Anyone watching Davina: sex, mind and menopauseon c4

[Meltinthemiddle]

Really interesting and relatable.

but I can’t figure out whether for women like me, whether I should be demanding hrt. It would be purely because I’m 50, rather than any signs or symptoms of menopause yet.

You clearly don't need it. Yet- at any rate. You may not feel so good in 5 years - who knows?! Lots of women aren't post menopause till 53-55.

I think the whole Davina thing has overblown the issues in some ways.

On the one hand, only around 15% women use HRT. Clearly, when 75% have symptoms- some severe- more ought to think about using it especially if they are struggling to work full time or in demanding jobs.

The basis of the NICE guidance is to make it individual. (This is in the guidance.)

The first step is to use lifestyle measures- diet especially, exercise, stress-reduction, and getting as fit as possible.

If this doesn't help, then HRT is an option.

There's also the issue of family history and predisposition to illnesses in old age.

So someone with only minor meno symptoms might have a high risk of osteoporosis (family history, small frame, normal low weight, history of some medications, etc.)

Or the same for early heart disease (family history.)

A good dr will look at your whole health and how HRT may be used not just for meno symptoms but also to reduce risk of long term illness.

This is the issue. Yes it probably is worth taking to protect against all sorts of issues. But there is a lack of research. Maybe because big pharma like us getting ill?! Taking statins and other treatments. Who knows?

The NHS could provide hrt as a preventative for those with family history of osteo, dementia etc. We might need a new government for that. But The Lancet has just had articles calling for exactly this - more research 👏

The NHS could provide hrt as a preventative for those with family history of osteo, dementia etc.

it makes sense if there is cost effectiveness

But does anywhere use it as preventative treatment?

So in summary there is no research whether it’s of any use as a preventative, and should be given to everyone. So the answer is don’t know.

presumably the difficulty with a blanket rec is how do you know when menopause will be. It would require blood tests from a certain age?

and that isn’t going to happen until studies show that blanket hrt prevents significant health issues in most or all women.

God I'd love it if my new(ish) GP took a history, but she never asks any questions about me or my family history. Just says, 'No'. And I say, 'Yes, actually, because NICE guidelines and I HAD MY OVARIES REMOVED AND MY CONSULTANT WROTE TO YOU'. Fuck's sake.

Are you only talking about HRT and dementia @Reallyreallyborednow ?

There is a lot of evidence that HRT helps bone density (it is licensed for the treatment or prevention of osteoporosis in women under 60) and it is also known to be of benefit to the heart if taken within 10 years of the last period. If is any later, it still have benefits to the skeleton, but the positive effects on the heart and arteries is lost as the arteriosclerosis that has already happened is not reversed by HRT. Studies show that women on HRT have as much as 50% less arterial plaque.

and that isn’t going to happen until studies show that blanket hrt prevents significant health issues in most or all women.

There is also a lot of evidence that women on HRT live longer and have a better quality of life.

That's not the same as saying all women should or must use HRT. It's a personal risk v benefits situation. Every woman has to make up her own mind.

I don't have time to link to all of this but if you put the words into google, and also use British Menopause Society and International Menopause Society, you should find all the info. 🙂

sounds like there isn’t enough evidence in the UK. There clearly is growing evidence elsewhere.

Newgirls where are you thinking when you say this?

Are you only talking about HRT and dementia

no, i’m saying there doesn’t appear to be any evidence to back up giving hrt to asymptomatic women in good health with no risk factors, who are approaching or in menopause.

presumably so far all studies have been done in women who need hrt because of existing issues.

my question is, is there any evidence someone like me, age 50, no menopause symptoms, good bone density and overall health, should be given hrt in order to prevent future issues. Presumably with a blood test first to see if actually menopausal, although 50+ you’d assume so.

hrt is being promoted as some amazing cure all for menopausal women. Like you say bone density, dementia, heart health etc. so naturally I am thinking if it’s that great, Should I be taking it to prevent those future problems, or is there no/little benefit if you’re fit and healthy?

@Reallyreallyborednow The only way you will know is to a) have a DEXA scan for your bones now and in 3 years' time and b) have things like your blood pressure and cholesterol checked.

You'd have to pay for the DEXA scan as they NHS won't provide as 'prevention', which is pretty scandalous IMO considering the figures on osteo.

The other answer is that you'd be very lucky to find any GP giving your HRT as a preventative drug, so it's all theoretical anyway!

You ask how do you know you are post menopausal at 50. Have your periods stopped? I wasn't post menopausal at 50.

Also, how do you know your bone density- have you had a scan?

The other answer is that you'd be very lucky to find any GP giving your HRT as a preventative drug, so it's all theoretical anyway!

well yes 😂.

bp fine, on the low side if anything. Cholesterol healthy.

bone density, no scan, but lift weights, cycle commute, no familial osteporosis.

not post menopausal no, like I said i am only assuming I am approaching menopause because of my age. Periods still regular and no other indications or symptoms.

I got the impression hrt is effective for women going through menopause, not necessarily completely post menopausal.

so if one day my periods just stop and I feel fine still, do I or don’t I need HRT if it has such major benefits?

@Reallyreallyborednow Cycling doesn't help bones. It's not weight bearing. (I was diagnosed with severe osteopenia before I was post menopausal. No risk factors.)

1:2 women get osteoporosis.

HRT is for women in peri and post meno. I had very few symptoms in peri. Nothing, really. I started HRT about 4 months after a final period, in my early 50s.
That's when the flushes (hourly) and insomnia began.

Everyone is different.

so if one day my periods just stop and I feel fine still, do I or don’t I need HRT if it has such major benefits?

Your decision and a dr willing to go along with that!

without symptoms, you'd need to find a dr willing to give you HRT. Some will. Specialists would, on the whole. One is on record as saying this on the Liz Earle Wellbeing site, under HRT interview.

Most GPs won't.

It's up to you to decide if you want to go down that route. But be aware that some signs of menopause only appear several years afterwards.

I have queries about vaginal atrophy though. Does it happen to all women? Or some earlier than others?

Could hrt protect against that if other symptoms aren't felt?

There is loads online about this including the website of Dr Louise Newson - called Balance. (You can use topical estrogen- it's not HRT.)

So I chased up my GP surgery about the waiting list for the Mirena coil and I’m getting it fitted next Friday. One thing the GP said to me which confused me a bit was that as I’m already on the combined pill that would have “had the same effect” as HRT so I probably won’t see many benefits to my symptoms if I start taking oestrogen on top of the coil?

Thanks for asking @Sitdownifyoulike It's been 6 weeks since I had the coil fitted and I feel pretty good, not noticing the same peri symptoms I was getting before though there were a few days a couple of weeks ago where my skin was utterly awful! I haven't started on HRT yet as I agreed with my GP to give the coil a bit of time and see if it helped on its own. It does seem to be helping right now so I am monitoring things to see how they go, but if the symptoms do return I will be banging down the door for oestrogen!

My HRT is absolutely brilliant. Felt much better after three days using the gel. Sleeping well, no flashes, anxiety and that creeping sense of dread is gone, can think and remember, I'm energetic, positive and chipper about life.

I use oestrodose gel and micronised progesterone vaginally. I have a short bleed every month, and a endometrium scan every two years, as well as a mammogram every three.

im 54 this year and still feel young, still married... so many of my friends aren’t on HRT and have separated, or seem to have a lot of unsolved arguments. IMO they have poorer mental health - feelings of anxiety and feeling that nothing is right. They take herbs, watch their diet etc instead.

hormonal insufficiency seems to affect so many areas in life, it’s fantastic to talk about it.

i agree that it should be taught in schools, and Obs and gynaes should talk about when you’re having a baby. It would be so helpful if men also were included, as menopause can feel like a very lonely place.

I’m sad for some of my well meaning friends who are dead set against HRT and struggle on with homeopathic remedies and herbs because they’re Embarrassed, wrongly scared of cancer, or their GPs are useless.
I do try to convince them, but they believe the old media stories and disinformation from the 90s.

davinas show is relatable, so hopefully women will watch it and get themselves on HRT!