To try HRT before the menopause has started

[FuzzyYellowChicken]

Obviously I'm going to go to the doctor...

But has anyone any experience trying HRT in the years before the actual menopause?

I am 40.

Have mirena coil so no idea where I am with actual periods as don't have them.

Symptoms:

Extremely tired, fed up, no motivation, sad, irritable, hungry all the time, brain fog, struggling with job, no focus, not myself.

I know most people seem to go on it because of hot flushes. I don't have that. I feel that's still years off.

Has anyone tried it for my symptoms?
Are GPs open to giving it out for that? What was your experience?

I know there are risks (breast cancer etc) but I feel there are probably risks to me just sitting here eating crap and achieving absolutely nothing. Probably heart attack pending....

I started hrt at 44.
I did go privately though as my own gp wouldn't entertain it - said I should try meditating instead. Private gp prescribed it no issues and I've been feeling great on it

I also got it at 42, though I had to go private as GP said I was too young. GP has now taken over the prescription and has agreed to blood tests as it hasn't actually improved anything for me. This was after 3 years of insomnia, crushing demotivating, exhaustion, brain fog and period changes. No hot flushes or irregular periods yet though, just a gradually reducing cycle after decades of being regular as clockwork.

Very encouraged by these tales of early prescription! I have an appointment tomorrow, I know what to ask for so am crossing my fingers. Good luck @FuzzyYellowChicken

Good luck to you too. Im going to give them a ring ( or fill in an online form, whatever it is you do nowadays!! ) tomorrow and see how things go.
Going private is not an option for me at the moment due to not having the money available but fingers crossed that a. Our GP is sympathetic and b. It works

you can’t stay on it forever, so if you have it now, what you gonna do 10 years from now when you can’t have it any more and hot flashes start. That’s when you’ll really need it.

My kids will be young adults at that point so if I completely lose my shit and walk out of my job at that point... They'll be old enough to sort themselves out!

Who says you can’t stay on it forever?
There is no cut off

You stop taking it when you no longer need it, I thought. I’m aware of women well into their 60s still using HRT, do you think there’s a limit on how long/how much you should get?

There isn’t a limit, unless you have other medical issues. But if they’re well controlled, there isn’t a real limit

yes but when did they start it? I’m 60 I just started it. I put it off so I could have it for bone density, drs don’t like to prescribe it to you for years and years, because of the associated risks. Or if your blood pressure goes high

I think that was the hype a few years ago but now there is increasing push back from certain quarters of the medical world. Some Drs still don't trust it, others think there is too much needless medicalisation going on and that women are going straight to HRT as soon as they 40. There is concern its now seen as a kind of anti-aging treatment by some, the dosing is too high, the people are expecting to be on it too long from too young an age.

I don't really agree with that but its certainly being spoken about by Dr's, pharmacists and the NHS in general. Some GP's are already refusing to to shared care going by what a private menopause Doc has said if they feel the dose is too high meaning you need to pay privately or accept a lower dose. There was an article in the bmj I think where GP's were saying they were facing quite aggressive demands from women for HRT and having complaints put in against them if they refused.

I'm not saying these doctors where correct or that I agree but there is still a lot of dispute over HRT in the NHS and its clear many doctors think its use is out of hand.

Interesting. I’ve heard that you can preserve bone density and protect against Alzheimer’s if you start replacing oestrogen earlier, and I thought the cancer risks were much lower nowadays than in earlier years.

I would have thought so too. As it's delaying the decline of hormones. Either way if it's needed to get through life then so be it!
I honestly think if I didn't have a combination of kids and career I may just scrape by (all be it in a misery).but it's just not sustainable as is

It can be beneficial to start sooner rather than later but at the moment the recommendation is that progesterone is considered safe for the first five years of use but there after it may increase breast cancer risk. Also many women seek estrogen and struggle with progesterone but in fact many women have very high levels of estrogen in perimenopause and their symptoms may actually worsen with supplemental estrogen. Unfortunately the symptoms of high estrogen can be quite similar to low estrogen and so that is why some women end up with very high doses and no relief from their symptoms.

The upshot is that women's healthcare is still very much subpar.

I think the reality is that it needs to be balanced with overall health expectations. Years ago women were written off in their 50s as past it, too old, gave up work earlier etc….. Our expectations of life and healthcare have changed. We want to live ‘well’, and hrt helps with this. Doctors are quite happy to prescribe medication to prolong life when someone is at the end of life and struggling. Yet it’s a complete lottery when it comes to healthy women in mid life. Hrt has been shown to have many benefits, of course it won’t suit everyone, some will have side effects, and yes it can be abused. But in general it’s a positive thing for female health, with many protective benefits.

I'm reading this thread closely. Thanks for starting OP. I've been toying with the idea of speaking with my GP about possible peri and HRT.

I'm 42 and have been having flushes for about a year, intermittently. Always been a person who feels the cold but now not as bothered by it. Occasional night sweats.

Had my current Mirena 4 years so no idea about periods at the moment as it completely stopped mine.

Struggling with work, concentration, motivation. Can't be bothered with people in general. Sleep has been way worse than normal in the last couple of years.

My issue though is that I have a long history of depression, with some anxiety. Been on ADs for years but MH still up and down. History of being signed off work because of my MH at times.

I just KNOW if I speak to my doctor he's going to try fob me off by saying it's probably my MH and not peri. This is the only reason why I'm avoiding discussing it.

Anyone else had similar?

I started at 41 and thought I would have to go privately but my GP prescribed oestrogen and progesterone. Eventually went to Newson clinic to get testosterone too. Had gone to a talk by her when she said sooner the better. Had no obvious menopause signs like hot flushes or no periods but was very anxious and couldn't sleep. HRT fixed that for me. Good luck

It might be perimenopause, it might be other things. I’d want to do some bloods first for eg anaemia, thyroids, haematinics, vitamin D.

Then assuming all normal trial some oestrogen gel. I am very pro HRT for most women but do feel that for some it’s inappropriate and others need to manage their expectations. Lifestyle is absolutely crucial too. Smoking, drinking, poor diet, lack of exercise, stress, relationships, all contribute to many of the symptoms that women assume are due to the menopause.

Did the testosterone help?

No- see a gynaecologist who actually knows their stuff, they will help you.

They are worth their weight in gold. Don’t waste your time with a GP who is not usually trained in this field unless they are specialised in women reproductive system. I actually know couple of GPs who have done that but it is not the norm.

But (unless you have money or health insurance) to get to gynaecologist you need the GP. They are the gatekeepers to the specialists 😔

Interesting thread, thanks op.

I went to the GP 18 months ago with a list of perimenopause symptoms. I was 42 and she said I could not be prescribed hrt as I still have regular periods.

I ended up quitting my job and now do a much more junior part time job as it's all I can cope with. I'm a mess.

Having read this I might try to see a different GP.

This is probably a silly question but can you take HRT when on the combined pill? And does the pill mask some peri symptoms?

You do all realise that the GPs aren’t being deliberately obstructive?

It’s the specialists, eg consultants who determine the referral criteria. If you don’t meet the criteria a GP can’t refer you. In many areas (including the one I work in) secondary care services are under such pressure gynae waits for routine outpatients can be over a year.

Yes the GPs should be open to prescribing HRT. Yes waits shouldn’t be so long. But it is what it is. The NHS is in crisis and menopause isn’t seen as a priority.

No you can’t.

And yes it sometimes can.