Yes the word menopause will become redundant in the future, but it’s not only about fertility and having babies at 60,” hormone specialist Dr Marion Gluck tells me. “Maintaining optimal hormone levels is anti-ageing — for men and women. It’s very desirable to stop the decline of hormones because of all their benefits.”
Last week news broke that the menopause could be eliminated within 20 years. According to Dr Aubrey de Grey, co-founder of the Sens Research Foundation in California — rapid progress in stem cell and regenerative therapies means that current age limits on when women can conceive and give birth are likely to all but vanish in the foreseeable future. There’s no reason why anti-ageing treatments should not extend to the female reproductive life-span, he says.
This is great news for fertility experts and their patients, but for Gluck, named by Tatler magazine as one of the UK’s top 250 private doctors, it is further proof that hormone balancing (rather than replacement) is the key to ageing well.
Gluck, 64, is a world pioneer in the prescription and preparation of tailored bio-identical hormones to rebalance the body’s endocrine system. Rather than prescribing synthetic one- size-fits-all medications such as HRT, she addresses each woman’s unique hormonal make-up. “We all have our own endocrine system. It’s like our fingerprint.” The ovaries are one of the most complex organs in the body and produce hugely important hormones, she explains. “Oestrogen aids brain and bone function, testosterone maintains muscles and strength, progesterone is calming.”
Women’s health is Gluck’s passion. Although she tackles everything from endometriosis to postnatal depression, she is best known for helping women go through the rite of passage that is the menopause. To rebalance the endocrine system, Gluck prescribes bio-identicals made from natural plant sources — usually wild yams or soya beans. Because they have an identical structure to the hormones our bodies produce “they are considered a safer option and because their effects are consistent with your normal biochemistry, side effects such as weight gain are minimised”.
If you spot women at a party exchanging the latest address-book secret, you can be pretty sure it’s her number. Bella Freud says she cured her migraines. Novelist Jeanette Winterson credits Gluck with restoring “the strong reliable body I used to know”, after two years of hormonal disruption, where her hair fell out and her energy was depleted. When Oprah Winfrey, a fan of bio- identical hormones, did a TV show on the topic, it was Gluck she rang.
Hormones are chemical messengers circulating in our bloodstream, regulating every function from building bone strength to coping with stress. From teens to our late thirties, the battle is to keep them on an even keel. By our late forties (the years leading up to menopause are called the perimenopause), it’s all in freefall. Then, as women approach menopause, production of the three main sex hormones oestrogen, progesterone and testosterone fluctuates.
“Hormones regulate every function in our body,” says Gluck. “They work like a symphony together. When they are out of whack, we are out of whack.” It’s not just about declining fertility. “We need all our hormones — our ovarian hormones, our thyroid hormones, our pancreas hormones. When our endocrine system is functioning optimally, then we have our health and vitality.”
A warm, vivacious figure (her?clinic, off Harley Street, is full of bright and bold art), Gluck is a qualified GP — her procedures are not alternative therapies, but she is a great listener. “A lot of doctors wouldn’t want to listen to women’s stories for hours. But I’m never bored.”
She is seeing a “scary increase” in infertility. And the number of women going through a premature menopause rises. She puts it down to environmental factors such as lifestyle and nutrition. “We are infiltrated by exogenous [external] hormones which have this effect on our body — it’s in the foods, the plastic, the water, and of course this huge use of the oral contraceptive Pill.” She would prefer to give the body a chance to work with itself in the healing process before focusing obsessively on the dominant symptom. “I might have three patients with the same symptoms, but end up writing very different prescriptions.”
She begins with a one-hour consultation asking about lifestyle, diet and emotional wellbeing. “It’s like a jigsaw puzzle.” She takes blood tests to build up a picture of our hormonal quirks, then prescribes bio-identical hormones, which are made up to the patient’s exact needs by a specialist compounding pharmacist. “I try to copy the body as closely as possible.”
A dab of progesterone cream can correct an oestrogen imbalance which leads to bloating and weight gain. Or if your libido is plummeting, testosterone cream boosts sex drive and energy. A friend teases me by saying I dab it on the back of my wrist like Chanel No5.
The treatment — either in cream form or taken orally as lozenges (for higher doses) — works out at about £1 a day. She prescribes sparingly. “Hormones are the best thing for women of all ages — but only if we need it. Women go through a life cycle of hormonal fluctuations from puberty. That is perfectly normal and a healthy body will readjust. But in the world we live in, environmental toxins, poor nutrition, stress, means that the body cannot always rebalance itself.”
What’s worrying is that GPs often mistake the symptoms of a hormone imbalance for depression. “So manyso it works in partnership with oestrogen to maintain healthy bones.
However, she has no interest in using hormones to delay ageing. “That is a nonsense concept. It is about being the best version you can be.” If a woman sails through “the change”, then fantastic, but Gluck would like?to see a holistic health model where blood tests, diet and exercise advice?sit within medical practice.
One topic makes her furious: that?1 in 5 women is recommended a hysterectomy (that’s 40,000-60,000 operations a year in the UK). “Often it’s an easier option, doctors not up to date with the alternative hormonal balancing therapies that are available.” Plus you earn much more money doing an operation than handing out a prescription, she says dryly.
Only 10 per cent of hysterectomies are for life-threatening ovarian and uterine cancer, bleeding or infection, she claims. So there is no defence for using it as a preventative measure or telling women who have completed their family that they don’t need their reproductive organs. “Castrating women is not being proactive.”
She cites studies that show women who have had their ovaries removed at an early age and are put into?a premature menopause surgically have a much higher risk of mental illness. A woman’s ovaries and uterus are “inherently female, part of our body and part of our psyche”.
She tells me how one client who went through an early menopause was examined by a gynaecologist who never even looked at her face then told his assistant: “Look at this atrophic shrunken vagina.” “There is a head and a heart to this vagina,” the poor patient replied, mortified.
No wonder women pay to go to the Marion Gluck Clinic (consultations start at £280). Success means she’s brought her son, Sam, 28, to help run the business. “It’s a great experience for a young man to see what women go through,” she laughs. But she’s adamant that everything she prescribes is licensed on the NHS.
Gluck is now treating men (several very high-profile) suffering from low energy and loss of libido. “Yes there is an andropause,” she says.“The men I see are prepared to go on a journey. They have felt better and recognise something’s not quite right now.”
Breaking taboos is essential. “Women in their forties talk openly about loss of libido and the sadness it causes them when sex with their husbands becomes more of a duty.?But at the same time they are taking more control to manage the situation. I see women who say: ‘I’ve met a man after being single for a long time and I want to start a sexual relationship. Can you help?’ And I say: ‘Yes sure.’ Women are getting much braver.”