Can you start HRT after 60?
I started taking Hormone Replacement Therapy (HRT) about eight weeks ago and since then it seems that it seems that taking HRT has become a rather toxic debate.
Doctors are being pitted against doctors in the press, from writing articles in learned journals such as the British Medical Journal (BMJ), to, er, rather less learned newspapers such as the UK’s Daily Mail Online. The menopause causes many changes in women’s bodies, and many of these changes can negatively affect a woman’s body as she body as she ages.
Women and men are living longer, and these physiological changes that women experience after the menopause can negatively affect their quality of life for a lot longer than might have been the case thirty or forty years ago, when the population was not ageing in the way the in the way that it is now. Indeed, the recent UK census result show that, show that the ageing population in the UK is larger than Generation Z (those born around the mid-90s to 2010).
I decided to take HRT after experiencing some symptoms that I thought might be related to the menopause. These included these included poor sleep, feeling full when I hadn’t eaten, and intermittent hot flushes (flashes).
I’d listened to a really interesting podcast by Zoe, the Imperial College Health Study, focusing on the menopause, and which discussed what women lose when they go through the menopause and the protective effects of HRT. One of the most interesting facts I learned was that the study, now around twenty years old, which had revealed women were more likely to develop breast cancer if they took HRT was now discredited, due to the fact that the cohort of women in that study had several other health issues such as obesity which would have lead them to develop the disease in any event.
So I spoke to my doctor, who was rather reluctant to put me on HRT, given that I was well over 60, and I was over ten years post-menopausal. To address the fullness, he sent me for a colonoscopy to check my bowels, and an ultrasound to check on my ovaries. Happily all was found to be normal, although I did have ovarian cysts, but I had had them for some time and they are benign.
So I decided to seek specialist help from a specialist menopause doctor. The doctor was very honest about what she felt what she felt HRT might and might not do for me. She certainly didn’t suggest that it could help me with my sleep, in fact she doubted it, but she said only time would tell if I decided to take it.
We talked about the fact that both of my grandmothers had lived long into their nineties, although sadly not my mother, who died at 69 of a heart attack, and the most persuasive idea that formed in my mind when speaking to the doctor about the fact that I about the fact that I might live a very long life, well into my mid-nineties and beyond, was that I would want to live well live well and healthily.
I found out a few years ago that I had a condition called osteopenia, which I was told at the time was a step on the road to osteoporosis. I didn’t really take the time to enquire further but I knew my mother had had osteoporosis so I thought I would do as the doctor said and take the prescribed medication, called alendronic acid. It was a pain to take because you had to take it first thing in the morning and sit (or stand – as if!) for 30 minutes after taking it. I did this for a year or so but then thought to myself, why am I medicalising a condition – stupid girl that I was, I should have read around the subject – so I stopped taking it and then went on to develop full-blown osteoporosis a few years later, so restarted the tablets.
However, there is some debate about whether you should stay on this medication for too long, as some studies have shown that it can be harmful after a while and have the opposite effect, so rather than protecting your bones from breaking it can in fact make them more likely to break. HRT, on the other hand, once started, will keep your bones at the density they are when you start, so will fulfil the same role as the alendronic acid, but without the concern that you may have to come off it eventually.
Recently, research has revealed that women taking the combined HRT medication have a 9% lower risk of dying from any cause than women who do not take HRT. And that is was I was prescribed, a patch of oestrogen twice a week and a daily progesterone pill. As the scientific peer review community would say, more research is needed, but the signs are positive. After all, what is HRT? It’s a hormone, replacing what we’ve lost, so although nature has decreed women must go through the menopause, with all its attendant risks, there is no reason why we shouldn’t do our outmost to say fit and healthy by trying to put back our bodies, if not to where they were before, at least to a time when they had more oestrogen with all the benefits that brings.
So, having been on HRT for a few weeks now, what have I noticed? Well, honestly, not much. I may have slightly fewer hot flushes, but I wasn’t having that many to begin with. I’m about to have my three-monthly review with the doctor, and of course I will let her know that I don’t really feel any different.
But will I stay on HRT? Yes, I definitely will.
Why? Well, the primary reason is that I can do away with the alendronic acid weekly tablet and protect my bones. But the other reason is that, from current research, HRT provides some protection against other diseases, such as heart disease. There is heart disease in my family, and if I can help to protect my heart by taking HRT, as well of course as watching my diet, keeping a healthy weight and not smoking, then that’s what I’ll do.
I’m just annoyed with the medical community that they didn’t think to give women a choice about HRT instead of putting barriers in their way.
Of course HRT is not the holy grail, nothing is, we will all shuffle off this mortal coil at some point, but if I can live a long life feeling as healthy as possible, then that’s what I’m going to do.
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Have a great week,
Love Dez
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