How to get through menopause without HRT
These days, you can’t move for hearing about the menopause. It’s gone from being something that people were embarrassed to talk about, to the hot topic du jour. This is great, of course. But two years ago, I couldn’t have cared less. I had just turned 40, and assumed I had at least another decade before I even had to think about it. And then came cancer.
My last period, before chemotherapy brutally extinguished my ovaries, was February 2021. I distinctly remember searching through my bag for a tampon in the chemo ward toilets, hair wet from the cold cap and rising nausea in my stomach. On that day, I would have been pretty happy to know I’d never have to do that again. Now, though, I weirdly miss my periods. Well… perhaps I don’t miss the actual periods, but I miss the rhythm of feeling great while ovulating and hunkering down with PMT. And losing my fertility - along with my hair and my right breast - was one of the things that made me feel so bereft during cancer treatment.
Now my hair is growing back, my breast has been reconstructed and I’m getting a handle on my menopausal life. So I’m incredibly grateful for the open conversation about it that’s happening right now. But it’s slightly annoying that so much of that conversation is about HRT.
Whether or not you can or should have HRT after breast cancer is a topic of some debate. But my oncologist was pretty clear when I asked if it was an option for me. No, it is not, even though my cancer was triple negative (so not related to oestrogen). As my oncologist straightforwardly put it: “If it comes back, it might be the other type.”
My symptoms haven’t been too severe. I can handle the hot flushes (I mean, it’s good that I work from home so I can just peel off my top and stand in front of the open freezer), and the anxiety I’m feeling is probably as much to do with my fear of recurrence as it is a menopausal symptom. Oh, and there’s a new pain in my knee, reminding me that I now need to take better care of my joints and bones. But the worst symptom for me is that I seem to have lost… shall we say my ‘mojo’?
A recent breakthrough in menopauseland for those of us who can’t take normal HRT is the announcement that locally-applied HRT (a euphemism for popping it up your vagina) will be easier to access over the counter without a prescription. This appears to be safe for women who have had breast cancer, and apparently will put the party back in your pants. It’s currently only available to women over 50, but I’m going to ask about it if my referral to the menopause clinic ever results in an appointment.
Happily, there is so much more information out there now about the menopause that it is actually possible to learn about natural ways to manage symptoms without HRT. Annice Mukherjee is a hormone specialist who has been through a breast cancer diagnosis herself, and her book The Complete Guide to the Menopause is as exhaustive a guide as you can find. And the newly-released The Natural Menopause Method by Karen Newby is a nutrition-focused handbook for getting through it.
The advice is as you might imagine: eat a variety of different coloured fruit and veg, practise good sleep hygiene and manage stress as much as possible. One thing that both books have in common is that they fervently extol the benefits of exercise. Yeah yeah, you might be thinking, we all know that exercise is good for you. But the research into how weight-bearing exercise in particular reduces the least pleasant menopause symptoms is really quite astounding. Annice Mukherjee actually says that ‘exercise is my HRT’. Add to that the fact that exercise reduces your risk of breast cancer recurrence by around 40-55% (depending on which study you read) and that is QUITE an incentive to do some lunges or squats right now.
On a slightly more vain note (and I know you care about this as much as I do): what to do about the aesthetic effects of the menopause? By that I mean the fact that your collagen drops off a cliff as soon as your oestrogen does, and the lack of elasticity combined with the dry skin that’s yet another menopause symptom means you appear to age 10 years in six months.
Enter Boots (good old Boots) with their brand new No7 Menopause Skincare Collection, the first range to have been co-created with a cohort of more than 7,000 menopausal women. Now, if I know one thing about menopausal women, it’s that we tend to have a finely tuned bullshitometer. So how do we know this isn’t just the usual anti-ageing products with the word ‘menopause’ popped on the label as a marketing tactic to hook in all women of a certain age (and hormonal situation)?
‘The Menopause Skincare range is differentiated from No7’s existing Pro-Age range because it contains ingredients that target epidermal and skin barrier health, in addition to anti-ageing and hydration,’ says Dr Ellie Bradley, No7’s senior skin scientist. ‘The range has been developed by No7 scientists using unique insights from our partnership with the University of Manchester, leveraging nearly five years of research and development into how the skin changes during the perimenopause and menopause journey. We proudly put ‘menopause’ on its packaging, breaking industry norms where beauty brands typically shy away from calling out the word explicitly on pack.’
It’s funny, because I initially felt weird about having these products on my bathroom shelf, as though any visitors who saw them might think, ‘Ooooh Rosamund’s menopausal!’ But, having read more about the menopause, I’m not going to hide it. I’m going to embrace this ‘second spring’ as it’s known in China, as a time of transformation with the wisdom and confidence that comes from experience. And, importantly, I’ll report back on how my skin’s doing, once I’ve given these new products time to do their thing. Because part of wisdom is self-awareness, and I know that I still want good skin.
This week I’m…
Sifting through the latest batch of menopause-related book releases. I recommend these, which were all published within the past month:
Menopausing: The positive roadmap to your second spring by Davina McCall
Hagitude: Reimagining the Second Half of Life by Sharon Blackie
I'm taking HRT plus testosterone via Newson Health. Adding the testosterone was a game changer for me. I will read The Natural Menopause Method as I am interested to see what else is possible rather than being on HRT. Thank you for sharing.x
Thank you, Rosamund. Super interesting as ever.