By Jane Feinmann
If menopausal symptoms strongly interfere with your daily life and your sleep then you may be considering HRT (hormone replacement therapy).
Most women apply a skin cream before bedtime. My daily regime is a blob of oestrogen gel, a hormone replacement therapy that my GP has prescribed on the NHS ever since I went through the menopause. Yoga and a healthy diet has kept me healthy enough in my sixties.
But it’s the HRT that stopped hot flushes, mental fog and other menopausal problems – and given me strong bones postmenopausally. That’s not just my view. There’s evidence that it works.
But surely, you ask, there are huge health risks in taking HRT?
Well not really. Certainly reports of two large-scale studies published in 2002 and 2003, persuaded many thousands of women to bin their HRT. And I’ve interviewed some who suffered barely manageable menopausal symptoms thereafter. 
Yet from the word go, menopause experts – gynaecologists and hormone specialists (endocrinologists) – have insisted that these trials were flawed – and the findings inaccurate. 
And this message continues today. On websites like www.menopausematters.co.uk, menopause experts make it clear that while HRT is neither necessary nor appropriate for every woman, it can safely relieve unpleasant symptoms and, in the long term, prevent osteoporosis and possibly heart disease.
What’s more, HRT involves ‘natural’ oestrogens – derived from soya bean or yam extract – and so-called because they are virtually identical to the female hormones oestradiol, oestrone and oestriol. Another type of HRT, known as conjugated equine oestrogen is made from horse urine. Both can be taken as a daily tablet, a twice weekly or weekly patch, an implant or, my favourite, a daily gel. Importantly, it can be taken in different strengths to suit the individual’s needs.
Be aware: any woman who has not had a hysterectomy needs to take progestogen alongside oestrogen. This too can be taken in a number of different ways. I have a Mirena intrauterine system, delivering tiny daily doses of progestogen directly into the womb – once again available on the NHS, provided you ask.
3 steps to successful HRT:
- See a doctor who will tailor HRT to your individual symptoms, past history and family history.
- Try not to give up too quickly on HRT. If symptoms persist beyond three months ask your doctor if you can try a different version.
- You can stay on HRT if it suits. Gynaecologists say there is no evidence that women need to stop HRT at an arbitrary point.
The next blog in this health series will be on ‘Fat or sugar, which is bad for your health?’.
As a freelance medical journalist for more than 20 years, Jane Feinmann has contributed to severalnational newspapers and magazines (www.janefeinmann.com), written books and produced radio programmes. She has covered the hot issues about anti-ageing and women’s health from the perspective of both mainstream and complementary medicine. Her aim is to provide the evidence base for and against, provided by authoritative research.
This is the first of a short series of blogs on health covering some of the investigations she has found most helpful.
 Managing the menopause. British Menopause Society Council consensus statement on hormone replacement therapy. Journal of the British Menopause Society 2003; Vol.9, No.3: 129-131