ACH Blog

Menopause HRT and Ageing

Isobel Cosgrove - Friday, April 17, 2015

There are very few models for creative ageing in western cultures. We seem to have lost the art of revering the elders, and the role of handing down wisdom through generations is fading as technology races ahead of us.

HRT was hailed as the answer to menopausal symptoms a decade or so ago. Gradually, in the last few years, research has begun to question the value of being on hormonal drugs for more than a short time. They may be good for crisis management, but not so good as a post menopausal way of life. Hormone treatment keeps us in a pre-menopausal state by increasing the body's oestrogen levels. It delays the onset of menopause and therefore delays the important transition all women have to make into post menopausal life. In a culture which reveres youth and is afraid of - or in denial about - ageing, anything which delays this process is seen as a good thing.

However, currently GPs are advising women who have been on HRT for more than five years to consider coming off altogether in the interests of their continuing good health. The Million Women Study, launched in 1997, has followed 1.3 million UK women over the age of 50 through breast screening centres. One in four UK women in the target age group have participated in the study, making it the largest of its kind in the world. The results have confirmed the relationship between HRT and the risk of breast, endometrial and ovarian cancer. As a result the Million Women Study has had a dramatic effect on HRT prescription patterns and prescription guidelines, leading to a reduction in breast cancer rates. In the UK, HRT use has been falling since the millennium. Studies suggest that in 2005 there were 1,400 fewer cases of breast cancer in the UK among women aged 50-59 than would have been if there had been no drop off in HRT use.

Last month The Times and The Guardian both featured short articles quoting research which indicated that menopausal and post menopausal women have hot flushes and/or night sweats for seven or more years. It poses the question that if prevailing wisdom says only have HRT for five years at most, what can we do to help ourselves manage these symptoms?

Understandably some of us worry that by coming of the drugs we will experience a return of menopausal symptoms. It is always better to come off a drug slowly, gradually reducing the dose. The body adapts best to a number of consecutive, small changes over a period of time. While our bodies go through this biochemical and physiological transition, acupuncture and Chinese herbs can help the hormonal system to find a new balance and stabilise, and provide a place to talk through our concerns. Then we ourselves can start to regulate our own hormones again, instead of relying on the drugs to do it for us.

There are tried and tested herbal formulas which have been used for many decades to reduce hot flushes and night sweats. Many of our clients have benefitted from using a combination of acupuncture treatments and daily herbal tablets as an alternative to starting HRT, or while slowly coming of it.

In the west the clear message is to defy ageing, to use drugs to stop the clock, to use surgery to change our body shape to prolong youth. To age is seen as defeat. Our challenge is to redefine ageing so that it is seen as a life achievement, a celebration of a life lived. As youth passes, as energy levels slowly change in the older person, so our experience of life becomes more important and we have the wisdom of life's experiences to hand on. This has been called the Second Adult stage of life. It is important that we all feel able to acknowledge and honour its gifts, strengths and unique opportunities.

Isobel Cosgrove


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