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[bombsh3ll]

In terms of health economics, it is much easier to quantify the short term costs; appointments, prescriptions, investigations (often inappropriate) for HRT related bleeding, than the longer term morbidity that occurs as a result of untreated or suboptimally treated menopause, because the symptoms are typically suffered in silence and the health consequences occur over decades and are siloed into different specialties eg cardiology for the premature CVD, orthopaedics for the broken hip, psychiatry, rheumatology, neurology, hospital admission with urinary sepsis etc.

It is difficult to conclusively say which individual might have got that disease regardless, and at what age, even if at a population level the rates of these diseases are significantly lower in women receiving hormone therapy. Patients are also blamed for their lifestyle, often without any relevant social history being elicited.

[sheila99]

Don't beat yourself up about it. I consider myself pretty knowledgeable about many things but I was absolutely clueless about this too, as was my doctor. It took celebs talking about on TV before I worked out what the problem was with me. My parents generation didn't talk about these things so it really should be a topic in school so at least you have basic understanding of it. My daughter is fully informed having been on the receiving end of my bad temper 

[Jules]

In terms of health economics, it is much easier to quantify the short term costs; appointments, prescriptions, investigations (often inappropriate) for HRT related bleeding, than the longer term morbidity that occurs as a result of untreated or suboptimally treated menopause, because the symptoms are typically suffered in silence and the health consequences occur over decades and are siloed into different specialties eg cardiology for the premature CVD, orthopaedics for the broken hip, psychiatry, rheumatology, neurology, hospital admission with urinary sepsis etc.

It is difficult to conclusively say which individual might have got that disease regardless, and at what age, even if at a population level the rates of these diseases are significantly lower in women receiving hormone therapy. Patients are also blamed for their lifestyle, often without any relevant social history being elicited.

Reading all that I'm definitely glad I wasn't told about It. It's bad enough contemplating old age.  My dad suffered some of that as he aged and he wasn't menopausal. I'm 68 and after reading your post I think I'm a lot healthier than I thought I was😄

[Eliphanty]

I can see the various reasons why women might or might not choose to take it. But it should be just that. A choice that we are given … not something we have to almost stumble across through chance.
That said I must admit I have never gone to the NHS routine health check that start at 40. I intend to go when invited from now on though.
Positively I’ve just googled it and it says:

New Additions (2025): Menopause awareness is now part of these checks to help women understand symptoms and seek help, improving uptake, say GOV.UK and www.healthcheck.nhs.uk.

So that is a very positive step in the right direction. Hopefully future generations of women will be properly informed.

[Jules]

I've had my health check this year. No mention of menopause. She probably thought I was too old. It's a nurse not a doctor that does ours. Big focus on cholesterol and weight and BP. The nurse talking to me about my lifestyle was at least twice my weight! But hopefully most who carry out health checks are now including menopause.

[bombsh3ll]

I think it's criminal that we don't routinely get a DEXA scan.

Breast cancer affects one in 7, we get a mammogram.

Cardiovascular disease affects one in 3, we get cholesterol, BP etc

Cervical cancer is 1 in 130, we get a smear test.

Osteoporosis affects one in two older women. Yet despite the existence a cheap and non invasive screening test, this is usually only identified when they fracture.

[Aprilflower]

From what I understand one in three are at risk of osteoporosis.

One in two are the stats for osteopenia.

Poor diet and lack of Vitamin D play a huge part in the development of both conditions, as does genetics.

[Mary G]

I think it's criminal that we don't routinely get a DEXA scan.

Breast cancer affects one in 7, we get a mammogram.

Cardiovascular disease affects one in 3, we get cholesterol, BP etc

Cervical cancer is 1 in 130, we get a smear test.

Osteoporosis affects one in two older women. Yet despite the existence a cheap and non invasive screening test, this is usually only identified when they fracture.

I've noticed the NHS are increasingly fobbing people off with the "you are a low risk" line.  They said that to my sister when she insisted on having a DEXA scan and the doctor was irritated and sighing down the phone at her while arranging it.  It turned out she obviously wasn't low risk because she's got osteopenia and she's getting lousy, inadequate treatment for it too. 

All the exercise, diets, vitamins and minerals in the world will not protect you from osteopenia/osteoporosis if you are susceptible.  Oestrogen at the right dose is the best option and it is far more effective and has far fewer side effects than osteoporosis medication. 

[Aprilflower]

I think it's criminal that we don't routinely get a DEXA scan.

Breast cancer affects one in 7, we get a mammogram.

Cardiovascular disease affects one in 3, we get cholesterol, BP etc

Cervical cancer is 1 in 130, we get a smear test.

Osteoporosis affects one in two older women. Yet despite the existence a cheap and non invasive screening test, this is usually only identified when they fracture.

I've noticed the NHS are increasingly fobbing people off with the "you are a low risk" line.  They said that to my sister when she insisted on having a DEXA scan and the doctor was irritated and sighing down the phone at her while arranging it.  It turned out she obviously wasn't low risk because she's got osteopenia and she's getting lousy, inadequate treatment for it too. 

All the exercise, diets, vitamins and minerals in the world will not protect you from osteopenia/osteoporosis if you are susceptible.  Oestrogen at the right dose is the best option and it is far more effective and has far fewer side effects than osteoporosis medication.

Not if you have had E positive breast cancer.

Too many sweeping all inclusive replies.  Sorry.

Everyone is different and HRT is not always the answer,  no matter how much you may want it to be.

[Ayesha]

Absolutely right, Aprilflower. Everyone's situation is different.
A close relative on HRT developed breast cancer in her late 70's, now no longer on HRT. Another relative in her late 50's developed severe osteoporosis due to many years of a diary free diet, she knows its her fault and is reluctantly on HRT because of it with the knowledge of breast cancer in her family.

Has Davina McCall mentioned anything about her breast cancer, I haven't read anything lately on what was the cause considering how vocal she is on all things menopause. Lets not sugar coat this, HRT is not the preventative medicine for future health in old age, you take it at your own risk.

[Jules]

I agree and being honest, I feel anxious enough and am doing my best to sort out my fluctuating vaginal and vulval health and other life things so hearing that I should have been taking hrt and as I haven't I'm at risk of numerous diseases doesn't help. My GP told me some treatments in this country are precautionary and all about potential money saving down the line and not necessarily about the patient's health in the present and that in other countries they have a higher threshold for BP for instance. The bottom line is we each have a responsibility to keep ourselves healthy and we don't all need the same medical interventions.

[Aprilflower]

I agree 💯.

[Mary G]

So what would you do in my position if the only thing that stopped you being plagued with several migraines auras every week was HRT? 

It's not a case of wishful thinking on my part or willing HRT to work, it does work.

Re breast cancer, there's no proof these women wouldn't have developed cancer without HRT.

If you personally don't want to take HRT and you are happy and comfortable with that decision then don't take it but don't scare other women off trying it.

[Aprilflower]

Agreed, but women shouldn't be scared into thinking they must take it, or suffer.

Neither position is tenable.

[bombsh3ll]

For those with or concerned about breast cancer there are a range of SERMs that can be used as bone protection.

These include tamoxifen, raloxifene, bazedoxefine and tibolone.

Women have options that they just aren't being told about, and if osteoporosis was routinely screened for it could be caught early and many, many fractures prevented.

It is actually the health conscious people, the "muesli munchers" who tend to get osteoporosis like both my parents because they are thinner and live longer, and that generation of ladies tragically shunned estrogen believing they were doing the right thing.