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Should you take HRT? Here’s how to think clearly about the risks


Hormone replacement therapy has a bad reputation because of potential risks to long-term health. A new look at the evidence could change our relationship with HRT – and the menopause



Health



31 August 2022

Angus Greig

THE mood swings I could handle. Ditto the night sweats, irregular periods and a libido that swung between randy teenager and old maid. Then the menopause came for my brain and enough was enough. If ageing “naturally” meant giving up the job I love because I could no longer think, I was out. Bring on the hormone replacement therapy.

Within weeks, I found energy reserves that I had forgotten I had. The urge to crawl into bed mid morning disappeared and was replaced with a clear head and renewed zest for life.

It was quite the transformation. So much so that one of the first things I wanted to do with my new mental clarity was to dig in to the science behind what was happening to me. Was I experiencing an age-related hormonal deficiency that I had, sensibly, nipped in the bud? Or was I guilty of jumping on the latest well-being bandwagon, making a big fuss about a natural life stage that would soon pass? And, importantly, am I protecting my long-term health by taking HRT or risking it?

These are questions that scientists have been grappling with for more than 80 years, ever since the first HRT was approved by the US Food and Drug Administration. Premarin, made from oestrogens extracted from the urine of pregnant horses, was licensed in the early 1940s for the treatment of hot flushes and night sweats, the most common menopausal symptoms. There are many others, ranging from heart palpitations and joint pain to brain fog, anxiety and depression.

These symptoms are eminently treatable with HRT. Yet its use has been controversial …



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