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!

@DrManhattan
possibly - the only other side effect was feeling more horny which wasn’t helpful either!
Im feeling more benefit from vitamin D, B12 under tongue spray and general multivitamins than I did from HRT

Then you could wait until a year after your last period and start oestrogen only HRT, as that has no discernible effect upon the rates of breast cancer rates (despite the fact that would seem almost paradoxical when some breast cancers are oestrogen sensitive)?

I doubt 90% of the things that are automatically put down to perimenopause and I did make a point of actually looking at the numbers (ie, the actual studies rather than the infographics) before I raised the idea with my GP in the first place. Plenty of people do have the equivalent in alcohol consumption, plenty of women have a BMI over 30, plenty smoke or do not exercise regularly.

I don't think it's a magic elixir of youth, nor do I think it's the automatic answer to a 39 year old who says she's feeling tired and frazzled with work, children, parents, life in general or is displaying symptoms consistent with, say, autoimmune disease - but I also do not think that medicine on the whole is automatically a bad and dangerous thing in comparison to fairly ordinary human behaviour, such as drinking wine, sitting on a sofa and eating pepperoni pizza and a bacon sandwich on Saturday mornings.

You have to have progesterone if you still have uterus regardless of whether your periods have stopped or not.

Patches/transdermal HRT only reduces risk of blood clots/cardiovascular side effects, not breast cancer. It's the progesterone part that's associated with breast cancer risk. The safest progesterones to take are utrogestan (oral or vaginal) and Dydrogesterone (Femoston patch)

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.

Again, stupid old MN catchphrases being trotted out without any thought. Attempting to downplay risks. Not all 59 year old women are drinking every day or are overweight. But you're dangerously minimising the fact that if they are, then their breast cancer risk increases FURTHER with some HRT.

The risks and benefits to a woman's health are best discussed by their own medical team, or you could point to helpful articles and studies for them to do their own research. People on here need to stick to their own experiences and stop giving medical advice (while insisting their GP doesn't know shit).

I'm not giving medical advice. Do what you want.

I inject a medication that carries a higher risk of cancer than not having it - except that the untreated condition also carries a higher risk of cancer and cardiovascular events. I came down on the side of 'Well, if I'm probably going to get cancer or have a heart attack and die by sixty five either way, I may as well get a sense of actually having lived life in the intervening period by not having the untreated condition running rampant'. The risks of HRT in comparison are far, far lower statistically. And that's what is often missing - the actual scale of risk; something with an increased risk can sound massive when it's a increase from fuck all to not that much, really.

Jumping on this, I’ve had Breast cancer 6 years ago. I think I went into menopause about a year after (45 ish)
Ive obviously never taken HRT because low risk or not, I’ve had cancer once already….

However there’s never been any talk of anything I should take! Should I be taking calcium supplements? If so what?
What else should I be taking?

My cancer was not hormonal (TN) so I’m not on anything and this conversation has never come up anywhere.

I am a massive fan of HRT - for me. I know that my symptoms (anxiety, depression, muscle aches, vaginal dryness) have been transformed by 75 mcg a day of oestrogen. So for me, the benefits are massive. Those of us who have had a bad experience with menopause and have found symptoms alleviated with HRT are clearly going to recommend that other women who are experiencing difficulties give it a go.

That's totally different from recommending every woman, whether or not she is having symptoms, uses HRT.

No it doesn’t. Each Microgynon 30 tablet contains two active ingredients, ethinylestradiol 30 micrograms (mcg) and levonorgestrel 150 micrograms (mcg). These are synthetic versions of the naturally occurring female sex hormones, oestrogen and progesterone respectively. Plus synthetic hormones are more potent than naturally derived hormones.

This. No one wants to discuss diet and exercise to help deal with menopausal symptoms. That's clearly too much effort. I wouldn't touch HRT with a bargepole.

thank you.

Anytime. I should add though that HRT tops up your natural hormone production, whereas the combined pill shuts down your natural hormone production and then replaces it.

So it really doesn’t matter that the combined pill has a higher dose of hormones than HRT does. Pp have said it like it means while on the pill you are living with a higher level of hormones than while on HRT, when that’s not necessarily the case at all.

@highfidelity you said "One last thing, patches are not the best way to go - you want the creams and gels (and the pessary for the good of your vagina)." - can I ask why cream/gel is better than patches???

It’s individual. I didn’t get on at all with the gel and patches suit me very well. One isn’t better than the other, it’s just what suits you.

It's simple really, not everyone gets on with the patches, not only in terms of dosage levels and they fact they cannot be tweaked in the way creams and gels can, but some are allergic to the adhesive itself.

I much prefer the patches too. I haven't got the time, or frankly the patience, for running cream in and so much prefer just sticking a patch on. I am on the lowest dose of 25 mcg ones and am finding that fine so no issue with dosage. As a scientist, a patch seems more like a controlled dose to me and I would worry about differences in individual pumps or spray due to settling etc.

Its good that there are 3 different delivery mechanisms to suit different people. I find the patches quick, easy and convenient.

I asked about the gel at one of my checkups. The amount I am on at the moment would mean I'd be rubbing it in for days 😂

Has anybody found a good way of erasing the residual sticky bits? My bum and tum is covered in little squares of glue!

Mineral (Baby) oil or liquid paraffin.

Thanks @NeverDropYourMooncup

Ok so been taking pueraria mirifica for nearly a week, and I can’t quite believe it BUT happy to report that my number one peri gripe (loss of sex drive and nigh-on impossible to orgasm) appears to be solved! I saw my partner at the weekend (he works away so we only see each other every couple of weeks) and I’ll spare you the graphic details but I honestly haven’t felt that up for it since I was about 20 😂. I wasn’t expecting to see any benefits from the capsules for a few weeks, so I’m pleased about that.

I also feel a lot more energetic and have got loads of stuff done over the last few days that I’ve been putting off for years. I have CFS and so am very aware of my energy levels but I’ve been unstoppable the last few days, even managed a full spring clean of my house! Normally I don’t even have the energy to push the hoover around. Honestly, this is not normal behaviour for me at all so I can only think it’s the capsules as that’s the only thing that’s different.