January 16th 2018
Sarah Vine: The menopause diary - to HRT or not to HRT?
September 13th 2017 / 4 comments
In the second installment of her diary, Sarah Vine makes a decision on hormone replacement therapy with a little help from the experts
A few days after the blood results, when the dust has settled, my husband and I discuss HRT. I have already spoken to my vitamin guru, Shabir at Victoria Health. I am taking Sage Complex and something for my cholesterol which, uncharacteristically, is slightly raised.
We both agree that an expert opinion is required, so I make an appointment to see Katy Clifford, my gynaecologist for the past few years. I love Katy: she’s quick, efficient and extremely direct, while at the same time being a very nice person. And then I go away with the kids for half term.
I return a week later feeling rested (having slept like a tot all week), and with my symptoms somewhat abated. I guess doing little or nothing when you’re trying to manage throbbing headaches, exhaustion, loss of appetite and the wrong kind of hotness is a good thing.
The break has also helped me make my mind up about HRT: there is no way I can carry on working, looking after children and generally keeping up the pace of life in the Gove/Vine household while feeling this ill.
In short, I am not ready to slow down. Even if I wanted to, I couldn’t afford to. I’m just not at that stage of my life - nor, to be frank, will I be so for at least another two decades. I need to keep going, and I can’t do that if I’m fighting these really quite debilitating symptoms.
So by the time I sit down with Katy, I don’t need much persuading. But when she tells me, with great excitement, that the following day NICE would be issuing new advice positively encouraging doctors to prescribe HRT, my mind is made up: I will start immediately.
Katy being Katy, she gives me a whistlestop tour of the science. Since I am so young, and below the average age for the menopause, HRT for the next few years will only be bringing me back in line with most of the female population. In other words, a zero sum game.
Thereafter, we will review the situation. The important thing is not to prescribe blind: we will need to weigh up the pros and cons in the light of my own personal health. But broadly speaking, the advantages, as we now know, outweigh the disadvantages, especially in ‘younger’ women such as myself.
Crucially, HRT protects bone health, can guard against colon cancer and the oestrogen helps keep the hearth healthy. The risk to breast cancer is there; but it is a far lower risk than the others. Katy’s view is that we can safeguard against that with vital breast screening - and that, once again, sooner rather than later is better.
The NHS offers free screening to all women over the age of 50; I will be having my first one in a few weeks' time, and investing £170 a year thereafter in having private screening until I’m old enough to get it on the NHS. It will be money well spent.
And now to the big question: does it work? Well, it’s too early to say. I’ve only been taking oestrogen, in gel form, for five days. But already my energy levels are creeping up again. I’m not falling asleep at my desk. And the muscle aches have subsided.
I am, however, still prone to overheating; my winter coats hang unused in my wardrobe, even in this weather. And the irritability hasn’t subsided. If anything, it seems to be getting bit worse…