The Dr Louise Newson Podcast - 096 - I have taken HRT for nearly 50 years and won’t ever stop it - Kay Anderson and Dr Louise Newson

Episode Date: April 27, 2021

Dr Newson has a fascinating conversation with Kay Anderson, a woman in her 80s who began taking HRT after a hysterectomy in 1972, when she was only 36. Kay remembers the frightening and devastating depression that suddenly engulfed her, as a mum with 3 young children, and how her gynaecologist agreed to use her as a 'guinea pig' and let her have some HRT.   They discuss the different types of HRT that Kay has taken and prescribing trends over the last 50 years, and Dr Newson explains how safe modern types of estrogen is through the skin, and how it can protect the health of your heart, bones and mind as you age. Kay has been the only one of her friends to take HRT and is also the only one who doesn't have to take any other medications!   Kay's top 3 tips: See another doctor if they won't give you HRT or try and make you stop taking it. Don't feel pressured to stop taking it, because if you do you will probably be right back where you started. Tell your friends and family what you want, so they can support you to get the right help for you.

Welcome to the Newsome Health Menopause podcast. I'm Dr Louise Newsome, a GP and menopause specialist, and I'm also the founder of the Menopause charity. In addition, I run the Newsome Health Menopause and Well-Being clinic here in Stratford-upon-Avon. Today on this podcast, I'm going to introduce to you my mother-in-law, Kay Anderson, who I've been trying to persuade for the last few months to record with me because as many of you might have heard, I recorded my mother about a year ago and a lot of people found it really interesting to hear her views about HRT. So I have Kay with me today and I'm delighted to introduce you to her. So thanks Kay for agreeing to be recorded today. My pleasure. So I'm not sure whether you are actually officially the person that I know

who's taken HRT for the longest, but you must be up there in the records. So how long have you been taking HRT for? I think I was 36 when I first started taking it. And are you allowed to say how old you are now? 85. I don't usually share that with the world. Oh, well, it's great that you have because I think it's really important because, as you know, we see and speak to a lot of women in the clinic

but also just generally through social media who have been told they have to stop taking HRT or they're too old to take it or they're not allowed to take it at a certain age. And I'm not sure that anyone's going to stop you taking your HRT, are they? No, they're definitely not. No, I should take it forever. Excellent. So, Dennis, what happened then when you were, because 36 is young, obviously, to be starting to take hormone replacement therapy.

So what happened to you when you were in your 30s? When I was 34, I had a hysterectomy. and that was because of fibroids, they started to grow again. As I didn't want any more children, I'd got three. I decided a hysterectomy will be better for me. At least my gynecologist told me that. And he was quite right. And for the first six months, I felt absolutely amazing.

It was the best thing I'd ever done. And then suddenly the depression hit me. It was actually just like a black cloud had been just thrown over me, a black cloth, I mean. I just couldn't believe it. It just one moment. I was so happy and, you know, just everything in my life is perfect. In the next moment, a black cloth had been put over me.

And I was just serving out of his lunch. I gave him his lunch and just walked away upstairs and just sat on the bed and just sobbed my heart out. And a few minutes later he came up holding Paul, he was only, what, just 15 months old. He was just over a year old. And he just said, you know, this is what's happened, told me. He said, if he put it this way, you've lost the uterus.

And the ovaries haven't got a football to play with anymore. Made me laugh about it, and that helped. But he was very good, being a GP. He knew what to do, and he just talked kindly to me. But it didn't get any better, really. I had a really hard time. And I happened to read a book, Corfu. Feminine Forever by Robert Wilson, MD.

And I just couldn't put this book down, and I knew when I was reading it, this is what's wrong with me. I need this estrogen. So I gave it to my gynecologist, who was very good. He sent for the papers from America. When he had them back, he said, look, hey, if you'd like to be a guinea pig, you know, let's try it. So I had the tablets in those days, and I just put the two tablets, actually.

And after six days, literally, it was on the summer. afternoon morning, I woke up and I thought, oh my God, I'm normal. I just leapt out. It's me. I'm back. I really did. It was just the most amazing feeling. It really was. And I took this for about, oh, just over four years, I think. And then he said, now look, you've got to make a decision. If you want to carry on taking it, or if you're going to give it up. And I was on my way to college I was teaching at the time at Coventry Tech. And I thought, I just feel so amazing. I'm going to see my students and I'm going to do this up and the other with them. And I thought, well, I'm going to take my chances. I'm just going to keep on it. I just made a decision there and then. And I've

been taking it ever since. And I will never stop. That's fair. I then went on to taking the I had the implant and used that for quite a few years. And then, of course, you suggested that I used the gel. And that was absolutely amazing. That's wonderful. So I'm on the gel, absolutely. But all that time ago, there weren't many people taking estrogen then, were there? No, they weren't.

What did your friends think? Did you talk about taking it or did you just get on it? I did actually. I tried to sell it to all my friends, but they just said, no, they were working. about breast cancer and all sorts of things, but I just felt so well, Louise, that I was determined I wasn't going to give it up because only the minute I did, I'd be back where I was and I didn't want to go back down that black route, which is so awful. You know, the despair. There I was with a lovely family and I suddenly, out of nowhere, felt this utter and total despair

wondering what I had to live for. And it was just horrible. And I remember when Alec came up and found me there, and he got Paul in his arms. And he put Paul on the floor, and he ran to the dressing table and got two tissues and stuff worn in H-I. And I just thought, no, I don't want to be like this.

So I'm determined to keep on HR. I mean, it's very frightening, isn't it? It is, actually. A lot of people think the menopause is just about some hot flashes and sweats and women can get through it. This psychological effect, the low mood, the feeling of despair, the feeling of low self-worth is really haunting actually for a lot of women. And so many women don't realise it's related to their hormones. In some ways it was almost easier for you because you had an operation. So there was something that had changed in your life.

But for a lot of women, these symptoms come on really gradually. and they think it's something else that's causing it. And as many of you who are listening, no, I see in my clinic every week we see women who are suicidal. And I saw a lady recently in my clinic and she also like you had had a hysterectomy and she'd had both her ovaries removed as well. So therefore she had no hormones.

And she began to feel very dark like you describe. And she self-harmed and then she tried to kill herself and the psychiatrist sectioned her because they were worried about her. And she said, it's my hormones. And they said, no, it's not you're mad. You just need more antidepressants. And kept increasing the dose.

And then her daughter reached out to me through my Instagram. I said, I'm really worried about my mother. I think you might be able to help her. And, you know, it's very, very frightening for these people. And this lady, quite rightly, she said, I know I'm not mad. I know it's my hormones because it's just happened since my ovaries have been removed.

So when you know there's a. event and something's changed, then just putting two and two together and making four, it's quite obvious then, isn't it? That it's related. It's very frightening, though, it is really. I'll never forget that total despair I felt. It was just really frightening. And, you know, it was only because I got Alec there, reassuring me. He was always so kind and gentle. Did he have many patients at that time who were taking HRT? No, no, he didn't.

But because of me, he did after that. But it takes a while, doesn't it, for people to realize what's happening to you, to some people. Absolutely. And, you know, we see a lot of women who have been misdiagnosed with conditions such as fibromyalgia or chronic fatigue or depression, anxiety, and even now long COVID. A lot of them, it's related to their hormones. And we know it's related because when we give their hormones back to them, their symptoms improve. and the hormone, well, estrogen, but also testosterone, are very important in our brains. They help our brains work.

And as you know, the power of that hormone in our brains is often really just so strong. But have many doctors tried to take you off your HRT over the years? Well, yes, because I think I've been taking the tablets for about four or five years when Stephen Lester died. And so I was referred just to my GP. and the GP didn't know anything about HRT, but luckily, Alec knew Danuta Gray, who was the hormone queen in Edgboson, and sent me there.

She was amazing, and I went to see her many years. She was very, very good. And it was because of her, really, that Alec then did send a lot of patients to her. So a lot of these patients were then on HRT. Which is so good. And the implants, as many of you listening might know, go in under the skin.

And they were very common actually because they had the advantage of not having the risk of clot that tablets have. But as you know, you have to keep going back for them, don't you? You can't do the implant yourself. I used to go four times a year.

And then it's quite hard sometimes to get the dose right. And sometimes with the implants, once they start reducing and wearing out, you can feel that effect coming on, can't you? Oh, you can. Yeah. You can, absolutely, yes.

you suddenly know when that's going and I know our leg would say, I think it's time you went back and had another implant. But with the gel that you've given me, I can control that. Yes, and that's the big thing. Certainly we don't offer implants in the clinic because all our patients can control themselves. Sometimes it's a combination. We give them patches and gel.

I've got some patients who have tablets and patches or gel. So they can be in control because when you need a doctor to do, a procedure, then that's quite hard, isn't it? Because if you can't make the appointment or the doctors away, then it's very hard. And now a lot of implants are only available privately, and they can be quite expensive. Very expensive, actually. Yeah. So actually the gel for the majority of people is available on the NHS. It should be available to everyone, of course, on the NHS. But it's very safe and very, very easy to use, isn't it? It rubs in very easily. Yes. Yes, I have a prescription from the GP. And they're very happy to give it to me. They are now, anyway.

I thought it was the last thing I ever do. I ought to be putting that up before I go. Which is great because, you know, you've had a hysterectomy and women who have had a hysterectomy and youth estrogen have actually a lower risk of breast cancer, which is quite different to how people think, because over many years people have thought estrogen is the bad guy almost and estrogen can cause breast cancer, whereas actually there isn't any evidence to support us at all

and some long-term data that came out not that long ago shows that women who have estrogen-only HRT, so women who've had a hysterectomy, actually have a lower future risk of breast cancer. But as you know, there's also lots of benefits, not just you feel better, but your health actually really benefits from estrogen. Yes, absolutely. I used to take the progesterone, but I can't take that anymore. No. It doesn't seem to suit me at all.

Yeah, so it's interesting. So a lot of women, it's hard. to know the figures around 10% of women do have some progesterone intolerance and women who've had a hysterectomy don't usually need progesterone anyway. Some people like it. It actually makes them feel quite calm and helps them sleep. But a lot of women do find they have some side effects, but the more natural body identical progesterone often has less side effects than older types. But certainly the estrogen that we use now is this body identical estrogen. So it's derived from fresh yams. So it's,

it's not derived from horses urine, which probably the tablets that you were on years ago was probably derived from pregnant horses urine. Oh, right. So things have moved on quite a lot. They have, haven't they? But certainly when you started HRT, I mean, I don't know how much information you were given, really. You probably were just prescribed it and told to take it, were you? Well, all I knew is that it just made me feel so good if I wasn't about to give it up.

and I was always very busy and I never wanted to feel tired like I did before I had it. So I was suddenly back to normal, lots of energy and enthusiasm for life. So, no, I've never changed my mind about it. And it doesn't matter how many times anyone would tell me that maybe it's not good for me. I know it is and I just listen to myself and my own body. And you're absolutely right. And there's been so much controversy about estrogen. and in fact I was doing some work early this morning preparing for a talk.

And one of my slides, I was comparing the benefits of estrogen to reduce risk of heart attacks compared to statins, you know, the drugs that reduce cholesterol. And there's more evidence to support the use of estrogen to lower future risk of heart disease than there is for statins. And as you know, lots of people take statins. And there is some evidence, actually, that statins increased risk of developing breast cancer. Yet no one is worn that at all. And status have given out left, right and centre.

But there's something about hormones, female hormones, that almost makes some healthcare professionals want to know there's a risk or want to think there's a risk. And I remember giving a presentation a few years ago and there was a gynaecologist talking just after me about something else. I think she was talking about fibroids actually. But she sat in my talk. And there were questions after from GPs.

And I remember one GP said, We have a policy in our practice that every woman, when she reaches her 70th birthday, she stops HRT. And I said, well, why would you do that? They said, well, because of the risks. And then this gyneecologist said, well, it's rather addictive. We want to wean these women off. And I said, but I don't understand.

It's not an antidepressant. It's not something that is addictive. Women actually, she said, well, women feel so well, and they feel awful after, but they've just got to get through that time. and I don't understand why. You wouldn't stop cyroxin if they had an underactive thyroid gland. Why would you stop a really natural hormone? But it's almost a lot of doctors have this inbuilt in them

that they feel that it's wrong if a woman takes our own hormones. I do, oh dear, that's terrible. That really is terrible. That's shocking. Yes, I know. And then we see also quite a lot of women who want to start taking HRT when they're in their 60s, 70s, even 80s, because they've missed out, because there's a lot of women, I'm sure,

you know, some of your friends who never took HRT, and then they start reading about the benefits to their heart, their bones, their brains, and they're saying, am I too old to start taking HRT? And the evidence is not as clear. We know that when women start taking HRT within 10 years of their menopause, the benefits are the most for their health, for their bones, the heart, their brain. But there is some evidence that even a low dose can still help bones even when started older. So more than 10 years after the menopause. And we had someone recently in a clinic who was 90 and she decided for her 90th birthday to treat herself to a consultation and start HR too. Oh, that's wonderful. So there's lots of people on my Instagram who say,

is my mother too old or am I too old? And I think no one's too old to start something at all. no. Well, I don't take any other medication. And a lot of my friends that are not on HRT are on all sorts of medication. Which does speak volumes, doesn't it? I mean, you know, obviously my mother who's spoken before us on a podcast takes HRT. And I think the two of you are incredible because you're physically strong, you're mentally strong. And, you know, that speaks volumes. And obviously, who knows what you both would be like without HRT? But I'm sure. Your bones would be a lot weaker, your hearts probably. It's such an important hormone for every single cell in our body.

So have you got any friends that take HRT? I'm just trying to think, no, I haven't because the friends that are my age, no, they don't take it. But there are all sorts of other medication, which is very sad. And if I mention this to them, they say, well, I can't take it because, you know, because of bloodshops or something. And it's often they can. They just haven't been given the right.

information, which is desperately sad. Very sad, isn't it? Yeah, absolutely. And in fact, just before I left my general practice, I did an audit. I just looked at the prescriptions of all women who were in nursing homes and residential homes and care homes and warden control flats. And I wanted to know how many of these women were taking HRT. Can you guess the number that I found?

None. Yeah, zero. Zero. Yeah. And Rebecca Lewis, the clinical director with me in the clinic, she did the same. same for her patients as well. Just in the practice, she had a look because it's quite easy on the computer system to see. And again, there were none. It doesn't tell you, obviously, it doesn't tell you that taking HRT will keep you out of a residential home or a nursing home,

but I'm sure it is related because most women I know who are older who take HRT are physically and mentally very strong. And we know actually from data that women who take HRT for more than 18 years have a lower risk of death from all causes, actually, including from cancer. So that's quite amazing actually. And also, you know, just thinking about how young you were, we know that when women are under the age of the natural menopause, so as you know, the natural menopause is 51. But when women are in their 30s and have an early menopause, there's an increased risk of so many more diseases actually, even diseases such as lung disease or kidney disease and other psychological diseases such as bipolar depression,

or schizophrenia also increase without hormones. And there's some work showing that women age a lot quicker without hormones. And when we say age, it's not just the skin or the way they look. It's internally the organs just become older quicker because estrogen is so important. And it makes sense when you understand how estrogen works. It really does. Yes. Well, I'm going to keep on taking it, Louis.

and thanks to you, I shall certainly keep taking the gel. Yes, well, it's great and it's really lovely. I think it's very reassuring, hopefully, for people to listen, to know how safe it is and how important it is for you to be in control, you know, even just you're saying how you know your own body. And I think that's really important because I think for many years, even now, sadly, women are not recognised as being independent beings. it's almost like we're controlled by male healthcare professionals often or sometimes even

women as well. But I do often think if this was a male problem, we wouldn't be in such a mess as we are now. I'm quite sure. You know, it's quite scandalous actually that so few women take HRT when we know the benefits, that way, the risks. And it's almost been allowed to happen for so long. And that's what I find really sad. You know, we know that osteoporosis is far more common in women. We know dementia's far more common in women. You know, suicides are more common in women in their 50s, but no one knows looking into it. It's almost just, that's the way it is. It doesn't seem right, doesn't it? Thank goodness you're doing something about it. Telling the whole world. Yeah, well, it's important though, isn't it? I was talking to.

When you've got to, Louise, you really have. Well, I just, I feel like a bit of a mission, but I was talking to a professor in India today, actually. And she runs the Indian Menopause Society for doctors. And she was asking about my clinic and she was really interested to hear about it and also to hear about the app balance that we've produced. But she said, well, how many of your patients, Louise, actually take HRT? I said, what do you mean? And she said, well, what's your pickup? How many? And I said, well, the vast majority. That's what they come to the clinic for is for HRT because they've often been refuse it elsewhere. And she said that's really interesting because all the women we see in our menopause clinic probably only about 20% will take HRT because they're so scared and they

don't have the understanding. Yeah. It's quite sad. That's very sad. It is really sad. And she said most of the doctors, especially the GPs in India, are not giving HRT at all. They're too scared to prescribe it so they're promoting other treatments instead of HRT. Oh dear. That really is very sad. Yes. And she also said that the average age of the menopause in India is four years younger than in the UK. It's about 47.

And a lot of women in India have hysterectomy early. So there's a lot more who are even younger. So these poor women are just being denied HRT, but also they're denied the knowledge. They don't know what's going on. And I think this is really important. I think it's about women being allowed to have a child. choice, isn't it? It is. It's all about choice. And I think certainly, you know, 30, 40 years ago, women didn't have as much choices as they do now, do they? No, they didn't, did they? No, if your GP said,

no, that was it. Yes. And I think generally, I think, you know, gosh, you've always worked. You've got a great talent with your sewing and your designing, but that was quite unusual to work as hard as you've done. And like you say to lecture, I think things have changed, haven't they, over the decades? They have. and now have a voice, which perhaps they didn't have quite so much before, did they? That's true, yes. But once we find our voice, we don't shut up very easily, do we? They don't like to be quiet, do we? I want to tell everybody and share it, so that everybody can feel fit and well.

No, I think it's, it is so important because, I mean, it's easy now to share knowledge than it was before, wasn't it? I think, you could obviously tell your friends, but it's not so easy to look at it. up information or to find out what others are doing in the way that we can now. But you've written your book anyway, so at least a lot of people can, you know, read your book, find out a lot. Yes, and it's having information that's based on the available evidence as well, which is really important because, as you know, there's so much misinformation out there, which really upsets me because then it scares people.

Yes, it does, of course. And I do try and put them right when I hear anybody saying anything wrong, because, you know, everybody should be able to access this. They really should. They need HRT, they should be able to take it. Yes, absolutely. It's so important. It is.

You're doing a wonderful job anyway. Oh, you're very kind. At it, Louise. Keep at it. I know it's hard. Oh, yes, yes, it is. Definitely. I think there are lots of times when I go to bed and think,

what on earth am I doing? Maybe I should just give more time to the children and to, you know, looking after the house better. But it's very hard, isn't it? Because I hate the suffering and I hate hearing, you know, about how people suffer needlessly. You know, we all have suffering in our lives that we can't avoid. But if there is something that can change by having something as simple as hormones,

it's really not rocket science. It's such a simple thing, isn't it? Such a simple thing to do each day to, you know, put on the gel and you're right for the day then. That's right. Just amazing. Exactly. Yeah. So, well, I hope everyone who's listening has found this interesting and informative and

that I have written a fact sheet on my website about starting HRT many years after the menopause or continuing it many years after the menopause, which hopefully people can refer to as well. So just before we finish, Kay, just to put you on the spot, I always ask for three take-home tips from my guests. So I was wondering if you could just say three things to actually encourage women. So if women have been told by their doctor, they need to come off HRT because they're a certain age, what three things would you just advise those women to do?

Change their GP for a start. Just say absolutely, no, you must keep on it. Do not give it up. You just mustn't give it up. Because if you do, you'll just be right back to where you started. Yes. You don't want that. So please don't give it up.

So maybe see another doctor which I think is really important. Absolutely. Absolutely, yes. Don't give up. And then perhaps talk about it to your family as well. And I think, yes, or friends, because I think. Tell your friends and family. I think that's very important to even ask a family member to come with you to the doctor or nurse or whoever it is who's prescribing the HRT. Because I think a lot of women will take their first consultation as the only way. So if a doctor or nurse says, no, that's it. They think that's all they can do. But actually, it is worth exploring someone else. in the surgery and maybe going with someone else or if it's a remote consultation,

having someone with you on the screen to say, well, actually, why are you stopping? Because if I think about you taking estrogen, what are your risks? Actually, you don't have any. There's no risk of clot or stroke because it's going through the skin into your bloodstream. There's no risk of breast cancer. I've already said there's probably a lower risk of breast cancer. So actually, why would I stop it? is if I was your doctor, why would I stop you having something?

Because there are absolutely no risks, but there are plenty of benefits. And sometimes I do speak to doctors when patients have been refused or women have been refused HRT and they say, well, they're just worried about the risks. And when I say to them, well, what are the risks? Then they say, well, oh, gosh, I didn't realize how safe it was. So it's often a misunderstanding. So I think it's important that women can try and educate their doctors as well, at the same time because it will help other people.

Yes. As I say, I will not give it up. Never, ever. Brilliant. So, well, thank you ever so much for sharing everything. It's been really, really useful and informative. So thanks, Kay. Thank you, Louise.

Oh, thank you. Thank you for all the help you've given me as well. Oh, thank you. For more information about the perimenopause and menopause, you can go to my website, menopausedoctor.com. or you can download our free app called Balance available through the App Store and Google Play.