Is HRT safe?

Is HRT safe?

It’s crucial to remember that the advantages and hazards of HRT should be properly compared. HRT carries some hazards, including a higher risk of blood clots, stroke, and specific forms of cancer. Considerations including age, medical history, family history, and personal preferences should all be taken into account while weighing the risks and advantages of using HRT.

Factors to consider
Benefits: For women experiencing menopausal symptoms, HRT can successfully reduce symptoms, enhance bone health, and restore vaginal health.
Risks: HRT carries some risks, and the severity of these risks might change with age, the length of HRT treatment, the particular hormones used, and personal health features. Increased risks of blood clots, stroke, heart disease (in some women), breast cancer (with long-term usage of combined oestrogen and progestin therapy), and gallbladder disease are some possible side effects of HRT.

Individualised Approach: A woman’s overall health, medical history, personal risk factors, and preferences should all be taken into account when deciding whether to use HRT. In order to determine whether HRT is the right choice for you, your healthcare provider will evaluate your unique circumstances, taking into account elements including age, menopausal symptoms, bone health, cardiovascular health, breast cancer risk, and personal preferences.

Timing and Duration: The hazards and advantages of HRT may vary depending on when it is started. HRT may work better if it is started earlier in the menopausal process. Another crucial factor is the length of HRT use. In order to manage symptoms and accomplish desired health outcomes, it is often preferable to utilise the lowest effective dose for the shortest amount of time possible.

Regular Monitoring: Regular monitoring and follow-up with your healthcare professional are crucial if you opt to use HRT. This enables continual assessment of the advantages and hazards, modification of the course of therapy as necessary, and observation of any potential adverse effects.

Body identical hormones v bioidentical hormones
Bioidentical hormones are precise duplicates of hormones such as estradiol, progesterone and testosterone, in the same way that modern regulated body identical hormones, which I prescribe, are. Bioidentical is often used by clinics as a marketing term purporting the benefits of compounded bioidentical hormones, however, there are concerns about their purity, effectiveness and safety. Progesterone in particular, which is given predominantly to prevent thickening of the womb lining and endometrial cancer in response to oestrogen, when given through the skin, as a cream or gel, may not be absorbed which is of grave concern.

Prescribers of compounded bioidentical hormones are often healthcare professionals (HCPs) who are not experts in the field of menopause medicine and have not been certified by the British Menopause Society or any other postgraduate educational organisation as having appropriate training in this specialty. They tend to charge large sums and offer to personalise your therapy, however, due to the variable nature of our hormones and the fact that most cannot be measured in saliva this is not possible to do with any degree of accuracy and is usually unnecessary.

The management of women with menopause related problems should be underpinned by the principles and guidelines of the British Menopause Society and wherever possible, regulated products, that have been thoroughly tested, should be prescribed. The 2015 NICE NG23 menopause diagnosis and management guideline 1.4.15 stated ‘Explain to women that the efficacy and safety of unregulated compounded bioidentical hormones are unknown.’

Advertising Standards Association (ASA) The ASA ruled in 2017 against the ‘misleading’ promotion of cBHRT when a prescribing dermatherapy cosmetic clinic in Stratford upon Avon was reported. This test case led to a ruling being passed that these clinics and prescribers of cBHRT should not claim greater safety and efficacy as there was no evidence from clinical trials for these products. The ASA also advised that there was insufficient evidence that multiple serum and saliva tests could be used to precisely individualise therapy. The public should be cautious of marketing that can give rise to false securities and should avoid purchasing cBHRT products over the internet.

Non hormonal treatments

For women who prefer not to utilise or are unable to use hormone replacement therapy (HRT), non-hormonal treatments can be useful in treating menopausal symptoms.

Changes in lifestyle: A few lifestyle adjustments can help reduce menopausal symptoms. These include getting adequate sleep, engaging in regular exercise, maintaining a healthy weight, using stress-reduction strategies (like yoga or mindfulness), and avoiding triggers like caffeine and spicy foods. Healthy lifestyle choices can improve overall wellbeing and possibly lessen symptom severity.

Cognitive-Behavioral Therapy (CBT): CBT is a type of talk therapy that can assist women in managing emotional symptoms associated with menopause, such as mood swings, anxiety, and sadness. It focuses on recognising and altering unfavourable thought patterns, creating good coping mechanisms, and enhancing general mental health.

Cooling Methods: Common menopausal symptoms include hot flashes and nocturnal sweats. By lowering body heat and enhancing comfort, cooling strategies including layering clothing, utilising fans, keeping the bedroom cool, and using cold packs or cool cloths can help manage these symptoms.

Vaginal Moisturisers and Lubricants: Non-hormonal vaginal moisturisers and lubricants can be used to treat symptoms of vaginal dryness and discomfort during sexual activity. These items can help rehydrate the vaginal area, lessen friction, and enhance general vaginal health. They can be purchased without a prescription and don’t include hormones.

Medication: Specific drugs can assist manage particular menopause symptoms. As an illustration, regularly prescribed antidepressants such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) can also help lessen hot flashes. Off-label prescriptions of other drugs, like gabapentin or clonidine, may be used to treat hot flashes or nocturnal sweats.

Herbal treatments and nutritional supplements: Some women use herbal treatments or dietary supplements to alleviate menopausal symptoms. Black cohosh, red clover, evening primrose oil, and soy isoflavones are a few examples. The effectiveness and safety of various treatments varies, and it’s crucial to remember that they should only be administered under supervision. Before beginning any herbal therapies or supplements, talk to your doctor.

Benefits of whole-body cryotherapy (WBC) in the menopause
Relief from Hot Flashes: Hot flashes, which are sudden and intense feelings of heat, are a common symptom of menopause in women. WBC entails exposure to extremely cold, which could perhaps offer momentary relief from hot flashes by lowering heat-related symptoms and cooling the body.

Reduced Pain and Inflammation: WBC is said to have anti-inflammatory properties, and some research indicate that it might aid in lowering inflammatory indicators in the body. WBC may be able to ease the symptoms of joint pain, muscle aches, and general discomfort that menopausal women may encounter.

Better happiness and Well-Being: Cold exposure during WBC has been linked to endorphin production and elevated levels of specific neurotransmitters, such as norepinephrine, which are known to improve happiness and well-being. This might be helpful for controlling the mood swings, anxiety, or depression symptoms that could happen after menopause.

Improved Sleep Quality: Sleep problems are frequent throughout the menopause. WBC may enhance sleep quality, maybe by encouraging relaxation and lowering stress levels, according to some anecdotal data. The management of menopausal symptoms and overall wellbeing can both benefit from better sleep.

Energy and Vitality Levels May Increase: Cold exposure during WBC enhances the body’s physiological responses, which may lead to higher energy and vitality levels. This might help to combat the frequent menopausal symptoms of weariness and poor energy.

Please attach below infographic on breast cancer.