How many women on HRT

[ParisUSM]

Does anyone know the figures on how many women in the UK are presently on HRT? Just interested after reading comments about all well informed women being on HRT for life and realising that although I think it is a tiny minority, I don't really know the figures.

Menopause is not a natural part of life women are probably meant to be dead before it happens either through disease, childbirth or trauma
This is a common misconception which arises from not appreciating the differences between mean median and mode averages

It is a fact that evolution has designed human females to have reduced oestrogen levels post menopause.
That doesn't mean that there are no benefits to using HRT.
I would like to see more research into what factors predispose some women to having problems at menopause while others need no medical intervention

There is no overall misunderstanding about the difference in average life expectancy between (eg) the 1700s and the 21stC
Humans did most of their evolving pre agricultural Revolution, so as I said to get an idea of ancestor life expectancy we need to look at hunter-gatherers.

As to Your other point yes, modern lifestyles tend to mean that the timing of menopause is very unfortunate and of course woman need medical help if life is unmanageable.

I really like your post Fontella and totally agree with you. I too am tired of both extreme camps. Either you are considered a whimp for going on hrt because really, symptoms are manageable if you accept your situation or you are made not to go on hrt because it will resolve all your issues.

I've suffered from symptoms for 2 years now and yes, it correlates with me starting the perimenopause as confirmed by blood tests. My symptoms are neurological though, and although I also suffer from anxiety at time, very poor sleep, feeling low, I don't have night sweats, anger outburts, hot flashes or vaginal dryness, yet because most of my test have come back to say all is fine, everything is put down to it.

Because there's no point in being stubborn, I've accepted to try hrt. I'm now on week 6 and feel no better for it at all, if anything, I feel worse. Still I'm being patronised that I'm too impatient, that it takes some time to start working, and that even if there still no improvement in 3 months, it's probably because I'm not on the right one and I need to try another dose/brand.

Maybe the above is true, but maybe it's just not the menopause and maybe hrt will not be the miracle cure that everyone is telling me will if I'm patient enough.

I totally agree with your analogies that show how we are all different and it's not right to assume that what works for ourselves works for everyone else.

I was prepared to ditch the patch this week-end because I'm so tired of feeling like crap but then decided that if I do, I'll still be told that everything is down to the perimenopause and that I should have gave it longer, so I'll keep going. Of course, I'd love nothing more for it to work for me, I'd give anything to feel normal again.

Interesting discussion. Have to say, if menopause was a choice, I'd take it. Although perimenopause had been pretty bad (understatement)I can't wait for the freedom menopause will bring. No more periods, no more pmt, no worries about contraception, hopefully no more fibroid pain. Surely I'm not the only person?

I had a full hysterectomy so hit the menopause full on, was horrific, I couldn't manage the sleepiness nights and the restless legs - I tried the natural route first (in fact I supplement my hrt with them) and Found they took the edge off it but not enough. I still,take menopause and soy isoflavones plus 50mg patch (no ovaries)

I’m just in my third month of HRT and I love it. I’d put off having it as I only read the scaremongering stories from years ago. Then I read stuff on here and decided to give it a go even though I’m technically post menopause as nearly 3 years without a period.
I’ve had a tiny bit of bleeding but am told that is normal for the first 6 months but I can sleep now with no hot flushes and a lot less brain fog. Plus I have loads more energy and a reduced appetite so I’m loosing weight slowly.
Would never have ventured to take it if I hadn’t been on MN so thank you and particularly to @PollyPerky

I would like to see more research into what factors predispose some women to having problems at menopause while others need no medical intervention

Some of it exists already- family history/genetics.

Flushes, insomnia and sweats are 'nuisance value' at best and can destroy careers and relationships at worst.

Post menopause loss of estrogen creates an environment where diseases of old age can flourish, although lifestyle can offset and delay some of it to a degree.

Genetics
Bone density= small frame means a woman has less bone to start with. Lower body weight(under 9 stones) is classed as a risk factor.

CVD- family history/ predisposition.

Bowel cancer - family history

Dementia - family history

Ethnicity= Caucasian women have less collagen than black women for example, which affects their bone density and pelvic support.

Vaginal delivery= some women need/ benefit from HRT to help preserve pelvic support if they have mild or moderate prolapse.

HRT is part of modern medicine (like drugs, vaccines, etc) which can help women live more healthily in old age. In the past, it wasn't available and women put up and shut up. Some women have symptoms (flushes) forever.

The NHS doesn't offer preventative medicine except in terms of vaccination; its modus operandi is to mop up the damage once it's there.

Menopause exists because women have all the eggs they are ever going to produce in the womb. They do not constantly make new ones. Such a process is only going to work for a limited time. It starts to fall apart in our 30s when it starts to get harder to get pregnant, and by the 40s there are more dodgy eggs and follicles until the ovaries fail to respond to stimulation, more or less, although the ovaries can keep trying and mess some women about beyond the last period.

There is no evolutionary pressure to keep it going longer because by then, there are probably enough children surviving to keep your genes going.

I don't buy the grandmother theory - by 50, if you start being fertile enough to have children from 15, you could be a great grandmother. I expect women live longer than menopause because men live longer and it is not a trait that is carried on the sex chromosomes. Men have a more gradual decline in gamete production, and in hierarchical societies, could probably use them well into old age, if they survive long enough. Older men were probably more likely to have the resources to have more surviving children.

Men have a more gradual decline in gamete production, and in hierarchical societies, could probably use them well into old age, if they survive long enough. Older men were probably more likely to have the resources to have more surviving children.

Mick Jagger, Hugh Grant, and Rod Stewart come to mind.

Ah yes - plus ca change etc

'Interesting discussion. Have to say, if menopause was a choice, I'd take it. Although perimenopause had been pretty bad (understatement)I can't wait for the freedom menopause will bring. No more periods, no more pmt, no worries about contraception, hopefully no more fibroid pain. Surely I'm not the only person?'

No, you're not. I look forward to it and I'm one who never had problems with periods - always regular, not too many negative symptoms or pain, etc. I'm still peri, having regular periods at 47, although they are now very light (only 3 days long), and I can't get pregnant anyhow because age and DH had a vasectomy 8 years ago (did wonders for our sex life!), but I'm looking forward to the post-menopause stage. My surviving daughter is only 12 and just started her periods a couple of months ago and already whinging about what a drag they are. Ahhh, the menopause.

village shop - in a word - NO!!! HRT refers to systemic HRT ie oestrogen that is designed to be absorbed into your whole body's system and replace what is missing in all the different areas of the body where oestrogen exerts an effect. Vagifem is an oestrogen tablet put into the vagina and the amount it contains is absolutely minute. If you are post-menopausal and have been without oestrogen for some time there is an initial rise in estradiol levels, but again this is very small and once the vaginal tissues have plumped up - very little is absorbed. Dinna worry!

Interesting discussion. Have to say, if menopause was a choice, I'd take it. Although perimenopause had been pretty bad (understatement)I can't wait for the freedom menopause will bring. No more periods, no more pmt, no worries about contraception, hopefully no more fibroid pain. Surely I'm not the only person

ParisUSM

That's exactly how I feel - peri was hell, I won't deny it and it went on a fair few years, but now I'm out the other side I feel bloody marvellous. I see my 22 year old daughter suffering every month with her periods - the other day she mentioned her sore boobs, and I shuddered because every month I suffered agonies with breast pain - and I have big boobs. They'd be painful and swollen for two weeks out of every four - now there's none of that.

My moods are steady, my weight has stabilised, I am no longer governed by my hormones. I don't give a shit about a lot of things that used to upset me, make me worry - and I look and feel better than I have in years, as well as having a new found energy which I can't really explain, but I've just got more oomph these days. There is a real freedom that comes with being 'past it'. I am owning the crone!!

I never took HRT and I'm glad I didn't now, but that's just me and my experience. I'm not going to preach to anyone else what they should and shouldn't do. We have have such different lives, tolerances, demands ... etc. and women will do what they need to do for themselves.

Thanks for answering, Bellaciao. I wasn't worried, I just wondered if it was classified as HRT.

This does not differ very much from the pattern of life still seen in WEIRD countries; while they have made significant improvements in overall longevity over the past century, the quality of life in those additional years has not always kept pace

I have been puzzling and trying to find out what WEIRD countries were and also why I could not find reference to them, as I couldn't get access to the full paper (on Wiley) without payment, so I presumed one would need to read the full paper to find out. However I have now solved the conundrum as this last sentence in bold above (and the comment on Gurven and Kaplan's paper) comes from this website: www.rewild.com/in-depth/longevity.html

For those who were also wondering - (but didn't like to ask - or maybe I'm the only one who didn't know?) WEIRD countries are "Western, Educated, Industrialized, Rich, and Democratic".

Even though I haven't read their original paper, for me the most telling part of the analysis on the Rewild website was their last sentence reproduced by ohfortuna and which I have highlighted above, and in particular the very last phrase.

In view of the recent discussions I think that taking HRT around the time of menopause and beyond can (and increasingly does) play an important part (in addition to appropriate lifestyle changes) in bridging that gap referred to, and potentially improving quality of life for a longer period.

I would also posit - sometime long into the future (evolutionary timescale) - that if current trends in life expectancy continue, selection may operate to gradually increase the age of menopause to be closer to that of life expectancy than it is now (and the corollary the number of eggs in the ovaries maybe will also increase?) since there will be direct selection for these genes? Any evolutionary biologists out there?

Very interesting post Bella.
I'm not evolutionary biologist but I think the opposite, that our fertility will decline more in the future.
Some studies suggest that there has been a slight decline in human sperm in every year because of factors as toxins in food, stress etc. On the other hand POF and early menopause is a more common phenomenon than we tend to believe with a tendency to increase.
My thought is that in future we will cannot make babies and maybe IVF will be a common practice and that the menopause will be a phenomenon we can handle taking exogenous hormones earlier. Maybe menopause will not exist in the future...

Yes maybe - in the short term. I was thinking - in the absence of other evironmetal factors affecting fertility - in the broad much longer term ( ie hundreds and thousands of years or the same timescale it took to evolve anyway!). However, selection should still operate?

Yeah I can see your point!
I think that the so called biological clock continues to function more similarly to our ancestors and hasn’t evolved with social changes.
But we change our mind concerning fertility and reproduction, the role of genders, the way we perceive and handle menopause etc.
I guess that maybe we will have not so strict gender identities in the future and maybe our reproductive system will be influenced because of it as well.

www.ncbi.nlm.nih.gov/pmc/articles/PMC5137796/