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Highland NHS menopause specialist sets the record straight about HRT

By Annabelle Gauntlett

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Dr Hame Lata, menopause specialist.
Dr Hame Lata, menopause specialist.

Amidst the maze of information surrounding menopause and Hormone Replacement Therapy (HRT), there is a need for clarity and expert guidance.

An Inverness specialist menopause doctor, who holds a wealth of knowledge and experience in this realm, is keen to set the record straight.

Service clinical director, Dr Hame Lata has unravelled the misconceptions, myths and concerns surrounding HRT, offering invaluable insights and evidence-based information.

Menopause can be a worrying transition for any woman, as they portray symptoms such as hot flushes, infertility, brain fog, joint pain and severe anxiety.

When enduring the symptomatic backlash of menopause, HRT is prescribed, however with the stigma surrounding this form of medication, many women have become increasingly reluctant to take the pill. But, why?

Dr Lata has shed a light on the truth and has dispelled the uncertainties surrounding HRT, in order to empower women with accurate knowledge to help them navigate their menopausal journey confidently, on an informed basis.

Dr Lata has had 24 years of extensive experience as a menopause specialist and was also involved in the women's health group, who help tackle women's health inequalities. She worked as its remote and rural representative, which soon ended up forming the women's health plan.

She has since become "incredibly passionate" about women's health across the Highlands and a well-known advocate for menopause health.

She said: "The first form of HRT became commercially available in the 1940s and was then available in the UK in the 1960s.

"The average life expectancy for women was around 45 a hundred years ago, so at that point we weren't living long enough to go through and experience the menopause, so it's been something we have evolved into.

"From the '60s to the '90s, menopause care was established.

"There was a big medical trial in the late '80s and '90s called the women's health initiative that wanted to look at whether HRT could benefit women as they got older and if they would be able to reverse cardiovascular disease.

"This ended up being one of the biggest trials done on HRT, but as the results started coming out they noticed that more women were being diagnosed with breast cancer, heart attacks, strokes and blood clots.

"Unfortunately this was leaked to the media prior to a full evaluation of the trial and that hit the headlines massively in 2003."

HRT soon became known as the dangerous drug that caused breast cancer.

It wasn't long before women stopped taking HRT because of the proposed health risks and clinicians stopped prescribing it because suddenly they had this drug that was under trail and claimed to be "incredibly dangerous".

Dr Lata continued: "And that really was the end of menopause care as we knew it, because it suddenly just went out the window.

"Only about 10 per cent of women who needed to be given HRT were actually prescribed it, and they were all from specialist services because primary care no longer wanted to feel that they were able to prescribe that drug.

"However, what was not known was that this trial was based on a single type of HRT, it was a tablet form of oestrogen derived from the urine of pregnant horses and a synthetic type of progesterone. In addition to this, the average age of women recruited into this trial was 64, so there was thousands of women in their 60s, 70s and 80s who had been commenced on HRT with existing cardiovascular disease, and lifestyle choices such as smoking and obesity, which obviously effected the results."

These results were then translated into every woman and every type of HRT, engraving "the fear" of HRT.

Dr Lata said: "Since the trial in 2003, women were not coming forward because they thought there was nothing we could do.

"It wasn't until 2015 when NICE, the National Institute for Health and Care Excellence, reevaluated all of the data, including the women's health initiative and 35 other trials, as well as different age groups, risk factors and various forms of HRT, that they confirmed that if HRT is commenced before the age of 60, then the benefits are likely to outweigh the risks and that is where the changes started to happen."

Since 2016 Dr Lata has been training GPs in menopause, and there has been a "real push to try and get that knowledge and skills back up to speed".

It wasn't long before Dr Lata saw a 2000 per cent increase in her specialist menopause referral rate and continues to be the only specialist menopausal clinician in Highland.

This subsequently led to a waiting list of up to a year due to the demand.

Whilst her clinic has received adequate funding for another specialist to be taken on, Dr Lata has not been able to recruit anyone because "there are not enough SRH consultants, who manage a range of complex medical problems and procedural skills, being trained."

As consultancy training takes several years, Highland services have struggled to fill the demand despite their hard work and are now keen for more specialists to join.

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