I’m on HRT. I had some limited symptoms and decided I’d like to get rid of them. An added advantage for me was the long term benefits for bone health etc.
If I’d had zero symptoms, I dont think I’d have gone on it purely for the long term benefits.
It might well be that in the future it is standard practice for GPs to advise 45+ to go on HRT because the long term benefits become better understood, as well as the cost savings in the long term for the NHS. I suppose it might be viewed rather in the way we do vaccinations - not necessarily delivering a short term advantage or even to all, but very much as a preventative long term strategy.
I don’t feel we are there yet with HRT. Most people feel they only want to regularly take something that requires a prescription if they need it and have a short term problem. The drug/whatever it is seems serious if it’s not available over the counter and requires a prescription. Most people prefer to limit what they take to the absolutely necessary, and if they don’t have a short term need, it’s much harder for people to get their heads round the long term benefit, especially if there are also some risks associated with the product.
So this is a headspace thing and in my view, it’s a marketing and provision issue for government to get their heads round.
If the medical establishment is at a point of thinking that the risks of HRT are low enough and the benefits of HRT in the long term, that the vast majority of women should be on it as a matter of course from middle age, they need a HUGE campaign to get the message across. It needs to be available in the same way you’d get vitamins or something that needs to be easy access, rather than in a way which suggests it is a medicine or needs extremely careful management.
The thing is, the jury is still out in aspects of it and it’s not totally straightforward. There are some risks, albeit low. It isn’t suitable for all women. Although there are long term proven benefits, these have to be weighed against possible risks and it be considered if for women with zero or very low menopausal symptoms, if those benefits only seen into the long term, outweigh the possible risks. It’s tricky and not straightforward.
I think for these reasons it needs to remain as it is. It does need to be prescribed and not over the counter, because each woman is different. Some shouldn’t have it. Some have risk factors which mean certain types and very much better for them. It needs review so that the fact women respond differently can be considered in terms of long term administration.
Probably what is needed is the following and what’s been campaigned for over a period of time;
- more training for GPs so they understand the risks to certain women, the benefits available from it and the different types with the +/- of each.
- An opportunity for all women to have a health review at a certain key point (flexible to reflect women hit peri at different stages) where symptoms of peri and menopause are explained, each women’s health discussed and pros and cons of HRT covered, with literature given and a chance for women to return when they’ve given it thought or when it seems relevant to them and their bodies.
I think it’s all about information gaps. GPs have information gaps and lots of women do too. I’d never known anything about menopause until my late 40s and the GPs I’ve spoken to know some stuff but have lots of gaps. I know more now than them when I go on a call because I’ve plugged my information gap with lots of reading. However, they retain the medical knowledge I lack…of course.
In the end, every woman needs to make a decision for herself. It will always be based on incomplete and imperfect information. However, given more and better information, women are more able to make that choice and to feel more in control of it. The problem currently is that there isn’t enough information and lots of women don’t know anything about it all and will remain in the dark.
When we faced AIDS in the 1980s a massive information campaign helped plug the gaps and make a real difference. This isn’t the same of course, but information is power. More research is needed and more messaging is needed so informed choices can be made.