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!

Absolutely. The NHS website says something similar - that there's a very small increased risk of cancer but it's usually outweighed by the benefits:

www.nhs.uk/conditions/hormone-replacement-therapy-hrt/risks/

I'm not anti-HRT, I'm weighing up the risks and benefits for myself currently.

If your symptoms are manageable, you could try other things - lifestyle changes like diet, exercise, meditation, sleep hygiene, skincare etc.

I have friends who have managed perimenopause and menopause without HRT.

I tried all of these things before opting for HRT. It was my last option, when my poor sleep and mood swings were becoming debilitating. I was 45 and still having regular periods, no hot flushes - but over about a year I just became this shell of myself, so tired and anxious and lacking any drive, with worrying brain fog. HRT has really reversed that. A nice bonus side effect is much better skin.

I'm 51 and haven't taken HRT yet as I am not having symptoms.

However, there is good evidence that it's good to take whatever, as it is correcting a hormone deficiency.

For what it's worth, my mum has been on HRT for half her life, and was on the Pill before that and is still here! No breast or other cancer.

Yesterday I did the National Osteoporosis Society risk assessment and my current risk of osteoporosis is low. However, HRT is known to help prevent it, also strokes and heart attacks and quite possibly dementia as well.

I can't really see any disadvantage to taking a low dose if it doesn't have side effects (obviously you might have to try a few options to find one that works), other than availability.

My employer pays for the Bupa menopause service so I will probably avail myself of it at some point.

As for the cancer risk, yes it might be slightly increased, but it is lowered again by the fact that you sleep better, probably have fewer aches and pains so can exercise and keep your weight within a healthy range and have less stress and anxiety.

So there's quite a few people on here now claiming HRT reduces the risk of dementia, as one of its key benefits. One said the reduction was significant. What is your source? Please? Since the repeated insistence that it doesn't increase breast cancer risk has been debunked.

Study found increased incidence of dementia in women taking HRT
pubmed.ncbi.nlm.nih.gov/36240091/#:~:text=Hormone%20replacement%20therapy%20(HRT)%20might,increases%20the%20incidence%20of%20dementia.

Study found HRT slightly decreased risk of dementia and slightly increased risk of Alzheimers
www.bmj.com/content/374/bmj.n2182

This in spades . Invest in your future self

I would go on it again like a shot - they took me off it when I hit 60 and I now have osteoporosis with all its problems.

OP, I would suggest having a thyroid function blood test too, as many peri-menopause symptoms overlap with thyroid problem symptoms.

Most definitely.

Thyroid disorders are hugely undiagnosed.

For those worried about increased breast cancer risk it may be useful to compare with increased risk from;

. Overweight, not just obese or morbidly obese simple overweight
. Drinking alcohol

I find it interesting when women don’t compare the risks.

When I was on the pill some years back I was on microgynon 30– which has 30 mg of oestrogen. (I didn’t get on with it and it put me off, foolishly, considering hrt for a while.)

Two pumps of oestrogen provides me with 50mcg of estradiol, so that’s 0.05mg? Obviously of a different, body-identical, oestrogen, not the same form as in the pill.

I have a mirena.

Also a newson patient.

I can’t see how I am on a higher dose of oestrogen now than I was when I was on the microgynon? I can see tha I’m on a more effective form, perhaps, but in terms of numbers? I am not being snippy, just interested.

Hi - hope you don't mind a bloke popping up on here. I'm a vegan and I follow Dr Michael Greger's nutritionfacts.org. So I put HRT into the search engine:

nutritionfacts.org/2019/11/21/how-phytoestrogens-can-have-anti-estrogenic-effects/

Hope this helps.

I was offered HRT at 50, but turned it down, as I was super fit and had no problems, apart from a few hot flushes and I was scared re the breast cancer risk.

15 years later I regret not at least trying it, as the effects of getting older don't start immediately post menopause, but take some years before you start to feel/see the effects and as you are still relatively young at 42, I would suggest maybe try it for a time, as once you get older it will be harder to access.

modern society seeing that natural processes need to have medical intervention

The trouble with the view that medical intervention is unnatural or bad is that some natural processes are not benign. Cancer, after all, is a natural process, just one that might end in death. These views are often held by people who are in good health themselves and have never seen significant illness or disability in others caused by natural processes (childbirth for example).
I’m another whose life was saved by HRT and I intend never to stop taking it. I know other women who never felt the need for it or who didn’t find it helpful, so stopped. Each to their own. As pp have said, if you feel it could help, and your doctor encourages you, give it a go.

I look at my poor DM who never had access to hrt. In the last year alone she has suffered 3 fractures and 2 surgeries from fairly minor accidents. One she didn’t even fall over, just twisted on her ankle walking along and broke a bone. She started peri at 42. Her 40s-50s were a disaster for her…she was overweight, depressed and drank heavily. Women of her generation were shortchanged (while the men of that gen were delivered viagra).

I’m on hrt and have no intention of stopping. It requires patience, other lifestyle changes and monitoring but it’s so worth it. No plans to stop.

go for it OP and check your boobs regularly and have mammograms - as one should do anyway.

I am late 50's and 15 years post menopause .I have never taken HRT as my symptoms were manageable (just the occasional hot flush). I still have a head of very thick hair and good skin, I sleep well and am not constantly tired. I realise I am very lucky but after years of dealing with the hell that I had when having periods I can honestly say I feel better now than I did then.

There is no right or wrong answer when it comes to HRT, just what is best for you.

While I appreciate you're trying to be helpful, this isn't really your place to offer help, more so given you're consulting google 🙄

I would say to weigh up the pro's and con's carefully especially if you have any medical conditions that run in your family that may be an issue.

I have very high level of DVT down my maternal line, some of the women in my family have had blood clots at young ages (in their early 20's) and while treatable we have sadly also lost loved ones too. This includes my own mum who died suddenly from a pulmonary embolism at age 57, both DVT and HRT Treatment were also listed as causes on her death certificate. Having to go through a sudden loss and inquest is something I wouldn't wish on anyone. My mum was actually advised against HRT but she decided that the benefits outweighed the risk because of her menopause symptoms. So while im not trying to scare anyone or create fear mongering (it was a very rare set of circumstances that led to the loss of my mum) I just want to remind people to take the risks seriously.
If any of you ladies on HRT have any symptoms that may indicate a blood clot go straight to A&E, PLEASE do not ignore it in hope it will go away like my mum did.

I would have put money on that being your response. Me too, to a certain extent. What helped (apart from the severity of my symptoms, there's nothing like suicidal thoughts to focus the mind) was understanding that a) HRT is natural these days, it comes from yams and b) that the reason we see not managing menopause as 'natural' stems from both the inherent sexism of medicine and c) there's something that's hard for me to articulate but it's around both women living longer, women not dying in childbirth and women being expected/wanting to stay active in spheres outside the home that mean managing this phase of our life has reached a critical mass.

In other words, I didn't die in childbirth (thanks entirely to medical intervention in my case, I absolutely would have done in a pre-surgical age). I will (hopefully) live a long life thanks to medical and social interventions. And I want to remain active in the workplace, which means I need brain fog, energy and confidence to be at the right levels. HRT is a tool for me.

(Also, as a DF pointed out, I was on the pill for a long time and took a lot of E, so not that adverse to a bit of intervention when it suited me, but that's me, not you.)

Why is it worrying that they asked? Isn't it good that they're collecting this data?

@bruffin I'm sorry your diabetes symptoms were mis-diagnosed as menopause. That must have been very frustrating for you. However, in no way does that mean HRT is bad/unsafe/or ineffectual. It means you were misdiagnosed and given the wrong medicine for your condition.

If I was given HRT for a broken ankle I'd still have a broken ankle, but it wouldn't prove anything other than HRT doesn't treat broken bones.

No they weren't misdiagnosed.
I had mild symptoms I put down to menopause, but they weren't , the were diabetes. The same with others on this thread with thyroid. It's dangerous to assume it's all down to menopause when it may not be.

Having being misdiagnosed for years and attempted suicide, ended two marriages and lost countless jobs due to my rage I finally was offered HRT privately only 3 months ago, aged 53: - )I am still peri but as I have waited so long I can only take it till December as they don't recommend it after 54 currently. I have to go private as my lha do not prescribe what I am on. From December I will move on to post menopausal hrt. Which I can take for life. Yesterday I was offered to trial testosterone to deal with libido but I don't suffer in that area so I declined. I found Davina's book revelationary and used that as a basis to talk to the private GP about it. Before I had been on antidepressants for about a decade which did not help at all.

@bruffin I think we're actually agreeing.

I think that's true for women in their early to mid forties - you need to rule out other things. But if your 49/50/51 and having trouble sleeping, hot flushes, sudden anxiety, aches and pains, itchy skin, vaginal problems then it's pretty much going to be the menopause. I hesitated starting on it at 49 as, in hindsight, I didn't really need it to have a functional life.

At 51, the situation was very different. And I'd question the narrative that many women, our mothers etc all got through without it because we're in a different context, in many cases. Did that still have school age children? Did they have full time high pressure jobs? My mother didn't (and went through a horrendous menopause that turned her into an abusive narcissist) but I do. So I also came to the same conclusion as a PP. If it takes a year off my life, perhaps or gives me a small increase of breast cancer maybe then I'd rather that to have a pleasant, functional life and see my children into adulthood, rather than go through what my mother went through with the long term damage it did to her mental health and relationship with her children.

What I did do before I started was establish a baseline (scientific training). So I waiting until just after I'd managed to arrange my NHS mammogram, booked a smear test, had a scan of ovaries and uterus and had weight, blood pressure recorded and a full blood test checkup done and blood sugar levels checked (possibly not easy to arrange on NHS but my mother is T2 diabetic so they would do it). All on the NHS post COVID which wasn't easy, as getting face to face appointments is hard enough, but I spent the year or so when I was considering it getting those baselines established. So when physical symptoms hit me (like a rock) at 51, I was ready to go and have to regrets so far.