This thread is evidence of how poor the available information is around this subject (edit - not because posters are ill-informed, I'm not saying that at all!) GPs seem to be largely out of step with what we hear in the media and you can produce any number of research studies and papers that prove one thing, and an equal number that appear to show the opposite. It's no wonder women are caught in the middle and confused, and are suffering because of it.
There's no doubt that menopause has been woefully neglected as an area of research in the past and that women were fobbed off and their very real symptoms dismissed. I think we're in something of a pendulum swing the other way now, which is great for the women who suffer really debilitating, life-restricting effects of peri-menopause and menopause. But I think a lot of us are getting caught up in a sort of trend, led by celebrities like Davina and capitalised by the likes of Louise Newson, where HRT is pushed as some sort of midlife wellness cure-all, rather than powerful medication, with significant side effects for some.
I got swept up in it during the pandemic when I'd just turned 50 and was going through a period of intense anxiety and insomnia, with associated brain fog and inability to do my job. I got a last minute cancellation at the Newson clinic the week before the first Davina programme went out (and was told if I didn't grab it I would have to wait over 6 months for another one as they were expecting to be swamped once the programme had aired.) I wanted to discuss my symptoms and options with an expert because I didn't feel I could do that with my GP during covid when they were so stretched. However, within the first five minutes of the Newson zoom consultation I'd been offered HRT, and the rest of the 15 minute appointment was spent on how and when to take it, dosage etc. At the end I was left wondering what had just happened, with a prescription for Oestrogel and Progesterone and a bill for over £400, all in.
I never took the medication. I realised that all my symptoms were a natural reaction to the strange circumstances we all found ourselves in back then, and because of my age and media messaging I had fallen for what appeared to be the obvious cause. I'm absolutely NOT saying that other women don't have real and horrible symptoms that can be hugely alleviated by the right HRT - I know it can be a genuine lifeline for many, many women, but I do believe that a lot of us are swayed by the narrative that the life stage in itself is something that needs medicating, rather than the difficult symptoms some women experience as a result of it. There is a certain 'glow up' narrative. The justifiably celebrated new awareness of menopause and HRT has a kind of 'what are you waiting for, join in and rediscover your youth!' kind of zeal that doesn't leave much room for nuance or individual alternative options.
I haven't ruled out taking it. I'm not anti-HRT at all, but I am interested in optimising my health through diet, exercise, stress-management and medical monitoring where appropriate (I intend to book a DEXA scan to check bone health in the next year or so.) I am beyond delighted that women's health and wellbeing is being taken more seriously at last, by medical professionals and the media, but I think we need much more well-balanced information about all aspects of peri-menopause (medical, social, political) so we are equipped to make our own choices. (Which I think is exactly what the OP is asking for!)
I found Tania Elfersy on the Magnificent Midlife podcast an interesting listen for an alternative perspective. Not a path suitable for everyone, but a counter-narrative that might be useful for some. (will post a link, not as an endorsement but for information on a different way of approaching menopause for OP and anyone else who is not sure HRT is right for them.)
https://magnificentmidlife.com/podcast/137-being-wiser-about-menopause-tania-elfersy/