The Controversial Topic of HRT – Through the Eyes of a GenXer
When I was writing my course The Menopause Playbook, I took a good look at Hormone Replacement Therapy (HRT). Not to lecture others on it but to figure out what I actually thought about it. What started innocently with a slight bias towards “natural treatments”, ended with me going full circle, depending on oestrogen like it was the crack of midlife.
A Virgin on the Contraceptive Pill
But let’s start at the beginning.
Like many of us GenX’ers, I was put on the contraceptive pill before I even had sex. I had absolutely no clue about hormones but my period cramps were so painful that it was decided “the child needs hormones”. My teenage years were spent carrying around my wheel of pills, always worried that I might forget to take them. Since we were all on it, we generously handed them out to our girl friends or nicked one of theirs during an unplanned sleepover.
I felt protected when I eventually used it as a contraceptive and never questioned why I had migraines, digestive issues and sex wasn’t as mind-blowing as Cosmo told us.
That was until I stopped taking the pill in my early 40s - and OMG - what a difference that made!
After two decades of suffering through debilitating headaches and bloating, both disappeared within weeks (full disclosure: I also changed my diet) but the biggest change was how my mood, energy and confidence shifted throughout my cycle. I freaked out at first, convinced there was something wrong with me (my breasts seemed to have a life on their own) until I discovered a pattern - everything was rising and falling in sync with my female hormones. A very strange feeling after 25 years of hormonal flatlining.
And don’t get me started on sex. It was as if someone lifted a lid and allowed me to go from a little flame to a roaring fire. My first thought was - fuck, I missed out on this for over two decades! My second thought was to never ever take hormones again.
But you get older and wiser.
After reading many, many research papers, a ton of books and articles I realised there are hormones - and then there are hormones. They can be chemically identical to what our bodies naturally produce or be very different, like Premarin – one of the earliest forms derived from horse urine (😲). You can pop them as a pill or apply them to your skin. And they do far more than keeping hot flushes at bay or giving you a radiant glow.
Here are my biggest aha moments:
You can be as healthy and youthful as you like (eating salad, working out, self care and what not), your hormones will decline and you will suffer the consequences.
Declining hormones increase your risk of long-term health issues like heart disease, osteoporosis, diabetes and Alzheimer’s.
Taking oestrogen and progesterone has been shown to reduce the risk of long-term health issues associated with hormone decline, eases menopausal symptoms, and significantly improves sleep quality (I love taking my little progesterone pill before bed!).
The contraceptive pill doesn’t fully replace the hormones that naturally decline during menopause.
Taking oestrogen orally slightly increases your risk of stroke and breast cancer, so it’s better to use a cream, spray or patch instead.
If you still have a womb, you’re advised to never take oestrogen on its own and always combine it with progesterone. This helps lower the risk of endometrial cancer.
Why I’m on Board with HRT (but Open to the Debate)
The new generation of bio-identical hormones are a far cry from the contraceptive pill I took in the 80s and 90s with none of the nasty side effects. The more I read about HRT or BHRT, the more I’m convinced that we should at least consider them to restore our hormone levels to protect us from cognitive decline, brittle bones and heart disease.
I know it’s a polarising topic and I’m not here to push anyone on a path they don’t want to follow but I found the research solid and very convincing. For now, I’m happy to top up my oestrogen and progesterone because I can absolutely feel the difference.
As always, I’m interested to hear both sides of the story so if anyone here is on HRT and loves it as much as I do, tell me. And if you’re in the HRT-is-evil camp, I’m genuinely interested to hear why you’re against it and what you're doing instead.