Other disadvantages of taking hrt


        OTHER DISADVANTAGES OF TAKING HRT
For women who still have a uterus, a return to monthly bleeds is usually a complete turn-off. And the further past the menopause they are, the more of a turn-off it seems. Not many 60- and 70-year-olds would willingly go back to all that again. But the interesting thing is that they do, especially if they have, or are at risk of, osteoporosis.
As with most medical treatments, if the benefits of the treatment substantially outweigh the disadvantages, then people will continue with it. At present, the great majority of women who stay on HRT for any length of time are those who have had a hysterectomy; the highest drop-out rate is among those who need to take progestogen and who therefore have 'periods' and other side-effects.
Women who have just reached the menopause are usually delighted to see an end to their periods in sight, until the hot flushes come along. Then having a monthly bleed seems somehow less troublesome than coping with the flushes. For those, however, who are only mildly troubled with them, the thought of continuing with periods is probably out of proportion to the small discomfort of the flushes. The decision will be yours.
Many women over 60 seem willing to accept a return to periods once they realise they are likely to be regular, predictable and usually light; in fact they eventually become little more than just 'spotting'. Perhaps part of the older woman's aversion to periods is her memory of bulky sanitary towels, belts, even plastic 'sanitary pants'. Nowadays, every older woman has at least heard of tampons, even if she never quite got round to using them, and advertisements for slim-line sanitary towels that stick on to pants appear regularly on television. You can forget the bulk, the belt, the plastic pants. With tampons and slim pads you would hardly know you had a period. Honestly! Even buying them in shops is not the awful embarrassment it used to be — just pick them off the shelf in the chemist or supermarket and they are discreetly wrapped at the till.
How happily you return to periods will depend on your perception of the trade-off between symptoms and periods, and on your doctor's attitude to HRT. If he is fairly negative, then he will probably portray periods in a negative light; if he is enthusiastic, his enthusiasm may make you feel altogether better about it.
A comparatively minor disadvantage of being on HRT is the need for regular gynaecological check-ups. Doctors, like policemen, get younger every day, and most older women don't like the idea of being given a breast and vaginal check-up by a younger male doctor. Yes, he has certainly seen it all before, and yes, he regards the genital area with the same disinterest with which he regards noses and ears, but even so the average older woman (and younger woman too) can find these check-ups embarrassing.
It is worth making two points here: Firstly, you may not need to see a young male doctor. Most GP practices nowadays have at least one woman doctor, so you might prefer to see her. Or perhaps the practice has a Menopause Nurse who specialises in all aspects of the menopause and does these check-ups every day. Failing that, you could go to your local Well Woman Clinic, where all the staff are women, and to which you don't need to be referred by your doctor. Secondly, the regular check-up really is to your advantage. It will probably include a cervical smear (to detect any possible cancer of the cervix), a breast check (to detect any possible breast cancer or other abnormality), and a check on your weight, blood pressure and, possibly, cholesterol. Conditions that might have developed unnoticed will be picked up early; these regular check-ups really could save your life.

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