Can HRT make you feel worse before better?
Posted on 27th August 2024 at 13:17
Menopause is a significant life stage that affects many employees, and understanding its impact is crucial for HR managers and employers. One common question is, "Can HRT make you feel worse before better?" This article will explore this topic and provide insights on how to support employees experiencing menopause, also referencing the Verve Healthcare Menopause Action Plan checklist.
Understanding HRT and Its Initial Effects
It does not just mark the end of a life of menstrual cycles, menopause is often characterised by its debilitating symptoms - hot flashes, mood disturbances, unusual bowel habits and dry skin to name but a few. It really can affect quality of life, and its effects vary from person to person. One person's experience may not be the same as another's.
Before trying hormone treatment (HRT), your employee may have explored self-found remedies like taking black cohosh to help with hormonal balance. There is no scientific evidence that shows black cohosh works. And so while HRT may not be the first avenue they have tried to manage menopause symptoms, it could be the first that has an evidence base behind it. The NHS website is a mine of evidence-based information about HRT, and your GP will also be able to advise.
HRT can be helpful for those seeking a new way to avoid health conditions due to menopause. But while it may be the best route for one person and dramatically improve their daily life and enable them to feel like they can continue their normal healthy lifestyle, others may struggle with it.
Hormone Replacement Therapy (HRT) is often used to manage menopausal symptoms, but it's important to recognise that the journey with HRT may not be smooth from the start. It's good to be pre-armed with knowledge about the effects of hormone therapy so that if someone experiences adverse effects then they can speak about them with their GP.
Being aware and being able to have helpful conversations about this type of hormone therapy with a GP will help your employee decide whether it is for them.
Can HRT Make You Feel Worse Before You Feel Better?
Yes, it can. Some women experience temporary side effects when beginning HRT, which might make them feel worse initially. These unwated or adverse side effects usually subside as the body adjusts to the new hormone levels, or as they work with their GP in follow-up appointments to find the type of HRT that suits them best. Common side effects may include:
Oestrogen-related side effects
Breast tenderness or swelling
Bloating
Nausea
Headaches
Leg cramps
Indigestion
Vaginal bleeding or spotting
Progesterone-related side effects
Mood swings, including low mood or depression
Abdominal pain
Acne
Breast tenderness
Vaginal bleeding
General side effects
Feeling confused or not quite yourself
Increased tiredness
Fluid retention and swelling
Changes in appetite
Digestive issues like constipation or diarrhoea
Encouraging open communication between employees and their healthcare providers during this adjustment period is essential.
Why Does HRT Sometimes Make You Feel Worse Initially?
It varies - which is also why an individual would be best to see their GP for specific advice. Some reasons that HRT can make you feel worse before you feel better are:
Hormone Fluctuations: The body needs time to adjust to new hormone levels, which can cause temporary discomfort.
Dosage Adjustments: Finding the right dosage is often a process of trial and error. Initial doses may need adjustment to find the optimal balance.
Type of HRT: Different types of HRT (e.g., oestrogen-only, combined oestrogen-progesterone) can have varying effects on individuals.
Individual Responses: Each person's body reacts differently to hormonal changes, leading to varied experiences with HRT.
What are the evidence-based benefits of HRT?
Relief of menopausal symptoms:
Reduction in hot flashes and night sweats
Improvement in sleep quality
Relief of vaginal dryness and discomfort during sex
Bone health:
Maintainance of pre-menopause bone density and reduction of calcium bone loss
Reduced risk of osteoporosis and fractures in postmenopausal women
Cardiovascular effects:
Improved blood lipid levels
Possible reduced risk of diabetes
Potential reduction in coronary artery disease risk when started close to menopause
Other benefits:
Reduced risk of colorectal cancer
Improvements in joint pain, anxiety, and quality of life
Possible protective effect against Alzheimer's disease when started during perimenopause
Additional potential benefits:
Improvements in albuminuria (and therefore kidney disease risk), carpal tunnel syndrome, lung function, and tinnitus
Supporting Employees Through the HRT Journey
Creating a supportive environment for employees navigating menopause and HRT is crucial. Here are some strategies:
Educate Yourself and Your Team
Organise workshops or training sessions on menopause and HRT.
Share resources, such as the Menopause Action Plan on Verve Healthcare's website.
Foster Open Communication
Encourage employees to discuss their needs without fear of stigma.
Train managers to have sensitive conversations about menopause-related issues.
Flexible Working Arrangements
Offer flexible hours or remote work options to accommodate appointments or manage symptoms.
Consider adjusting work environments (e.g., temperature control, access to toilets and quiet areas).
Implement Supportive Policies
Develop a menopause policy that outlines available support and accommodations.
Include menopause-related absences in your sick leave policy.
Provide Access to Health Services
Partner with healthcare providers like Verve Healthcare who can offer clinical guidance and support.
Access to a private GP can be quick and easy with our Verve On Demand pay-as-you-go service.
Create a Menopause-Friendly Culture
Normalise conversations about menopause in the workplace.
Celebrate menopause awareness events to reduce stigma.
Implementing a Menopause Action Plan
Verve Healthcare's Menopause Action Plan checklist provides insights into creating a comprehensive strategy for supporting menopausal employees. Key elements include:
Risk Assessment: Identify potential workplace factors that may exacerbate menopausal symptoms.
Policy Development: Create clear guidelines on menopause support and accommodations.
Training and Education: Provide resources and training for all employees to increase awareness and understanding.
Support Networks: Establish peer support groups or mentoring programmes for menopausal employees.
Regular Reviews: Continuously assess and update your menopause support strategies based on employee feedback and new research.
A Holistic Approach to Menopause Support
While HRT can sometimes make individuals feel worse before they feel better, understanding this process and providing comprehensive support can make a significant difference. By implementing a robust Menopause Action Plan, fostering open communication, and creating a supportive work environment, you can help your employees navigate this challenging life stage with confidence.
Remember, every individual's experience with menopause and HRT is unique. Offering flexible, personalised support and staying informed about the latest developments in menopause management, can help keep your workplace inclusive, productive, and supportive for all employees.
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