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DR MAX PEMBERTON: Don't feel ashamed of taking HRT, Davina

Since the 1940s, women of a certain age have had the option of taking hormone replacement therapy (HRT) to treat the symptoms of the menopause. When first introduced, it was heralded as the elixir of youth. How things have changed.

It has been so dogged by controversy and mixed messages from the medical community that women now don’t know what to do for the best.

It’s got to the stage where menopausal sufferers are wary of even considering it, while those who do take it, often do so in secret.

Only last week, presenter Davina McCall revealed she was embarrassed to admit she turned to HRT. But why?

So many women have to battle their doctors to get it, then feel ashamed to say they are on it as it feels like ‘cheating’ in some way or valuing looks over your health.

Only last week, presenter Davina McCall (pictured) revealed she was embarrassed to admit she turned to HRT

A big part of the problem comes from the fallout of a study, published in 2002, that linked HRT to increased rates of breast cancer and strokes. It prompted widespread panic among the medical profession, as well as the general public.

This cast a long shadow over the drug. The problem is that doctors of my generation and younger have been brought up with these stories of doom and gloom.

The studies linking it with cancer and heart disease have made it into every gynaecology textbook and there’s no doubt this has coloured doctors’ view of HRT and made some of us reluctant to prescribe it.

Subsequent analysis of the original study that caused so much concern has shown that, actually, while HRT can be risky for some groups of women, for others the benefits far outweigh the risks.

In hindsight, it was an error for the medical profession to respond so quickly to the results of just one study.

But the idea that HRT is dangerous persists.

Despite pleas from women, some GPs continue to refuse to prescribe it, ignoring the enormous benefits it can bring in alleviating meno-pausal symptoms and judging women as vain or irresponsible for asking for it.

I think it is in part a nasty combination of old-style misogyny and ageism, with far too many doctors not listening to women or dismissing them.

What’s more, many patients are still deferential to doctors and don’t want to be seen to cause a fuss. I also think it’s partly down to simple ignorance among our doctors.

I was taught next to nothing about the menopause at medical school, except for a brief lecture on HRT in my second year which only emphasised the risks. It certainly didn’t go into any detail about menopausal symptoms. That was it.

'So many women have to battle their doctors to get it, then feel ashamed to say they are on it as it feels like ‘cheating’ in some way or valuing looks over your health', says Dr Max Pemberton (pictured)

The menopause is a natural phenomenon. It is not something going wrong with the body. It is not an illness in any way.

For some women, the symptoms are debilitating and HRT can be a godsend. And it’s not just the physical impact of the menopause that women struggle with.

What’s not talked about as much is the impact it can have on people’s mental health. Changes to the body, disrupted sleep, hot flushes and so on can make women feel like they are out of control and depressed.

I’m also convinced that hormonal fluctuations are directly responsible for low mood, much in the same way a change in hormones can lead to postnatal depression after a woman has given birth.

I’ve seen many patients for whom HRT has worked wonders, helping them to manage the anxiety triggered by the menopause. But because of doctors’ reluctance to prescribe HRT, many women are prescribed antidepressants instead.

This is rarely reported and indeed the benefits of HRT —such as reduced risk of bone fractures from osteoporosis, lower rates of heart disease and certain cancers such as bowel cancer — are forgotten. Instead, the downsides of HRT are what make the headlines.

All of this adds up to a toxic situation whereby women in desperate need of help are routinely ignored.

Yes, HRT is not perfect. There are risks associated with it and it’s not right for everyone. Like many medicines, whether or not it’s right for someone is a careful balancing act between risk and benefit.

My concern is that the constant negative publicity that HRT receives means women are scared off it, with doctors wary to even consider it.

Really, it beggars belief that there is a medication that can alleviate people’s suffering, yet it is being withheld or shrouded in shame.

Finally! No masks in class 

A survey found a third of us preferred lockdown and one in ten wants restrictions to last for ever! We’re starting to feel rather stuck in our ways I fear — which is a shame because there is so much joy in acting on the spur of the moment. Things like changing the shops you go to can help you get out of the rut so many of us have fallen into. 

David Perks was the first headteacher to make a stand and speak out against face masks in the classroom. As a result, he was pilloried, bullied and investigated by the schools governing body.

But, now, it appears he has been vindicated, as ministers have defied unions and announced that, from May 17, secondary school children will no longer have to wear masks in lessons. At last, some sense.

Mr Perks is head of East London Science School and, as such, he should be praised for following the science rather than blindly backing politically motivated rhetoric, even in the face of fierce opposition.

This is what real science is about — standing with the evidence, regardless of what those around you, or the unions, say.

The science is clear — there’s no evidence that face masks in classrooms are of benefit and plenty of evidence they hamper the education of pupils.

Ministers have defied unions and announced that, from May 17, secondary school children will no longer have to wear masks in lessons (stock photo)

Women who have a C-section are no more likely to suffer poor outcomes compared to those who have a vaginal delivery, according to a recent study. And yet women are made to feel inferior or ashamed if they opt for one — not by the medical profession but often by other women. The pressure mothers now feel under to conform to the feminist model of a non-medical childbirth is damaging. It makes them feel guilty, ashamed and a failure. And these are feelings no new mother should ever be made to feel.

'I do love something sweet in the evening. Fortunately, I have discovered Skyr (pictured)', says the doctor

Dr Max prescribes... Icelandic ‘yoghurt’

As part of my post-lockdown get-fit kick, I’ve been watching what I eat using an app called MyFitnessPal. But I do love something sweet in the evening.

Fortunately, I have discovered Skyr. High in protein, it is an ancient Icelandic dairy product categorised as cheese, but similar to yoghurt.

It’s made by heating skimmed milk and adding live cultures, before straining off the whey. It’s delicious and makes you feel fuller for longer. I’ve been getting mine from M&S.

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