WOMEN: HORMONE REPLACEMENT THERAPY (HRT)
Are there other side-effects of HRT? The most common side-effect (not a health risk but not acceptable to all women) is bleeding from the vagina, like a period (usually shorter and lighter), after each course of progestogen supplements. If you don’t want this, ask your doctor about ways of taking the progestogen to eliminate bleeding or to increase the interval between bleeds.
Most women will notice some breast enlargement and tenderness when they first start treatment, but this settles within a month or two. A minority of women have some side-effects while taking the progestogen. These are similar to premenstrual symptoms such as fluid retention, abdominal bloating, sore breasts and mood changes. These effects can usually be overcome by reducing the dose or changing the type of progestogen. Less than one in ten women give up HRT because of side-effects.
Some other objections to HRT A small number of doctors are still unwilling to prescribe HRT. A few are afraid of unknown effects. Others believe that health disturbances due to the menopause are just a normal part of growing older, which we should put up with. This argument just won’t hold water. Becoming longsighted (which happens to all men and women during middle age) is also a natural process of ageing, but would anyone suggest that we should all give up reading at the age of 50, and ‘put up with’ the fact that we can no longer focus on the printed word? Would anyone try to justify not treating other health problems associated with ageing such as heart failure or prostate disorders? Certainly not!
Many women feel doubtful or hostile about taking hormones because they believe that it interferes with nature. So it does, but if nature were left to its own devices many women would suffer from health deterioration after 50 years of age. No other species outlives its reproductive life span (except some domestic animals maintained with veterinary care). Progress in preventive and therapeutic health care could be seen as part of the natural evolution of human life, so the use of hormones to treat menopausal symptoms and prevent illness in later life may not be so ‘unnatural’.
There are those, like Germaine Greer, who argue that HRT is just another way for those who sell hormones to make profits. This unfair argument could be extended to everything we buy, including all orthodox and alternative health services. It’s usually held by those who’ve never needed any pharmaceutical products or health services to remain well.
Other women are afraid of side-and unknown health risks. Some just don’t like using any medicines. Discuss your doubts about HRT with your doctor.
You may change your mind when you understand the benefits, but the choice whether you use it is yours.
Making the decision Some doctors believe that almost all women should use HRT after the menopause. However, many experts in postmenopausal health-care point out that HRT has not proved to be of benefit to all women and there may be
no reason to use it if you have no symptoms of the lack of oestrogen and no risk
factors for coronary heart disease and osteoporosis. If you are well informed about all aspects of HRT, you’ll be in a better position to decide with your doctor whether you need or want to use it.
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