We know that HRT (hormone replacement therapy) is the most effective treatment for symptoms of the peri menopause and menopause. HRT can improve quality of life and wellbeing. There is good evidence now that HRT also protects against risk of future diseases. The menopause is a time when risks to health start to climb. Before the menopause women’s hormones are protective against heart disease and bone thinning, meaning generally women before the menopause have lower health risks compared to men. Once the menopause starts and hormones drop this protection also diminishes. HRT can reduce the risk of developing heart disease by up to 50%, treat and prevent bone thinning and reduce the risk of fractures. There are also studies showing it reduces the risk of developing osteoarthritis, type two diabetes, depression, bowel cancer and there is growing evidence that it may also have protective effects against dementia and Alzheimer’s disease.
The key to the benefit of replacing hormones is timing. Starting hormone replacement before these disease processes take hold is important. Because with the exception of osteoporosis, bone thinning and low mood for which HRT is a very effective treatment, for the other diseases the effect it has is in prevention. The evidence shows that starting HRT within 10 years of a woman’s menopause, which is usually before the age of 60 years old is when these health prevention benefits can be found. This is termed ‘the window of opportunity’. There may still be benefits to starting HRT beyond this window of opportunity, but this depends on an individuals’ health and circumstances and would require a more in-depth conversation with a doctor.
HRT is particularly important for women who enter the menopause at a younger age. Some women experience the menopause before the age of 40 years old. For these women their health risks of not having hormone replacement is particularly high and therefore it is vital they receive HRT for long term health and wellbeing, at least until the average age of the natural menopause which is 51, in the UK.
As well as the direct long-term health benefits of HRT, many women feel better on HRT. This can allow them to be more engaged in leading a healthy lifestyle. We know that a heathy lifestyle with exercise, a balanced diet, good sleep and minimising stress has a positive impact on your health as a woman get older.
Women can continue to take HRT for as long as they wish if the benefits outweigh any potential risks for you as an individual. If a woman stops taking HRT her health risks will start to climb again because she will be in an oestrogen deficient state again.
The average woman now lives into her 80’s. Therefore 1/3-1/2 of the average women’s life is in the menopause, without oestrogen.
The evidence shows that the majority of women would benefit from taking HRT.
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