Myths and facts about HRT: What you need to know about Hormone Replacement Therapy
Hormone replacement therapy (HRT) remains one of the most hotly debated health topics of our generation.
“I'm a big fan,” says Liz Earle MBE. “After talking to many doctors and health professionals, not to mention friends who take HRT, I’ve found that even low doses of HRT can be of benefit and improve symptoms. People may be surprised to hear me talk about HRT thinking it’s not natural but today’s body identical hormones are largely extracted from plants and as far as I’m concerned HRT is simply topping up what my body is lacking as I age. For me the improved quality of my everyday life together with the health benefits, outweighs my own personal risk factor.”
What you need to know about HRT
There are risks associated with HRT. The most obvious is that some types of HRT are linked to an increased risk of breast cancer, with some studies suggesting between 5 and 12 extra women in 1,000 taking combined HRT for five years being affected. However, the risks are lower if you take HRT for five years or less, and similar to the increased risk of breast cancer in a woman who is overweight or drinks around two glasses of wine each day. Any increased risk reduces after you stop taking HRT. There is little or no increase in breast cancer risk from taking oestrogen-only HRT and none in women who take HRT when they are young (under 45).
The benefits are greatest for those who start using HRT within 10 years of the menopause. HRT does not delay the menopause, it simply helps relieve the symptoms. As well as relieving hot flushes and night sweats, it relieves vaginal dryness, improves mood and relieves joint inflammation. HRT lowers the risk of osteoporosis by maintaining bone density as we age, and can actually reduce the risk of heart disease if you start it around the menopause.
HRT may also lower cholesterol levels. It does not increase the risk of cardiovascular disease if you start taking it before 60, and can protect against heart attacks.
HRT (taken orally or transdermally) does not increase the risk of developing type 2 diabetes and does not impact on blood glucose control.
HRT is taken daily but it has no cumulative effect. The day you stop taking it, your body reverts to its natural hormone level at that moment.
HRT can have side effects in the first few weeks (common ones include breast swelling and tenderness, bloating, headaches, nausea and indigestion); if they are persistent see your doctor. They may change your HRT medication or suggest you take it in another form – HRT comes in different forms including tablets, skin patches and gels. There is no evidence that HRT causes weight gain.
So called ‘bio-identical’ HRTs, often offered as an alternative to an NHS prescription, are often very similar (if not identical) to HRTs prescribed by GPs, which are usually plant-derived and body identical. Although ‘bio-identical’ hormones are deemed more natural and safer than standard HRT there is little scientific evidence for this, they are unregulated, and often expensive.
Gradually reducing or immediately stopping HRT makes no difference to symptoms in the long term, although gradually reducing HRT may limit the recurrence of symptoms in the short term.
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