Menopause Without HRT
Can you really get through menopause without HRT?
We’ve all heard of HRT as a treatment for menopause symptoms and since the Davina McCall programme ‘Sex, Myths and the Menopause’ aired in 2021, there’s been a huge push to get as many of us as possible onto HRT when we reach menopause. Davina’s done a great job at bringing menopause out of the closet and getting everyone talking, but despite the narrative that HRT is safer than before, many women are still nervous about taking it. So if you’re struggling, is it really possible to get through menopause without HRT?
Let’s have a look….
What Is Menopause?
Firstly, we need to understand a little bit about what’s going on. Officially, menopause marks the first year’s anniversary since your last period, but it’s not quite as simple as that! For around 20% of women it passes almost unnoticed, with very mild or no symptoms. Another 20% suffer terribly, and the rest of us sit somewhere in the middle!
But for anywhere between 2 and 10 years before the big day, we can go through a phase called ‘peri-menopause’. This is the lead up to menopause, where your hormone levels will start to wobble somewhat as your body prepares for its next phase. And when I say your hormone levels wobble, I mean that virtually ALL of them do at some point or another, not just the ones you need for reproduction! Your thyroid, adrenal and pancreatic hormones are all affected too, as well as key brain chemicals like serotonin. This is why peri-menopause can bring us such a wide variety of both physical and mental symptoms at different points.
When you think of menopause, you probably think of hot flushes, mood swings and weight gain, but the fun doesn’t end there! Those symptoms your body saves for later on in the proceedings, but the signs that you’re in perimenopause can start off much more subtly. Here are a few to be aware of:
- Anxiety, insomnia, depression or irritability
- Joint pains
- Fatigue
- Loss of self confidence
- Loss of libido
- Migraines
- Heavy bleeding or other changes to your cycle
- Itchy skin
- Poor alcohol tolerance
- Constipation
Honestly, I’m not trying to scare the life out of you, but knowledge is power, and it’s good to be aware of what can happen both for ourselves and for the other women around us.
Far from heralding the start of our old age, it’s thought that menopause is actually a very clever evolutionary adaption, which has been vital for the survival of humankind. Back when we used to live in nomadic tribes, we obviously would have depended on hunting and gathering to feed ourselves. The problem was that feeding an entire tribe in this way took a lot of effort, and sometimes the hunters would have to spend long periods of time away from home. Raising babies and children was also very labour intensive, and if the mothers were taking care of their little ones, there weren’t many able people left to forage for food. So along came menopause to the rescue! That meant that the older women weren’t able to have children of their own, but could raise the others, leaving the mothers to go and get food. Elder women had also accumulated years of wisdom that would help the tribe survive any crisis, so they became highly revered for their life experience!
Women’s lives have three phases:
- The Maiden phase – childhood up to childbearing age.
- The Mother phase – childbearing age.
- The Elder or Crone phase – after childbearing age.
So where adolescence marks the transition from Maiden to Mother, menopause marks the transition from Mother to Elder. Both are natural processes we need to go through, but just because they’re natural, it doesn’t necessarily make them plain sailing. I honestly don’t know many people who enjoyed their teens, and most women don’t relish the thought of being menopausal either.
Why Is Menopause So Difficult?
Although menopause comes to most of us around the age of 50, it can happen at any point during adulthood. Very rarely, some women go through it in their teens or early 20’s, and I know one lady who reached menopause in her early 60’s! The problem is that this isn’t common knowledge, even amongst Doctors, so often women complain that their Doctor has dismissed their concerns about menopausal issues because they’re too young.
As well as the physical changes, it can be a very emotional time too. The window of opportunity for starting a family is closing, and it’s unbearable for those women who desperately wanted children but couldn’t have them for whatever reason. As another rite of passage, menopause often gets us thinking about our mortality, how our life has gone so far, and what we’d like to do with the rest of our lives. If something’s made us unhappy for a long time, menopause usually brings that to crisis point, heralding the end of unhappy partnerships or careers. The emotional and psychological side of menopause is often harder to cope with than the physical side. Everyone knows about hot flushes and mood swings and they’re talked about often. We don’t hear so much about the raging anger, the sense of grief, emptiness, or disconnection. Many women don’t realise that anxiety, depression and even paranoia can all come with menopause, and that makes them all the more frightening if they happen.
It’s not all doom and gloom though. Menopausal ladies around the world are opening up and talking about it much more. Discussions around menopause in the workplace are happening, employers are slowly becoming more aware and more supportive of their female workforce. The more we talk about it and know what the options are, the easier it becomes.
How Can You Get Through Menopause Without HRT?
The first thing most of us think of when we’re looking into surviving menopause is HRT, but it’s certainly not the only option. When considering any mainstream options make sure you use BRAN:
- Benefits – what are the benefits of the medication you’re being offered?
- Risks – what are the risks?
- Alternatives – what other options might be suitable for you?
- Nothing – what would happen if you did nothing?
Whilst BRAN is always a good place to start, finding reliable information about the risks and benefits can be tricky. You could use the BNF website here to learn more about the benefits and side effects of the specific medication you’re being offered. Your Doctor or Pharmacist will be able to tell you about the benefits, and how long it might take for you to notice a difference.
For alternatives, you’ll need to look elsewhere but there are lots of options. Self care is always the best place to start, as it’s good to get the basics in place, and even small changes can make a big difference. If after that you still need more help, there’s plenty available, but do make sure you check out any prospective practitioners thoroughly before you hand over any money.
Self Care During Menopause
Usually by the time we reach menopause, we’ve put ourselves at the bottom of the list of priorities for a very long time. Family, career or other commitments have come first, and perhaps we’ve spent years not getting quite enough sleep, or moving enough, or eating quite as well as we could. When menopause happens to a chronically overstressed, overtired, undernourished person, it’s no wonder we can run into problems is it? But luckily our bodies are very forgiving when we step up and take better care, and for me, tackling the root cause of the problem first makes far more sense than simply taking medication.
Bestselling personal growth author Louise Hay said “When you love yourself, everything in your life works”. That doesn’t mean that you need an ego the size of Australia, or that life will never throw you a curve ball. It means that when you love yourself you will:
- Have firm boundaries to keep you safe from burnout
- Work to live rather than living to work
- Nourish your body with healthy foods
- Move your body in a way you enjoy
- Rest when you need to
The list goes on, but you get the idea. Our capacity for just about everything can really diminish during peri-menopause, and that’s not necessarily a bad thing. If you’ve lived at 100 mph for most of your life so far, menopause might just put your brakes on for a while anyway. This transition calls us to slow down, take stock, put ourselves first, and contemplate how we’d like the rest of our life to go.
What Other Options Will Help You Through Menopause Without HRT?
Sometimes self care on its own simply isn’t enough, especially if you’re one of the unlucky 20% who are really suffering.
Herbal medicine, hypnotherapy, health coaching and nutritional therapy all work in different ways to get you back on track. If you’re willing and able to invest in some help, the sky really is the limit, and I’d suggest you assemble your own ‘team.’ They might include the friends who will make you laugh no matter what, your GP, maybe a meditation or yoga teacher, or a massage therapist, and someone who can work on getting your hormones back to their happy place.
And of course helping you navigate menopause without HRT is my favourite thing to do! There are plenty of options available, but to get really quick, lasting results, it’s best to work on the physical, psychological and emotional aspects at the same time. You can find out how other women have got on with this approach here.
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