Hello Dr Annie
I'm 51 and my periods have just about stopped. I'm a bit overweight and have been getting hot flushes, brain fog, and so stressed and moody. My teenage kids aren't helping. Should I ask my Dr for HRT, I want to go down the natural route as afraid of breast cancer. My older sister had it, but didn't take HRT, but she was always overweight too. What do you think? Is HRT safe? I know I have to lose weight, but the cravings for sugar and carbs are just too hard.
Stressed out and overwhelmed in Castle Cary.
----------------------------------------------------------------------------------
Dr Annie's Response:
Stressed out and overwhelmed in Castle Cary
There is good medical evidence that in women with w tendency to weight gain especially around the tummy, even if they are not diabetic, can have raised insulin levels. This is called insulin resistance, and is associated with definite carbohydrate munchies. In women experiencing the menopause, the use of HRT decreases insulin levels and improves cardiovascular risk in those with normal or near normal weight levels. The more overweight, even if non-diabetic, could be given an insulin blocker such as Metformin by their GP, in addition to HRT. People with diabetes might be eligible for Wegovy, or one of the other injectible insulin blockers.
The breast cancer risk of course is a concern, and annual mammography while on HRT is essential even though the risk of cancer is small. There is an increased risk with being overweight anyway, but the benefit of HRT to cardiovascular risk (heart attack and stroke) outweighs the risk of breast cancer. It is important also to emphasise that there is no increased mortality from breast cancer, but there is with cardiovascular disease.
The benefits of HRT are beginning to be appreciated, and you should discuss this with your GP, abd possibly also consider Metformin.
Dr Annie