- MHT is the most effective treatment for hot flushes & quality-of-life symptoms in menopause. Confusion following the early 2000s Women’s Health Initiative (WHI) led to fear & misinformation… Evidence has been updated… He maramatanga hou, he oranga hou – new knowledge supports better wellbeing.
Myth 1: MHT will make you gain weight – He whakaaro hē tēnei – this is incorrect.
- Women using MHT do not gain more weight than women who don’t. Midlife weight changes are mainly due to ageing, lifestyle & social factors. Menopause can shift fat distribution toward the abdomen – not caused by MHT. Ko te pakeketanga te take matua – ageing is the main driver.
Myth 2: Breast cancer is the most common cause of death after menopause.
- Fear of breast cancer is a major reason women avoid MHT. Heart disease & stroke are far more common causes of death. Breast cancer deaths are lower than cardiovascular causes. Me matua titiro ki te katoa o te hauora – we must look at the whole picture of health.
Myth 3: 1 in 4 women on MHT get breast cancer – He iti noa te tūraru – the risk is small & time dependent.
- This is misreported MHI data. Updates evidence shows:
Combined MHT (oestrogen + progestogen)
No increase in breast cancer risk in women aged 50 – 49 or within 10 years of menopause.
After 13 years: Small increase (9 extra cases per 10,000)
Oestrogen-only MHT – no breast cancer risk even after long term follow-up.
Myth 4: MHT increases heart disease risk.
- Analysis of 40,000+ women shows:
No increase in deaths from heart or blood vessel disease.
No increase in heart atacks or angina.
This applies to healthy women & those with existing cardiovascular disease.
Mā te mohio tika ka heke te mataku – knowledge reduces fear.
Myth 5: You need a blood test to diagnose menopause – Ehara i te mea me whakamātou toto – it is not necessary to have a blood test.
- Menopause is a clinical diagnosis + 12 monthjs after your last period – blood tests may help only:
Women under 40.
Women with a hysterectomy & symptoms.
Ka rangona te tinana – the body tells the story
Myth 6: Natural therapies are safer & just as effective – He iti noa te tainakitanga mō ēnei rongoā – there is limited evidence for these treatments.
- MHT remains the most effective treatment for menopause symptoms. Many “natural” products lack evidence, regulation or safety testing. Some (e.g soy) may be insafe for women who can’t take MHT. online products may be contaminated or unreliable. Kōreri ki tō rata – always discuss options with your doctor.
Myth 7 & 8: Bioidenticals & progestogens – Ngā tangirua e rua – 2 areas of confusion.
- Compounded bioidentical hormones:
Are not safer or better than prescribes MHT. they are not regulated, quality & safety are not checked. Associated with serious risks (e.g endometrial cancer).
- Progestogens:
Not all progestogens carry the same risks
Progesterone is different from synthetic progestins
He rongoā mō te tangata, ehara i te rongoā kotahi mō te katoa – Treatment should be individualised, there is no one size fits all.
Myth 9: Non-hormonal options work just as well – He iti ake te whai hua i te MHT.
- Non-hormonal medications are less effective for hot flushes.
- Useful when MHT isn’t appropriate or desired.
- Decision making should be shared and informed.
KEY MESSAGES:
Many myths stem from early MHI reporting.
Modern evidence shows that MHT is effective & safe for many women.
Best outcomes occur when MHT is started within 10 years of menopause.
He mana tō te wahine ki te kōwhiri – women deserve informed choice.
