You are correct. From a medical perspective the menopause is just one of many factors that may have a minor roll in the process of aging.
But with the current trend HRT is seen as a cure all. The reason LN is coming under fire is that she is prescribing higher and higher doses to treat these symptoms when they don’t respond to the advised doses. There comes a point when there is a bit of a cross over.
If you google symptoms of low oestrogen and compare them with symptoms of too much oestrogen the list is pretty similar.
HRT is still in its infancy and LN is making the school boy error of increasing doses when there is poor response. Since many of the symptoms of menopause have a huge differential component, blinkered focus on menopause is poor medicine.
Before embarking on HRT a robust evaluation of all the symptoms should be undertaken to rule out more serious conditions.
In addition, the possible side effects of HRT should be addressed. I had no idea that HRT would fuel the growth of fibroids, which usually shrink post menopause when they are no longer fuelled by hormones. I suffered from debilitating sciatica as a result of multiple large fibroids causing pressure on nerves in my lower abdomen. Just one possible outcome.
Also that breast cancer is not the only cancer risk that is slightly increased. We talk in terms of statistics, the reality of being one of the unlucky percentage is very different. LN reassures women with risk assessment but those numbers are real people and you can be one of them. Something that I didn’t fully appreciate until I was diagnosed out of the blue. It’s very easy to be flippant but time and again on the support sites I use new members arrive with the same question, “why me?” having done everything right, diet, exercise etc. they are angry and confused that it has happened to them. We know that it is generally bad luck but so many of them are also asking the question “ is it my HRT?”.
There is currently no reporting system if you are diagnosed with bc while taking HRT, the data is derived from trials and studies which may be flawed simply because candidates for the trials are often heavily screen and not necessarily an example of the general population. For example anyone with a history of bc in the family may be excluded.
I took HRT for four years before being diagnosed with bc. Even with hindsight I would still have taken it because it was the best choice for me. However, I may not have taken it for as long. Evidence suggests that the longer you take it for the greater your risk of bc. This is something not addressed by LN, she uses the overall risk.
Taking HRT for 12 mnths does not increase the risk however after 10yrs your risk is significantly higher than at 5yrs. The risk is accumulative. This is often a difficult concept for people to understand so is simplified to overall risk.
I had radiotherapy which caries a risk of causing leukaemia. The risk is longterm so I may develop it in 20yrs or so. I’m 60 so for me , developing another form of cancer in my 80s is an acceptable risk. I may have looked at it differently if I had been 40 at diagnosis.
I was 53 when I started HRT, I’m sort of glad I didn’t start HRT any earlier.
Risk assessment is a personal process, it’s complicated. Maybe we should simplify it with some kind of formula that gives you a number so you can visualise your personal risk. It certainly helps post cancer treatment, to put a figure on your risk of the cancer returning. But there is so much more data available on relative outcomes with bc treatment. HRT is still a bit of an unknown.