WE WANT OUR HRT

By Jennifer Upton

[This article is reprinted with permission from mySysters.]

I started taking HRT almost a year ago. 

A combination of estrogen delivered via a transdermal patch and, for two weeks a month, a dose of progesterone. 

For the first 7 months, I had no problems filling my prescription. 

The 2022 shortage where British women were forced to ration and share prescriptions in the UK happened before I began treatment. 

Recently, things changed. 

My pharmacist called me with the dreaded news, “We don’t have those items and we aren’t sure when they will be back in stock.” 

When I asked why, there was silence. 

My life suddenly became a sequence of phone calls and googling every pharmacy within the greater London area to find the patches and tablets I so desperately needed. 

My fear of the return of night sweats and insomnia drove me. 

After the tenth phone call, I wondered if this was “drug-seeking” behavior.

 I went to the medicine cabinet and counted my remaining doses. 

The prospect of quitting cold turkey grew with every “out of stock” alert. 

Why take both estrogen and progesterone? 

Doctors commonly prescribe the combination of estrogen and progesterone to women experiencing symptoms of menopause and perimenopause who still have a womb. 

Taking estrogen on its own can cause a thickening of the lining or sometimes cancer. 

Progesterone helps prevent this. 

Progesterone is typically stopped within 5 years of starting HRT. 

Quitting HRT Cold Turkey

Many who suddenly quit HRT experience withdrawal. 

The symptoms are similar to perimenopause and menopause and can include: 

  • Temperature sensitivity

  • Hot flashes

  • Night sweats

  • Insomnia

  • Anxiety

  • Depression 

  • Irritability 

  • Fatigue

  • Difficulty concentrating

  • Headaches

I finally made the decision that many cannot afford.

 I found a private online pharmacy where I could fill both of my scripts for a grand total of £105 plus shipping.

 On the National Health Service, each medication normally costs £9.35 per item. I count myself among the lucky. 

As an American living in the UK, I’m in the unique position to have experienced two very different health care systems. 

One nationalized with many private options and one that operates entirely for profit. 

Neither system is perfect. 

Both currently have a problem serving those in perimenopause and menopause. 

The U.S. has no shortage of HRT, but the fact remains most women in the US will never have access to HRT for several reasons: 

Innovation can help fill the health care gap. 

Apps and blogs like mySysters give women a place to learn about what their bodies are going through and offer alternatives when they can’t get the treatments they need. 

If you are currently on HRT and can no longer afford it or find it in your area, consult your doctor about the best way to taper your doses to minimize your symptoms. 

What are the alternatives to HRT?

If you're unable to continue taking HRT or can’t start, there are alternative ways of controlling your menopausal symptoms.

Alternatives to HRT that may control symptoms include:

  • Regular exercise

  • A healthy diet 

  • Cut down on caffeine

  • Drink little or no alcohol

  • Cutting down on spicy foods,

  • Quit smoking

  • Tibolone – a drug that is comparable to combined hormone replacement therapy (oestrogen and progestogen), but may not be as successful and is only appropriate for women who last had a period more than a year ago.

  • Antidepressants – Although they can have unpleasant side effects including agitation and dizziness, some antidepressants can assist with hot flushes and nocturnal sweats.

  • Clonidine – a non-hormonal medicine that may help reduce hot flushes and night sweats in some women, although any benefits are likely to be small

Yet another issue to contend with is the tendency for the media to criticize “the commercialization” of menopause.

 Some argue this is the leading cause for the UK shortages, but research shows it’s a combination of demographics and ongoing supply chain challenges brought on by the Covid-19 pandemic.

 

If we want companies to come up with solutions for menopause symptoms, we need to stop complaining when companies create solutions for menopause symptoms that become popular to the point of shortage. 

America needs to make them available at a reasonable price as part of a national health care strategy.

 

The UK is making strides where the U.S. is failing on that point. 

Beginning in April, 2023, “women prescribed HRT - the primary treatment for menopause symptoms - will have access to a new scheme enabling access to a year’s worth of menopause prescription items for the cost of 2 single prescription charges (currently £18.70.)” 

Will this boost demand? Most likely. 

But, we’re still better off than in the States where we have not even discussed the possibility of such a program.

In the future, both countries will continue to struggle to keep up with the needs of increasing menopausal populations. 

It’s time to stop blaming the victims for falling for “commercialization” and step up our games. 

The information and other content provided in this blog, website or in any linked materials are not intended and should not be considered, or used as a substitute for, medical advice, diagnosis or treatment.

For more information on menopause or perimenopause, visit mySysters.


Jennifer Upton is an American (non-werewolf) writer/editor in London.

She currently works as a freelance ghostwriter of personal memoirs and writes for several blogs

on topics as diverse as film history, punk rock, women’s issues, and international politics.

For links to her work, please visit https://www.jennuptonwriter.com or send her a Tweet

@Jennxldn


Sources: 

https://medicalxpress.com/news/2012-05-counties-ob-gyn.html

https://menopausesupport.co.uk/?p=14434

https://www.nhs.uk/conditions/hormone-replacement-therapy-hrt/alternatives/

https://www.nhs.uk/mental-health/talking-therapies-medicine-treatments/medicines-and-psychiatry/antidepressants/overview/

https://www.menopause.org.au/hp/information-sheets/tibolone-as-menopausal-hormone-therapy

https://pubmed.ncbi.nlm.nih.gov/7145250/

https://www.gov.uk/government/news/hundreds-of-thousands-of-women-experiencing-menopause-symptoms-to-get-cheaper-hormone-replacement-therapy


Skin Changes in Perimenopause and Menopause

[This article is reprinted with permission from mySysters.]

You know about hot flashes/flushes, but you may not be prepared for a lesser known side effect of perimenopause: changes in your skin.

Changes in Hormones

When we enter perimenopause, the production of estrogen begins to slow down until it stops.

Estrogen stimulates the formation of skin-smoothing oil and collagen, which also begins to slow down once we reach perimenopause.

Changes in your skin during perimenopause are mainly due to rapidly falling estrogen levels.

Collagen

The dermis is a layer of skin that is mostly made up of collagen.

Collagen, along with elastin, is responsible for the structure and elasticity of the skin.

In only five years after menopause, you may expect to lose over a third of your skin's collagen content.

The outer layer of the skin produces fewer glycosaminoglycans, often known as GAGs, as estrogen levels drop.

This hormonal shift causes a decrease in collagen production, making skin less elastic.

Estrogen promotes water retention and plumpness in the skin, and when estrogen levels drop, some of the molecules that keep the skin moisturized are lost.

Perimenopause vs. Menopause

Perimenopause differs from menopause in that periods may become erratic, but you still have estrogen.

Because you're having hot flashes during perimenopause, your skin may get red.

You may also experience breakouts, and previously balanced skin may develop dry or oily spots.

At this point, rosacea can appear.

Things change after a woman reaches menopause.

You won't notice many changes in your skin if you start estrogen therapy but your skin will get quite dry if you do not take estrogen therapy.

Because there is a link between collagen formation, skin thickness, and estrogen deficiency, skin thins after menopause.

Dryness is exacerbated by a natural slowing in cell turnover and a decrease in humectants in the skin.

Some people will see skin changes right away, while others will notice it over time.

The difficulty is that while hormone therapy is effective, transdermal estrogen is frequently used as a menopause treatment, and not everyone is a candidate.

Most Common Skin Issues

Dry Skin

During menopause, your skin begins to thin, and the upper layer becomes less effective at storing water.

Estrogen is crucial not just for collagen production, but also for the production of the oils that keep your skin moisturized.

Dry skin can cause itchy skin in addition to being annoying and preventing you from looking your best.

Acne

For many postmenopausal women, hormonal imbalances can result in the development of adult acne.

Stress, which is a frequent symptom of menopause, leads your body to create androgens in addition to cortisol.

Because androgens activate the oil glands in your skin, they frequently cause acne breakouts.

Wrinkles

More skin cells die or atrophy when collagen is lost and synthesized in lower amounts after menopause.

As a result, the skin's look changes, and wrinkles form.

Itchy Skin

In the worst-case scenario, if your skin dries up too much during the transition, you may experience pruritis, an itchy sensation that makes you want to scratch and scratch.

This can manifest itself in the arms and legs, the back, or the chest.

Loss of plumpness and sagging

Collagen is a protein that connects the tissues of the body.

When estrogen levels drop, so does collagen formation in the skin.

Collagen deficiency causes the skin to lose its young volume and firmness.

Many people take collagen supplements or eat high-collagen meals like bone broth to fight this problem.

However, the verdict on this method is still out.

Tips for Smoother and Fresher Skin

  • Use gentle soap.

  • Using mild or lightly scented soap bars will help retain your body’s essential oils, leaving your skin with the healthy amount of oil and cleanliness.

  • Always moisturize.

  • After you gently towel dry your skin, smooth on your favorite moisturizer.

  • Using petroleum jelly will help too.

  • Drinking water will help your body produce healthy fluids that keep your skin moisturized.

  • Apply sunscreen before you leave the house.

  • A dermatologist can help you find the right regimen for you. Ask your primary provider or GP for a referral or search online for one in your area.

The preceding information does not constitute medical advice or treatment.

Happy New Year! Now Forget Those Resolutions!

As one calendar year ends and another begins, we’re bombarded with words such as: “Revitalize!” or “Recharge!” or “Reorganize!”

Sure, it’s always good to have goals, but what if we’re good just the way we are?

As we welcome 2018, let’s resolve to not worry about whether we’re attractive enough, thin enough, have enough money, or are buying the trendiest items.

Let’s not worry about hitting the gym every day or striving for supple skin or shiny hair or eating enough kale. Being a woman isn’t about how we look, but what we’re doing with our lives—and life is messy, complicated, full of surprises, and waiting for us every day if we’re lucky.

It doesn’t begin on January 1st. Every day is an opportunity to make life whatever we want it to be, and that can include not reorganizing the closet or not redecorating the living room or not reading that pile of bestselling books or not cooking a fabulous organic dinner.

We don’t need to re-anything. Change is constant, so why pile on the pressure with New Year’s resolutions?

We’re enough—right now—exactly as we are today.

Moreover, womanhood is a spectrum of possibilities, not an advertisement promoting perfection. In an era of growing sociopolitical exclusion, we want to foster an environment of inclusion.

Womanhood is strength, resilience, resourcefulness, compassion, independence, and so much more. Womanhood is every skin color, every body type, every faith, every sexual orientation, every political affiliation, every income level; it’s being a mother or not being a mother. To be a woman in 2018 means a realm of choices and opportunities our mothers and grandmothers did not have.

We are all trying to find our way, so we understand how hard things can sometimes be, and how important it is to feel heard and to connect with others.

In the coming year, this app will undergo changes of its own to reflect our evolving views on womanhood, so please stay with us to see what unfolds in the new year.

As our community here grows, we seek to create a safe space where women can speak honestly about what’s going on in their lives as well as have fun. After all, humor heals.

Raise a glass and toast to being a woman and to being perfect the way you are.

Wishing you a happy, healthy 2018, Sister.

~Cindy, HFS Founder

Photo by Brooke Lark on Unsplash