To HRT or not to HRT… that is the question

28 Mar 2023
No Comments


Hot flushes, night sweats, anxiety, irregular periods, mood swings, vagina dryness, breast soreness, headaches, burning mouth syndrome, itching, sleep disruption, low libido, fatigue… these are just some of the 34 ‘official’ symptoms of peri/menopause and there may be more (bladder infections, high blood pressure, increased facial hair to name a few more). It’s no walk in the park for many, many women.

The answer’s easy, right? Just go to your doctor and get a prescription for HRT, it does what it says on the tin – hormone replacement therapy.

But it’s not that simple

Firstly, many women have to battle with their GP’s to be taken seriously (You’re only 44, you’re too young… You’re stressed, depressed, anxious, it’s all in your mind…), then there are still many medics who don’t ‘believe’ in HRT or they’re stuck in the old-school belief that it’s dangerous (yes, the 1996 Million Women Study is still cited associating breast cancer with HRT despite it being discredited as not fit for purpose and completely misleading – and HRT itself has moved on from being made from pregnant horse’s urine to it’s modern incarnation made from yams, identical in makeup to the hormones the body produces naturally).

Secondly, you might not be suitable for HRT whether it’s down to family history that means you have an increased risk of breast cancer or other illness, or perhaps your own medical history throws up a red flag – if you’ve had breast cancer for example (as I have).

And even if the first two aren’t an issue for you, you may not find HRT suits you. There is trial and error involved because we are talking about fluctuating hormones here, one minute you might be in a state of oestrogen-dominance, the next it might have subsided.

Or you might simply not want to have it, for whatever personal reason.

Without a doubt, HRT can offer tremendous benefits, it can help to manage some of those symptoms, it can also reduce the risk of diseases such as osteoporosis, dementia, cardiovascular disease, so where does that leave you if you can’t have it? It can feel like the HRT party bus is waiting at the bus stop but you haven’t got a ticket to get on.

So, how do you cope through this life stage? Whether you’re on HRT or not, you simply cannot ignore your own lifestyle choices… you can’t take a tablet (or patch or gel) and think, “That’s that then, I don’t have to do anything else, it’s all taken care of!” because there are lots of other factors that will impact your hormones and your health.

For example, being overweight or obese increases your risk of high blood pressure, diabetes, even certain cancers. Drinking too much alcohol has obvious ramifications on your health, particularly your liver as it tries to metabolise it, but it also impacts on your weight, your food choices, your sleep. Lack of sleep increases your risk of developing dementia as well as diabetes, high blood pressure, heart disease.

There is no one magic solution, your health is like a jigsaw made up of lots of little pieces that come together to form the big picture that is your good health!

Nutrition, exercise, relaxation are your pillars of health, and sleep is the foundation. Getting these four elements in balance is the key.

Nutrition – eat a variety of plant-based foods, with an emphasis on proteins and healthy fats, reduce refined sugar and ultra-processed foods. Your liver prioritises alcohol and sugar metabolism, it also metabolises your hormones. When it has an overload of toxins to process, it can cause hormonal mis-fires as it shunts hormones back into circulation.

Exercise – is good for your body and mind, it release endorphins and positive hormones like serotonin, your mood stabiliser. Mixing in strength-building movements helps to support your muscles and bones which can reduce your risk of developing osteoporosis.

Relaxation – and I include stress management here, as well as finding your joy in life! Do what you love to do, spend time with people you love and who love you, notice the little things in your life, feel grateful for every day and make it count in whatever way you want to, big or small.

Sleep – sleep has been largely marginalised in our busy lives. We regularly steal from the night to augment the day, there’s just so much to do, from work to entertainment, we struggle to fit it all into our day. But lack of sleep has a profound impact on our lives, when we don’t get enough sleep we tend to reach for sugary fatty foods to shore up flagging energy levels, we don’t feel much like exercising and those relaxing activities end up with us falling asleep! Sleep is a time for our physical rest and restoration, but even more it’s important for our brain health, it’s a time of memory consolidation, it’s when your brain clears out toxins that build up in the day, it’s a protective activity.

Stop leaving your health in the hands of others, take back control! It’s all about those every day choices you make…

Read more in this interview…

Geraldine Joaquim, 52, hypnotherapist and wellness coach

Share this post