A few months ago I was invited by a large group GP practice to participate in a lecture evening to the public on the menopause.
The topics were varied and included a talk by a physiotherapist on the pelvic floor, a talk by a psychologist on moods, a G.P. talk on bones and my talk on the physiology of menopause and HRT.
It was a hugely successful meeting with about 50 women all keen to learn about “The change of life”. My talk was medical and I discussed in detail the pros and cons of HRT.
HRT has almost come full circle. In the past, everybody was on it and the HRT industry thrived.
Then all the negative facets of the medication started coming out and everybody stopped using it. We saw many women really suffering with incapacitating hot flushes, mood changes, sexual dysfunction and genital prolapse. In fact, we predicted an enormous increase in prolapse which has happened. Today the ‘Prolapse industry” is huge with research into different operations and different mesh usage receiving millions of dollars in funding.
People are now talking again about the positives of HRT. I get daily requests from women for information regarding HRT. They are sick of feeling the way they do and are prepared to take the risks.
When we prescribe any medication we always ask ourselves the following questions.
- Is it indicated?
- Are there any contraindications to the use of the particular medication?
- What are the side effects of this medication?
- What is the cost and is there a cheaper alternative.
- Would there be compliance?
- How long would one need the medication?
- Does the person understand the risks of the medication?
I really believe there is a definite place for HRT.
Take, for example, Mrs. X. She is 53, has a busy life with work (many meetings a day), has 3 demanding teenage kids, and a husband who “does not quite get it”. She has about 10 hot flushes a day often quite embarrassing At night she is woken at least 3 times with flushing. She is sleep deprived and exhausted.
Her memory is not what it used to be and her employer is starting to be unhappy with her performance. She is moody and often feels down. Her personal life with her husband is almost nonexistent. When they do get together it is dry, uncomfortable and she is so tired that she can’t wait for it to be over so she can try and get some rest. She has had a few thrush infections and recently had a bout of cystitis that she has not had since she was in her twenties.
Does this sound familiar. Yes, it is an extreme case but still many of you reading this may have similar but less severe symptoms. Mrs. X would benefit greatly and very dramatically with HRT. She has no contraindications. She would need to be on it for about 3 to 5 years and then see how she does off it.
If you are in any way unhappy about your menopausal symptoms, discuss it with your doctor and explore with the doctor the possibility of HRT.
Of course, it is not for everybody but it may be for you. What was interesting about our talk was the question time. I heard a number of really unhappy and suffering women. A number of them have started HRT and they and function so much better.