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....

HRT helped me greatly but down the line I have hormone driven breast cancer, have had a mastectomy and am now going through chemo. As it’s hormone driven my risk of recurrence doesn’t go away.

Do get the best medical advice you can on the lowest possible risk meds and review how long you take it for.

Get your thyroid checked first.

I'm 40 and have recently had a clear hormonal shift. Almost overnight, I've developed a very high sex drive, have ovulation pains in my back for half the month, have heavier periods and - the killer - severe insomnia. I'm getting 2 hours sleep a night and starting to panic about my ability hold down my job.

I had an appointment with a female doctor yesterday and said I'm adamant I want to try HRT. She was really open to it. I'm booked in for bloods next week, after which she has said she's definitely willing to let me trial it and see how I get on. She's thankfully given me prescription sleeping tablets to tide me over until I get this (hopefully) sorted. It's the sleep that I care about, I can cope with any other symptoms.

One thing that threw me was she said I'm very young to be thinking I might be in peri and the average age for it to start is 55! I know this isn't true from so much reading I've done on the subject.

Please do that, and make sure you use phrases like this has had a massive detrimental impact on your life, you have had to quit your job etc. It’s scandalous they didn’t help you earlier.

@FuzzyYellowChicken my story (& symptoms) is quite like yours, came on full whack over 2020/2021 but with hindsight had been building the year before, I put it down to stressful life situations, covid pressure and getting older but really thought I would have to quit my job. Had to go through 2 lots of blood tests, vitamin loading doses and they tried to put me on antidepressants but eventful gave me in summer 2021 and it made such a difference, though have had to increase my oestrogen twice. Think I could benefit from testosterone too but haven’t got the fight in me at the moment.

Talk to your lineal female family if you can, it really helped the gap get their head around it when I was able to say my mum and her mum were both in menopause by he end of their 40s, so me starting early 40s made sense.

Good luck.

Have you had a full check up, OP? Have you been tested for autoimmune markers?

Thank you, your post has made me decide to get a second GP appointment about this.

I’m 44 and don’t have any of the big ticket symptoms but: I am tired ALL the time*, just exhausted and don’t have energy to do much beyond the essentials; I have zero sex drive; I’ve got anxiety issues; I often wake with a racing mind and heart; and my mood has completely flat-lined and I’m sure I’m not depressed (I’ve had that).

I’ve had loads of blood tests and they’ve all been fine.

My job is fairly stressful at times and I do have a 3 yr old but I can’t change those, so I’ve nothing to lose by giving hrt a try and see if that helps!

@NameChangedForThis2025 good luck and hope it goes well for you. You have nothing to lose by trying it. It's also a journey in a way. It's only now I know how important progesterone is for you. Your body needs more of it than oestrogen and it's the first hormone to decline. I sleep like a baby now and feel like me which is such a relief. I had 13 symptoms of varying degrees by the time I started HRT. I feel like I lost a couple of good years and the extreme rage damaged by marriage which I am repairing now.

Good luck with your GP, it seems to be really hit & miss what happens on this. Obvs you need checking for other stuff to explain how you feel first, though. I'd already had my bloods checked for thyroid, anaemia, deficiencies, liver etc etc & had my copper coil removed cos it caused severe anaemia.

I'm 46, still with regular periods & am on my 4th box of patches (2wks oestrogen & 2 weeks with progesterone added in) but it was the GP who recommended it to me after I had a UTI which I'd never had before. I've definitely been having a lot of peri symptoms for a couple of years.

I was on the copper coil for ten years cos it was hugely intolerant to hormonal contraception & was told it was copper coil or surgical. Now being on the patches I can see it's the progesterone that doesn't agree with me - I don't have any of the benefits others get & it actually stops me sleeping & makes me low, stomach cramps etc. The oestrogen patches make me feel awesome!

Might be worth thinking about getting the mirena out & seeing how you feel? If you have a partner, could he think about getting the snip? You'll get a better idea of where you are without additional hormones.

Honestly it's a minefield, though, and different for everyone.

I as on hrt at 39 but I was having major hot flushes

There are comprehensive NICE guidelines, honestly I cant be arsed to Google (sorry!) - but have a look they are out there.
The quoted poster needs to see a new GP. I don't know how some of them get away with this crap.

My friend said print out the NICE guidelines (I am not sure what age they suggest HRT from as I am older) and when you go into the GP's office you state you are here to be prescribed HRT and here is why, list your symptoms, state that you believe it is perimeopause and you are willing to try the HRT to see if that helps you.

I am 50, definitely in peri and didn't have any hot flushes and still have periods. But I do have a list of symptoms that are firmly in the peri bracket. I am not on HRT because I have endometriosis so mine is more complicated. But I went to my GP for something for endo, we talked about my periods and she was very good at saying if and when you want to be prescribed HRT then come back and I will start you on it.

Don't suffer, speak up, get what you want.

I spent my early 40s back and forth to the GP with various vague physical and psychological symptoms - I've been tested for everything going and no cause found. A male GP said I was too young for it to be perimenopause, but then a female GP said that was nonsense!

In the end I wrote a list of everything and asked the surgery which GP would be best to talk to about women's health. Saw her and she immediately said she'd prescribe me HRT If I wanted it.

I never had hot flushes and my periods are still regular so I kept questioning whether I just needed to eat better, exercise more, reduce stress etc.

It took me a year to decide to try it - the last straw was raging mood swings and some kind of mental breakdown over Christmas. I've now been on it a couple of weeks and - it may be coincidence - I've had actual good moods and energy for the first time in months. I'm 44 and wish I started sooner.

Really shocked to read of so many women being fobbed off by their GPs!

Complain, this is awful care and against guidelines (especially if you are over 45 but regardless). I got HRT in early 40's based on symptoms like yours although, periods still were regular. Was life changing within about a week.

You may have to really persist / beg. (Under 45. )

I got it eventually (a locum ) a few risk factors addressed .
I got tablets and gel
Tablets didn’t suit me - I’m getting mirena in a few weeks .
Similar to you , no hot flashes but the rest !!!

NICE guidelines I believe state that over 45 can get HRT regardless , but under 45 may be required tests etc

@Jenkibubble thats not what the NICE guidelines say.

They say each woman must be considered on an individual basis, but there is no benefit to doing hormonal blood tests age 45 or over.

Under 45 women should be considered for HRT (you can’t get it regardless, it needs a clinical risk assessment whatever age you are) and MAY require blood tests to exclude a differential diagnosis for her symptoms and check FSH. However prescribing isn’t based exclusively on blood results but symptoms too.

Those were my symptoms... HRT has helped a lot! I also have a Mirena. I just use the oestrogen gel and it has really helped the grumpiness, dry eyes, headaches, tiredness...

I started last year at 43 - didn't have to persist or beg at all. My blood tests came back fine. My periods were still regular but heavier (and they were heavy anyway!). My symptoms were mostly rage (!), brain fog and constant bloody itchiness, but I was struggling a bit with sleep and anxiety too, plus the aforementioned much heavier periods which were lasting 2 + weeks at a time. Temperature regulation went a little wacky too - though more that I was freezing all the time, though did get some sweats around period times. My female GP said she was happy for me to give it a try. I have the lenzetto spray and progesterone tablets now. I think I upped the dose a bit quickly so ended up with permanent bleeding, though not heavy like before.

I've scaled it right down now - I think it's almost certainly helped with the brain fog, and my periods are more manageable again. Jury is out on the mood swings and itchiness!

Thanks for everyones experiences. It's cemented the fact that I am going to try. Just waiting for GP appointment.
It sounds like it could either be very easy or a bit of a battle!

I thought pre-menopause was the stage before peri menopause, when your hormones haven't started to drop yet. What is that stage called then?

Why can't you stay on it?

It is. You're correct.

I'm 45 soon and been on hrt tablets for 4 months.still have regular periods.

No you can't i had to come off it

Of course! I have regular cycles like clockwork but have HRT since I was in my early 40s. HRT is for peri too, and more useful for this. Prescribed happily by NHS GP despite normal hormone tests.