‘I’m 76 and thriving on HRT’

In this week’s episode of the podcast, Dr Louise Newson talks to Paula, a 76-year-old woman who reached out to share her experience of being on HRT for over 30 years.

Paula explains how she was prescribed HRT after a hysterectomy when she was 44, following a complicated gynaecological history, which included an ectopic pregnancy, ovarian cysts, fibroids and endometriosis.

She had been taking HRT for a decade when the 2002 Women’s Health Initiative study was released. Paula explains how she researched the study, then weighed up her personal risk and benefits in discussion with her doctor and made the decision to carry on taking HRT. Paula was happy to stay on HRT and credits it with helping her to feel better in her 70s than she did in her 30s.

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Transcript

Dr Louise Newson: [00:00:00] Hello, I’m Dr. Louise Newson. I’m a GP and menopause specialist and I’m also the founder of the Newson Health Menopause and Wellbeing Centre here in Stratford-upon-Avon. I’m also the founder of the free balance app. Each week on my podcast, join me and my special guests where we discuss all things perimenopause and menopause. We talk about the latest research, bust myths on menopause symptoms and treatments and often share moving and always inspirational personal stories. This podcast is brought to you by the Newson Health Group, which has clinics across the UK dedicated to providing individualised perimenopause and menopause care for all women. Today on the podcast. I really want to welcome to you Paula, who is someone that I’ve connected with remotely. This is the first time I’m seeing her, speaking to her and she’s approached me because she wants to share a good news story. Sometimes some of my podcasts are quite harrowing or quite negative stories, but actually Paula’s is brilliant and actually she wants to talk about how her treatment has really kept her to be so healthy. So, Paula, welcome today. [00:01:16][76.3]

Paula: [00:01:17] Thank you, Louise. Nice to meet you. [00:01:19][1.6]

Dr Louise Newson: [00:01:19] So you are, you’ve you’ve agreed that I can share your age, which is very good. And and the people that are watching or see a photo, I don’t think you look your age at all, you’re 76 and you’re fit and well. You certainly look very fit and physically but mentally fit as well, aren’t you? Which is wonderful. [00:01:36][16.6]

Paula: [00:01:36] I like to think so, yes. Yeah. [00:01:38][1.8]

Dr Louise Newson: [00:01:38] And and so just and you do take some medication, of course. And obviously goes without saying that you’re menopausal could have 76. So the average age of the menopause is 51. Some people, I have met women who are 56, 57 when their periods stop. But at 76, you would be really, you know, creating history if you were still having natural periods at the age of 76. So you’re definitely menopausal and and you’re very open that you take HRT. But I’m just really keen to hear about how long you’ve been on HRT for, how you started it and how you’ve managed to keep going with so long taking it and what you think it’s doing for you as a person now? [00:02:18][39.2]

Paula: [00:02:18] Okay, well, I’ve been on it for 32 years since I had hysterectomy when I was 44. And I had a complicated gynaecological history before then, which started it all off when I was 22. I had an ectopic pregnancy, the discovery of a bicornuate uterus. And I was told very clearly, I must not be ever get pregnant again. And I was fine after that. I just I mean, I got on with my life, but I did have two episodes of ovarian cysts. And the second one was what led me to have a hysterectomy. I think it was a combination of the two ovarian cysts plus my previous history, my bicornuate uterus, the ectopic pregnancy, and probably quite a lot of adhesions as well. So it was agreed by a company doctor who happened to be a gynaecologist, which was really handy for us. And the man that he referred me to, which was somebody that he knew, who was a brilliant surgeon, who was also a menopause specialist as well. Which was really a stroke of luck. And he also agreed that that hysterectomy was the only way forward in that situation. [00:03:35][76.7]

Dr Louise Newson: [00:03:36] So you had your hysterectomy [00:03:37][0.6]

Paula: [00:03:38] I did. [00:03:38][0.2]

Dr Louise Newson: [00:03:39] And were you given HRT straight after then? [00:03:41][2.5]

Paula: [00:03:42] I was much to my surprise and when the specialist came and saw me, he first of all reassured me that I didn’t have any cancer because I think that was the biggest worry because the ovarian cyst was quite large. But he said, I had had not only a big ovarian cyst, but I had fibroids and quite extensive endometriosis. And I didn’t know this at all except I didn’t feel terribly well, I have to say, during my 30s at all. So he said to me, I don’t want you to feel unwell going forward. And I think, you know, with that, the result of some sort of a surgical procedure that brings you to immediate, immediate menopause, this will not be good for you without having some some hormone replacement. So he said, I have popped in an HRT pellet, which is what I started with and which will last you for six months and hopefully it will help you get better recover from the operation if you want to use it going forward, you can. And that’s how I got to continue because I felt so much better after the hysterecromy. I can’t tell you. I hadn’t realised how bad I had felt until I felt so much better. [00:04:58][76.7]

Dr Louise Newson: [00:04:59] Yeah. And isn’t that interesting because a lot of people, if they’ve had an ovary removed or they might have had endometriosis or just their ovaries, weren’t working as well, and then they get replacement hormones, they feel so much better often. But it’s, it’s really great that you were offered this, the HRT. And actually many years ago, they did give a lot more implants. So the implants, the pellets, they go under the skin, they’re slow release. And that was really because we didn’t have the patches and gels that we do now. So it was either a tablet and and actually it was it was genius. And so sometimes people gave just oestrogen or sometimes they gave testosterone as well. I didn’t know which did you have can you remember? [00:05:43][44.2]

Paula: [00:05:44] I think I just had oestrogen. I think it was just oestrogen at the time. Yes. [00:05:48][4.0]

Dr Louise Newson: [00:05:49] Which is great. And actually the recommendations now are that if people have had a surgical menopause, so they have their ovaries and womb removed, then they should be offered HRT unless there’s a real reason why not, especially when they’re young. But we’ve recently, one of our research team did an audit on one of the hospitals in London, I won’t say which one, looking to see how many women, after having their ovaries removed who are young, were offered HRT and the number was vanishingly small. And it’s really quite shocking actually. You’re removing their ovaries which are still functioning. So you’re meaning that the ovaries won’t be there, won’t be having any hormones or there will be some hormones, but not anything that was produced from the ovaries, of course. So that can lead to symptoms, but more importantly, it can lead to health risks as well. And the more I understand what menopause really is and what it means, we shouldn’t be thinking about just symptoms, actually. And I’m very interested in, you know, being well, as long as possible. And it’s this whole sort of health span rather than lifespan is so important. It’s not the age we die. It’s the journey to that age. And it’s very hard when you’re in your 40s because you do feel better than you do when you’re in your 50s and 60s because, you know, you’re younger. But actually, like you say, even in your 40s, you were struggling but didn’t realise because you didn’t know you could feel any better. [00:07:17][87.8]

Paula: [00:07:18] That’s absolutely right. And in fact, even now, I’m in my 70s. I still feel better than I felt in my 30s. And I think it was. [00:07:28][10.1]

Dr Louise Newson: [00:07:29] Because you were hormone deficient? [00:07:29][0.8]

Paula: [00:07:30] Probably, yes. I was dragging myself around. I was very tired. I was in quite a demanding role. I worked in the city at a senior level. I didn’t mind it. I was quite enjoying it, but it was full on 100% and and there was no time to breathe, you know, it really was. I know I assume that the tiredness was to do with the long hours and although I did sleep quite well, but you know, it was very long hours and, and the thing is insidious, it sort of builds up. You don’t realise. I didn’t know I had endometriosis, I had bloating. I had been kind of in discomfort during periods. But again, I’d been brought up in an era where women were told or young girls were told, Look, you’re going to have periods, you’re going to feel maybe ropey for a couple of days, take a couple of aspirin, you’ll be fine. Get on with it, which is what we all did. And I don’t knock that because that was how things were handled then. [00:08:25][55.1]

Dr Louise Newson: [00:08:26] But it still happens now. And there’s a very much this attitude that you have to put up and shut up and just get on with it and that’s your lot. And for some things, of course, we have to just put up with things, you know, certain disasters that happen or things that have happened in our life that are out of our control. I do constantly feel having that mindset we can cope with things is really important. Otherwise you dwell. And someone said to me a while ago, You can’t change the past Louise so don’t reflect on it. And I think actually that was a really good piece of advice because I, like many people, can catastrophise. I think I wish I hadn’t said that. I wish I hadn’t done that. If I hadn’t done this, that might not have happened. But you can’t change the past. But you can change the present and the future. And certainly when it’s symptoms or or we know there’s a medical reason for something and what’s happened so much and it still happens now with menopause is normalised. So it’s like, well, you will have symptoms, you will feel tired, you will have flushes, you will have low mood. But that’s just your lot. But that’s not right, is it? [00:09:33][67.7]

Paula: [00:09:34] No, no. And I think it’s it’s far better now. People can speak out, say if they’re feeling unwell. Although to be fair, it wasn’t bothering me sufficiently until I had a particular episode that frightened me. Well I went to see a company doctor about, you know, having this pain again before my hysterectomy because I felt very light headed, too. And this is something I felt when I had an internal haemorrhage when I was 22 with the ectopic, and that worried me. I thought, Something’s not right here. And fortunately, he acted immediately, sent me immediately for a scan. And I was referred, I went and saw him on the Monday and I was in hospital having surgery on Friday, which was fantastic. And you know, both those doctors really, I think, really did a great job for me. Really did. And I’m very grateful for that. And that’s a really good story. [00:10:32][58.4]

Dr Louise Newson: [00:10:34] Of course it is. So you’ve been on HRT, you felt great, and then over the years, I’m sure it hasn’t always been easy to keep HRT being prescribed for you because obviously in 2002, the Women’s Health Initiative study came out, the WHI study, which I was looking at some of the news reports recently. Actually some of the videos were saying HRT causes breast cancer. Everyone needs to stop it overnight. Like it was just awful. Actually, it’s the biggest travesty to women’s health, but you would have been caught up in some of that, I’m sure. So can you remember what happened? [00:11:09][35.5]

Paula: [00:11:10] Yes, I did. Well, when I read it, I thought, okay, I’m not, I don’t tend to panic. I tend to think, what am I going to do next? What, what’s my next course of action? What can I do if there’s something I can do. And I thought well the first thing I’m going to do is talk to the company doctor because he was the one who was prescribing this for me. There was no chance of getting it locally at all, and I was quite happy to pay for it because it worked fine. So I, we spoke about it. I didn’t think immediately, I’ve got to come off this. In fact quite the opposite. It was, my main concern was I hope he’ll be able to continue to prescribe this because I’ve been on it by this time probably for 11 years. And I thought, you know, I feel fine. If anything awful was going to happen, it probably have happened by now. A large part of what might go wrong has been removed in any event. And yes, breast cancer. Okay. It wasn’t in my family. It didn’t run in my family. Doesn’t mean to say it won’t necessarily appear, but it didn’t. And I thought no, I don’t want to panic about this. And I very quickly learned as well that this was a flawed study and it hadn’t been properly peer reviewed. And I thought, no, I don’t, I don’t want to come off it. I’m going to take, yeah, I’m weighed up the balance, I so much better. I don’t want to feel like I felt ten years ago. I want to continue to feel well as I do now. So I stayed on it, didn’t come off it at all. And with the support of the doctor. He said, Well, obviously it has to be your decision, but if this is what you want to do, that’s fine. And he continued to prescribe it until he got to the stage and carried on this, until I sort of retired myself. And and I knew that he would because I could see him privately after that if I wished that it wasn’t a problem. But I thought, you know, there’s going to come a time when it will be so much easier to have it prescribed locally. So I asked him if he would write to my GP, which he kindly did and sent all the up to date information as well, which was available at the time. I told him I’d been on it for a long time and that in his view I needed to continue on, wanted to continue and they did let me have it. But it was quite clear that there wasn’t the standard of knowledge about it within the surgery, although they were kind and they helped and they listened to, which was a good thing. [00:13:43][153.3]

Dr Louise Newson: [00:13:44] Which is wonderful of cause, isn’t it? And it’s very interesting because there are a lot of doctors now have grown up in the area of the WHI study, and some doctors and some practices were actually paid to stop people on HRT. And it was people were actually called in to be stopped because of this study, which is awful when you think about it. And and then then after that, menopause wasn’t a priority because people thought, well, there wasn’t the treatment or the treatments is too dangerous, so people weren’t being educated. So there’s a lot of people with misinformation. And as you might know, I’ve worked as a medical writer for many years, and I started doing my medical writing in 2000 when I was qualified as a GP, and I wrote a weekly column and it was for a GP magazine actually called GP, and it was just a hot topic. So I would choose a topic and I would give them some tips really. So about raised blood pressure or diabetes, and I would scour the evidence, I would summarise it and add a few references so they could see the sources. And so I wrote first about Menopause and HRT in 2000. And it’s one of the first topics I wrote that, said there’s more benefits than risks, it’s very safe, it’s well-tolerated, lower risk of heart disease and osteoporosis with some references. And then it was interesting because then I wrote again in 2002 and the study had come out. But because I wasn’t, I was just in my GP practice, I wasn’t aware of all the take people off HRT, this is awful. I wasn’t aware of all this really, because anything in medicine I’ve always looked at the evidence. So I was looking the articles that I wrote recently and this article basically just said this studies come out the WHI study. It shows that there might be an increased risk of breast cancer, but it’s only with synthetic progestogens. The risk is still lower than if someone drinks wine regularly or smokes or is overweight. So actually, this study’s really reassuring. And the study did show that it reduces risk of heart disease in some women and reduces osteoporosis. And and I thought, isn’t that interesting? I’ve just used what I read from this. I didn’t see all this sensational reporting. And so it was quite interesting that I sort of just carried on regardless. But actually what’s happened is there’s been this big media effect. There’s been this big worry and anxiety in the medical profession, especially by gynaecologists, but some GPs and other healthcare professionals. And when the MHRA took it on board. So they keep pushing all these risks and they still are with HRT. And it’s not just in the UK, it’s been globally. So globally HRT prescribing was really on the increase. It was more than 30% of menopausal women in the UK, around 40% of menopausal women in the US were taking HRT because people understood the disease prevention effects especially for the heart and bones and then suddenly that’s it. The rug’s pulled under a lot of these women. HRT prescribing went down to 4% in the in the US and around probably 5,6% in the UK. So you were very lucky that you were one of the minority that managed to keep going. [00:16:53][189.3]

Paula: [00:16:54] I really was lucky and I can’t be more grateful for this because I really think it’s made a huge difference. And I know I have a number of friends who have had terrible problems trying to get onto HRT and they shouldn’t have to fight. Women shouldn’t have to fight to to do what they think is best for their own body. We’re constantly being told you must take control of your own health, you eat properly. Do this, do that, do the other, but when you want to do something that helps you, then you’re being told no. I mean, what I can’t, I find difficult to swallow is if you had diabetes or a thyroid prioblem, which are hormone related issues, they will be routinely treated. And this is a deficit, a hormone deficit. And I can’t understand why this is done. It would keep so many women, I think, out of the doctors generally, not just for gynaecological issues, but for all sorts of other issues, you know, because they would feel well and feeling well and quality of life is so important. [00:17:59][65.7]

Dr Louise Newson: [00:18:00] I totally agree. And I think there’s been so much sort of debate about it that we’ve lost what we’re trying to do sometimes, and that happens in medicine when we’ve got lots of different opinions. People might have their own agendas as well. But I went into medicine to help people feel better and to be healthier. That was why I went in medicine and most people do actually. But also I’m quite scientific, so I wanted to give people the best treatment based on the available evidence that we have. But the other thing being a GP taught me far more than a hospital doctor, so as a hospital doctor I was for a few years before I went into general practice that was very much about evidence and regurgitating papers and giving the right drug to the right person at the right time. Really important, of course. But my general practice taught me about sharing decision making with the patients and seeing what was the most important thing for them. And even in the clinic now, we ask all our patients and they come back for three, what are the three things you want to get out of this consultation? And it’s been the best thing ever to ask because sometimes it’s not what I want to get out of the consultation and I focus on what the patient wants. And that’s really important. And like you’re saying, you’re really into your health in general. You’ve made an informed choice. And so I don’t feel as a doctor, I can say no to something when someone has made a considered choice about something. And this is where I can’t think of any other medicine that is refused so frequently as HRT. And that’s what’s really sad when we know that there are more benefits and risks for the majority. Most types of HRT actually don’t have a risk, but actually lots of other medicines have far more. [00:19:47][107.3]

Paula: [00:19:48] More risks. [00:19:48][0.0]

Dr Louise Newson: [00:19:48] Risks and less benefits. [00:19:49][0.7]

Paula: [00:19:51] I agree. I absolutely agree with that. It seems that women have had to fight for things for a very long time and it goes on. We’re not there yet. It’s improving, but we still have a way to go. [00:20:04][12.7]

Dr Louise Newson: [00:20:04] We do don’t we? [00:20:05][0.5]

Paula: [00:20:05] Yeah, yeah, yeah. [00:20:06][1.2]

Dr Louise Newson: [00:20:07] And I think also it’s convenient for society for us to be not performing quite on par. I do think it’s become more apparent what a problem it is when you think about the workplace, like you were saying. You had a very high powered job in the city and I wonder aged 44,45 if you if you had had a hysterectomy and not had replacement oestrogen, whether you would have been able to continue to work? [00:20:34][26.7]

Paula: [00:20:34] I don’t think so. I don’t think so, because I got busier after I’d had the hysterectomy. To me, things got even busier. It was a really, really busy period for me. And, you know, I mean, I was surrounded by working mums and what have you, how they managed to do it, I don’t know. Except they weren’t running the show, but they were still working extremely hard. But I had elderly parents at that time who had to keep an eye on as well. So it was, it was all consuming and there’s no way I feel I could have continued in that role had I gone downhill after the, you know, even further after, after having the hysterectomy. And I feel I would have done so. For me, energy levels are there. When I talk to some of my friends or see some of my friends or people that not necessarily friends but aquaintances, they don’t have the same energy level. And I think that’s really important and I believe that’s helped a lot. [00:21:32][57.4]

Dr Louise Newson: [00:21:33] For sure, and I think people underestimate because I was talking to someone the other day who’s doing some research into exercise, which obviously is really important in menopause. And she said, well, if we can just get people to exercise more, then they’ll feel better. And it’s, and their bone strength and their heart disease risk will reduce and they’ll be so much healthier. And I said, have you ever spoken to menopausal women who are really tired and really struggling? Because actually it’s quite cruel for a lot of them because they don’t have the energy and the stamina if they don’t have their hormones. But actually when they have hormones, they often feel more energetic and then it’s easier to exercise and then you feel healthier and you are healthier. And it all works together and it’s really important. But I think looking at workplace again, we know around 10% of women give up their jobs because of menopause symptoms, usually anxiety, memory problems and fatigue. So it’s not about having a fan on your desk or a different uniform. Which still is being told, so much. But we also know we did a survey from NHS, people working in the NHS, but we found just from surveying there’s about 1,300 people we surveyed, 37% said that they would like to reduce their hours, but they couldn’t afford to do so. So those women will be going to work and not doing the job they really want to do or they won’t be going for promotion. And I feel that’s really sad because most of us want do our job and we want to do the best we can do. You know, you turn up, and you know, when you’ve got a job that’s right for you, you’re, you’re excited to get to work. You get to work a bit early, you’re thinking about it on the way to work, you’re going home. And it’s a wonderful feeling to have a job that you really enjoy. Isn’t that? [00:23:22][108.6]

Paula: [00:23:23] It certainly is. Yes. I enjoyed my job, but I’ve never thought of that going part time because it wouldn’t have been a possibility in that role, well I understood that. But as you said, the exercise, that issue when I was in my 30s, if somebody had said to me, you need to go and exercise, I’ll have just said yeah, I’m far too busy, first thing. And secondly, I just don’t have the energy. And that was the thing I really noticed in my 30s. It felt like I was dragging myself around the whole time. So and now I don’t have that. I don’t wake up tired. I wake up refreshed. I get out of bed. I do Zumba twice a week. I took up singing during lockdown and I took my exams last year, my grade eight last year. So I’m really pleased about that. It’s been great and it’s been great fun and I think that’s really what’s important. So now I’m trying to concentrate on doing some of the things I never got a chance to do when I was younger because the world wasn’t like that, but it is now. And, you know, so I did some voluntary work for 20 years. I did 16 years as a trustee at the hospice, a local hospice. And if anything opens your eyes about quality of life, it’s doing that. It’s so important. And I also worked as a an independent specialist for the Association of Anaesthetists too, very interesting work and I really enjoyed doing that. All that was post-retirement and now I’m just having fun, which is great. [00:24:56][93.8]

Dr Louise Newson: [00:24:58] But it is wonderful to have choices as well. And certainly the more I talk and think about menopause, I think about it as a brain disorder, not a disorder of ovaries, because these hormones go into our brains, but also they’re produced by our brains as well and with our brains, obviously, we’re we’re nothing. But we know dementia increases as we age, it’s more common in women. It’s certainly related to hormones. The longer we are menopausal without replacing hormones, the greater the risk of dementia. And obviously dementia can be multifactorial. So having low hormones, eating the wrong foods, not sleeping well, not exercising, not being stimulated, they all go hand in hand, of course, and will increase risk. But isn’t it important that we can light up our brains? We can be taking on new hobbies, we can be keeping our brain active because that’s so important, Especially, you know, as you age. You want to keep healthy, don’t you? [00:25:55][56.9]

Paula: [00:25:56] Yes. And I think you want to keep interested in life as well. You know, it’s you’re quite right. You do want to keep healthy. That’s that for me is the most important aspect because you can’t enjoy your life if you’re not well. Like, you know, nobody can much. [00:26:10][14.7]

Dr Louise Newson: [00:26:10] No absolutely you’re so right. And then I wanted to ask you something, which, putting you on the spot here so you may or may not want to answer me, but you’re taking HRT. What other medications do you take? [00:26:22][12.0]

Paula: [00:26:23] I don’t take any other medication at all. At all. [00:26:26][3.5]

Dr Louise Newson: [00:26:27] So just to summarise this, you are a 76 year old lady who takes hormones but no other medication. [00:26:33][5.8]

Paula: [00:26:34] That’s absolutely right. [00:26:34][0.7]

Dr Louise Newson: [00:26:35] And I am labouring the point here to really, just to highlight, actually, because there are very few 76 year old women, probably less men, but even most people aged 76 will be taking medication, usually for blood pressure, often for cholesterol. They might take some painkillers for some muscle and joint pains at the very least. And then other medications, maybe for bladder problems, maybe for a heart arrhythmia, maybe skin condition. There’s so many things that can happen as we age. And we know that people who take HRT have less biological ageing. I can’t change the number, no-one can change the number of your, you know, your date of birth. But how healthy you are is really important. And when I think about a lot of the work I’m doing is to try and help people keep healthier, as I said at the beginning. And that’s really important when we think about draining health services as well. We’ve got a really difficult time with our NHS, but globally health systems are straining as well because we’re living so much longer with more diseases, more illnesses, more medications as well. We often talk about polypharmacy, lots of drugs people are taking. And my mother was in hospital recently and I’m not allowed to publicly tell you her age, but she is older than you. She takes HRT and she’s only she’s on one heart medication. That’s it. And when she was being admitted, the nurse, yes and what other medications? She said I’m not. Well, you must be. No, no, I’m not. And this nurse was really shocked because she’s not used to seeing people. And it’s not a coincidence. It’s not just good genes and good eating and looking after yourself because we know these hormones. Oestrogen is very biologically active. It helps every cell process to work better. So this is basic science we’ve known for many, many years. So you are just a living proof really. [00:28:35][119.7]

Paula: [00:28:37] Well, touch wood it continues. But yeah, I have to say I don’t have, take anything else. And, you know, I feel fine. Obviously we’re all going to get older, as you say, we’re all going to have to die of something. But I believe that this HRT, continuing to take it, plays a really big part in keeping well for me. [00:29:00][22.3]

Dr Louise Newson: [00:29:01] And so just before we end, just really for those people listening, there is no upper age limit for taking HRT. The guidelines and the evidence are very clear that for as long as the benefits outweigh any risks, we have an annual review if we’re taking HRT and then it’s an informed decision making. But we know that older people, even taking low doses, still has good bone protection, can help keep bone strong so people can keep taking it. As we said earlier, menopause lasts until the day we die. And so if you stop taking HRT, then you’re going to have this increased risk of diseases, possibly symptoms. But it’s not all about symptoms, as I’ve explained already. And then I know you started HRT in your 40s, but some people haven’t been on HRT for decades and they haven’t ever been on HRT or they might have been taken off in 2002 or they might never have thought about it until they reached their 60s, 70s, 80s. We do see people in the clinic who say, Well, I feel I’ve missed out, but I’m wondering whether it would help. And we’re very fortunate. We have the body identical, the natural types of hormones that we can give to women who are older because they can often be very beneficial. And we often start at a low dose, review people and people can really feel very different and healthier. And we know, you know, all the other effects as well. So I don’t want this podcast to be thinking, only listen to if you’ve been on HRT and continue because there are choices and that’s the most important thing. So, so but before I completely finish, Paula, I’d just like your three take home tips, so for three for three things really for women who are listening and when it’s alright for her. But I’m really struggling to continue my prescription. What three things do you think we should do as women to enable us to continue if that’s what we want to do? [00:30:51][109.1]

Paula: [00:30:51] Well, first of all, I said don’t be afraid of trying HRT. I would say, go read up about it, find out as much as you can about it from reputable sources and know that there are different types that you can take. So have a go. You’ll, if you if you want to take it, and you know within a few weeks you will notice a difference. And if it’s not quite right for you or you need that dose adjusted, then go back. Don’t don’t give up. and say oh well I’ve tried it, it’s not… and while we’re on this subject. There are a lot of older women, I’m sure, who would be very interested to hear what you said a moment ago about it’s not too late if you want to start, because a number of them have said, I’ve been told many times, it’s too late, can’t start it now. So that’s the good news. The second one is if you’re taking HRT, this is my view and it works for you and you’ve been through the menopause, the change has actually taken place but you’re well, don’t stop. Say if you had diabetes, you wouldn’t be stopping. If you had a thyroid problem, you wouldn’t be stopping. You’d be carrying on because there’s nothing to be gained from stopping in my view, at all. And a lot to be to be gained by carrying on having the protection against these various diseases, inflammatory based diseases that that that, you know, can make you old before your time. So I would say keep going. That would be. And finally, the third thing will be, I think as you do age and many of the people that are on HRT are much younger than me, that the more important quality of life becomes. Keeping well, feeling well, and having a good quality of life. It really is so important because you can’t enjoy your life without feeling well and also maintain your independence. Most people my age want to be able to maintain their independence for as long as possible and stay out of the doctor’s surgery for as long as possible. And I think that will help them to achieve that. And, you know, unless they’re a very strong contraindicators to say that can’t do that. But then I think, as you’ve said, I think the most women, it’s it’s safe. And for most women, it will be beneficial. [00:33:11][139.9]

Dr Louise Newson: [00:33:13] Yes. Well, thank you so much for your time for us today and for being so transparent and sharing so much information. I know it’s going to help a lot of people. So thank you so much. [00:33:23][10.3]

Paula: [00:33:23] Thank you for having me Louise. Thank you very much. [00:33:25][2.0]

Dr Louise Newson: [00:33:27] You can find out more about Newson Health Group by visiting www.newsonhealth.co.uk. And you can download the free balance up on the App Store or Google Play. [00:33:27][0.0]

ENDS