Women have struggled for decades to get help through menopause, but it’s about to change Kate Muir

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HRT used to be a dirty word. Now it’s a battle cry. Women will gather in London’s Parliament Square later this month to support menopause law to demand free prescriptions for hormone replacement therapy in England. The bill could help thousands of women access this life-changing treatment and will put menopause under the microscope.

A combination of medical sexism, hysterical reporting, and outdated science has kept women from asking about the health care they need for years. HRT supplements the estrogen, progesterone (and sometimes testosterone) that women lose during menopause. HRT has long been considered controversial based on previous misleading reports linking the treatment to a risk of breast cancer and dementia.

However, last week, a BMJ paper examining more than 100,000 HRT users in the UK over two decades found that there is no general link between hormone replacement and an increased risk of developing dementia. Meanwhile, the science that puts the many different types of HRT together in one “Causes Breast Cancer” basket is being questioned by menopausal experts.

I speak of the battlefield after taking a plant-based, body-identical HRT myself for five years, which I fought for at the NHS. This newer, body-identical HRT, which shares the same molecular structure as our own hormones, is much safer than the older, synthetic HRT pills.

Before I took HRT, I was in a hot mess of hot flashes, memory loss, and unsteady anxiety. Now I drive there like a steady, hormone-powered Tesla. I intend to take this HRT for life, not just for the short-term symptoms, but for the proven long-term health benefits that include prevention of osteoporosis, dementia, and heart disease.

Why haven’t I been told about the long-term benefits of HRT from my GP? Why wasn’t the discussion about menopause as common as it was about puberty or menstruation? Part of the answer is ignorance. It’s only been a year since menopause was added to the school relations and sex education curriculum following a #MakeMenopauseMatter campaign. By then, biology students had been taught the beginning of the period, but had no clue that it ended, on average, at age 51 – although the kids may have noticed that Grandma wasn’t after a box of Tampax along with her Horlicks and Murray Mints asked.

Until recently, many women – myself included – helped to keep quiet about their experiences with menopause. This was partly due to the fear of age discrimination, of losing our jobs and our status if we admitted our brain fog and hot flashes that we were experiencing. But now we have MPs like the exuberant and unstoppable Labor Carolyn Harris, who is bringing the second reading of her menopausal bill through parliament later this month. In addition to being free of charge in England (it is already free in Scotland and Wales), the bill will also address broader issues related to menopausal rights and education, especially in the workplace. Or as Harris puts it: “It’s the menopause revolution!”

A sexist, ancient culture has kept menopause – and the stigma associated with it – hidden for decades. In a TUC survey of 4,000 women, 85% said that menopause had affected their working life. Many women have lost their health, their jobs, their relationships, and even their menopausal life when suicide rates peaked.

But there are also many questions for the scientific and medical community about the roller coaster ride of health issues surrounding HRT that has damaged its reputation and generated shocking headlines. Most notoriously, the 2002 Women’s Health Initiative (WHI), an American study of more than 16,000 women, reported that breast cancer rates were increasing in HRT users. As a result, millions of women threw away their treatment. It wasn’t until years later that the WHI study was discredited, showing that the median age of the women in the study was postmenopausal, with many smokers at 63 and most of them overweight, all key factors behind increasing breast cancer rates. The study also looked at the older synthetic HRT pills, which carry greater risks than the new body-identical HRT, which is now available through the NHS.

Still, these headlines stuck with a lot of people, including me. I avoided HRT until my symptoms made it impossible to work without it. After my own health mess, I started investigative journalism and produced Davina McCall: Sex. Myths and the Menopause Documentation where we debunked the results of the GHI report for common women using a pink and white ball pit in a Shoreditch cocktail bar.

Studies on HRT and its supposed association with dementia are being reassessed. A study led by statistician Yana Vinogradova from Nottingham University aims to shed light on contradicting findings about this connection and aims to “calm women who need hormone therapy during menopause”. Interestingly, the study also showed that in women who have been using estrogen-only HRT (usually after hysterectomy) for more than 10 years, a 15% rate reduction in dementia.

In particular, body-identical HRT – now the most preferred by NHS and menopausal specialists – shows positive effects in preventing age-related deterioration of the brain after hormone drainage. This is where the HRT story begins to get really promising. It’s time to take a fresh look at HRT, perhaps with the transgender community doing similar work on hormones, and realize that the positives far outweigh the negatives in people looking to take HRT . October 18th is World Menopause Day: Time for a scientific and social rethink.


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