A.Vogel Talks Menopause: What you need to know about HRT

The study

British study finds risk of breast cancer nearly tripled by combined HRT

2% of women monitored for six years got breast cancer – and they were 2.7 times more likely to contract it if they were on combined HRT than if they were not.

Read all about it on THEGUARDIAN.COM

Read the full video transcript below

Today's topic

Hello, and welcome to my weekly video blog. And today on A.Vogel Talks Menopause, I thought I will talk a little bit about HRT. Now, for those of you in the UK, you will know that just this week there was another study published actually indicating that if you take the combined HRT which is a combination of hormones oestrogen and progesterone, that it may increase your risk of getting breast cancer. And I know that there are probably a number of you out there that are getting really worried about this. There’s probably a lot of you may be thinking about going on HRT and now feeling even more confused than what you were before.

If you're on HRT, don't stop it suddenly!

If you are on HRT and you are worried about this study, please go and see your doctor. Now, I know sometimes it can take a few weeks to see your doctor. In the meantime, please, please, please, don’t stop taking the HRT. If you stop it suddenly, you can get a huge hormonal crash and it could really make you feel unwell. So don’t be tempted to stop on your own. And a little later on I’ll maybe give some idea of the things you can do if you actually want to stop the HRT with your doctor’s okay.

What HRT does

Now, what actually does HRT do? Because there’s an awful lot of you who actually get in touch with me wondering what exactly happens and what happens when you stop taking HRT after you’ve gone through the menopause. Now, first of all, HRT does not stop the menopause. As women, we will have to go through it one way or another. It’s not something we can jump over, crawl under or just disappear through. We will have to go through the menopause at some point.

HRT will keep your hormone levels artificially high when you’re actually going through the menopause. Your own natural hormones will continue to fall. So inside you will be going through the menopause but you don’t feel it because the HRT is keeping your hormone levels high and that will hopefully stop any of the symptoms that you may have got otherwise.

Coming off HRT – what to expect

The problem with HRT is that if you have been on it for a number of years and then maybe the doctor says or you decide to stop taking it, there is a huge gap between the level of hormones you’re getting from HRT and your own natural hormone levels which after four or five years in the menopause will actually be very low. And this why suddenly stopping HRT is not a good idea because you would very quickly go from a high hormone level being given with the HRT. There would be a very quick fall down to your own natural hormone levels, and that sudden drop can seriously stress your nervous system and it will very often trigger a whole raft of menopause symptoms.

And I know we get emails from a huge number of women who have stopped HRT or have had to come off HRT for various reasons and they are really, really struggling because instead of going through the menopause at 45 to 55, they’re now going through a kind of induced menopause at maybe 65 and 70. And we’ve even had women in their ’80s who have been pulled off HRT and are having a really, really horrendous time.

Speak to your doctor about coming off HRT gradually

So just be aware that if you decide with your doctor’s permission to come off the HRT, not to do it overnight because you really might have a difficult time. Our view is you need to take as long as you possibly can to allow your body to actually adapt having a lower level of hormones. And we would say at least try and cut down very slowly over six months to a year. And in that time, it’s really important that you look after yourself extremely well. Get a good multivitamin, maybe take some plant phytoestrogens just to help to keep your oestrogen levels naturally balanced a little bit better.

What to be aware of if you are thinking of going on HRT

For those of you who are still thinking of going on HRT then, you know, do be aware that at some point when you come off, you might end up having a few problems. This doesn’t happen to everybody. Some women can come off and there is no particular problem at all. But, you know, from the emails and the phone calls that I actually get, a large number of women do have a slight problem.

The other thing that is really important here is there are some women that in the menopause they have the most horrendous time. Their hormonal changes can create huge physical symptoms, very debilitating symptoms. There could be huge, emotional and mental issues as well with women getting severe depression even to the point where they’re considering really serious actions such as suicide. So in these conditions where it’s really important to get some kind of support then HRT is really a must. There’s no question about not taking it because you have to have some good support and also to get your quality of life back.

There is also a number of women, especially younger women too who have had a hysterectomy. And again, if you’ve had a complete hysterectomy with your ovaries out as well, you’re going to have a really sudden hormonal fall because of that. And for the majority of women who can take HRT, it’s a good idea to start off with that just to help your body to get back into balance.

Don't panic!

So I hope this has given you a little bit more information about HRT, and as I said at the beginning, you know, this is another one of these studies. They come out every now and again and there’ll probably be another one in six months’ time saying everything is absolutely fine. So don’t panic too much, but if you’re worried in any way whatsoever, please go and see your doctor. And I will look forward to seeing you next on A.Vogel Talks Menopause.