To not start taking HRT?

[OldSkoolLikeHappyShopper]

My doctor has mentioned that HRT would be an option for me. She said patches because of a family history of breast cancer. I’m 42, no not flushes or night sweats. But my symptoms are:

low mood/irritability
loss of sex drive
find it hard to orgasm when I do have sex (never been a problem before)
bad skin
forgetfulness/brain fog
achy all over
crazy menstrual cycle (anywhere between 18-38 days)

I guess I’m a bit scared because of my family breast cancer risk, and also because I’ve never got on with any kind of hormonal contraception, I always had hideous side effects with it. I know HRT isn’t contraception, but would it have a similar effect in terms of not agreeing with me?

Really don’t know what to do…I wouldn’t say my symptoms are unmanageable or massively affecting my life (the sex drive/orgasms one is probably the most annoying), and I don’t know whether to go for the HRT or play or by ear and see if things get worse.

Others experiences and opinions would be appreciated, I feel completely clueless, this whole peri menopause thing has crept up on me and I feel woefully unprepared!

I was persuaded to go on HRT by a very proactive GP because I started menopause at 43. I took a while to actually put the patches on so didn’t start until I was maybe 45, but I’m glad she explained it clearly to me because I probably had a slightly misguided view of the risks and benefits. I’m on it to protect my bones and heart mainly. Have also spoken to a male GP at the same practice and got good advice about HRT type so we are lucky to have a proactive surgery. I’m on Evorel Sequi patches. They seem to work well but they are quite itchy. So I may get them changed, though perhaps will wait until there is less of a shortage!

I’ve also got family history of breast cancer in my family (but not the brca1 & 2 genes). Also a family history of blood clots. And I’ve had a clot in a vein myself while I was on the combined pill (not a deep vein). I’ve always just assumed I’d have to have a patch because of the breast cancer thing, but can I even have that if I have the blood clot history?

I have all the symptoms apart from hot flushes. I’m almost 50.

You're having symptoms that impact your life.

There's a safe medicine available which will likely help you manage those symptoms. And you have a sympathetic GP who is able to prescribe it.

Why on earth wouldn't you give it a go?

If it doesn't work for you, or if it gives you side effects that are worse than the symptoms, you can just stop. It's literally a plaster - you can pull it off at any point without replacing it.

So why wouldn't you?

Why not try it? Transdermal HRT is the safest type and if you don't like it you can just stop. There's nothing to lose.

I thought I didn't need it and didn't really want it, got through the peri and early postmenopausal years without it. Then the aching joints, brain fog and vaginal atrophy got the better of me and I started HRT just as I turned 58. Late I know, but within ten years of menopause.

It's been amazing for me, I feel so much better.

I've read mixed things about dementia/HRT, is it better to be on it?
Massive family history of dementia (every female in my family) and I want to do anything I can to help. My nan had it and mum died with early onset Alzheimer's
Am 38 so a little while yet hopefully

I can't take HRT as I have a degenerative condition linked to excess estrogen whereby my body is systematically destroying my own lungs. It is controlled by another drug but I will have to look at how I get through without it. I am only 42 and so far have incredibly high libido, periods of irritability and less patience, trouble sleeping.

I'm working step by step on

• getting down to a good weight. I lost 2.5 stone and am hovering at the higher end of my BMI. I'd like to lose another 0.5 stone. This is primarily for energy.
• regular exercise following NHS guideliness which is 3 strength sessions a week and 75m vigorous cardio.
• caffeine 😭 At least get down to 1 green tea in the morning
• for sleep the best thing I found is liquid melatonin. I sleep solidly on this.
• good fats in my diet and probiotic yoghurt every day
• keeping sugar to a reasonable level
• taking a digestive enzyme helps a lot with brain fog, that is the only thing I found helps with this. Lamberts do one Digestizimes.
• my memory is awful, I now write everything down.
• epsom salt baths

I do get breakouts which are really annoying, I thought it was my meds but maybe not.

42 seems very young to me. I didn't even feel the need to consider it until 49 and started at 51. Everyone is different though I guess. My experience was that you know when you really need it.

I didn't have any physical symptoms like hot flushes until 51 and had assumed I wouldn't need it prior to that and didn't really want to take it. After 10 days of trying to work through a near continuous hot flush with feelings of extreme dread and hideous heart palpitations, culminating in being sent to A & E by GP to rule out a heart attack, I quickly changed my mind. My feeling is that if you are questioning whether or not to go on it (as I was) then you possibly don't need it yet.

I feel loads better and much more my normal self 6 months later.

Yes, I have osteoporosis. I’m only 53. I had an earlyish menopause (45). Strong family history of osteoporosis but two members of family have had breast cancer. I was on HRT, came off when sister got diagnosed but have since gone back on - since osteoporosis diagnosis.

I did a lot of research, I spoke to a brilliant meno consultant who also worked in a breast cancer clinic. I got off phone totally confident in my decision to go back on HRT.

i have had extremely poor experience with hormonal birth control and with hormones that were attempted to be given to treat something else but quickly aborted because the side effects were so severe the doctor had to terminate treatment.

I’m dealing with Peri symptoms now and I won’t be taking hrt. I am honestly shocked by the number of women who take it so casually.

Thanks so much for all the responses. I started this thread and then clean forgot I’d done it and went and did something else 😂 (good old brain fog right there).

I am booked in for bloods to check there’s nothing else going on, but if they don’t show anything the doctor suggests HRT could be the way forward.

I don’t really know why I feel weird about it - I guess I’m a bit of a hippy at heart and also studied the medicalisation of every day life as part of my degree - modern society seeing that natural processes need to have medical intervention, and questioning this, which has just made me stop and think as to whether I should let nature do its thing, especially as most symptoms are pretty minor at the moment.

But as many on this thread have said, it’s probably worth a try to see how I get on with it. I had no idea about the dementia thing, I have a family history of that too.

Will see what happens with the bloods and then give it a whirl if that’s what the GP suggests, it sounds like it’s definitely worth a try, and as others have said it’s easy to just stop it if it’s not working for me.

I could never take hormonal contraception, it made me crazy and I had some very, very dark days. I was therefore dubious about HRT but I’m a year in and I’ve never looked back.

@Rebel2 definitely better to be on it. Family history here too. Body identical HRT is simply naturally replacing the hormones that are dwindling. Same as if you were told you were deficient in iron you would take a supplement. I also take omega supplements.

My aunt took it, swore by it but had to stop as kept getting painful cysts in breasts, which she grew with HRT! Often joked about it (growing breasts not the lumps!). DM didn’t bother with it, neither did my other aunt.

Try it? If you hate it then stop.

HRT in perimenopause has literally given me my life back. My oestrogen levels had dropped so I was really sore down below and sex was painful. I lacked energy, had anxiety and brain fog. I never had hot sweats but the other stuff was bad enough to mean I had to give up a very well paid corporate career and my marriage fell apart.

Since going on HRT I've rebuilt my life and now I'm competing in endurance sports, back in my career and all is good and healthy down below.

I'm super healthy and hate to take medication unless essential so I did tons of research and I'm really happy that it's safe and beneficial.

There are so many myths and pre conceived ideas about HRT that are wrong. These days it's made from the Yam plant, a natural source. It's body identical which means the chemical structure of the supplement exactly matches that of the hormones we make ourselves in our ovaries. Taking it through the skin, typically applied around your hips, means it gets to where it needs to be without needing to go through your stomach and liver.

The only reason it's not recommended to go out and eat lots of yams or head to Holland and Barrett for Yam tablets is that the hormone levels vary from yam to yam so it would be really hard to
It's also proven to be protective against cancers, diabetes, heart disease, dementia and osteoporosis.

The reason you get sore down below is your skin literally gets thinner due to lack of oestrogen and it can even bleed during sex. I don't even need topical estrogen cream or lube now.

Oestrogen is required to absorb vitamin D and calcium hence it protects against bone loss from osteoporosis.

My mum has a crumbling spine due to osteoporosis and trust me I do not want it. My Dad died of dementia, my GP was about to refer me to a memory clinic as my symptoms were so bad but on HRT after a year I've been able to return to a big career and resume my normal life.

I don't really understand why people are so against it tbh.

I should add that the level of hormones given in HRT is much lower than in the contraceptive pill, which is synthetic hormones - whereas modern HRT is naturally derived, body identical hormones 🍠

Hormone levels in HRT are much lower than in the pill and natural not synthetic. There's no comparison.

Where are they derived from then?

do they still use mare’s urine? I remember reading an article years ago and the circumstances were pretty awful.

if “natural” hormones means animal abuse I’ll steer clear.

The three main things that put women in nursing homes- broken hips due to osteoporosis, incontinence and dementia - all can be greatly reduced with suitable hrt.

Sorry to hijack OP but I'm very interested in the evidence that HRT greatly reduces the risk of dementia. Can anyone share some solid research? Or this this another 'saves lives' comment?

I did a quick Google and first up was the Alzheimer's Society saying such claims were 'inconclusive and contradictory'.

I feel like I am managing both peri symptoms and the risk of heart disease/ osteoporosis without HRT but with a family history of dementia, this is an interesting aspect I hadn't thought about.

There is no increased risk of breast cancer with transdermal HRT. shall I say that for those in the back. THERE IS NO INCREASED RISK OF BREAST CANCER WITH TRANSDERMAL HRT.

With regards to whether you get in with it or not, just try it. Give it a month or two. If you don't like it, stop.

@Lastnamedidntstick
Where are they derived from then?

Yams. There is some soya in Utrogestan so if you have a soya allergy then you need to get progesterone from patches or coil.

I took the pill for ivf. Within the first day I was exhausted and it left me permanently with less energy. No issues with patches or oestrogen tablets. I don’t take combined as I don’t have ovaries anymore, removed during hysterectomy.

There is an HRT section. All your symptoms are classic.

Only you can decide op. Just a cautionary tale to monitor yourself regularly. I know somebody, who refuses to take hrt and her life has now imploded. She has become extremely erratic and is currently not able to look after her children. I can only imagine she’s reached the tipping point, where she cannot see through the brain fog. Obviously this is an extreme example and I’m in no way suggesting this will happen to you.

You are in a really normal age range to start feeling the symptoms of perimenopause.
How about asking for a topical oestrogen to see if it improves sexual response?
I started hrt at 42, felt alot better within days but did need to add testosterone for my orgasms to return.