Menopause is a natural phase in a woman’s life, yet it brings a host of symptoms that affect around 70-80% of women. These symptoms include hot flushes, night sweats, and anxiety, but surprisingly, only about 25% of women receive treatment for them.
Historically, menopause may have evolved to benefit society by having non-reproductive women available to help with childcare and food gathering. However, for the individual, the loss of oestrogen during menopause significantly increases the risk of osteoporosis, heart disease, diabetes, and central adiposity.
Hormone Replacement Therapy (HRT) is a common treatment for menopause symptoms. It involves the administration of oestrogen and progesterone, or oestrogen alone for women who have had a hysterectomy. The Women’s Health Initiative, a large-scale trial, initially suggested that HRT might reduce heart disease and strokes. Contrary to expectations, the trial found an increased rate of these conditions, approximately 0.6-1.1 per thousand people receiving HRT. This led to widespread fear and a significant drop in HRT prescriptions, which in turn caused an increase in osteoporotic fractures.
Subsequent analyses have revisited the data and found that for women who started HRT before the age of 60 or within 10 years of menopause, there was no increased risk of heart disease and stroke. In fact, for those on oestrogen alone, the risk was actually reduced. Conversely, starting HRT at an older age, such as 60 or 70, increased the risk of these conditions. This concept is known as the “timing hypothesis,” which suggests that prolonged absence of oestrogen makes starting HRT riskier, whereas continuing it after menopause is safer.
When considering HRT during menopause, it’s important to weigh various factors. However, based on the best available evidence, fear of cardiovascular disease should not be a deterrent. ❤️
If you have any questions or need further information, feel free to ask!