🌸 Menopause and HRT: Why It’s Not Always the Answer

The conversation around menopause and hormone replacement therapy (HRT) has dramatically evolved in recent years. Once whispered about behind closed doors, menopause is now a mainstream health topic – from talk shows and podcasts to policies in the workplace. But amid this visibility lies a pressing question:
Should every woman be taking HRT?

🔍 The Rise of the Menopause Movement

• Between 2020 and 2022, HRT use in the UK rose by 60%.
• Celebrities like Davina McCall have shared their stories, encouraging others to consider HRT.
• Social media is filled with tales of night sweats, brain fog, hot flushes, and declining mental health — making it easy to assume menopause is a guaranteed nightmare.

But this narrative, says Dr. Myra Hunter, a clinical psychologist and menopause researcher at King’s College London, may be over-medicalizing a natural life stage.

🧠 “Menopause Is Not a Disease”

Dr. Hunter cautions against the idea of menopause being a hormone deficiency disorder that must be treated by default.

“Women vary so much in the type of menopause they have… Most symptoms are time-limited, and we don’t want every woman to expect the worst-case scenario.”

Symptoms like fatigue, low mood, and irritability might not even be menopause-related. Only around 10% of women experience increased depressive symptoms — while some actually feel better during this time.

🚨 The Danger of “FOMO HRT”

Many women now say things like:

“All my friends are taking HRT. Should I be on it too?”

That kind of fear of missing out is driving unnecessary use of hormone therapy, even among women with no or minimal symptoms. This trend may also reflect fears about aging, youth, appearance, and vitality.

⚠️ HRT Is Not a Preventative Elixir

Although some experts promote HRT for long-term protection against:

• Osteoporosis
• Heart disease
• Dementia
• Urinary and bowel issues

Dr. Hunter clarifies:

“There isn’t enough scientific evidence to recommend HRT purely for prevention of future health issues.”

National guidelines (NICE, BMS) recommend HRT only for managing moderate to severe symptoms—not as a blanket solution for aging.

🧘 CBT: An Evidence-Based Alternative

Dr. Hunter pioneered CBT (Cognitive Behavioral Therapy) for menopause, showing it helps women:

• Manage hot flushes
• Reduce anxiety and shame
• Reframe negative thoughts about aging
• Feel more confident in work and social settings

She also emphasizes the interaction of life stressors:

“Midlife stress — like finances, career shifts, caregiving roles — can worsen menopausal symptoms.”

🔄 Depression and Hot Flushes: A Vicious Cycle

• Low mood intensifies hot flushes.
• Hot flushes, in turn, disrupt sleep and trigger embarrassment, worsening mood.
• This loop can be broken with lifestyle adjustments and mental health support, not just medication.

🗣️ Breaking the Silence, Not Fueling the Fear

Menopause shouldn’t be viewed as a crisis. Rather than assuming decline or dysfunction, women deserve:

• Accurate education
• Empathetic care
• Confidence in their choices

Hunter encourages a balanced narrative:

“Women don’t age overnight. Let’s challenge the assumptions around midlife.”

💡 Final Word

HRT can be life-changing — for some. But it isn’t a panacea, and it’s not right for every woman.

✅ If you’re struggling with menopause symptoms, seek help early, but don’t panic.
✅ Consider non-hormonal options like CBT, lifestyle changes, and stress management.
✅ Most importantly, approach menopause with information, not fear.