The Importance of Menopause Hormone Therapy (MHT) in Menopause Management: My Thoughts on the Latest Research

By Dr. Kelly Needham

As we embrace the new year, I’m excited to be focusing more on menopause and perimenopause in my practice with the launch of The M Clinic. This new chapter allows me to dive deeper into the unique health challenges women face during this transitional stage of life and provide personalised care that can truly make a difference.

One of the most significant aspects of my work at The M Clinic will be offering Menopause Hormone Therapy (MHT) to women, and I want to take this opportunity to address some of the concerns and the latest developments in this area.

The Evolution of MHT: From Controversy to Confidence

For many years, MHT has been a controversial topic, particularly following the 2002 Women’s Health Initiative (WHI) study. This study halted due to concerns about a 26% increased risk of breast cancer for women using MHT.

However, this conclusion was based on faulty data that didn’t account for the baseline risk of breast cancer or the fact that it included women up to the age of 80. It’s important to note that the risk of cancer naturally increases with age, regardless of MHT use.

As a result of this study, doctors significantly reduced or stopped prescribing MHT, and a generation of women was either incorrectly scared or denied this treatment. However, the data from the WHI has since been reanalysed, and more recent studies have shown that MHT is safe when used appropriately.

Understanding the Risks

When we look at the actual risk, studies now show that the increase in breast cancer risk for women starting MHT between the ages of 50-59, or within 10 years of their last menstrual period, is just 0.08%. To put that into perspective, women who drink three alcoholic beverages per week have a 15% increased risk of breast cancer over their lifetime compared to non-drinkers.

Additionally, while there may be a small increased risk of blood clots with some types of MHT, this risk is still rare and comparable to the risk associated with the oral contraceptive pill, which is routinely prescribed without hesitation.

The Safety of Modern MHT

The advancements in MHT administration have also made it safer and more effective. For example, transdermal estrogen (through a patch or gel) is considered the safest option, as it does not increase the risk of blood clots or stroke.

We also now have access to body-identical hormones like micronised progesterone, which has no significant increase in risks and offers a safer option for many women.

The improvements in the type and delivery of MHT have significantly reduced risks, making the benefits of MHT far outweigh the minimal risks for most women.

The Benefits of MHT: Short and Long Term

There are clear short-term and long-term benefits to starting MHT, particularly if begun before the age of 60 or within 10 years of your last menstrual period.

Short-Term Benefits:

These benefits usually appear within 3 months of starting MHT and can include:

• Relief from hot flushes
• Brain fog
• Anxiety or depression
• Weight gain
• Vaginal dryness
• Painful sex
• Loss of libido
• Mood swings
• Urinary incontinence
• Insomnia
• Joint aches
• Tiredness
• Dry skin
• Headaches

Long-Term Benefits:

Starting MHT early can also offer long-term health benefits, including:

• Decreased risk of breast cancer for certain groups of women
• Improved cardiovascular health and a reduced risk of heart attack (the second leading cause of death in women in Australia)
• Improved bone health, which reduces the risk of fractures due to osteoporosis (particularly important as bone loss is most significant around the time of menopause)
• Brain health improvements, including a reduction in the risk of Alzheimer’s disease, thanks to estrogen receptors in the brain

The Importance of Individualised Care

I understand that there is a lot of information, and every woman’s medical history is unique. That’s why I strongly encourage you to have an in-depth conversation with a doctor who is up to date with the current MHT recommendations.

Too often, I hear from patients that their doctor has told them MHT isn’t safe, but I want to assure you that this advice is outdated and often incorrect. If you hear this, seek a second opinion from a gynaecologist or a doctor specialising in women’s health. In reality, only a very small minority of women have contraindications for MHT, where the risks may outweigh the benefits.

Empowering Women with the Right Information

Every woman deserves to have the correct information based on her personal circumstances so that she can make an informed decision about her care. At The M Clinic, I’m here to support you through every stage of perimenopause and menopause, offering shared decision-making and individualised treatments that align with your health goals and lifestyle.

If you’re navigating the transition of menopause or perimenopause, I invite you to book a consultation with me at The M Clinic. Together, we’ll explore the best options for you and your unique needs, ensuring you feel confident, informed, and empowered as you embrace this new chapter.

With care and commitment,

Dr. Kelly Needham
Founder, Coastal Goddess & The M Clinic 🌸