Am I a crap feminist for not taking HRT?

The Pill, HRT, and the Missing Conversations

Couple weeks ago, I went to an event called Hormones in Your Head with Kate Muir, the woman behind the Davina McCall TV show about menopause. It was a brilliant event, covering so much ground, and I love that these conversations are finally being had.

But I left feeling conflicted, a bit stuck in a quandary, and honestly, like a bit of a shit feminist.

One of the most powerful moments was an interview with a woman who had a stroke at 32 due to the pill she was taking. Absolutely awful. Thankfully, she’s recovering well. There were stats thrown around about the likelihood of this happening, which varies depending on the brand and hormone dosage. But no brand names were mentioned—a missed opportunity, in my opinion, for giving women the full picture.

It’s been clear to me for a long time that women can be medicated with hormones for their entire lives—starting at 16 and carrying on until we shuffle off this mortal coil. There’s mounting evidence that synthetic hormones impact us on a cellular and emotional level. At every talk I’ve given, someone has said they felt like a fog lifted when they came off the pill. Their mood changed, their weight shifted, their gut health improved. There’s evidence for this—if you go looking for it.

Yet, when we step into a GP’s office, we’re told, “This will balance your hormones,” or “This will stop the pain/heavy bleeding.” But it doesn’t balance your hormones—it shuts them off completely and replaces them with what’s in that little white pill. Maybe it does stop the bleeding, maybe it does reduce the pain. But are we told that certain brands carry a higher stroke risk? That some are linked to depression and anxiety? That others cause weight gain you can’t shift no matter what you do? And that’s before we even get into the subtle, long-term changes happening beneath the surface.

The marketing of the pill has always been exceptional. The industry—it is an industry—is worth an obscene amount of money. Of course, contraception is vital. Women deserve the right to choose. But shouldn’t that choice come with all the facts?

I was put on Microgynon—the first-line pill they give everyone. It was awful. I felt moody, sad, like a dark cloud had descended. My periods didn’t improve, and I gained nearly two stone overnight. When I went back to my GP nearly a year later, having finally realised the pill was the only thing that had changed, she said, “Oh yes, I hear that a lot.” I remember thinking—then why the hell are you still prescribing it?!

The conversation at the event eventually moved on to HRT. Yes, it’s amazing that we have access to it. Yes, I believe women shouldn’t have to suffer. Yes, we need to talk about menopause. But actually, we need to talk about our whole menstrual lives—because for many women in that room, this was brand-new information. And that in itself is a problem.

But I still felt uncomfortable with the narrative that HRT is the fix. That the pill is awful (which, to be fair, I mostly think it is), but HRT is the saviour. That it’s safer, better, necessary—and that there’s something wrong with you if you don’t take it.

At the end, we were asked, “Who here wouldn’t take HRT?” I put my hand up. And I’ll be honest, it felt like a badly phrased question, like I was being awkward for the sake of it. But I don’t want to take it. I also have to be careful with extra oestroge

n given my history—I’ve been around the oestrogen block enough times to know I already have more than I need. There is hardly any research on menopause, Endo and HRT. So here I go again having to be my own leading light in navigating this because the mainstream narrative doesn’t fit for me - and I won’t be the only one.

I take the pills and risk my Endo and Adeno flaring beyond belief or I don’t take it and fear for my brain, bones and heart?! What a choice, I feel right back in the space of my consultant saying to me I would be demanding a hysterectomy because the way I was going to manage my conditions was in her eyes wrong. How is that empowering ANYONE?

We were shown slides of brain scans, illustrating what’s happening in my head this very second as I navigate perimenopause. Should I be scared? Or in awe of what my body is doing? It’s not broken—it’s just going through a transition, just as it did at puberty and (if you’ve had children) pregnancy. And let’s not forget—men also go through a version of menopause as their hormone levels decline. But where’s the push for them to start taking hormone replacements to protect their bone density, muscle mass, cognitive sharpness? It’s just… not there.

So what about those of us who don’t want to take HRT, or can’t, or have tried but didn’t get on with it? Are we outsiders? Are we excluded from the crone table because we’re choosing to do things differently?

I had to find an alternative way to manage my fertility because hormonal contraception wasn’t an option for me. That’s a burden men simply don’t have to carry. It is a gendered issue—there’s no getting around that.

And yet, if you choose not to follow the mainstream medical route, you’re often othered. Taking the herbal approach is a valid choice. And if you do need medical intervention? That’s fine too. The two can co-exist. It doesn’t have to be one or the other.

The research on plant-based treatments is limited—because there’s no money in it. It’s dismissed as quackery and snake oil. Meanwhile, the limited research we do have on pharmaceuticals? Almost all of it has been conducted on men—because they don’t have the hormonal fluctuations that “complicate” results. So every medication you’ve ever taken? It’s been trialled on male bodies, and the recommendations have largely been made based on their responses, not ours. And yet, if you ask for the science behind herbal medicine, you’re met with scepticism. The irony is staggering.

I’ve never been one to follow the crowd. I question everything. And when it comes to women’s health, there just isn’t enough research full stop. But it’s growing. I hope we keep pushing for more, keep learning, keep demanding answers about our complex, brilliant bodies.

Do they need to be pumped full of hormones at every opportunity? I’m not convinced.

Because underneath all of this is a much bigger issue that isn’t being addressed. Why are we seeing so many hormonal imbalances? Why are these problems so prevalent? Yes, we’re more aware—but there’s something else at play. Our health is impacted by everything we consume—physically, mentally, emotionally. Our life experiences shape our health. Trauma, in particular, plays a far bigger role than most of us realise.

Would I have developed my autoimmune conditions if I’d had a less chaotic upbringing? I’ll never know—there’s only one of me. But I do know this: when you really listen to people, they tell you their broken pieces. And I wonder—if those pieces were held and healed, how many of our symptoms would disappear?

I’ve never treated my endometriosis or adenomyosis with western medicine. Instead, I’ve used herbs, changed my diet, been in therapy, meditated, exercised, given up alcohol, sought out joy, practised gratitude, cut sugar, tracked everything, taken vitamins, tried new things, cried, grieved, stayed open and curious, researched, studied, attended training, let go of toxic people, places, and habits.

It’s a weird prescription—but I can’t help but feel there’s something in it.

I see it in my clients. I see it in my nieces. I see it in the world.