59 - Can you start HRT after 60? What the evidence shows
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What is the main topic discussed in this episode?
There are many benefits of taking hormones, as many of you know. But one of the questions that comes up a lot is, can I take HRT if I'm over the age of 60? So I want to unpick this because it causes so much confusion and I don't think it should.
Can women over 60 safely start hormone replacement therapy (HRT)?
So let's think about hormones first. And when I talk about hormones, I'm only talking about three of dozens of hormones we have in our body. So we've got progesterone, we've got estradiol and testosterone, and they're made in our ovaries, they're made in our adrenal glands, they're made in our brains, and they're made in other organs and tissues. And as you know, they're chemical messengers. So they go into our bloodstream and they affect every single cell in our body. They have really important biological actions in our cells to keep us healthy, like our other hormones do. But when we become menopausal, the levels of these hormones reduce and decline, and then they stay low forever. Now, because we still produce hormones in other tissues, we are still getting some hormones.
And because our other hormones are biologically active, they can often take some of the jobs of our other hormones, but not all of them. So we have receptors on each cell that are specific for each hormone. So we have a progesterone receptor. We have an estradiol receptor. In fact, we have two of them. And we have testosterone receptors. And as you know, I'm sure as well, is that our cells are constantly being remade. Like if you think about just our skin, we're constantly shredding skin cells from outside of our skin and our body's making new ones all the time. Our bone is dynamically active. We're building new bone and breaking down bone all the time and repairing. Our blood vessels are regenerating.
In our brains as well, we are forming new brain cells all the time. And all of these cells have receptors for these hormones in them. And so our bodies work a lot better when we have the right amount and type of hormones in our body. But as I've said, when women become menopausal, the hormone levels reduce and stay low. The average age of menopause in the UK is 51, but we know in many countries the average age of menopause is younger, in the 40s. And you also know that our hormone levels fluctuate and start reducing often 10 years before we're menopausal. So women in their 40s will have hormonal changes that often affect them. Now, traditionally, menopause has been thought of as something that doesn't cause periods, and indeed you have to be a year since your last period to officially be menopausal.
But also, once they discovered hormones many years ago, they associated low oestrogen with hot flushes, So a lot of people think menopause is lack of periods, hot flashes and night sweats, the so-called vasomotor symptoms. And indeed many doctors still think that's how we define menopause. But we need to be thinking beyond that because we know the symptoms can be a lot more than flashes and sweats. And there are a lot more severe symptoms than flashes and sweats as well. When we've looked at our data of hundreds of thousands of women who are reporting their symptoms often daily on our Free Balance app, then we notice that the most frequent symptoms are those affecting our brains. So symptoms such as memory problems, fatigue, brain fog, poor sleep, reduced concentration, irritability.
but also symptoms such as muscle and joint pains, urinary symptoms, reduced libido. And in fact, flushes and sweats aren't even in the top 20 of common symptoms. Now symptoms are often worse and more severe during the perimenopause when hormone levels fluctuate. But when women are menopausal, many of us still experience symptoms. Symptoms of vaginal dryness, soreness, irritation, urinary symptoms, so cystitis, urinary incontinence, increased frequency of urinary tract infections. Those symptoms often persist and continue, sometimes forever, but for many years. There's been lots of studies looking at how long the symptoms last for. And it depends what you read and it depends on the study.
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Chapters
4 chaptersSpeakers
1 identifiedMore from The Dr Louise Newson Podcast
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