I suppose it should not surprise me that when official bodies are looking at treatments for Menopause and discover something “new“ it is usually something that does not involve any form of bioidentical hormones.

These have been in used worldwide for more than 30 years proving to be effective for helping with menopause symptoms, but instead they are suggesting talk therapy instead of, or as well as, HRT for problematic menopause symptoms new draft guidance for the NHS says.

What is being suggested  

I certainly have no problem with talk therapy itself as it can be extremely effective, but its benefit for menopausal symptoms has not been established in my view.

The advice  says cognitive behaviour therapy (CBT) can help with hot flushes, and sleep and mood changes. Health watchdog The National Institute for Health and Excellence (NICE) says this will give women more choice. But its critics have called it disappointing.

CBT may have a place when taking a holistic approach to managing perimenopause, but it won’t improve every menopause symptom and won’t treat the underlying hormone deficiency.

The draft says that some might want to use individual or group talking therapy sessions, either in person or online.

According to some studies, coping skills taught by CBT can help sleep problems related to menopause, including how long it takes to nod off.

NICE says the evidence on HRT has become clearer since its last guidance on menopause in 2015. Its new one lists the pros and cons of different formulations that are available.

NICE says women should pick which treatments from its guidelines work best for them, weighing the risks and benefits with the help of their doctor.

And if they opt for HRT, use the lowest effective dose which is certainly something I would agree with.

My experience has been that starting on a high dose can be counter-productive as it can bring on more side-effects which then means women being switched between different brands to try to find one that is more effective for them but without such a reaction.

What is HRT and the menopause?

As women approach the menopause their hormone levels fluctuate and drop. It is these fluctuating hormone levels which can cause problematic symptoms.

Although both hormones fall, it is progesterone levels that drop more dramatically as oestrogen continues to be made in the body from the fat cells of the abdomen, belly and thighs.

There are many different types of HRT but, like any treatment, there can be side effects or increased risks.

What are the risks?

The risks may be small and depend on individual factors, including age and existing health, as well as family history of these conditions. Ones to think about include:

• The chance of getting breast, ovarian and womb cancer
• The potential for blood clots, stroke and dementia

It might also marginally increase the risk of dementia if started over the age of 65, the guidance says.

If you are considering HRT then you need to discuss with your doctor your own personal potential for risks specifically for family history of hormonal cancer or if you are at risk for conditions such as osteoporosis.

If the latter then the synthetic progestins in HRT will not be helpful as it is the actual hormone progesterone that is needed. Our bones are being continually broken down and replaced throughout our lives and it is oestrogen that clears away the old bone, but you need progesterone to build new bone to replace it .

What about testosterone?

Although it is a male hormone, women make testosterone in their bodies too and levels can decline with the menopause.

It has been given increasing publicity and prominence with some women say taking testosterone helps a number of menopausal symptoms, in particular libido.

However, bioidentical doctors believe if needed it should only be given under direct medical supervision.

There are two reasons for this: firstly testosterone in women has a potential for side-effects and the dosage for women has not been in use long enough either for dosage or long-term use.

Helpful information:

If you feel that your menopausal symptoms are not being controlled, then it’s important to establish which hormone may need boosting.

So if you are not sure, then this article can help.

https://anna.blog.wellsprings-health.com/which-hormone-or-hormones-might-you-need/