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Can HRT make you feel worse before better?

Supporting employees through menopause

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 unwanted 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

  • Maintenance 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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