Ep 80 Why I Changed My Mind About HRT

[00:00:00] Meegan Care: So today’s episode is entitled, Why I Changed My Mind About HRT, and I will preface it by saying, I am on HRT now, and I haven’t stopped taking HRT, so it’s not that kind of change your mind, it’s a different kind of change your mind, so I didn’t want to do a bait and switch with you on the title. There’s no big revelation that I’ve stopped taking HRT, I’m still happily taking it, but I wanted to share how I got to this place and why taking HRT is not It is not a panacea, it is not a quick fix, it is not something that makes all of that mid life menopause, perimenopause stuff go away but I have more to add to that because it can actually be incredibly helpful for menopause symptoms which I do bang on about quite a lot.

But I want to talk about my story around it because I think there’s three reasons why I want to talk about my story around this. And the first one is that it’s something that I talk about in person with women a lot. Whether we’re at events or we’re just sort of talking about menopause. I’ve been asked by a few women to talk to them about this.

My experience of menopause, I’m going on HRT, as a way for them to figure out whether HRT is right for them, or it’s the right time for them to start taking HRT. So HRT, we know, stands for Hormone Replacement Therapy. The common term for it now in medicine is MHT. Menopause, hormone therapy, but we’ve called it HRT for so long it just kind of sticks with us, so I’ll probably continue to alternate between those two terms.

So that’s one reason. And so, because this podcast is all about having those conversations as if you and I were going for a walk together, as if you and I were chatting about the issues of perimenopause, menopause and midlife, this is a conversation I have quite frequently with women, and so I wanted to share it with you with my podcast audience.

So that’s one reason. The second reason is that I don’t know about you, but I had to go through a place where I had thought I’d made my mind or my decision up about not taking HRT for a long time, and then I had It felt like one of those synchronistic divine interventions one day, and I’ll tell you about that in, in this podcast.

And that opened up a doorway of possibility around, well, maybe I need to find out more about HRT. Maybe it is for me, maybe it can help me. And so, because we often get quite locked in our decision making. But, we have to remember that perimenopause for a start, can last up to 10 years for some women, even a little longer.

But then, menopause and postmenopause is really for the rest of your life. And the research that they’re doing now on HRT is that the sooner you start it, the better, for your bones, heart, brain, general physical health. But also that we can be a number of years past that date of menopause, which is the 12 months without a menstrual cycle, and still benefit from hormone replacement therapy.

So there’s not the hard and fast cut off. that there once was and research is still being done around it. So if you’re five years post menopause, like some women I’ve talked to, you might think, well, it’s too late for me. I didn’t start then. So my chance is gone. Well, probably not. You can very likely still, if you’re a good candidate, receive the benefits of HRT.

from now going forward. And so I really wanted to open up the conversation around that because I think that’s an important piece that maybe that window of opportunity hasn’t closed for you as a postmenopausal woman. And then the third reason I wanted to talk about this topic and my journey with HRT is, is a little more nuanced and it’s a, it’s around a naturalistic bias.

I think that’s what it’s called, a naturalistic bias. Or the naturalistic fallacy. And I’m just learning more about that now. But basically, it’s where my blinkers were on around being able to support myself and because of my internal biases around mainstream medicine and natural medicine, I chose a path and then became quite trapped in that path in terms of my physical health in perimenopause and postmenopause.

And so I wanted to open the conversation around that. Because we can easily get, get locked into black and white thinking. This is right and this is wrong. And I also think that for some of us our brains more tend to do that, go into that black and white thinking. And we do that a lot as teenagers. And then the adult brain should, in theory, be able to hold more nuance and tolerate more gray in, in between.

But we’re very influenced now, of course, by social media. And social media offers information in these very tiny little sound bites. And so it’s hard to get the nuance of the information that’s coming through. So it can feel very black and white. For example, HRT is bad for you. It is not natural, it is not what nature designed, therefore it is bad.

Or, HRT is the answer to all of your questions as a midlife woman. It is going to make you completely turn around and change and own and rock your life. You’re going to feel incredible, you’re going to look amazing, you’re going to lose weight and life will never have felt better. You can see that we get those sound bites of information come through on social media and that sort of makes that black and white thinking.

a whole lot worse. So I wanted to introduce that concept in terms of my journey with it and probably admit some of my own faults and failures to see the broader perspective and the evidence based facts that are out there. So, Where to begin? Let’s begin at the doctor’s office. So I find myself in my doctor’s office. I hadn’t been to the doctor for a very long time, a number of years actually. I thought that I had been looking after my health. I had a naturopath on board. I had been seeing colleagues for acupuncture. I had been having natural medicine. I had been watching my diet and introducing really nourishing foods it felt like a surreal moment why did it feel like a surreal moment? Because I had been really invested in natural medicine and complementary medicine, if I’m really honest. I had Crohn’s disease when I was a young woman. I went through my 20s struggling with this chronic illness and to all intents and purposes I healed it. I went from having a body that was 39 kgs in weight, incredibly underweight, with multiple fistulas which are a side effect of Crohn’s disease, not being able to eat or take care of myself.

very slowly and gradually, naturally healing to a stage where I had my first child. And then once we got a handle on that, seven years later, decided to have another child and, and was doing really, really well. And I’d had so, such, a lot of trauma in the medical system when I was sick, that I had very much avoided mainstream medicine since that time.

And that’s probably another story, but I mean, if you’ve gone through childbirth, if you’ve been sick in your life, you’ll understand that the, that mainstream medicine can be very traumatising and, and, and, and, and, and, and, And that’s not just about the physical pain that goes on, right?

Mistakes can be made. The way that we are treated can often be not respectful or thoughtful or adapt to our own sensitivities and predispositions that can lead us feeling very untrustworthy of mainstream medicine. So there I am sitting in my doctor’s office and and lucky for me, she was very well versed in menopause.

So she was in, she is an integrative GP here in local New Plymouth and,

and I had no knowledge whatsoever of what was going on, of what I, what I wanted or what I needed. So, nine years prior to that, I had had the conversation with my doctor that I was, they told me that I was postmenopausal, that I was in postmenopause. I hadn’t had a cycle for more than a year.

My numbers, according to them, clearly showed that I was in postmenopause.

Premature menopause, of course, at the age of 41. The average age is 51, 52 in New Zealand. And I had worked really hard to manage the symptoms, to manage life, to keep moving through for those nine years. So here I am sitting in the doctor’s office asking her about HRT, something I never thought I would do.

And, never say never though, right? And she laid out for me three different options, and I can’t quite remember them now, but they went from the most minimal, to the median, to the full HRT, estrogen patches, plus progesterone. And of course I had a lot of questions, I had a lot of fear, I had a strong negative bias away from HRT.

But she was in no way pushing me towards one thing or the other. I had gone because something had changed for me. literally overnight, although often when there’s an overnight change there’s a big lead up to it, and I’ll talk about that in a sec, but she scribbled down all the options for me on a piece of paper.

She gave me the backup documents and some studies that I could go home and take a look at, and I went home and this was before HRT was so mainstream because I’ve seen in the last three or four years, it become much more to the fore and we talk much more openly about it. We now understand much more clearly what we take, what is the normal, protocol for HRT for a woman in New Zealand.

At that time, I didn’t know anybody that was on HRT. It was very, very new to me. So, from that conversation, I decided to start with estrogen patches at the time. 25, the low end of the prescription and obviously the progesterone goes along with that and my doctor prescribed a melatonin at the same time we did a whole bunch of blood tests and the melatonin because I was still struggling with sleep.

I was managing it okay, but I was still struggling. So, I would wake up at, say, 3 in the morning, maybe stay awake for a couple of hours, and then get a couple of hours sleep from 5 to 7 or 6. 30, and then wake up, wake up and, and haul myself through the day, but my sleep was not deep, I felt like I was waking up really easily, and I could feel myself getting more and more tired. How did I get to that place? I had been struggling with sleep, struggling with energy, struggling with hot flushes. When I first found out I was in menopause, I was post menopausal, hot flushes were not a massive issue.

What was an issue was fatigue, intolerance to any alcohol, not that I was a big drinker, but one glass of wine at night would have me in a hangover the next day. Frequent headaches and migraines, insomnia, and just this creeping, generalized anxiety had started to build in my system. There was this English woman on YouTube, and she started to talk about when she first started taking HRT. And because her story was so similar to mine, she had a strong natural bias, she was very much invested in natural medicine.

And then a friend talked to her and, and she was really, really struggling with symptoms of perimenopause, postmenopause for 10 years, she said. And then a friend talked to her and said, why don’t you go and try HRT? And she was very much like me. She was like, no, I’m a natural person. So this is where the the natural bias comes in.

She said, I trust mother nature, me, tick. I trust my body, me, tick. I’ve healed my body before. I know my body can heal. I identified with that as well. I don’t trust mainstream medicine over the long term.

And so she had all these biases against HRT. Now her story was, turns out to be quite similar to mine, but it was really triggering me in a great way because I was like, Oh, that’s me. That’s me. She was trying all these natural medicine. She was growing regularly. She was getting all these treatments.

I could see myself in there. And And then she said, and then when I, I started on HRT, everything changed. Not overnight, but everything changed. And she went on to talk about her own bias towards natural medicine. And something opened up inside of me where I understood that I had been perceiving this from a very black and white place where my brain was saying, Natural medicine, good.

Western, allopathic, mainstream medicine, bad. And a light switch went off for me and I realised this is getting worse, not better. My well being is getting worse, not better. I am struggling to keep up here. What is it worth to me to have a quality of life? I am 50. I was 50 then. How many more decades on this planet have I got?

A few, I hope. Quite a few, I hope. Do I want to struggle through them? And remember, I do struggle well. I’ve done struggle well. I know how to cope with that. Or do I want to thrive and live my best life for this next chapter of my life? And so that little YouTube video flicked a light switch for me and I was able to identify my own natural bias.

I was able to look at it from a higher perspective, like a bird’s eye view and go Is this really serving me? Still. I’ve been at this for quite a long time. Am I living with the vitality and the resourcefulness and the inner energy that I want to? And can it be improved? And I had just at that time done a whole bunch of inner work as well and I think somehow all of that medical trauma that I went through when I had Crohn’s disease and some from very early on in infancy which was very subconscious to me became more resolved and more resolved. And so then you combine those two pieces together and, there’s a doorway that opens where I realized that there was another choice available to me that I hadn’t yet taken.

And that just because it sounds so simple now. Yeah, it sounds so simple like I want to go back in time. Go back in time and tell my younger self, my 45 year old self, that there’s an easier way to do this. But in any case, what I learned through that moment was, I don’t have to choose between complementary natural medicine and mainstream medicine.

It is not either or, it is not good versus bad, it is both and. It is what serves me. It is, what does the research say? What does the data tell us? What are we learning about women’s bodies? And just because something served me then, nine years ago, really, truly being honest with myself, is it still working at its capacity for me now?

And the answer to that was no, it’s not. And because I could take the blinkers off and see the shades of grey and make a choice that didn’t have to feel black and white, that didn’t have to feel like I was closing one door by opening another and going with HRT, that I could utilise HRT and natural medicine, that I wasn’t betraying anyone or anything.

I don’t even know how that belief got in there, but there it was. Thanks. And that ultimately, I was on a path by making a new choice at that stage, nine years after I was deemed in post menopause, I was changing the course of the next chapter of my life. And that it wasn’t too late. And that I could still receive all of the benefits of HRT if it was a good fit for my body.

And so far, it has been. So that’s that unwinding of the naturalistic bias.

And so the other piece of it is around what might serve me at the beginning of my postmenopausal journey, or later perimenopause, might not still serve me two years, five years later. And that was my experience, because I was kind of okay when I was in early postmenopause.

But because I was in premature menopause, my symptoms May be very different to what the normal kind of baseline is. But I was okay early on. And then there was a slow creep, like I said, of difficult symptoms that came up. So the insomnia and the anxiety and the fatigue and all of those horrendous headaches.

And so I, you know, in the beginning what helped my sleep was the Herbal medicine really helped my sleep. That was great. But then it got to the stage a few years later where my sleep was terrible again. It had shifted into a different pattern but it was really bad and it wasn’t restorative. It wasn’t helping me through the day.

I was just kind of going, oh well it’s okay. I can meditate in that awake time, I can have naps in the day, I can adapt my life around it. But that’s that piece I learned to adapt my life when I was really sick with Crohn’s. But what in all of that adaptation that I was doing, I was actually not able to see that there was another choice for me.

And so I think that that’s really key because I, I hear this quite a lot where we say, and I do it all the time, where we say, HRT is not for me. No, I’m sticking with natural methods. This was me. And, and then I’ve sort of signed on the dotted line, right? I’ve signed my contract with my post menopausal self.

And then I had in my brain and my mind and heart that this was the choice I made and there was no changing that now. I didn’t really think about it. It was just signed and sealed and locked away. But it was that dissatisfaction with my current state of well being And then also, I love how life just sometimes sends us the right people, the right conversations, the right YouTube videos, or it could be in this case, the right podcast episode that just opens another doorway for us.

And that’s what happened for me. And I followed down that path and came to a different plan at that time. That even though I had signed that subconscious contract with myself about how I was going to handle my post menopausal years, and let’s be clear, I’ve had so much influence from women that say that menopause is natural, that Why would I want to take HRT because that’s just the patriarchy controlling us again?

Why would Mother Nature give me menopause if it didn’t want me to have this experience? Being a post menopausal woman is equal to being a crone, equal to being a wise woman, equal to being a powerful woman. intuitive, psychically adept woman. This is all of the messaging that I had. I didn’t receive the messages that said you can take HRT and be a powerfully intuitive, vital woman in your 50s and 60s.

But we got here anyway.

And here’s what happened when I started HRT, because I wasn’t sure what to expect. It doesn’t always happen this quickly, but from the first few days that I started taking it, and it was probably something to do with the melatonin and the progesterone together, because the progesterone can be really calming.

I started sleeping better. In fact, I think in the first two days, I slept so much better. And then of course, if you sleep better, you generally feel better the next day. So that started to take place. And then after a few weeks, I started to go, Hmm, I’ve got a little bit more spring in my step. And that kept compounding.

That kept improving. And the hot flushes that I was getting, which were pretty difficult to manage. I wasn’t getting night sweats very often, but I was getting the hot flushes so I wouldn’t wear a long sleeve merino, like I’m wearing right now, just in case I had a hot flush.

Because if you’ve had them and they’re quite intense, you’ll know that it’s, it’s heat, yes, but it’s not like being hot at the beach. It’s like this heat from the inside out that also speeds up your nervous system a little bit. So you’ve got this fight and flight. Well, that was my experience as well. And so I, I would sometimes feel a little bit claustrophobic with them and have to work quite hard to slow my breathing down and just to slow my system down.

Those just went. They went. They disappeared. And I start, I told a few friends that I was taking HRT. And from one friend in particular who was struggling with menopausal symptoms as well, who was a few years older than me. She was really interested. But a lot of friends I had then a lot of pushback from, around the dangers of HRT,

why would you mess with something that’s natural, haven’t you heard that it causes cancer, have you heard any of these? Yes, I, I have, and that’s alarming, isn’t it? But of course if we look at the research, the research shows us that actually body identical HRT is very safe.. And another friend said to me, Oh, but I don’t want to take it because what if they come back in a few years and say they got it wrong and it’s now not safe to take. But for me, the way I perceive it now from having taken HRT for about three years is that The quality of life that I’ve gotten from that hormonal therapy has been so, so good that I’m willing to take that tiny, tiny, tiny risk as it stands now.

Medicine is always changing, research is always changing, I get that. But it’s also, also changing around the food that we consume, and the environments that we live in. Science will always move on, and will always change. And when we know better, we do better.

But, I’ll finish the podcast by saying this. I still hear pushback from friends. I have a lot of friends in the natural medicine space, in the wellness space, so there’s still a lot of stigma around HRT and around its potential dangers, as there is for a lot of mainstream medicine in natural circles. And I can be with both sides now, which I really appreciate, and that I’ve opened up to be able to look much more rationally.

around these different forms of medicine and really understand that they are there to work with us, right? I don’t take HRT and then go and drink loads of alcohol not exercise all day and eat junk food all day. I might do a tiny bit of that, of course. But I don’t expect HRT to be the cure for all of my ills.

I also now take care of my body, but the difference it’s made is that it gave me enough energy to think about the small improvements that I could make in my life that were going to increase my vital energy by changing the exercise that I do. Well, before HRT, all I could really manage was a walk.

That was it. I was done. It’s given me that, that extra boost to be able to dial in those changes that have improved my well being over the last three years.

And I now say to my friends,

that, because often friends ask me, well how long are you going to take it for? And that’s another myth is often spoken of, right? Oh, you’re just suppressing the symptoms of menopause. And when you stop taking HRT, then all of those symptoms are going to come back and you’re going to have to go through it anyway.

There’s absolutely no evidence that this is the case. That is not the truth. We’re replacing hormones that help us be well and vital that are very low in our body. Now, why nature has chosen to Make our body function in this way? I don’t really know, but Menopause is natural, yes. Tooth decay is natural.

Osteoporosis is natural. But we still do something about those in our body, right? We support our body in whatever way we can to be well, if we’re experiencing those. Just because it’s natural, doesn’t make it okay and right. And that we should just tolerate it exactly as it is in our body. And that’s why I sometimes say as a joke, but when friends ask me, well when are you going to stop taking HRT, I say, I’m not intending to stop any time soon.

They can put me in a box, in a coffin, in the ground, with my patch on, because it is staying with me for as long as it is viable. And the research is still developing on that, so watch this space, but currently you can As far as I’m aware, the protocols say that you can keep taking HRT well into your 60s and they’re still doing research on it.

Because we’re women, the research is really, really lacking. That’s just the culture that we live in. So watch this space and hopefully there’s more information on that coming soon. I really hope that’s been helpful. Helpful in one way or another, sharing my story around why I changed my mind about HRT and why I’m really, really pleased that I did.

Go well my friend, I look forward to talking with you again real, real soon.