Sex, Myths and the Menopause

[Margo51]

Is anyone watching Sex, Myths and the Menopause tonight? Its on C4 at 9pm. Davina McCall discussing menopause, HRT, taboos and myths surrounding it and how she coped with it.

She has been doing lots of work recently to raise awareness of the menopause and how hard it is.

www.channel4.com/programmes/davina-mccall-sex-myths-and-the-menopause

Yes it’s very well documented that she was a drug addict she really turned things around.

The NiCE guidelines say that women who’ve had cancer and are now going through the menopause must be referred to a specialist menopause clinic.

I’ve had cancer. I had to mention these guidelines to my GP but as soon as I did I was refereed. I’m on bio identical oestrogen and as I still have my womb, progesterone. It’s been amazing and has saved my job, my relationship and my life.

It’s a false comparison saying you’d rather have the effects of menopause than treatment for cancer. It’s such a shame that there is still a link in people, and medics, minds between the two.

I haven’t watched the programme yet, but I will. I had found Davina’s exercising uncomfortable but I’m at ease with it now I’ve read here that she’s an addict and this is her current addiction.

@JaniieJones

'The programme was clear about how low the risks are for HRT/breast cancer. Maybe rewatch it if you missed this information.'

I don't need to rewatch it. My point was I'd have liked another side of the discussion put forward rather than the overall suggestion women are being let down without anyone saying why. Ovarian cancer wasn't even mentioned yet we know that is a small risk too.

As I said I'm on the fence about it. Is it a natural ageing process we all need to accept and tolerate or something to treat even with the small cancer risks. Obviously the extent of symptoms is the issue it just seems so very wrong that privileged women seem to have easy access to it privately yet those who use the nhs don't. Why?

Yes, menopause is a natural ageing process, but, for centuries, as Louise Newson said, women rarely reached menopause age. It is only in the past 50-60 years as nutrition and healthcare has got better that women are living much longer and having to deal with menopause and all the many issues it brings.

The programme was very clear that women are being let down because the medical profession does not care enough. There is little to no research into menopause, and when GPs are training, the module on menopause is tiny. There is no ongoing training for GPs, and nor are they updated about the latest menopause findings.

Most healthcare is geared towards men. Menopause needs to be taken as seriously as breast cancer, which is one of the few areas of women's health that has had serious amounts of research and money spent on it, and as a result, breast cancer is not the death sentence it once was.

While I can not speak for others, I had horrendous symptoms which made the quality of my life unbearable. Why should I have tolerated it, particularly in my mid-30s? I did not anticipate going to see a private doctor but given several GPs failed me, it was my only option. Yes, it was expensive, but it gave me my life back, which is not an exaggeration. I can only wonder what you might have done in my situation? Would you have tolerated 60+ hot flushes per day, having to change clothes several times a day due to sweats, getting 45 minutes of sleep across the entire night, not being able to remember your own name, an inability to control emotions, joint pain so bad you have to crawl up the stairs on your hands and knees (to name just a few things I was having to deal with on a daily basis). These things all vanished within 3 days of the correct HRT. (The version the NHS eventually prescribed actually exacerbated my symptoms)

The bottom line is that every woman should be given access to good menopause care, if only so they can decide what is good for them. You only need to look at the menopause on here to see how poorly prepared woman are for this, and also, the lack of information out there. This is what we are fighting for, information and more access to menopause care.

It sounds great. I'm still on the fence personally- was the general idea that we should consider hrt even with no symptoms, if no other risks?

My GP's surgery doesn't have a female GP.

I’ve been patronised and dismissed by female GPs, and listened to sympathetically and prescribed HRT by male ones.

@aramox

It sounds great. I'm still on the fence personally- was the general idea that we should consider hrt even with no symptoms, if no other risks?

It didn’t go that far / it was looking at the main debate really.

It did point out that women are twice as impacted by dementia as men due to falling oestrogen through our lives. They had a neuroscientist on talking about the brain deterioration and he was pro hrt.

@Craftycorvid

I felt a bit frustrated with this, to be honest. Yes, it’s great that a taboo subject impacting the lives of half the people on the planet is now being talked about. I like Davina and her preparedness to be so vulnerable about her own experience was powerful. But: some of this was highly misleading. There was a skating reference to peri-menopause, which can last up to ten years and is the usual cause of health problems (though not all of them end at meno itself). It’s NOT a hormone deficiency. In fact, peri’ problems can arise due to hormone fluctuations which can include elevated oestrogens. And it is orstrogens plural. We stop making oestradiol at menopause but continue making oestrone in our fatty tissue. Lots of the health issues post-meno’ are effects of ageing itself and lifestyle. HRT may be brilliant for some but it isn’t a panacea. And mid-life generally can be a bastard, so any low mood may not be totally due to peri-menopause. It’s hard to get everything across in a one-hour programme of course, but hopefully this is the start of a wider discussion.

Given she only had 52 minutes to cover the menopause, I think Davina covered the most common issues, and did it well. That said, there is confusion for many between perimenopause and menopause.

Elevated oestrogen can also happen when it is out of balance with other hormones. My body had stopped making progesterone, and so oestrogen(s) were the dominant hormones. However, my symptoms were the same as if my body was deficient in oestrogen. This led to the GP prescribing more oestrogen, which made everything worse. There is a general misbelief that menopause is all about oestrogen, it is not, it is about your FSH (follicle stimulating hormone), progesterone and testosterone levels too. If your hormones are out of balance, you will have issues.

Our hormones regulates our moods, and hormones will be a major factor in low-moods. And while it might not necessarily be perimenopause, for most, this is what will be the cause. So many perimenopause symptoms present as depression, hence the AD treatment GPs still prescribe.

Diet and exercise does help, but exercise can also raise cortisol levels which will impact a stressed out perimenopausal body. I think it's a shame the programme was limited to just one episode, another one looking at women who have had an atypcial experience would be great.

Interesting to hear that it showed HRT was helpful at preventing dementia - I had heard that the evidence was not that clear and that it might even increase the risk, so I'd be very glad to hear that there is more research being done. I am just starting menopausal symptoms - had about 6 months last year with no periods (though maybe pandemic related?) and hot flushes etc, but it seems to be back to normal for a few months now. I was at the point of going to the GP then to discuss it, but then figured I could wait til the symptoms started up again. I have a huge family risk of dementia, and it is my biggest worry, so if this would help, I'd rather take it, even if I don't end up with bad menopause symptoms. I don't really think my GP will be very interested, though, or know the ins and outs of the most current research on things like that. I would even go private if needed.
I'll watch the show on catch-up.

@FlattestWhite

Interesting to hear that it showed HRT was helpful at preventing dementia - I had heard that the evidence was not that clear and that it might even increase the risk, so I'd be very glad to hear that there is more research being done. I am just starting menopausal symptoms - had about 6 months last year with no periods (though maybe pandemic related?) and hot flushes etc, but it seems to be back to normal for a few months now. I was at the point of going to the GP then to discuss it, but then figured I could wait til the symptoms started up again. I have a huge family risk of dementia, and it is my biggest worry, so if this would help, I'd rather take it, even if I don't end up with bad menopause symptoms. I don't really think my GP will be very interested, though, or know the ins and outs of the most current research on things like that. I would even go private if needed. I'll watch the show on catch-up.

I think bear in mind hormones continue to fall/fluctuate even after periods stop so it’s an ongoing situation.

Not heard hrt raises risk of dementia - the neuroscientist was very clear it helps.

Sansucre, so sorry to read that you had to endure such an appalling experience due to the ignorance of the medical profession. I've been on hrt for many years and, due to my age l still have to justify myself and receive the scare tactics every time l need a new prescription. I'm still made to feel l'm requesting something l shouldn't need as l am 'too old' and l get fed up with pointing out the NICE guidelines each time and my reasons for wanting to stay on hrt. But l will continue to to do so and hopefully programmes like this will help to raise awareness and lead to compulsory training about the Menopause in the medical profession so that women don't have to struggle to get help, advice, up to date information and proper care. As you say, this is what we are fighting for and it really shouldn't have to be such a battle!

I'm trying to remember where I read about raising the risk - it was something like NHS or Alzheimer's society or something that sounded quite respectable at the time (this was 6 months ago I was looking into it!!), but I'd be very relieved to know it wasn't the case, even if it doesn't turn out to actually help.

I'm not sure how helpful my GP will be at the best of times, but if I went in now, when my periods have restarted very regularly, ovulation pain started again too, other hot-flush type symptoms have disappeared etc, she'd write me off completely! But it wouldn't surprise me if things change in the next year and I get the menopausal symptoms again. I'd like to know what I want when I go in - well ideally, I'd like her to tell me and discuss options - but given that she'll probably fob me off, I feel like I have to do the research and know what to ask for. Also I don't like the sound of the gel at all, given skin problems and sensory stuff, so I'd much rather have some kind of tablets to take or maybe patches, but again I'm sure she will offer only whatever is the standard.

Were there actual studies mentioned that demonstrated that HRT prevented dementia? I found a Finnish study (in the bmj) that found that with HRT the risk of alzheimers went up 9 - 17%. I'm concerned the programme was very one sided with people who benefited from women being on HRT (although I haven't actually seen it).

This is what the Alzheimers society say:
Studies looking at whether replenishing oestrogen levels using HRT can reduce women's risk of dementia have been inconclusive and contradictory. For example, some studies of women who were already using HRT during menopause found that their risk of dementia was lower than those not on HRT. However, other studies found no strong evidence for this. There is some evidence that HRT may even increase dementia risk. Clinical trials looking at the use of HRT to treat Alzheimer's disease in women, rather than prevent it, did not show any beneficial effects on cognition.

Until there is better evidence, the potential benefits of HRT as a way to reduce the risk of Alzheimer's disease do not outweigh the potential risks of HRT, which includes an increased risk of certain types of cancer, heart disease and stroke.

I'm on the fence about it. Whatever unpleasant symptoms people experience do not compare to the unpleasant tests and treatment required for cancer. I hope there will be more research specifically into the effect of newer drugs.

^ the risk of getting cancer from taking HRT is minimal and considering it gives some protection against Alzheimer's, which is the biggest killer of women in the UK, far outweighs its negatives.

You're something like 6 times more likely to get cancer from being obese than you are from taking HRT.

I watched it with my husband and he was shocked and somewhat ashamed that he knew so little about it, something that has affected me so badly to the extent that I felt like I was going crazy.

Davina has done a huge service to us women by publicising the truth about the risks and benefits of HRT and making it something that isn't shameful.

If you are on here Davina, you ROCK.

I am getting anxiety over the last few months but thought it was triggered by bereavements. I am 2 years without a period(age 53) but now wondering if HRT would help.however I am still scared to take hormones. I think back to when I was little, when women at 50 looked really old, especially without hair dye, and were basically considered "past it". glad times are changing

A good point Dr Louise Newson made was that women are living so much longer beyond menopause than they did in the past.
Maybe a third of their life, or half if an early menopause. Probably historically it was deemed that once menopause happens that it's the end anyway so pointless to think beyond.

Haven't watched yet but looking forward to catching up. My (female and in her 60's) GP told me I couldn't possibly have peri symptoms as I was only 44. I'm 46 now and know I should go back (not that they'll see me atm anyway) but it feels like I will be wasting my time tbh, it's utterly woeful how poor the standard of care is for menopausal women.

Has anyone been patient of Louise Newson? How long was the waiting list and were you pleased with the care?

Like most peeps on here, I have had a rubbish experience at my GP

'I did make an appointment with the Newson clinic a few months ago but at £275 I think it was for a 45 min consultation, I had to cancel at that time as I just couldn't afford it.'

Yes and of course its a business, I'm not suggesting Newson should work for nothing but surely if womens health is a priority charging 275 quid just for a consult seems a bit excessive and having her as one of the 2 pro hrt experts shows some bias imo. I absolutely support the use of hrt we just need more balanced information.

I hope Davina carries on raising awareness and this is a first step. Lets hope there are more programmes like this. Stats from other countries would've been interesting too. Is the UK's 1 in 10 similar to other countries or do places like the US who pay for healthcare use it more. The (private) neuroscientist featured (who has a private hormone clinic) was only theorising about the dementia protection and even admitted that research is needed but hrt 'may' protect the brain.

'Ah well let's just stop giving pain relief in child birth, it's a natural process!It's attitudes like this as to why women's health care is so behind the curve.'

I didn't say it is a natural ageing process so tough, the rest of my sentence was or is it something to treat even with the small but still very real ovarian and breast cancer risks.We need more info and recent stats, not just advice from private drs who are making money from it.

@FlattestWhite

I'm trying to remember where I read about raising the risk - it was something like NHS or Alzheimer's society or something that sounded quite respectable at the time (this was 6 months ago I was looking into it!!), but I'd be very relieved to know it wasn't the case, even if it doesn't turn out to actually help.

I'm not sure how helpful my GP will be at the best of times, but if I went in now, when my periods have restarted very regularly, ovulation pain started again too, other hot-flush type symptoms have disappeared etc, she'd write me off completely! But it wouldn't surprise me if things change in the next year and I get the menopausal symptoms again. I'd like to know what I want when I go in - well ideally, I'd like her to tell me and discuss options - but given that she'll probably fob me off, I feel like I have to do the research and know what to ask for. Also I don't like the sound of the gel at all, given skin problems and sensory stuff, so I'd much rather have some kind of tablets to take or maybe patches, but again I'm sure she will offer only whatever is the standard.

Patches and gel are both bio identical so I think either is an option - I think it’s more about the delivery you prefer. Patches leave sticky residue but it’s easy to remove with baby oil

@Tal45

Were there actual studies mentioned that demonstrated that HRT prevented dementia? I found a Finnish study (in the bmj) that found that with HRT the risk of alzheimers went up 9 - 17%. I'm concerned the programme was very one sided with people who benefited from women being on HRT (although I haven't actually seen it).

This is what the Alzheimers society say:
Studies looking at whether replenishing oestrogen levels using HRT can reduce women's risk of dementia have been inconclusive and contradictory. For example, some studies of women who were already using HRT during menopause found that their risk of dementia was lower than those not on HRT. However, other studies found no strong evidence for this. There is some evidence that HRT may even increase dementia risk. Clinical trials looking at the use of HRT to treat Alzheimer's disease in women, rather than prevent it, did not show any beneficial effects on cognition.

Until there is better evidence, the potential benefits of HRT as a way to reduce the risk of Alzheimer's disease do not outweigh the potential risks of HRT, which includes an increased risk of certain types of cancer, heart disease and stroke.

Oh that’s interesting. I wonder what age they do research on though? Women already with Alziemers? So 60s+? So would have been on old hrt? We need more research!!

In the US HRT use is much more prevalent.
I’m surprised that people on this thread are focusing on the very very small increased risk of some cancers versus the proven benefits- nothing is without risk and the risk without HRT of other diseases is great.
At the same time, almost nobody has reiterated that the very small risk from HRT is massively dwarfed by the risks from lifestyle factors such as alcohol (and 2 drinks per day equivalent isn’t a lot) and being overweight- these are manageable risks but the focus is on HRT.
I use HRT because I want to mitigate the effects of menopause as well as the symptoms. A tiny tiny added risk of cancer isn’t a concern to me and I am very strict with diet, exercise and alcohol. I will continue to pay for private care as long as I can afford it - it costs about the same as a decent bottle of wine per week over the course of a year.

I have already had breast cancer and don't think I will be able to have HRT when the time comes so I feel like I'm screwed!

There are 70 nhs clinics in the uk so people don’t need to rely on private but they do need to push to be refered. I guess you only get referred if very bad symptoms due to demand.

I’m not sure women coming on here and saying hrt is bad, the experts are only wanting to make money is helping much. Let women investigate and yes there should be MUCH more research on it all. Pls don’t add fears when you haven’t done the research either.

@Letsgetreadytocrumble

I have already had breast cancer and don't think I will be able to have HRT when the time comes so I feel like I'm screwed!

You are exactly the person who would get seen at an nhs clinic for more specialised info. For example topical ostroegen for vulva dryness is considered very very low risk.

'Were there actual studies mentioned that demonstrated that HRT prevented dementia? I found a Finnish study (in the bmj) that found that with HRT the risk of alzheimers went up 9 - 17%'

That's what I mean, I think it was grossly irresponsible for the private neuroscientist featured to suggest it like a fact. I want to hear from nhs experts not just those with links to private clinics.

'There are 70 nhs clinics in the uk so people don’t need to rely on private but they do need to push to be refered. I guess you only get referred if very bad symptoms due to demand.'

There is one in the North. You just wonder whether in years to come the scandal will be the clinics charging a small fortune for something that the evidence is sketchy and often contradictory.

'I’m not sure women coming on here and saying hrt is bad, the experts are only wanting to make money is helping much'

I haven't said it is 'bad'. I've said we need more research and more conclusive evidence. Look at the AZ vaccine! vanishingly small risk of clots but now not given to user 40s because the risks outweigh benefits. That is what evidence based practice is all about.