We picked the outstanding brain of Professor Rod Baber on the misgivings and vast improvement of Hormone Replacement Therapy technology and practices in the modern age.
Professor Rod, could you please tell The Big Smoke readers a little bit about what has led you to become the Head of the Menopause and Menstrual Disorders Clinic at Royal North Shore Hospital and immediate past-President of the International Menopause Society? What was it about this area of practice that drew you in?
Quite early in my specialist training, I became interested in the effects of hormones on women’s reproductive health. I did my post graduate training in the UK in both assisted reproduction (IVF) and also post reproductive health. I gradually developed more of an interest in the latter area because it affects so many women in so many ways, is poorly understood and poorly treated.
Why does HRT (Hormone Replacement Therapy) have such a bad reputation, and is it deserved?
HRT has a bad reputation primarily because of a misunderstanding! The original results of the biggest randomised trial in post menopausal women – The Women’s Health Initiative – were misrepresented and misunderstood when first released in 2002. This was a very good trial but was done on the wrong population –women on average in their mid 60’s when recruited – and yet the results were originally said to apply to all women irrespective of their health status, age or ethnicity. We now know, and the original WHI investigators agree, that HRT, when given to women within 10 years of their last period, is a very safe option with benefits outweighing any risks.
What role do you believe the ‘wellness’ industry, if any, should play when it comes to postmenopausal women?
I think there is a role for ‘Wellness industries’ throughout life providing they provide good advice on how all of us should live our lives using a sensible, natural approach to diet, exercise and life style. I do object if they try to convince people using misleading or false information. Or promoting unproven treatments.
What is the one question you wish women would ask their doctors when discussing management of menopause?
What can I do to maintain my good health as I age? That is the most important question for all of us.
What would you say to women suffering from menopausal symptoms right now? Can these symptoms be controlled safely?
If your menopausal symptoms are mild then you can probably manage these quite effectively yourself but if they are affecting your life, your work, your health or your relationships, I would recommend hormone therapy. HRT given to women within 10 years of their last period is very safe. Of course each woman should have an individual risk/benefit assessment, each woman should have an annual review to see whether or not she should continue, and each woman should have a thorough ‘mid life’ check to assess her general health (remembering that 40% of women over 50 die of heart disease and also that osteoporosis is more common after the menopause) combined with the usual screening tests such as Pap smear, mammogram, fecal occult blood and so on.
What advice would you give women who want to navigate menopause in the healthiest way possible – in regards to both education and also tangible support?
I think everything I have said above should be taken into account. It is up to each of us to take some responsibility for our health by leading a healthy life style with careful attention to weight, exercise, diet, moderate alcohol intake and not smoking. We do know that HRT is very safe for most women, we know much more about HRT and what it can do to help women than ever before, we have learned to use lower doses, to use natural hormones (but only those prepared under strict supervision by our regulatory authorities) and always to treat each woman as an individual.
Note: Hormone Replacement Therapy (HRT) has now been renamed Menopausal Hormone Therapy (MHT) by medical experts.
Thank you to Besins Healthcare for partnering with The Big Smoke.