ENERGY LEVELS. Women at midlife sometimes claim that their get up and go has got up and gone. They can’t raise the energy to pursue activities they have enjoyed for years. Such a woman is Bronwyn, whose youthfulness comes from an appetite for adventure that was unquenchable until menopause hit. ‘I don’t have flushes and I generally feel OK, except that I don’t have any energy. I’m working near to home but I find it harder than ever to get up in the morning, and to get moving. The worst thing is that I just want to rest on my days off, instead of visiting friends or taking off for the bush. I haven’t been able to look my hiking boots in the eye.’

If this is your scenario too, it is important — before allowing a doctor to reach for the prescription pad — to establish that your loss of energy has a physical origin and is not explained by job frustration or dissatisfaction, or the need for new challenges in life. Once you are satisfied that there is a physical basis to the problem, it is essential to have a check on your general health, diet, activity levels and lifestyle stresses before even considering HRT. Some women do find that energy levels respond to HRT. It is unclear to what extent this is due to an effect of HRT in settling other symptoms such as night sweats and sleeplessness; a feeling of wellbeing induced by HRT’s action on the brain and other body tissues; or a placebo effect activated by a doctor’s interest in and support of his or her patient.


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