The survey found that over half of women experienced issues like inability to orgasm, vaginal dryness, and loss of libido during menopause. While some HRT users saw benefits, many did not, and over a third said their relationships were strained by menopause symptoms. Women received limited advice on alternatives from doctors and often turned to other sources like books and the internet to research options besides HRT.

1. Menopause
How it affects our lives and dealing with it

2. Menopause Relationships Survey
A survey of 673 women who completed an internet questionnaire
placed on the Natural Health Advisory Service websites about how
the menopause influences personal relationships.

3. Who completed the survey?
The survey was completed by over 1,000
women in 2004. 637 women were defined
as menopausal. The remainder would be
defined as perimenopausal. The study group
was defined as not having had a period in 6
months.
166 women in the sample were taking HRT
at the time of the survey. 186 said they had
taken HRT in the past.

4. Age of Respondents
 Age ranged between 30 and 70 years with an average of 49
years
 Last period varied from being within one month or as long
ago as 40 years with a median of 24 months. 100 women had
not had a period for over 10 years.
 202 women had had a hysterectomy and the age range at
hysterectomy was from 23 to 60 years. 132 women had had a
total hysterectomy with loss of the ovaries.
 484 had had a natural menopause and 21 reached the
menopause as a result of medical treatment.

5. Summary of Findings
 Over 51 per cent of women in the survey couldn’t reach orgasm
 55% of the sample had a dry vagina and 40% said HRT didn’t help
with vaginal dryness
 59% saw total loss of libido. 45% were moderate to severe
 Of the 166 currently taking HRT, 105 women saw no benefit to
their loss of libido
 36% said they suffered from painful intercourse

6. Summary of Findings (cont)
 Over two-thirds of the sample said that the
menopause put a strain on their relationship.
 37% said their relationships were moderately to
severely under strain.

7. Symptom Number of Women Average Duration
Severely affected of Symptom
Hot Flushes 122 18.5 months
Night Sweats 116 17.2 months
Fatigue 126 16.5 months
Mood Swings 114 15.4 months
Insomnia 123 14.6 months
Loss of Libido 147 13.5 months
Depression 73 12.4 months
Vaginal Dryness 87 11.8 months
Painful Intercourse 52 7.0 months
Symptoms of the Menopause
and their Duration

8. Duration of Use of HRT
Duration on HRT No. of Women
Less than 1 year 73
1-2 years 73
2-3 years 26
3-4 years 25
4-5 years 35
5-10 years 77
More than 10 years 43
Total 352

9. Symptom Response to HRT
Symptom Fully Partially No Benefit Worsened
Responded Responded
Painful Intercourse 218 60 61 7
Urinary Problems 209 60 62 15
Vaginal Dryness 187 79 73 7
Night Sweats 171 122 46 7
Hot Flushes 168 136 36 6
Insomnia 163 89 74 20
Depression 161 79 81 25
Loss of Libido 154 73 105 14
Mood Swings 139 102 80 25
Fatigue 125 106 95 20

10. Menopausal symptoms were rated as placing a strain upon the person’s
relationship with their partner as follows:
Breakdown of 16 women )
Relationship ) A Total of
) 85 women (13%)
Severely 69 women )
Moderately 168 women
Slightly 168 women
Not at all 216 women
Strain on Relationships

11. Strain on Relationships (cont)
Number of
Women
Percentage
Loss of libido putting
strain on relationship
241 38 of total 637
Partner is understanding 402 63 of total 637
Partner feels woman
doesn't care as much
121 19 of total 637

12. Strain on Relationships
(cont)
Amongst HRT users:-
HRT had no effect on relationship 198 56 of 352 HRT users
HRT improved relationship 123 35 of 352 HRT users
HRT worsened relationship 25 7 of 352 HRT users
HRT made no difference to libido 199 57 of 352 HRT users
HRT improved libido 105 30 of 352 HRT users
HRT reduced libido 42 12 of 352 HRT users
No. of
Women
Percentage

13. Strain on Relationships (cont)
Amongst those who didn't use
HRT nor any natural treatment:- No. of
Women
Percentage
Menopausal symptoms impinged
greatly on relationship
166 57 of 292 non HRT/non
treatment women
Menopausal symptoms impinged
moderately on relationship
44 15 of 292 non HRT/non
treatment women
Menopausal symptoms impinged
mildly on relationship
46 16 of 292 non HRT/non
treatment women
Menopausal symptoms had no
effect at all
36 12 of 292 non HRT/non
treatment women

14. As Hormone Replacement Therapy is no longer
regarded as suitable for long-term use, and in the
absence of adequate education for doctors on
alternative treatment for the menopause, it is
more important than ever that women learn how
to manage their menopause symptoms with a
scientifically based natural approach in order that
they can once again enjoy their relationships.
The Natural Health Advisory Service Menopause
Programme, which is outlined in the books ‘Beat
Menopause Naturally’ and The Natural
Menopause Plan, has been shown to address
these symptoms successfully.
Relationship Survey Conclusion

15. Conducted by the Natural Health Advisory Service
Increasing numbers of women have questioned the merits of taking HRT in
the long term and have been actively seeking alternative solutions to control
their symptoms of the menopause.
The Menopause Management Survey was conducted to determine the
percentage of women who had chosen or been advised to discontinue their
HRT, the sources of the information and guidance they received and which
approaches they felt most helpful.
The Survey was placed on our websites during the Spring of 2004. Replies
from 1,084 of the women who completed the survey were included in the
analysis.
Menopause Management Survey

16. Age of Respondents
Average age was 50 years
Average age of women on
HRT for more than 5 years was
55 years

17. Summary of Findings
34% of the sample had stopped taking HRT
50% had chosen not to take HRT
only 14% were still currently using HRT
Interestingly 19% of those taking HRT had been prescribed it by
their doctors for reasons other than menopause symptoms.
39% of the HRT users had been taking HRT for more than 5 years
there was a clear correlation between the duration of treatment
and the difficult in coming off HRT. 71% had opted to abruptly stop
taking HRT.

18. HRT Use Past and Present
Currently taking HRT 148 women (14%)
Taken HRT in the past 365 women (34%)
Never taken HRT 554 women (50%)
No answer 27 women (2.5%)
513 women which amounts to 48% had taken HRT

19. Reasons for HRT being prescribed
Menopausal symptoms (hot flushes,
night sweats or vaginal dryness) 295 women (58%)
Menopausal symptoms and osteoporosis 79 women (15%)
Prevention of osteoporosis 46 women (9%)
Treatment of proven osteoporosis 6 women (1%)
Urinary problems 5 women (1%)
Other reasons 98 women (19%)

20. Duration of Treatment with HRT
Up to one year 131 women (26%)
One to three years 105 women (21%)
Three to five years 75 women (15%)
More than five years 201 women (39%)
Percentage of 512 HRT users

21. Side Effects of Hormonal Replacement
Therapy
“Weight gain” 326 women (64%)
Breast tenderness 236 women (46%)
Fatigue 197 women (38%)
Aches and pains 181 women (35%)
Anxiety 177 women (35%)
Headaches, not migraine 155 women (35%)
PMS or other cyclical 155 women (30%)
Mental confusion 108 women (21%)
Other problems 44 women (9%)
Venous thrombosis 22 women (4%)
Breast cancer 12 women (2%)

22. Age of those with possible side-effects of
HRT
Venous Thrombosis Avg Age 57.5 yrs Range 45-60 yrs
Breast Cancer Avg Age 53.5 yrs Range 43-74 yrs

23. Return of symptoms from coming off HRT
Those who came off Abruptly(293) Gradually (119)
Increased hot flushes and night sweats 62% 74%
Return of other menopausal symptoms 45% 41%
Other health difficulties 19% 15%

24. Overall Experience of HRT
Very beneficial 33%
Beneficial 17%
Neutral 26%
Moderately negative 13%
Very negative 10%

25. Alternatives to HRT
Sources of advice for alternatives to HRT
Through an article or advice in the media 33%
Through the internet 29%
From a self-help book 26%
From a friend 15%
From a doctor 15%
From an alternative practitioner 9%
From a practice nurse 4%
From other sources 6%

26. Usage and Experience of Alternative Therapies
%
TRIED
NO HELP SOME
HELP
VERY
HELPFUL
Multi-vitamins 44% 36% 57% 8%
Herbal Remedies 38% 23% 60% 17%
Vitamin E 27% 35% 57% 8%
Isoflavone-rich Supplements 26% 21% 59% 20%
Mineral Supplements 26% 30% 60% 10%
Yoga 18% 19% 59% 22%
Homeopathy 12% 29% 57% 14%
Dong Quai 12% 48% 41% 11%
Ginseng 11% 47% 46% 8%
Reflexology 7% 30% 50% 20%
Acupuncture 5% 36% 47% 16%
Alternative Treatment Self Rated Outcome of Users

27. Summary of Survey Results
Women are often left to fend for
themselves as their GPs are not
educated about the alternatives to
HRT
There is tremendous confusion
amongst women about how best to
manage their menopause and
consequently unnecessary suffering

28. Relationship Survey
Summary of Findings
 Over 51 per cent of
women in the survey
couldn’t reach orgasm
 55% of the sample had a
dry vagina and 40% said HRT
didn’t help with vaginal
dryness

29. Summary of Findings (cont)
59% saw total loss of libido.
45% were moderate to severe
 Of the 166 currently taking
HRT, 105 women saw no
benefit to their loss of libido
 36% said they suffered
from painful intercourse

30. Is it working?
• Women received advice and information about
alternatives to HRT from:
• the media (33%)
• the internet (29%)
• self-help books (26%)
• a friend (15%)
• compared to a doctor (15%), an alternative
practitioner (9%) or a practice nurse (4%).

31. Is it working?
• Of those who received advice from their doctor or
practice nurse:
• only 10% were given advice on vitamins and minerals
• 9% given advice about diet
• 9% herbal medicine
• 7% calcium/supplements
• 6% isoflavone supplements.

32. When it comes to their health do women
have enough information?
The medical profession is letting women
down in providing information on the
menopause.
Both doctors and practice nurses are poor
sources of advice on alternative therapies to
HRT.
Doctors also had scant advice on diet and
supplements.
In some cases doctors even prescribed HRT
for symptoms other than those of the
menopause, according to study results.

33. Women unaware of the necessity to
wean off HRT
Women are unaware of the necessity to
gradually wean themselves off HRT, like any
drug. They leave themselves open to
depression and a sudden onslaught of
menopausal symptoms. Also the longer the
drug is taken the more difficult it is to wean
off.

34. HRT and weight gain
One of the biggest side effects of taking
HRT is weight gain, yet it does not feature
on the side effects list issued by
manufacturers. 64% of the study cited
weight gain as the largest side effect of
taking the drug. In NHAS experience
women gain on average 18 – 21 lbs in the
first year on HRT.

35. Women turn away from hormone therapy
to alternative treatments
Increasingly women are looking at
alternative therapies to relieve the
symptoms of the menopause. The
media, the Internet and self-help books
are the top three women turn to in a bid
to find information on alternative
therapies.