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!

Your symptoms sound very similar to mine. I had the same concerns - mainly that I never tolerated birth control pills. I started on oestrogen gel and two weekly progesterone pills two months ago (the natural based progesterone). It has helped me enormously. I was most concerned about the progesterone but it is the progesterone that has actually helped the most. My anxiety/brain fog is gone - I feel much calmer/even tempered. So much less rage!

So far no real side effects. I have always had hormonal headaches - and during the oestrogen only phase I still have those to some degree (but not as frequent or severe). I just generally feel better, back to my old self - more optimistic. Less like I am in slow state of decline.

Just to share my experience. Wishing you all the best.

It's your body, your choice OP. I'm pro-HRT, because the benefits for bone health are clear and there appear to be other benefits too related to heart health and possibly dementia, but at 42 you're likely at the start of peri-menopause and if you feel your symptoms are currently manageable/things you can live with and you have a family history of breast cancer, then hold off for now. Just because you make a decision at 42 not to take it doesn't mean you can't change your mind at a later date if you want to.

I've recently started HRT. My doctor explained the risks as follows 40-50 no particular risk, 50-60 some risk but outweighed by the benefits, 60+ risks may start to outweigh the benefits.

The increase in breast cancer was that out of 1000 women taking HRT 6 more would develop it compared to a comparable group not taking HRT.

However, HRT doesn't cause cancer but speeds up the biological changes that cause cancer. Essentially you may develop cancer at 65 rather than 75 if you hadn't taken HRT.

This is a simplification of the discussion and I don't have a family or personal history of breast cancer so I don't have the same risk factors as you.

The different types of HRT have different risk profiles and different ways to mitigate the risk.

I'd listen to your doctor and trial it for a few months to see if it makes a difference. I don't think taking it for a few months would increase your risk unless you are like another poster who is contraindicted for hormone therapy.

I also wish I had recognised my peri menopausal symptoms at 42 for what they were. In my opinion women are socialised to minimise their medical symptoms.

It took a friend raising her eyebrows at me saying "oh it's not too bad apart from the brain fog, fatigue, aching bones, hives, insomnia and hot/cold flushes" that made me consider HRT. Suddenly getting the RAGE at family for no reason tipped me over.

I've never been on HRT as I was advised not to by my Mum's oncologist. TBH I didn't need it I had very few symptoms, the odd bit flush and regular heavy periods, from irregular light ones. Then my periods stopped, since then I haven't had a hot flush either.

I also didn't get PMS or anything like that. Not sure if they're linked.

I completely agree @dolorsit - with hindsight my symptoms started in my late thirties (when i suddenly started getting spots for the first time in years, and my anxiety shot up). I am 47 now and just started HRT. I still have periods and have not really had hot flushes - but the other symptoms have gradually added- brain fog, fatigue, joint pain, irritability, huge mood fluctuations, rage...

All technically 'manageable' but I got tired of managing them. I basically weighed the risks. I luckily don't have any breast cancer history. I do have spinal issues though - so the Osteoporosis benefits of HRT were also on my mind.

I am personally glad I started taking it but agree it is an intensely personal decision.

does anyone know if HRT is advised if you aren’t having menopause symptoms?

posters are saying about the benefits- bone, heart health, dementia risk etc.

so should I take it for those things purely because at 50 I’m probably at least approaching menopause.

or do I wait until I show symptoms? What if I don’t? Am I risking the above if I don’t take HRT?

pp said about lack of research, and this is the one question I can’t find the answer to.

That is a really great question actually.

@Lastnamedidntstick

My doctor definitely seemed to give the impression that she thought most women aged 40-50 would benefit regardless of menopausal symptoms.

I'm not sure but I think guidelines may have changed recently and that HRT should be prescribed if a woman in that age bracket requests it. (Assuming no specific medical issues which would advise against it)

@dolorsit my GP said exactly the same...she said every woman over 45 should really be on it unless there is a medical reason for not being. She specialised in Menopause care.

I'm sorry to hear about your mum.

Mine died of a stroke and so I don't want HRT. It worries me some posters appear to say everyone should be on it. That is absolutely not the case. Sometimes the risk outweighs the benefits

Sorry, you misunderstood - I meant the search engine of Dr Greger's website. No google involved. All Dr Greger's work is science-based, peer-reviewed with full references. As for it not being my place to offer help, as a vegan my concern is not only for non- human animals, it also extends to my fellow human beings.
So here's another link you might like to check out:
nutritionfacts.org/video/dietary-approach-to-naturally-treating-menopause-symptoms/
And a book that the female members of my family recommend that all women should read is 'Your Body in Balance' by Dr Neal Barnard.

I also didn't get PMS or anything like that. Not sure if they're linked.

I had dreadful PMS/PMDD all my life, also two episodes of postpartum psychosis. My father - a psychiatrist- told me that I should be aware of what the menopause might hold for me. It was unusual for him to have that sort of conversation with family, so he clearly felt strongly about it.
Many of the repeat admissions in the large mental hospital he ran were women affected by their menstrual cycle, childbirth and the menopause. It was a distinct pattern, he said.

And on the flip side, I never suffered with PMT or post-natal depression, and the menopause hit me like a ton of bricks.

Everyone's different, it's all about recognising that your symptoms are particular to you, if you can cope or not having symptoms then fine. If you're struggling, there is something which might help.

Many of the repeat admissions in the large mental hospital he ran were women affected by their menstrual cycle, childbirth and the menopause. It was a distinct pattern, he said.

That is so depressing. It was good he is/was keeping an eye on you, though. Bloody hormones.

One of my lottery win plans is to fund research to see if my Dad’s theory was correct, and that a history of PMS and postnatal illness makes it more probable that a woman might have a difficult menopause. Of course, some women will have such a history and an easy menopause, and others might not have such a history and a difficult menopause, but it might be a useful indicator.

It definitely makes sense, @borntobequiet. I am sure that I have read that women who suffered post natal depression are more likely to suffer with the anxiety/depression side of menopause. Not sure about the hot flushes and rest of it.

I think what the medics are keen to stress though is that it's not a foregone conclusion that if you've had PND, that you're going to be depressed in menopause. And although I am certainly not on board with the visiting vegan, other things like taking vitamin D and getting regular exercise definitely helps.

I personally have no experience but my mum was at her GP for hrt on Monday and they told her to try herbal first. I've never seen her so depressed and down in my life she's on constant pain too. She's ordered menofriend and some cbd gummies to try for a bit. My friend has started taking the gel and said it's been a life saver if she hadn't she would be divorced or dead she said xxx

Thanks Breadandwine2 I think it was kind of you to post and enjoyed reading the article.

People who are on HRT - how long are you planning on taking it? the risks increase the longer you're on it. What about stopping- do the symptoms come back? I don't think these facts are made clear enough. Also where's the evidence that it stops osteoporosis - and is that just when you're on it? I still think there's a lot of confusion. I know when I researched it myself it said higher risk of heart attacks and strokes during the first year of taking it.

I'm in my third month of HRT and I have just turned 45.

I was hesitant to try it also bad experiences with hormonal contraception.

But...

My breast feel perky again instead of saggy and without any sensation.
I can go a lot longer before I need a wee.
I stay asleep a bit longer than I used to (never had any trouble falling asleep)
Still no libido, but I've never had much of one anyway

And...

I might be helping my heart, improving bone health and possibly reducing dementia risk.

I did however spend the first two months in tears until i increased the strength of my patch! Def feeling better now.

Gel not for me, I can't be bothered moisturising so had no interest in rubbing a gel into me. Too much high maintenance.

@salutsandy I will take it as long as it makes me feel better. So how long is a piece of string?

but my mum was at her GP for hrt on Monday and they told her to try herbal first. I've never seen her so depressed and down in my life she's on constant pain too.

Your poor mum. It makes me so cross that women have to get really stropped and practically demand HRT. In my case it took two prescriptions for anti-depressants which didn't work and about 5 lots of antibiotics for UTIs caused by vaginal dryness/atrophy for me to join the dots. If I'd left it to the GP I'd still have no HRT.

I am 57. I have never taken HRT and never will, because I don't want to medicate for what is, after all, just a normal phase of life. Menopause is not an illness.
But what you do, OP, is not up to me - you make your own decision. Speak to your doctor, and don't be swayed by others who are either for OR against.

@salutsandy easily found on google.

theros.org.uk/information-and-support/osteoporosis/treatment/hormone-replacement-therapy/

Menopause is not an illness.

This is true. However, menopause makes some women feel very ill indeed.

Thanks ohfibonacci - an interesting read