Kathy Abernethy
BMS Trustee and Menopause Specialist, British Menopause Society
With increased awareness of menopause, there has also been an increase in misinformation. Here, we tackle some common narratives to help women ask the right questions and make informed decisions about their own health.
Every woman experiences the menopause, yet symptoms can vary from one individual to the next. What works for one may not work for everyone. The British Menopause Society (BMS) aims to separate fact from fiction and provide information based on scientific, rather than anecdotal, evidence.
Testosterone levels need a boost during menopause
The allure of testosterone is real. Does it work? The honest answer is that research shows testosterone is most effective at improving sex drive during menopause.1 While some swear by it for other reasons (such as memory, brain fog and energy levels), there is not yet the scientific evidence to support these claims. UK NICE guidelines concur with the international consensus — that its use is primarily for those with a significant dip in sex drive, which is causing distress.
While many see testosterone as the answer to their low libido, it’s not that simple. Stress, body image and relationship issues all play a role. Physical symptoms like vaginal discomfort and painful sex all contribute to whether or not you desire sex. Testosterone can be a piece of the puzzle but is rarely the whole solution.
Not everyone needs HRT, and
some are advised against it.
The higher the HRT dose, the better
Hormone replacement therapy (HRT) dose should be tailored to the individual, and a higher dose doesn’t necessarily deliver added benefits. Taking a higher-than-recommended dose might also be harmful. High doses of oestrogen without the protective balance of progesterone cause unexpected bleeding for many women.2 This can lead to a lot of stress, referrals for unnecessary tests and an increase in the risk of womb cancer. If you have been advised to take a high dose of oestrogen and are experiencing unexpected bleeding on HRT, seek advice from your healthcare professional.
All peri and post-menopausal women should have HRT
Not everyone needs HRT, and some are advised against it. There are non-hormonal prescribed treatments available that can improve symptoms. Some prefer to try herbal or dietary supplements, which may ease some symptoms. Studies show that cognitive behavioural therapy (CBT) can also help with sleep during menopause and reduce the impact of symptoms such as hot flushes, low mood and anxiety.3 Lifestyle changes, including nutrition and exercise, play a key role in improving wellbeing and maintaining health at this important time.
Kathy is author of Menopause: The One Stop Guide, a practical guide to understanding and dealing with the menopause, available at www.kathyabernethy.com.
Learn more at thebms.org.uk and womens-health-concern.org
[1] Achilli, Chiara et al. Fertility and sterility vol. 107,2 (2017): 475-482.e15. doi:10.1016/j.fertnstert.2016.10.028
[2] British Menopause Society. (2024). Management of unscheduled bleeding on hormone replacement therapy (HRT).
[3] Mann, Eleanor et al. The Lancet. Oncology vol. 13,3 (2012): 309-18. doi:10.1016/S1470-2045(11)70364-3
