In recent years, celebrities such as Michelle Obama and UK television presenters Davina McCall and Mariella Frostrup have made talk of the menopause and its symptoms more mainstream.
While studies have confirmed that some hormone replacement therapy (traitement hormonal substitutif) medications raise the risk of breast cancer, they also suggest this risk remains low.
HRT is also now thought to have a protective effect against diseases relating to the ageing process, such as osteoporosis and even Alzheimer’s.
However, while HRT is a lifeline for many women, it is important to remember that not all women suffer the same symptoms of menopause.
The British Menopause Society recommends that “whilst HRT can play an important role … changes in lifestyle and diet can all help in alleviating menopausal symptoms, and improve later health”.
Low uptake of HRT might, therefore, be due to women managing their symptoms in other ways, rather than because of fear or reluctance.
Certainly, Dr Danielle Hassoun, a gynaecologist from Paris, feels there is no particular problem when it comes to women accessing HRT in France, and headlines citing anxiety about using the treatment are overblown.
“Women know that there are risks, for the breast in particular, even if these risks are low,” she explained.
“Menopause is not a disease and the majority of women experience menopause without bothersome symptoms and therefore do not need hormone treatment.
“Those who need treatment are those who have a lot of hot flushes and whose quality of life is impaired.”
As for the herbal treatments favoured by some women, Dr Hassoun does not believe they are a suitable alternative if HRT is required.
“Studies to date have shown that herbal treatments are not effective,” she said.
“If someone is having problems with menopausal symptoms, they should take the hormonal treatment unless there is a medical reason not to do so.”
No problems getting a prescription
Michelle, 55, from Puy-de-Dôme in the centre of France, had heard that HRT was difficult to come by in France, so when she went to her doctor to ask for it she was prepared to put up a fight.
“I had heard some difficult tales, so made sure I had written my symptoms (difficulty sleeping, hot flushes, frequent headaches and irritability) and other medical history in French, and simply stated in writing that I wanted to have HRT.
“The doctor read my information, did a basic physical review, prescribed some blood work, then happily gave me a prescription for HRT patches.
“I have not had a hot flush since then and there has been a huge improvement in my quality of life.”
Fight for it
Carine Harding, 51, from Gironde, had more of a fight on her hands, however, when she presented with perimenopausal symptoms in 2021.
“When I was 50, I had problems with my joints.
“At the time, the doctor prescribed physiotherapy.
“Then I read a book on menopause by Dr Louise Newson and found that joint pain can be a symptom of perimenopause or menopause.
“I went to a GP who specialised in gynaecological issues who told me I was not menopausal as I was still having periods. However, she did some blood work and in the end reluctantly agreed to offer HRT, but only for five years.
“I felt a bit like a stroppy child demanding sweets!
“However, I have been on HRT now for six months and although it has not cured my symptoms, it has certainly relieved them greatly.
“Here, among my French friends, nobody seems to be talking about HRT, but my English friends do discuss it.
“I think there is still a lot of misunderstanding around the menopause.”