The most common myths about HRT – busted!

Have you been experiencing the onset of menopausal symptoms? Hot flushes, night sweats, fatigue, low mood, the list goes on… but you’re not sure whether to try hormone replacement therapy (HRT)? No wonder, when there is so much confusion about the pros and cons of HRT.

Women need to be well-informed to make the best choice for them and understand that, in most cases, HRT is very safe and using it to treat debilitating menopausal symptoms outweighs any risks.

Here we bust some of the most common myths about HRT to help you make the right treatment decisions for you in conjunction with your doctor:

Myth: HRT causes breast cancer

Fact: This is what most women worry about when taking HRT. However, taking oestrogen-only HRT does not increase your risk of breast cancer and in women under 51, there is no increased risk regardless of the type of HRT they are taking. Using combined HRT after the natural menopause transition appears to increase the risk of breast cancer by no more than one extra case per 1,000 women per year; after stopping, the risk of breast cancer returns to the level before you started treatment. The increased risk may be linked to other modifiable factors such as whether you smoke, drink alcohol or are overweight.

Myth: Vitamin D and calcium supplements are better than HRT to protect against fractures

Fact: Numerous studies have found that the oestrogen in HRT is extremely effective in combatting osteoporosis and brittle bones, which affects one in four women aged over 50, and in protecting against bone fractures. The hormone helps to increase bone density and strength while studies have found that, while it is important to have a balanced diet, vitamin D and calcium supplements do not appear to prevent fractures.

Myth: HRT causes heart problems

Fact: If you are in your 40s and 50s suffering from menopausal symptoms, the benefits of HRT outweigh any risks in most women. Women who need oestrogen-only HRT (without a progestogen) have a lower heart disease risk than those women who do not take HRT, in other words it has a protective effect.

There may be a small increased risk of heart disease if you start HRT in your sixties or seventies which is why it is better to start HRT as soon as you experience menopausal symptoms. Your overall risk of heart problems will also depend on other factors such as whether you smoke and are overweight.

Myth: HRT causes blood clots

Fact: There is no increased risk from HRT patches or gels. Taking HRT tablets can increase the risk of blood clots but this risk is extremely small. It is estimated that for every 1,000 women taking HRT for around seven years, less than two will develop a blood clot.

Myth: HRT can lead to womb or ovarian cancer

Fact: There is no increased risk of womb cancer when taking combined oestrogen and progestogen HRT. Oestrogen-only HRT can increase the risk which is why it is used in women who do not have a womb (who have had a hysterectomy for example).

Experts believe that if there is any increased risk of ovarian cancer, it is extremely small.

Myth: You need a thorough examination to ensure you are suitable for HRT

Fact: Usually, before starting you on HRT, your doctor or nurse will only need to check your weight and blood pressure.

Myth: Natural treatments are more effective and safer than HRT

Fact: HRT is the most effective treatment for menopausal symptoms. It is worth bearing in mind that natural treatments have not been researched as thoroughly as HRT and so you cannot assume they are safer.

Myth: You should not start on HRT too young

Fact: It is important for women who experience an early menopause or have had a hysterectomy to consider HRT. Younger women will have an increased risk of conditions such as heart disease or osteoporosis because their ovaries are not making enough oestrogen and HRT will help to replace the hormones your body would normally make until the natural age of menopause (around 51).

Myth: HRT causes weight gain

Fact: Some women may have a tendency to put on weight as they age but this is most likely due to other factors such as being less active and the menopause itself. This can be addressed by following a healthy diet and taking up exercise.

Myth: You can only have HRT for a short time, whatever your age

Fact: Women can take HRT as long as needed at the lowest effective dose. Younger women on HRT should not stop before the age of 50.

Myth: You should wait until your menopause symptoms are severe before seeing your doctor about HRT

Fact: HRT can help with mild symptoms. The earlier that HRT is started the more benefits there are in protecting bone health, especially in women under 50.

Myth: You should not take HRT for longer than five years

Fact: Each woman needs to be assessed individually for what is right for them. This may depend on their menopausal symptoms and individual risk of certain conditions. If you are taking HRT in your 40s, it is beneficial to keep taking it until you are at least 51.