Dr Caoimhe Hartley

And we're giving numbers to women, but it's not really what we're prescribing them anymore.

So I agree, I don't know where is the driving force to do up-to-date research on what we're actually using.

But that's the issue, isn't it?

They weren't looking for breast cancer, they were looking for heart disease outcomes, which is why the average age is whatever, 63, I think, because older women are more likely to have heart attacks, etc.

Anyway, nowadays, no one that I'm aware of at the moment is sitting down to do this kind of purpose-built study for modern HRT.

Most of our modern HRT research comes from observational evidence.

So, for example, the Danish osteoporosis study, or DOPS it's called,

they looked at a population base who were diagnosed with osteoporosis and then they went backwards and said, well, how many of them were on HRT?

What type of HRT?

What happened to them on their HRT?

How many of them were developed, you know, were developed breast cancer?

How many of them X, Y and Z?

So they looked backwards.

So it's observational, not purpose built.

Absolutely.

I mean, I don't see the 20% of women who are not symptomatic because they don't need me.

They don't make an appointment to come in.

So I'm seeing a skewed population who are really symptomatic enough that they want to reach out and make an appointment.

The cognition, I mean, it's not just your brain, like most of you is built to adapt to losing oestrogen.

I feel this is controversial, to be honest, because there's a school of thought out there that, you know, you go through menopause, you lose oestrogen, it's oestrogen deficiency.