If your answer to menopause is HRT, you don’t understand the question

It should have been hailed as a major move forward. This week, the House of Commons’ Women and Equalities Committee called for government action on menopause, saying it should become a protected characteristic under the Equality Act.

What that would mean is you could not be discriminated against or harassed because of menopause. It means your employer would have a legal duty to make reasonable adjustments to allow you to continue working. It means menopause would be given the same status as pregnancy, with the same protections.

There’s a great video explaining it here:

Protected characteristics

Now I don’t know about you, but I would have thought that was pretty significant. So imagine my disappointment when I saw some leading campaigners complaining because the report’s emphasis wasn’t on HRT. One even said there would be no need for workplace considerations if all menopausal women were on HRT.

Well, that’s one way to deal with those pesky women demanding equality, isn’t it?

This niggled at me for a few days (I know, you’re surprised, right?) but it was only last night, as I was switching off Stranger Things and settling down to sleep with hopes of dreams of Joseph Quinn, that it hit me why this was bugging me so much.

And it’s because: if your answer is HRT, you don’t understand menopause.

Let me explain.

HRT is not right for everyone

First of all, cards on the table – I am on HRT. I am an advocate for HRT. I get calls and messages almost every day from women worried or anxious and I share my experience and we talk it through.

However, it’s taken me nearly four years to find the right HRT and even then, I’m not 100% “cured”*. I still have the odd day when my anxiety goes through the roof and the black dog is howling and I feel my life – life in general – is pointless.

There are still days when I’ve had next-to-no sleep and I struggle into work. My employers are great. My bosses understand menopause. But without any security in law, I feel I cannot take time off. It’ll go down on that pesky Bradford Score and when the menopause anxiety hits, the last thing I need is to worry about any impact on my attendance rate. So I go in to work.

Yes, I can hear them all shouting now: “But that problem is YOU!” And I understand why they’d say that because we have a pledge at work, but I still go in to work on days I’m struggling.

Because a pledge is not legally binding and while I trust my employer, I know that when menopause depression and anxiety hits I don’t even trust myself.

Which is why I, like many other women, struggle in each day because the alternative is crying in a corner thinking you’re going to be sacked because you’ve taken a menopause sick day.

It is a menopause mindset that needs to change and the way to do that is to have menopause recognised in law as a protected characteristic. HRT isn’t going to do that because HRT doesn’t work for everyone – and you just need to read the comments here to see that.

(*Yes, there will be a post coming up. It’s been a tough year for several reasons, some of it involving stories that aren’t mine to share, and I’m sorry for not writing so much.)

Some communities need protection

In addition, the work that I’ve been doing with Pausitivity, taking menopause awareness into deprived and vulnerable areas of society, has opened up my eyes so much to how privileged I am when it comes to seeking medical help.

I’ve been meeting and working with women who have no relationship with any form of healthcare provider. Some of them are asylum seekers and refugees, new to this country and unsure about officialdom. Corruption in their own countries has often made them cynical about what support and help is on offer – even from healthcare providers.

Others are women from the same type of estates I grew up on – again, wary of anything bureaucratic and living in a culture where their own needs are bottom of the list.

Shockingly, many are working two and even three jobs, part-time and sometimes temporary. These are some of the most vulnerable women in the workplace – the pandemic showed us that, with numbers of women employed dropping – and they need protections in law.

When they don’t have to worry about losing their job because they’re menopausal, then they can relax and seek help.

Scare tactics aren’t helping

My last niggle is the negative impact shouting “HRT is the only answer” has. Some women can’t take HRT for various reasons, including the fact it may be a risk to them (and until there are major long-term studies or research to show otherwise, that has to be taken as a fact).

Also, some women struggle with HRT and take months if not years – hello! – to get relief. And some women just don’t like taking long-term medication. That is their choice and that should be respected.

The answer isn’t to scare them into thinking there is no other option or with what could happen (and again, with very little scientific proof that HRT would prevent it). It is to find more ways to support them in the choices they make, whether that choice is theirs or the medical establishment’s or, as in the vulnerable communities, the societal pressures they are under.

Why I’ve changed…

When I first began writing about menopause, my focus was on the established healthcare system: the need for greater medical training and easier (and free) access to HRT. That hasn’t changed. I am still a proponent of all that and the first thing I say to a woman when she says she’s having problems is: “Have you thought about HRT?”

And on 18 October, World Menopause Day I’ll be outside parliament – as I was last year (by myself) – raising awareness again, whether there’s a promised rally or not.

So what has changed is that I now view menopause as more than just a health issue. Menopause healthcare is wrapped up and part of how society views midlife women in general: past it, dried up, invisible. Viewing HRT as the elixir of youth, which will keep our bodies as strong and supple and moist (yuk) as in our menstruating days, merely adds to this.

Age discrimination is on the rise and yes, it’s hitting women harder than men. These are menopausal women on the whole, hit because their body is doing what Mother Nature intended it to do. Putting the emphasis on HRT is giving employers (and society) a get-out-of-jail-free card.

“Well, she wouldn’t go on HRT so what did she expect?”

We need a holistic view that views menopause as it is – a lifestage, like puberty and like pregnancy. And like those, it has an impact on a woman’s life that drugs can’t do anything about.

I am mentally and physically different now to the woman I was pre-perimenopause.

HRT hasn’t and can’t change that. And that is why, if your answer to the problem of menopause is HRT, you don’t understand the question.

What do you think? Should we focus more on HRT? Please leave me a comment below as I’d love to know your thoughts

12 thoughts on “If your answer to menopause is HRT, you don’t understand the question”

  1. Totally agree Liz. I too want women to be aware of all the ways in which they can find support, and protection in the workplace is a vital one.
    My early menopause also resulted in trial and error with HRT, luckily sorted in about 6 months.
    Around this time, I felt compelled to take a career break. My heart wasn’t in it anymore and I was suffering with high stress. And this was with HRT. Who knows what might have been if there was better workplace support.
    After 7 years on HRT, as I was weaning myself off, I was diagnosed with oestrogen receptive breast cancer and advised to come off HRT immediately. I suddenly experienced many menopausal symptoms, but used my yoga practices (my new career as yoga therapist came in handy!), as well as dietary and certain lifestyle changes in an effort to reduce them. These did not completely eliminate all symptoms but did enough that I felt back on an even keel most of the time.
    I too feel different from before menopause and breast cancer. I feel more accepting that change will continue and I will need to keep adapting but it feels like a good thing. I guess I have learned to be kinder to myself. And I feel more resilient…most days!
    (Also interest in joining you for World Menopause Day!)

  2. ‘Viewing HRT as the elixir of youth, which will keep our bodies as strong and supple and moist (yuk) as in our menstruating days, merely adds to this’. This, this is the core on a personal level. I am what I am and ads like Gina don’t help when its the only info men are seeing

  3. I am absolutely with you on this and what a great article. I was having this conversation only yesterday. HRT has its place, most definitely but it is an individual choice. I have had people in my sessions who think anyone who doesn’t want to take HRT is mad and there is no changing their opinion! Some people prefer to take medication rather than thinking about what they can do to help themselves, such as looking at their lifestyle, diet/nutrition and exercise. How many people could help their symptoms simply by doing this and possibly not needing to even consider HRT? I am also with you in that I can find no research that shows that taking HRT for the rest of your life is harmless so it bothers me that there are medical professionals out there quoting that it is (if there is research, please do head me in its direction). Menopause conversation has come a long way in the past couple of years but we still have a way to go. I am on a mission to raise awareness and help employers to be inclusive when it comes to menopause. Go sisters!!!! 😀

  4. If only HRT were the answer to the entirety of the menopause plight. We have to go much much deeper than HRT. It’s a complete life transition which involves mental, physical, emotional and spiritual change.

  5. What a brilliant article – so well written and love the title …. wish I’d thought of that myself. As a menopause nutritionist I’m sick and tired of hearing about HRT as being ThE only answer to menopause symptoms as if it were a magic bullet.
    I’m so frustrated about the lack of discussion, education and awareness about how our hormones really work and the power of nutrition & lifestyle to really make a difference to symptoms. But shouldn’t be surprised really when you consider that in our health care system the answer to every concern is a prescription for something! No wonder the NHS is broken & just can’t cope with the massive and increasing burden of chronic disease that are largely lifestyle and poor nutrition choice related!

  6. Fantastic article thank you Elizabeth
    HRT is and has definitely helped
    And improved so many peoples lives but is it the be all and end all, NO, in my opinion 😉

    I believe I was peri menopausal around 40/42 and now I know what I know..the psychological challenges I was having was definitely hormonal not that I was depressed or going mad!!! And it wasn’t until I was about 52 that’s the physical symptoms started. After much research, ups and downs, A year past March I started HRT because I had to do something, and for sure there has been a significant improvement on my sweats, brain fog and moods. Now that I have clarity, and feeling more like myself, as well as taking HRT, I have proven to myself that my diet and lifestyle habits, also stress plays a massive part in my wellbeing. I know that if these 3 things are out of balance then so am I and the option of up of my HRT is not the answer, as I’ve been hmmm 🤔 recommended!!

    Education, awareness and talking to the right people:person is key, there is not a 1 fits all and HRT may not be the right option for a lot of women due to medical or other reasons.

    I’ve found that writing everything down how you feel, what your stressors and demands are in your life really can help and this can give clarity – then reach out
    And talk 🥰

  7. Whilst I agree that women should not have to use hrt if they don’t want to, I strongly feel that it should be made clear by GPs that hrt does not mean you will do away with menopause altogether. Both myself and my late sister in law were forced to come off hrt in our 70s. We both experienced (I still am at 75) hot flushes, lack of sleep etc. I’m not saying I would have never taken hrt, but an educated choice would have been handy

  8. Thank you Elizabeth such a refreshing perspective and one so little heard in the mainstream! I really worry the whole issue of menopause has become so one sided and medicalised that you dare not offer an alternative view So many women cannot or do not want to take HRT but those voices are constantly shouted down and made to feel marginalised and somehow betraying the cause.We are all in this together women should stay angry but not at each other !
    Have a listen I don’t agree with everything Tania says but still a very interesting perspective

  9. Loved this article and though HRT has kept me on an even keel I realise I to can keep myself on that even keel
    by remembering I need to fill my cup up over and over again I can’t give out if I haven’t first received.
    Finally at 55 I know who I am! and who I am not!! I love this quote that Comparison is the thief of all Joy and it certainly is. Acceptance has been the biggest key the Menopause is actually for us if we can find a way to go through it rather than fight it.
    Its a natural progression one our bodies were created for, its our need to sometimes be something were not that is our problem. In learning to let go of who we were so we can grow into who we are now we will find that inner peace
    our hearts are longing for.

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