HRT - is it for me?

[Autumnwoman]

I'm 47 and beginning to think about HRT after reading up on the benefits - mainly long-term bone health. I do have some perimenopause symptoms

• Periods getting slightly closer together
• Periods lasting a couple of days longer
• Loss of libido
• Annoyance at husband
• Migraines (had these for 10 years or so but they have worsened)

I'm fairly sure the doctor would prescribe me HRT based on my age and symptoms.

However, I'm conscious that I'm very sensitive to hormones - in my 20s the Pill made me feel depressed (or perhaps my relationship at the time did - I hated the fact that I couldn't trust my own emotions).

I've just spent a week on the med to delay periods for an upcoming holiday and it made me sweaty, anxious, insomniac and cross. There's clearly hormones I'm sensitive to.

Knowing this information, what do we think my chances of finding a "sweet spot" HRT combo are? Or should I just battle through?

I found the period delaying medicine awful. I’ve had the mirena and HRT patch. I’ve loved having no periods. However my mirena has moved! Which means for a period of time I’ve been having unopposed oestrogen through my patch!! That has scared the shit out of me and I’ve just had a scan and now having further investigations. But everyone I know on HRT are saying it’s gods gift. I don’t know how long I have to stay off the patch :(

I’m 46 btw

I have similar symptoms to you. Although I laughed at annoyance to husband. I think that’s just normal!
I’m also 47 and have been on the lowest dose for 3 months. 25mg patch and utrogestan days 15-26 of my cycle. I haven’t noticed much difference tbh only that I’m sleeping slightly better.
Have just been prescribed a 50mg patch so I’ll have to see how that goes.

So most people seem to go patches rather than gel?

My doctor never mentioned the gel at all. The patch is fine, I change it twice a week. I played around with locations but find the backside the best. Stays put.

Thanks. I wonder if it's easier to tweak the dose with gel?

HRT isn't for you if you're not concerned about bone, cardiovascular or cognitive health.
Gel is easier to absorb for some women, for some the patches don't work brilliantly.
If you have gel, for the love of God, apply it properly! (A quick swipe isn't applying it, rub it in properly)

I'm interested in answers to your question about sensitivity to hormones, which I don't think anyone here has addressed yet. I also suffered low mood on the pill in my twenties, but when I tried it again in my forties the mental health side effects were much more severe. I also have bad PMS which my GP has suggested is actually the more severe PMDD so I think it is progesterone that I react badly to. I've been advised that the mirena coil delivers a lower dose of progesterone directly to the uterus and can therefore me more gentle, and there are body identical progesterones too which may be more gentle. I've not tried either though because I'm a bit scared after bad experiences on the contraceptive pill.

I've also recently been pondering asking for hrt. I was put on progesterone as a teen and it made me horrendously moody and I never much liked being on the pill either so I'm also wondering how I'd get on with hrt.

Yes I also reacted badly to contraceptive pill… and to hrt! So I’m now weaning myself off it. Identical progesterone and progestin are horrendous for my mental health. Never cried so much in my life! Also tanks my blood pressure and creates histamine storm in my body. Which then gives me insomnia and raging anxiety.

I went on HRT at 45
My PMS symptoms were lasting longer and half the month was miserable. I never did well on the pill or coil but the body identical HRT hasn’t given me any issues. I’m 51 now and very settled on 75 patch and 200 continuous progesterone.

I had a uterine ablation for heaving periods at 40 and haven’t had a bleed since, would highly recommend.

Good luck it’s a mine field and hrt isn’t a fix all but it does help imo

"Heaving periods" is probably a typo, but it's absolutely an accurate description!

HRT changed my life. I use the gel and also use testosterone. Look up Louise Newson she has plenty of info.

Do you have to put anything over it to secure it?

I have had these a few weeks now and they work off after a few days. Maybe I need to try bottom. Currently doing top of legs.

No I don’t use anything else. Tried it on lower belly. (Too flabby) tried hip and thigh, maybe too much friction. Settled on the batty and it stays put.

I was very worried about starting HRT after previous difficulties with the progesterone pill. It's been a massive difference for me, I feel better than I have in years.
Information you get from Dr is minimal so I would do your own research, I started off with Davina's menopausing book and find the balance app really helpful

I was the same, absolutely suicidal on all kinds of pill.

I now have 100mcg oestrogen, the Mirena coil and testosterone plus vaginal oestrogen cream.

I no longer cry all the time, my bones are protected and very light periods.

I still have shocking brain fog and prolapse and light periods with period cramps/PMT so it doesn't solve everything. But it's definitely better than it was before.

Oh and I sleep SO much better now.

And I stick the patches on my bottom and they stick so well I have trouble finding an edge to peel them off again.

I was the same as you. The Mirena saved my life pretty much.

The thing I worry about with the Mirena is if it doesn't suit me, I have to try and get a doctor's appointment to get rid of it again. That lack of control bothers me (obviously I could stop applying a gel or a patch, or stop taking a pill).

My GP promised to take mine out if I asked.

As it was, the nurse dislodged it after a smear and the GP gave me a same day appt to remove it as I kept nearlt fainting!

It literally takes two mins to remove.

Im very pro HRT and use it myself since 47, but tbh you dont seem to have the symptoms that warrant it? Changes in periods are not something that HRT addresses. Typically the symptoms that trigger the need for HRT are any of the following: continual low mood; brain fog, hot flushes, anxiety, aches, sleep disruption. So Im not saying dont try it, but also that I dont think you have symptoms that it'd address at this point. If you are sensitive to hormones especially. Im not sensitive and even I felt pretty damm weird for the first few months , even on low dosage.

I hated how I was on the pill. But I assumed hrt is different in that it is replacing lost hormones whereas the pill is adding extra?

I never got on with the pill, come to HRT time it dawned on me that it’s the progesterone. My libido was also non existent. I tried a few types of HRT, Utrogeston was horrendous, I was crying non stop and rocking back and forth, my poor hubby was very worried.

I sought out a private specialist who prescribed Tridestra, which unfortunately is no longer available but my G.P prescribes the two components separately, estrogen and progesterone. This is 70 days of estrogen, followed by 14 days of combined estrogen and progesterone, then 7 days of nothing when I have a withdrawal bleed, a bit like the pill format. After 6 months on HRT and still no libido Testosterone was introduced. I’m so happy on my regime.

My SIL has gone au natural, taking herbal remedies etc, she has osteoporosis quite badly. Her issue was the threat of cancer, she drinks and smokes, kinda hypocritical, there’s more of a chance with these than with HRT 🤦‍♀️

Yes and no. If you react badly to progesterone in the pill, and you have had bad PMT (i think it's called PMDD now) then the chances are that even body identical progesterone will send you crackers as per PP.

I have never cried as much as when I was taking utrogestan. Sobbing. I'd say depressed. I cried in the car on the commute and I'd go for a walk in my lunch hour and sit on a bench and cry. Horrible horrible stuff. And that's not mentioning the sedative effects that make you feel like you are walking through treacle!

But if you didn't ever react to progesterone then you'll be fine!