Hormone-replacement therapy is safer than people think. More women should take it
It is known colloquially as “the change”. The end of a woman’s natural child-bearing years is a moment of transformation that is welcome to some and miserable for others. But for too many, menopause is also a painful process that can damage their bones, heart and brain. As societies age, the question of how best to preserve women’s health during menopause is becoming more urgent. In 1990 nearly half a billion women were 50 or older (the age when menopause typically begins). Today there are almost twice as many.
About 47m women around the world reach the age of menopause each year. In Western countries, where most research has been conducted, up to 80% will experience symptoms such as hot flushes, night sweats, depression, insomnia, anxiety and memory loss. Symptoms can last up to 12 years. Around a quarter of women going through menopause feel so wretched that their quality of life is dimmed, according to studies in rich countries. Almost half of British women experiencing it say that their work suffers as a result.
Twenty years ago, doctors would routinely have prescribed hormone-replacement therapy ( HRT) to women entering menopause. But in 2002 the results of a huge randomised trial were published, showing that the treatment brought health risks, including a slightly raised chance of breast cancer after five years. Women and doctors were alarmed. Around the world they abandoned hormonal therapy in droves. Before the study, 22% of menopausal women in America took HRT. Six years later that figure had fallen below 5%. In Australia, around 15% of menopausal women with moderate or severe symptoms receive the treatment. Take-up of HRT is now low in most countries. Women are scared and doctors wary.