Do nothing at Menopause?

[maclen]

I believe I'm perimenopausal and I just wondered what happens if you literally do nothing about the menopause? Is it safe? You see some horror stories and it's giving me anxiety (which is probably peri anyway lol)...

Well, it's what millions of women across the world do. Though not sure what you mean by safe.

This is a time of changing hormones and how this affects each one of us is different. You may find symptoms are manageable, or you may find them extreme and as such require help. I don't think it's unsafe as such. What have you heard?

We haven't always had medication to help. I don't know why our bodies doing what they do would be unsafe. Difficult yes.

It's more about balancing risks than about whether one choice is safe and one is dangerous, I would have thought.
I preferred HRT because the anxiety was so bad, I worried about bone density, I didn't want vaginal atrophy, the heart health stuff concerns me, dementia risk etc.
But it means you need to remember to take medication, it can have side affects etc.

If you do nothing, you might feel OK and you might suffer. But you can always take hrt later, up to age 60 I think.

It's entirely up to you. We're all different, some women do go through the whole process without any issues at all and that works for them. All I'd say is that you should be aware of the possibilities of what could happen and be open to the idea of seeing your GP if it gets to the stage you're not managing.

I think it's important to remember that menopause experience is a spectrum, from a breeze to horrific. (Much like periods or childbirth.) Don't assume it'll be horrific but be aware that it can be and what you can do about it.

I had other problems so have had a mirena coil fitted at 54 (still having periods). I was already on HRT as experiencing some brain fog. No other menopausal symptoms. Assume I'm menopausal now (two years later) but don't know due to coil.

I didn’t do anything, but partly because I didn’t need to. It wasn’t a big “change” for me.

I didn't do anything at all other than eat well and take plenty of exercise. I was absolutely fine. The grumpies were nothing to write home about and I just decided to let my body get on with it. Many years later I'm still fit, happy and healthy. I was very lucky but because of my epilepsy and a meds clash I was told I couldn't (then) have HRT anyway so I had little choice.

There are many women in my friends and family circle who haven't done anything and are perfectly fine. Not everyone needs HRT.
It's a good idea to eat well and exercise, but that is good at any time of your life.

I have totally ignored mine. Yes, a few hot flushes but nothing to worry about. Women all over the world, if they have been fortune enough to live that long, have done the same.

I have no idea if is relevant but I keep my weight at 8.5 stone, eat a mostly raw vegan diet, and do daily outdoor exercise. For another reason I had my bone strength tested and all is good.

There is nothing wrong in getting help if you need it though. Friends of mine have benefited from hrt.

It's not just about taking HRT to relieve the symptoms but it guards against osteoporosis as well.

In the Davina McCall program about menopause, it said all women regardless should take HRT

I didn't 'do' anything except pain killers for the joint pain. Wouldn't say I sailed through it but it wasn't horrific. As others have said millions of women go through it worldwide without intervention.

You don't have to do anything.

What you should do is to be alert to symptoms that might indicate issues.

I was adamant I'd never do HRT. I had an early menopause at 42 and by 49 was having to go upstairs to bed on my knees, with the pain.

Turns out it was osteoporosis and I've been on HRT ever since.

Just keep an eye on any symptoms, sleep patterns, and pain and see what happens. Hopefully nothing.

Of course it is safe to do nothing. The menopause in itself is not a medical issue. If people become ill or uncomfortable as a result of the menopause they need and deserve proper help from their GP, but millions of women just have weird periods for a while and then stop bleeding. That's it. It is a normal bodily process.

Honestly, conversation around the menopause has become so strange in the last few years. What began as a constructive move to ensure that women who became ill as a result of menopause got the support they needed has turned into a hugely sexist idea that all women of a certain age are broken. And a huge part of the motivation is to flog a whole load of useless products.

I hardly noticed mine. I had a few (not many) sleepless nights because of night sweats, and a few hot flushes during the day. Joint pain in the mornings which I ignored - got better as I moved around. I had a couple of issues with flooding which were pretty distressing but never got around to going to GP.

10 years on and I'm in great health. I know I'm very lucky.

I didn’t have particularly bad symptoms, just a bit of anxiety and insomnia. I could have managed that without medication.

But what prompted me to get HRT was the risk of osteoporosis, vascular dementia and heart issues. You wouldn’t necessarily know you had those problems until you have a fall at 60 years old, break a hip and discover that your bones are knackered. I’d rather minimise those risks.

I love Davina, but I'm not sure she should be your go-to for medical advice. She's a paid celebrity face for lots of nonsense, including Zoë

Yes it's safe! You don't have to do anything at all. I chose HRT at 52, but some of my friends have been fine without.

Looking for the link but there’s strong evidence that women on HRT have better heart health and lower risks of things like dementia, but the big random studies show that’s because the women who approach their DRs to get HRT are significantly rore likely to take much better overall care of their health.

You’re not broken. If you need HRT get it. If not enjoy your life.

I'm 45. Vaguely on the look out for symptoms and open to seeking help if I get any and feel I could do with some help but not assuming I'll definitely need any.

Tbf in defence of HRT, my bone consultant highly recommends it for bone health (why I started it it in the first place- I have osteopenia which hasn't got worse since I've been taking hrt)

Everyone is different.

If you have bad symptoms that mean you can't sleep, you feel terrible, and it's affecting your work and family life, there is no point 'struggling on'. The most-used forms HRT are safe several years after which you can reassess.

Also if you have a family history of osteoporosis or are at risk ( one risk is being 'slight' - weighing under 9 stone- or periods that stop before 50) you need to take that into account because HRT will help maintain your bones.

If none of these apply, there is no need to do anything, except all the usual stuff of eating healthily, exercising and doing things you enjoy for emotional health.

I didn't become menopausal til 58... bit of joint pain, loss of focus, hot flushes and night sweats. But my symptoms only lasted a year or so. At 60 I get an occasional night sweat. As I went through later in life, my bone density is great. (Checked when I had really bad issues after they put me on statins).
Would make sure you do weight bearing, low impact exercise to keep bones strong and blood pumping. HRT can be helpful to some. Not everyone can take it - I have a heart condition that it is not suitable for.

There is a lot of evidence on heart disease and HRT and it's not simply that those women see their dr.

The consensus across the world (International Menopause Society) is that HRT started within 10 years of the final period gives heart protection as it prevents narrowing of the arteries.

After 10 years it's slightly more risky to start and won't give the same benefits. as the plaque is already there and there is a risk that estrogen dilates the arteries and the plaque breaks away- causing a clot. But women over 60 can still very much start HRT (it's in the BMS statements) just on a low dose to begin with.

@BeyondMyWits I agree with almost all your say but all the exercise in the world can't win against loss of estrogen post meno.

It's a bit of a myth and too many women have this false security.

https://www.johnstevenson.org.uk/osteoporosis.html Professor in Endocrinology

Diet and exercise alone are not able to prevent or treat osteoporosis. Most treatments for osteoporosis are with drugs that reduce bone breakdown, and hence prevent bone loss. When such drugs are first given, there is often a gain in bone mass, because the reduction in bone breakdown exceeds that in formation, and thus a “positive” bone balance exists for some months or even years. There are now some drugs which primarily increase bone formation rather than just reducing breakdown.

Hormone replacement therapy (HRT) prevents bone breakdown, and may also increase bone formation to some extent. It is very effective in preventing the development of osteoporosis and fractures in postmenopausal women. It is usually given to those identified as being at increased risk, and is as safe and effective as any other currently available treatment (see Menopause and HRT section). It can also be used for the treatment of osteoporosis in women who already have the disease. It does not have the same long term adverse effects as the bisphosphonates and other drugs (see below).