be offered across the country, then shortages could be eased within days.

Mccall said perimenopausal brain fog left her unable to read autocues or remember celebrities’ names, but she hid her symptoms because she was “so full of shame”. But she said the latest research shows “just how much our brain changes during menopause”, adding: “Perhaps it’s time we’re given a little more understanding.”

Dr Brinton told the documentary: “Menopause is like a renovation project on the brain, restructuring, rewiring … the idea that we can just suck it up is actually deleterious to women’s longterm health.” Women are still being turned away when seeking HRT from their GP as they are incorrectly told they cannot start treatment until they’ve gone a year without a period, Mccall said.

But delaying treatment could be detrimental, the researchers said.

“The use of oestrogen and hormone therapy at the time of menopausal symptoms [is key], not 10 [or] 15 years later, the brain has already changed and it’s no longer going to respond to oestrogen therapy,” Dr Brinton explained.

The US researchers analysed brain scans of 161 women aged between 40 and 65, compared with 125 men of the same age.

Hot flushes are explained by the changes to the hypothalamus, which regulates body temperature and is very sensitive to the temperature changes, Dr Lisa Mosconi, the study’s co-author, said.

“Oestrogen also plays a big role in regulating energy levels in brain activity, so if oestrogen is not regulating or activating those regions correctly, the brain fog makes a lot of sense,” she said.

The results also found some of the changes to the brain resolved or partly stablised post-menopause, with recovery associated with an increased cognitive performance.

AN HRT substitute could be available across the country within days if the Health Secretary cuts NHS red tape, an MP has said.

Shortages of hormone replacement therapy products have forced menopausal women to share supplies, buy privately or go without.

Sajid Javid, the Health Secretary, will meet drug manufacturers on Thursday to try to fix the shortages. He will be joined by Madeleine Mcternan, head of the vaccines taskforce, who was appointed as the head of the newly formed HRT Supply Taskforce last week.

Carolyn Harris, Labour MP for Swansea East, who has campaigned for better access to the drugs, said “women can’t wait any longer”, and called for a national HRT formulary to allow all doctors and chemists to prescribe whichever products are available.

NHS formularies are lists of medicines approved for prescription at a local level, but the postcode lottery system means some HRT products are not available to all women.

The shortages come as research, highlighted in Davina Mccall’s new Channel 4 menopause documentary, found the brain is “reshaped” by the menopause and starting HRT earlier could protect it from long-term damage.

Theramex, which manufactures Bijuve – a substitute for Oestrogel, which is facing significant shortages – said it has ample supply to meet the demand, but NHS bureaucracy means it is only available in three areas of the country.

About 150 NHS hospital trusts and 130 NHS clinical commissioning groups have yet to approve Bijuve on their formularies, and only women in Somerset, Norfolk and Oxford can access it.

Tina Backhouse, UK country manager of women’s health at Theramex, told The

the supply shortages could be eased in days if the firm’s product was added to all formularies.

The firm increased its production a year ago in response to increasing demand and has “very good stocks”, she said. “It really could be a quick win. Frankly, this red-tape nightmare could be solved by the end of the week.”

Prescriptions for HRT have more than doubled in England over the past five years, according to NHS data. Figures from Openprescribing suggest nearly 538,000 prescriptions for HRT treatment were issued in December, compared with 238,000 in January 2017.

“It would be better for there to be a national formulary, with experts giving recommendations on what should be on the list. That would cut out the local bureaucracy,” Ms Backhouse said.

Echoing her calls, Ms Harris said the “regionalisation” of the NHS meant there is no central list.

“Allowing this product to go through on a national formulary, so that all doctors and chemists knew it was available,

‘Allowing this product to go on a national list so all GPS knew it was available would make life easier for women’

would make life a lot easier for the women currently struggling,” she said.

It comes as research shows that 10 per cent of women left their job because of their menopause symptoms.

The survey of 4,000 women aged 45 to 55 – which will feature on Mccall’s Channel 4 documentary Sex, Mind And The Menopause, a follow-up to her 2021 programme Sex, Myths and the Menopause – also found 14 per cent had cut their work hours, 14 per cent had gone part-time, and 8 per cent had not applied for promotion.

Just 39 per cent of women who spoke to a GP or nurse said they had been offered HRT once they were diagnosed with menopause.

A Department of Health spokesman said: “The Health Secretary has been clear he will leave no stone unturned to ensure women can get the HRT they need.”