How do you respond to the claim that menopause is natural and therefore you shouldn't use HRT?

[Neulip]

I was reading though an "anti hrt" account on instagram and first let me say I am totally in support of any woman making the choice that is right for her to take or not take HRT but one of the common threads of this woman's rejection of HRT was that menopause was a natural transition and therefore we shouldn't interfere with it. Yes menopause is natural but for most women it isn't a transition to a new optimal state of being but actually a rather brutal biological and evolutionary economy that isn't carefully planned to benefit women in anyway, frankly mother nature doesn't care what happens to us when we are past the point of reproduction, she isn't even that focused on our comfort when we are fertile. If it is unnatural and therefore inherently harmful to treat menopause as a disease then what about any other medical intervention? Is anyone arguing that type one diabetics just do more yoga or give up drinking rather than rely on insulin?

I just don't get this argument against HRT at all?

I do think diet, exercise and well being plays a huge part in aging well and for me personally, that includes not filling the body with man made hormones

I live a very healthy lifestyle - no processed foods, lots of oily fish and vegetables, 2L of water daily along with daily running and weight lifting. No alcohol.

Menopause still beat my ass and I only got relief when I started HRT.

Yes. However HRT is not the only thing that can reduce your risk of all three. If you can't/won't adopt the lifestyle measures that impact your risk, HRT is a sensible option.

Lifestyle is really vital, but isn't always enough. I don't think many women use HRT as an 'easy option'.

If you like, I can link to some videos on the British Menopause Society website where an expert consultant on both CVD and osteoporosis discusses exercise etc and the effects on heart and bone health.

Without HRT I had insomnia, nightsweats, mood swings and crippling brain fog. That might be “natural” but I felt I risked losing my career, struggling to care for myself and my family and slipping into debilitating depression. All health problems are “natural” but following that rhetoric would people avoid all medical interventions & treatments for cancer, auto immune issues, mental health problems etc etc?

So is death. But we still try to make it as tolerable as possible.

Arguably previous generations of women were not facing the same pressures modern women are. My mother and grandmother were not breadwinners. At my age they had retired or had never worked full time. They were not juggling caring for their elderly parents and children simultaneously. There were different expectations of what was acceptable and preventable and also of what women deserved.

Precisely.

I've seen what Mum's life was like and have had said that I'll take my chances with regard to HRT side effects.

Generations of women before us have lived post menopausally without HRT

Yes, and my mother went through hell because of it, she was suicidal at times due to her hormones.

I find this such a weird argument. In the 80s, I remember nobody really bothering with seatbelts and I managed to survive, does that mean noone now should bother with using a seatbelt?

Equally, lots of people smoked back then and didnt all die at age 30, does that mean we can all smoke with abandon now and not worry about our lungs?

Just because something happened years ago doesnt mean it was "a good thing"

I wasn’t disagreeing with you. But many people still worry more about breast cancer than anything. I don’t.

But the most natural forms of HRT - microgenised progesterone in particular, don’t seem to work in many of my friends who have found that it doesn’t keep the endometrium lining thin enough. So they end up on a cycle of gynae horrors with pelvic ultrasounds, biopsies and hysteroscopy - without anaesthetic obviously. Then unless they’re prepared to have an IUD ( more pain on insertion and higher perforation/ implant risk in post menopause plus class action in US now) they run the risk of hyperplasia and being lifelong gynae patient. It’s not a simple choice.

I don’t know where to start with the stupidity of “it’s a natural process so don’t interfere and let ‘Mother Nature’ do her thing”: many of us would have died in childbirth/our children would have died at birth or during early years/we’d have died of: sepsis from untreated infections/cancer of any part of the body/heart disease etc etc etc….ad nauseam.

Thankfully we have advances in medical knowledge and practices which mean many of us can live healthy lives into “old age”. HRT is one such new, fantastic medical advancement which gives women aged 50+ the energy to make the most of their lives, continue raising children and working, and not melt into a weeping angry hot heap and facing the prospect of osteoporosis and heart disease in the next ten years.

Frankly, Mother Nature and all those who believe in letting her do her wicked thing can fuck off.

It really is an informed choice. My mother watched her calcium and vitamin D intake and exercised, but that wasn't enough - the women on both her paternal and maternal side suffered from osteoporosis.

I'm watching what I eat and I am exercising but I cannot afford to remove the one medical intervention that might help. (I can't take biphosphonates because I've inherited the family gastric reflux problem.)

I'm only three years away from the age when Mum had her first major spinal fracture. I'm doing what I can to stay mobile and relatively pain free.

I agree actually that menopause is natural. But I also agree that women don’t have to suffer nowadays, and that we can use it to help prevent other diseases long term. Therefore HRT is great. Just as we don’t have to use gas and air or an epidural for childbirth (another natural process).

This person is obviously having a blissful menopause, or is just lying and is probably on HRT herself. Scroll on.

Precisely. It's not a case of either/or. In an instant, my mother went from being fit and healthy to being deformed and in agony.

I don't use the word "deformed" lightly. Mum was very self conscious of what happened to her appearance. The first time, her spine simply collapsed and she was left looking as though her arms were too long for her. I recall the shock on her younger sister's face when she saw my mum hobbling about on crutches.

Subsequently, Mum became more and more bent over with each break and was left with one hip higher than the other and a prolapse necessitating a hysterectomy when she was well through her 70s. (Her organs were squashed, you see. She was skin and bone but her stomach protruded.)

She was in terrible pain.

I'm doing everything that I can to avoid it.

To be fair I don’t think “many of my friends” is a scientific argument against HRT.

I haven’t experienced any of those things you mention. “Many of my friends” take HRT too and I have never heard them mentioning these issues.

Just to counter your statement, in case it puts women off HRT.

“Many of my friends” say they wouldn’t be able to function the way they need to without HRT. They say they’d have got divorced or murdered their husbands or walked out of work in a hot temper or lost friendships or been miserable all the time with constant sweating and very poor sleep.

I sleep like a baby on HRT and that alone makes me want to hug with joy all the scientists who have developed and refined this medicine. It’s marvellous.

I agree with you! I’m just saying it’s more nuanced than HRT great, all else bad.

Id be dead by now if it wasnt for hrt. I was in such a state I was close to throwing myself off Beachy Head where I lived at the time.
On hrt I recovered in a couple of weeks and my suicidal thoughts just went.

Why do you need to respond to it at all? It’s a point of view that probably doesn’t bear scrutiny. Presumably the person is vaccinated, doesn’t drink from puddles, uses some form of motorised transport rather than only their legs, cooks their food, washes their hair, uses the toilet. None of these things are au naturel. Leave them to their inconsistent view and do what you think is best for you.

That's awful. Your poor mum.
I know other women who went through that too. Spines collapsing, in constant pain, housebound for years on on zillions of drugs that caused other issues.
Please tell me you're having your own bones monitored?

I think there's been an understandable and loud corrective to the HRT dialogue I remember fifteen years or so back, which was all about HRT basically killing women and being cruel to mares because they were farmed for the hormones in their urine. I must admit that the equine issue put me off HRT for longer than it should have done. I probably made my life harder than it should have been for a few years because I didn't do my research.

It took A LOT to explain to women and tbh a lot of doctors that HRT is now manufactured from plants and is far safer than the older versions. Even now, usually from American sources, I'll get an occasional 'cruel to mares' post on my FB timeline.

Hopefully the pendulum will swing back to a sensible position now. Good for some women, not for others, but from the position of looking at the actual evidence.

All illness is ‘natural’. We treat it if we can..

I was refused a Dexa scan, but my GP agreed to HRT straight away because of the risk factors. (I had two broken elbows in my 30s. Apparently, that's not supposed to happen, not even when you land on them from a fall.)

Until they removed it in a recent 'refurbishment', I was using the vibro plate at the gym.

I'm now lifting as heavy as I can at the gym, but I'm trying to build up more. I'm a smidgen off 66 - three years younger than Mum was when she had her first obvious spinal fracture.

The heaviest that I'm managing with shrugs is carrying two 16 kg weights (and also using them for a farmer's carry.)

32kg isn't bad, but apparently I need to keep going to 44kg to protect my bones properly.

The gym has apparently bought in a fancy new body monitor which will give me information about fat, visceral fat, muscle and bone density so I'll be using that to monitor myself.

I'm following Dr Vonda Wright and reading her book "Unbreakable" and following her advice re bone density.

I had to see an ortho specialist about my knees. It turns out that there is some arthritis, but that's caused by patella alta. All these years, my knees have been set too high up.

His solution was for me to NOT run, avoid slopes, NOT do the breast stroke...When I asked about what I could do at the gym, he looked at me as if I had two heads.

Fortunately, another consultant who did a shoulder decompression for me referred to a physio. (The problem was a trapped muscle, caused by moving and handling my late husband.) The physio was a young woman who was marvellous.

She looked at me as a whole, not just a shoulder problem (if you see what I mean). She got me doing certain exercises and then referred me to a specialist class at the gym.

I'm now using machines and weights at the gym, plus attending classes for seniors designed to work on mobility and bone density plus other classes where I'm working round the knee issue and concentrating on building muscle and bone.

I'm back using the lat pull at the gym to help my back and there's a concentration in the Senior Flex classes on hip strength etc.

Sorry—this has turned out longer than I intended...But just to say that I've become much fitter over the past two years and I'm dong everything I can.

Vonda Wright recommends doing light jumps to increase bone density and that's all incorporated in the Musical Theatre Fitness class that I joined at the gym. I might look like an idiot, but it's fun and I can feel the improvement.

I'm also doing Pilates and I'm astonished that I can now get off the floor without using my knees.

I'd heartily recommend that women have a look at Dr Vonda Wright's recommendations on her FB feed, etc.

I started getting myself fit again a bit late in life, but all you youngsters in your 40s and 50s could really benefit from her advice, IMO.

She advocates, exercises, eating well and HRT. She's an orthopaedic surgeon.

By the way, I did have a scare over a teeny lump in a breast last year. The consultant who gave me the all clear told me not to worry about too much oestrogen "If you're going to get cancer, it's not the oestrogen that'll cause it." I'd explained why I was taking HRT.

He also told me to stop worrying about losing weight and to concentrate on lifting weights at the gym - "That's the best thing for a woman of your age."

Thank you. Lots to think about there. I feel torn. My ostepaenia makes me think stay on HRT but you make an interesting observation about how our bodies might respond. Unfortunately I am also on steroids for asthma.

I have doc appointment next week so will discuss

My money's on her getting up every morning, showering, doing her beauty regime ready for filming to sell the 'everything natural, you don't need to fill your body with Big Pharma' dream - with a Evorel slapped to her arse.

@Slimtoddy if you're using steroids long term, they are a known risk factor for osteoporosis.

How bad is your osteopenia? Presumably you have your scan results.
Are you having a DEXA scan every 2 years to keep an eye on it?

Other women are allowed a different opinion to you. I don’t care if they don’t want to take it.