is it fair othat older transwomen get to stay on HRT for life?

Thanks for the first-hand information @homefromthehills And your point:
Problem is this is the 5000 or so transsexuals all of whom have long term medical monitoring. If Self ID comes in then countless more will have no medical pathway but still might self medicate off the internet. The removal of medical assessment will create real health risks.
is worrying.

We are racing helter-skelter into unknown territory it seems - although for once it isn't women's biologies & physiologyies which are the site of experiment, as in early work on the Pill and indeed HRT. But it's still worrying territory ...

I'm post-menopausal, and managed menopause with absolutely no medical help at all. It wasn't raised with me, and the one time I wondered out loud to my GP about HRT, it was not commented on or followed up.

To be fair, the only lasting symptom I have is worrying (to me) memory loss on the silliest of things - mostly names. The momentary brain fog is horrid really awful, but as my job is about knowing more than most people have to about words & ideas, maybe I just notice it more.

I didn't push for HRT and I'm nearing 60 (periods stopped at around 55-56) so it's probably too late. One of the reasons I didn't push was all the negative press about the risks. But it seems if I had asked, I'd have had difficulties in being prescribed ...

I used to have extremely painful periods in my 30s - pain that made me throw up & get cold sweats & shakes about once every 6 months or so. But I just put up with it, took days off work, gritted my teeth & tried to sleep through the pain.

I thought that that was what I had to do there is such a culture of women suffering, and thinking there is nothing that can be done.

It's not as if there is a limited supply of hormones and transwomen have snaffled them all. If doctors won't prescribe HRT for health reasons, tackle that. But please dont turn it into another bloody trans thread

Surely the issue is a really that HRT is perfectly safe for long term use and therefore both TW and women should be able to access it without jumping through hoops,.or that long term use is unsafe in which case. Other TW and women should be advised against it.

I don't think they are connected, no, but if your post was attacking mine for turning it into another trans thread....and apologies if it was not.... I was just responding to the points on that made earlier. On which I could offer some first hand insight relevant to them.

I think if you do not understand what is involved with TS patients it is not unreasonable to suspect this is one rule for TS women and another for women.

It isn't, because there are different factors involved.

For goodness sake, surely the two issues are not connected. It's not as if there is a limited supply of hormones and transwomen have snaffled them all. If doctors won't prescribe HRT for health reasons, tackle that. But please dont turn it into another bloody trans thread.

Wandering Wavelet I am a TS woman who has been on HRT for 45 years now. Post 60 in my annual consult and blood tests my GP and I discussed options and she suggested much what you say should happen. Lowering the dose to an acceptable level that would not cause any adverse symptoms and would be more akin to a post menopausal woman.

So that's what I have been doing.

Taking HRT is not only about relieving dysphoria. When you have had GRS as I did so long ago your body would have real problems without any kind of replacement hormones as it is no longer producing more than tiny amounts of others it used to do.

There are health related pros and cons that have to be balanced and that's what we do.

Problem is this is the 5000 or so transsexuals all of whom have long term medical monitoring. If Self ID comes in then countless more will have no medical pathway but still might self medicate off the internet. The removal of medical assessment will create real health risks. Just another of the reasons (out of many) why I am opposed to self ID.

On the other question, my best friend who I have known since before I transitioned 50 years ago, has had been problems since stopping her HRT. Her doctor will not start it again given her age despite the issues she ascribes to coming off it. When my Premarin level was cut down I suggested she ask her doctor if it was safe as I had some tablets over and was happy to let her have them if the doctor approved. As I realised it was very unwise just to let her have them even though she was desperate.

Her GP said it is a balance of risk v reward and (with proper monitoring and reductions in level) that balance works for TS cases but is skewed the other way for women like my friend.

This is a complicated situation but it is not ignored by the medical profession.

As for hair removal I never had any NHS funded treatment. Though it was much rarer that long ago for anyone. I did not know it was funded today, but it is extremely expensive and I very much doubt all of it is paid for in TS cases.

There is an increased risk of breast cancer with prolonged HRT usage and this makes a lot of doctors unwilling to prescribe it long term. Obviously this isn't a risk for transwomen (not to mention their endocrine system/general health is pretty much screwed anyway).

May i ask 2rebecca a question pls
I have had stage one breast cancer, I’m now in my fith year following its removal.
I have i think osteoporosis in my spine and hips. I can hear and feel a crunching when i move and hips ache and are stiff what to do, or ask for HRT wise, also doctor wont give me testosterone, despite reading Alison Pearson in some woman’s mag getting it.
Apologies if this transgresses some MN boundaries

my 77yr old DM is still on HRT and refuses to come off it when she goes to the GP

I'm a GP and prescribe HRT and am on it. If my GP refused to prescribe HRT I'd change GP or ask to be referred to a menopause clinic (if there is one). I will probably stop age 55 though as the breast cancer risk goes up more then, (as well as having a higher blood clot risk) plus I'm not a fan of taking hormones forever. I have a couple of women on their 60s on it but they know the risks.

isn't this in the same vein as giving laser epilation to transwomen - poor hairy women have to pay though. It is probably a question of numbers.

If transwomen are women, surely women are also transwomen? I'm going to be a transwoman, then, and claim the GP is a transphobe if they won't prescribe it for me.

I'd also add my agreement that the way that HRT has been covered in the press has done a great deal of damage.

There are some really good menoapuse clinics which you can try pushing your GP for a referral to.

There's a great deal to do to improve the way that women going through menopause are treated.

intheparcark
Yes.

I'm quite well-informed re the HRT studies etc having had gyny cancer at a relatively younger age and so surgical menopause following total hysterectomy.

In order for me to have a very low dose it needed histology (some cancers are oestrogen sensitive), full MDT meeting etc. There is a potential risk vs potential benefit consideration and quite a large percentage of younger women either cannot or do not take it.

Logically, when a TW reaches, say, 60, then maybe she needs to go through a medically-induced copy of a real menopause?

In terms of risk, it's not about age it is about the number of years of estrogen dominance.

Prescribing HRT shouldn't "cause" breast cancer - what it can do is accelerate its development in women who contract the disease. (IIRC from the leaflet that comes with mine, it takes the mortality rate from 2 per 1000 to 3 per thousand - so 50% increase, which sounds scary, but is actually a 50% increase in something that's pretty rare, even in women who're 50+)

What should be done is a careful medical history of the patient - things like family history of breast cancer, previous breast cancer oneself, bcrb gene, obvious contraindications. Otherwise healthy, with no family history - prescribe, monitor, make sure the patient knows how to examine her breasts. And ask about things like family history of osteoporosis, which HRT protects against! I'm trading very slightly higher mortality rate against vastly reduced morbidity.

Transwomen aren't on HRT - that stands for "Hormone Replacement THerapy" They're not having diminished levels of oestrogen & progesterone replaced - oestrogen & progesterone are being added.

Logically, when a TW reaches, say, 60, then maybe she needs to go through a medically-induced copy of a real menopause?

Of course not, it is much more important that men get treatment for their mental health than women get treatment for their mental and physical...if you ever thought otherwise then more fool you.

Women who used to be men are the epitome of the perfect woman, everyone knows it.

Personally, I've no objection to transwomen being prescribed HT (no R) for as long as they like - it's a relatively cheap drug, and if it alleviates the symptoms of dysphoria, that seems like a good option, provided there's informed consent and they've been advised of the risks.

However, it is totally and utterly unacceptable that post-menopausal women without contra-indications are struggling to get HRT. I'm on HRT and it's been an absolute life-transforming experience. I'm a bit worried that when it comes up for my annual review, my continued access may depend randomly on which GP I see. (I have two young women GPs - the young is relevant because it means they're both pre-menopausal - one of whom is happy to take my word for it that it's a good thing, and the other who has made "we must take you off it as soon as possible" noises. Since my family history is one of musculo-skeletal problems in old age, rather than cancer and heart disease, I'm keen to take it as long as I possibly can.)

Annie that's crap for you. Any chance of changing GP or seeing another GP in the practice?

Its also concerning that the (large) studies identifying potential risks which are cited as reason why HRT is restricted / time limited seem to be completely ignored.
The R is significant and it is difficult to imagine that cross sex hormones are likely to present a lower risk than replacement ones.