Weighing up the benefits and risks of MHT
Weighing up the benefits and risks of MHT
đ§đ˝ââď¸ Why your experience matters
When people talk about MHT, the focus is often on risks versus benefits. But hereâs the thing: you canât truly weigh that balance unless you understand what the benefits actually are for you.
For years, many doctors were taught that MHT is only for hot flushes and only for short-term use. This has left some hesitant to prescribe it, which means many people miss out on the full picture.
Data shows that when doctors arenât confident about prescribing MHT, they often avoid it. This hesitancy usually comes from outdated guidelines that view MHT as mainly for hot flushes and only for short-term use. But in my experience, MHT can offer so much more than that.
đ Beyond the textbooks
Hereâs what people often tell me after starting MHT:
âI feel like myself again.â
âIâm not afraid of my own reactions anymore.â
âMy brain is working again."
These are not just minor changes, they can be life-changing. I didnât learn that from a textbookâI learned it from listening to my patients.
đ Why statistics donât tell the whole story
Statistics can tell us about risks and benefits in large groups, but they canât always capture what MHT can mean for an individual, like feeling calmer, clearer, and more connected to yourself again.
Thatâs why this course doesnât just look at the evidence and guidelines. Weâll also talk about:
- The lived experiences of real people
- How hormones impact daily life
- Making a safe and personal decision
Because safe prescribing isnât just about following rules. Itâs about putting you at the centre and making decisions that fit your life, while staying open to what weâre still learning.
đ Case history: The unexpected impact of MHT on pain
âI can walk again!â
Early in my MHT prescribing journey, I met a woman who had been on quetiapine (a medicine to help her sleep*) for years and was determined to come off it. We started hormone therapy, and at her follow-up, she said something Iâll never forget...
âI canât believe it - my ankle that I broke 10 years ago doesnât hurt anymore. I can walk up the hills again.â
It was the kind of benefit we donât talk about enough. With MHT, her chronic pain eased, her mobility improved, and sheâd regained a part of her life she thought was gone for good.
This isnât an isolated case. Research, even as far back as the late 1800sâhas noted a link between hormones and chronic pain, especially musculoskeletal and joint pain. Yet, itâs still not something we routinely consider when prescribing. There is even a condition called 'Musculoskeletal Syndrome of Menopause'.
It taught me an important lesson...
MHT isnât just for hot flushes and moodâit can also improve movement, ease pain, and restore quality of life in ways we donât always expect. Real-world stories like this matter. They remind us to keep learning, listening, and expanding what we think hormone therapy can do.
*Quetiapine is a medicine originally developed for mood and thought disorders; at higher doses it treats these conditions, while at low doses it is sometimes used for sleep. It can cause weight gain and, with long-term use, may affect memory and thinking.
References
Barber, K., & Charles, A. (2023). Barriers to Accessing Effective Treatment and Support for Menopausal Symptoms: A Qualitative Study Capturing the Behaviours, Beliefs and Experiences of Key Stakeholders. Patient Preference and Adherence, 17, 2971â2980. https://doi.org/10.2147/PPA.S430203
Wright VJ, Schwartzman JD, Itinoche R, Wittstein J. The musculoskeletal syndrome of menopause. Climacteric. 2024 Oct;27(5):466-472. doi: 10.1080/13697137.2024.2380363. Epub 2024 Jul 30. PMID: 39077777.
0 comments