Search for
Search for
Search forThe menopause is no laughing matter
Monday, November 17, 2008, 23:00
The Creator was not in an entirely generous mood the day he made women. He gave her just enough female hormone (oestrogen) to last until her 50th birthday and then mercilessly took it away when her reproductive role had come to an end.
The menopause can leave some women feeling miserable. Depression, hot flushes, poor sleep, headaches, loss of interest in sex, dry vagina, weight change and increased risk of fractured bones all add to the hardship that women have to endure.
Some women find the symptoms mild; others are tormented and cannot enjoy life. Fortunately help is at hand in the form of Hormone Replacement Therapy (HRT), which can treat or delay the symptoms of menopause. So what is HRT, how does it work, is there a downside to the treatment and why are many doctors and patients reluctant to use it?
HRT usually contains two hormones, oestrogen and progesterone. If a woman has had her uterus removed then only the oestrogen is needed for the tretament. HRT is available as a tablet, patch, cream or implant.
It stops hot flushes (77 per cent of patients), improves headaches (30 per cent), helps insomnia (55 per cent) and reduces the rate of bone fractures by delaying osteoporosis.
It improves many of the psychological symptoms and can give a woman back her confidence (30 per cent).
Some women take HRT for a few years to get them through the worst, while others stay on it for five or more years as symptoms may come back when they stop HRT.
There is a downside, however. All medication has side effects. The severity of side effects ranges from mild nausea and breast tenderness (10 per cent) to an increased risk of breast cancer.
People (quite rightly) fear cancer and doctors are always taught to first do no harm. The risk of cancer with HRT can be worked out and should be weighed against the likely benefit. This would allow women to make an informed choice about it.
How much risk is acceptable? Breast cancer is a risk to all women, not just those on HRT. In women aged 50 to 65 who do not take HRT, the normal risk of developing breast cancer is 3.2 per cent over the next 15 to 20 years. Taking HRT (for five years) increases this number to four per cent.
Put another way, for every 125 women who are prescribed HRT, one of them will get breast cancer as a result. Take HRT for less time and the risk falls. Take it for longer and it increases.
Weighed against the benefits of improving flushing, headaches, insomnia, depression, and delaying osteoporosis — some women will be happy to take a 1/125 added chance of breast cancer. Others will not. Every woman is different.
In you find the risk unacceptable, don't pull your hair out! Other options are available. Black Cohosh and Clonidine are two. They do not carry any increased risk of breast cancer. Ask your doctor for further information on these. In the meantime tell your husband or partner to count his lucky stars and go walk the dog until you feel like putting up with him again.
