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 had Hyperemesis in both pregnancies (also got hormonal migraine). Just started on patches 2 weeks ago. No side effects so far. Difficult to tell if helping as I've just had covid.

again the question I can’t find the answer to is if it’s beneficial if you have no menopause symptoms. It clearly is if you are

Yes because it can protect against heart attacks, strokes and osteoporosis. No controversy there, very clear evidence. So yes it is beneficial for everyone.

Why haven't I rushed out to get it? Because I don't have symptoms beyond heavy periods (which I've always had) and I don't want to be trying to get appointments with, and prescriptions from, reluctant GPs and pharmacists. Also I don't like the idea of having to try different things to see what is suitable for me. I will wait until I have to.

is there any evidence for that?

as far as I can find there are no studies in premenopausal women, or asymptomatic women.

if you have symptoms then it makes sense that hormone replacement will prevent the consequences of the hormone changes.

Hyperemesis Gravidarum

nutritionfacts.org/video/natural-treatments-morning-sickness/

I said it apparently kept the symptoms at bay

Yes because it can protect against heart attacks, strokes and osteoporosis. No controversy there, very clear evidence. So yes it is beneficial for everyone.

Where's the clear evidence? Saying it protects against strokes is a new one - do you have a link to this?

Haha I think I’m more confused now than I was when I started the thread 😂. Lots of conflicting opinions.

I think for now as I am pretty early stages of peri, I will hold out and see how I go. Life is actually overall OK at the moment - and it’s hard to know what is what as I have chronic fatigue and also had a lot of trauma in my thirties which meant my mental health hasn’t been great for a long time. So can’t necessarily pin everything on menopause. Relatively speaking, my mental health and energy levels aren’t too bad at the moment, but both of those have been REALLY bad in the past, so I guess ‘for me’ I feel like I am doing alright. Though I’m sure there’s room for improvement.

I’ve ordered a supplement called Pueraria Mirifica which is supposed to help with a lot of the symptoms I have, and increase libido, as well as boost oestrogen. Reviews of it are really good so I’ll see how that goes. Also been reading a book which a colleague recommended called ‘fast like a girl’…I’ve done intermittent fasting in the past which has worked really well…the difference here is that you eat differently at different times of your cycle to boost oestrogen and maximise weight loss. Keto before ovulation and then healthy carbs after ovulation seems to be the key, but always eating within a window of a set number of hours per day. So going to give that a try as I wanted to shift a few pounds before the summer anyway, and it might have a side effect of helping my peri symptoms. My colleague has only been doing it for a couple of weeks and has lost a noticeable amount of weight already.

As others have said, the fact that I’m dithering means I probably am not at the stage of NEEDING to take HRT at this stage. Definitely some changes going on but none that are making my life unmanageable right now.

Read the Nice guidelines and research is patchy at best but the breast cancer research was flawed years ago.
The positives are huge for me.
I've always felt hormonal so when they declined I felt like a wisened old prune. HRT is safe and made life worth living agsin. I'm never coming off them.

Read the Nice guidelines and research is patchy at best but the breast cancer research was flawed years ago.
The positives are huge for me.
I've always felt hormonal so when they declined I felt like a wisened old prune. HRT is safe and made life worth living agsin. I'm never coming off them.

I thought the cancer risk goes up the longer you're on it? A lot on MN are saying they're never coming off it but is that safe?

I tried the patches - didn’t help much do was put on a higher dose
breast tenderness, skin itching especially on chest and neck, horrible anxiety, mood swings worse
I’ve been much better since I stopped - I can live with the hot sweats, tiredness and poor sleep better than the awful side effects

Um, yeah. All very helpful, I'm sure, if you're physically capable of having any food, fluid or other substances entering your body at the time. Which is pretty much what you aren't able to do with HG. I just learned that any substance inflicted upon you at the time is likely to stimulate profuse puking for the next twenty-odd years as a learned response. See also room temperature water, vitamins and glucose tablets. Oh, and the only guaranteed cure for HG is to not be pregnant anymore - obviously how that is achieved varies in whether it's a positive or emotionally negative manner, but not being pregnant is fucking effective in ensuring you no longer have an illness literally (and I mean literally 0 the clue's in the name) dependent upon currently being pregnant.

Turning away from the 'natural remedies fix everything' shite and back to the subject of the thread, there's a greater risk of Breast cancer by age 59 from having a pub size glass of wine a day than there is in having combined HRT. And six times the risk if your BMI is over 30. Even the increased numbers are small enough that I'm happy that the odds are incredibly low.

If HRT allows women to keep working, get out and meet people, talk to new people socially, go to the gym, go for bike rides, do some puzzles, have the energy or enthusiasm to try some new hobbies, get the knitting out, sleep well so that they can go on ski trips and enjoy holidays - then for me that is plenty of benefit in terms of staving off dementia or Alzheimer's type endings, even if it's an indirect benefit.

The women I see with dementia issue (and metal helath issues) in their sixties are women that never worked, kids flown the nest, life has no purpose type of people. Obviously anyone can get certain forms of dementia (and breast cancer), but that early, slow decline into old age, via daily wine and empty days, certainly must contribute.

If HRT allows women to keep working, get out and meet people, talk to new people socially, go to the gym, go for bike rides, do some puzzles, have the energy or enthusiasm to try some new hobbies, get the knitting out, sleep well so that they can go on ski trips and enjoy holidays - then for me that is plenty of benefit in terms of staving off dementia or Alzheimer's type endings, even if it's an indirect benefit.

So, you kinda feel like it might help reduce dementia based on some assumptions you've made about some women you know, and more assumptions about what causes Alzheimers.

That's a far cry from 'HRT greatly reduces dementia' stated and repeated as fact on here.

It's great that some women have found HRT helpful and want to share that, but the some of the opinions put forward as medical advice on menopause threads is downright reckless, and @MNHQ should crack down on it.

I dont know any of my friends that have given up doing any of that except the one who is on HRT! and that is because of work induced injury which means she cant do her job. Everyone else has carried on their life doing what they normally do without taking HRT.

People make up any old shit to defend HRT in these threads.

Now we're being told it protects against stroke. It's well established that HRT increases the risk of stroke - quite substantially for some women.

As I said, bloody dangerous advice in here and I'm glad the OP was able to see through it.

so I decided to read the NICE guidelines on HRT.

Nice guidelines state the risk/benefit for HRT and dementia is unknown.

it has no effect on muscle mass.

the beneficial effect on bone health discontinues if HRT is discontinued.

there is an increased risk of stroke, DvT, depending on formulation.

breast cancer risk linked to family history.

so yes, some people on this thread seem to be plucking their “facts” from thin air.

For me, having read the risk/benefits, I won’t take it unless I have symptoms that affect my quality of life.

i wouldn’t agree that all women of menopausal age should take it without individualised analysis of the risks.

Exactky, like I said, indirect benefits. For some. I'm not claiming any direct medical benefits because I haven't read the papers. Though I think the osteoporosis link with estrogen is pretty well proven now. HRT doesn't need defending, or indeed promoting, because it's a personal choice that might help some women. Why do you care so much if other people choose to take it? The GPs make it quite clear what the risk factors are.

The pill has the biggest risk of stroke yet nobody hand wrings about their teenage daughters taking it or worries about taking it themselves. Being overweight and smoking is a much higher risk for Cancer, but I bet there's overweight smokers on here going oh I'd never touch HRT.

@SmartHome well said.

Please don't put words in my mouth. I've never stated that HRT directly protects from dementia. I think it's pretty unlikely tbh. I think leading an active life and using your brain regularly must be beneficial for some forms of age-related cognitive decline. And of course for mental health. If HRT helps some women with that then that's an indirect benefit which needs to form part of the risk-benefit analysis.

I don't remember everyone analysing taking the Pill to death though, nor anyone claiming it had health benefits, though clearly it changed a lot of women's lives for the better.

Several posters have said it protects against dementia. Including one who states her own mother only developed dementia because she stopped taking HRT.

the pill isn’t really the same discussion. Nobody is telling all women over 20 they should be taking it for the health benefits. The side effects are well known, but most women accept those risk because pregnancy is the bigger risk for them.

many threads about HRT send the message that it protects agains dementia, osteoporosis etc in addition to relieving symptoms.

that was my question, and I can’t find anything to back up the direct assertion that taking HRT when I don’t “need” it will still be beneficial. The NICE guidelines contradict much of what has been said on their thread and others.

Well I didnt..and they shouldn't really because it's only an indication at this point. This recent study is interesting though, at least for the 25% of women that have a genetic predisposition towards Alzheimer's

www.uea.ac.uk/news/-/article/hrt-could-ward-off-alzheimers-among-at-risk-women#:~:text=A%20study%20published%20today%20shows,factor%20gene%20for%20Alzheimer's%20disease.

Although again, they are measuring brain volume and MRI profile as an indication of cognitive ability that is reduced with dementia and they are also not suggesting any mechanism whereby estrogen or progesterone are improving that picture. So it could be, as I suggested, down to the indirect benefits of HRT on brain health, for some.

Sometimes I wonder if mumsnet is sponsored by some HRT drug companies…

there's a greater risk of Breast cancer by age 59 from having a pub size glass of wine a day than there is in having combined HRT. And six times the risk if your BMI is over 30.

In my case, I wouldn't do either of those things so it's not much consolation. I know this is trotted out all the time though.

Or maybe there’s just a lot of menopausal women who have benefited from taking HRT….

@JaceLancs I had a similar reaction to HRT as you did. Do you think we already have enough hormones naturally so the HRT just makes us feel rough?