To not want HRT

[Howszaboutthat]

Need some advice from ladies-in-the-know

I never got on well with contraceptives. They gave me perma-pmt and acne. So, for the last 15 years I’ve had a copper coil which is coming out soon. I was hoping to just ride it out sans synthetic hormones.

I’m 46.

However, Over the last year, the brain fog and poor sleep has set in. I’ve partically solved this by giving up alcohol, taking vitamins and magnesium. The brain fog is getting worse. I feel like such a dunderlinger and my role requires a lot of brainpower.

Other thing - dryness down there. My first UTI in 25 years.

What can I do that is not going to turn me into a fat, lifeless blimp? I was hoping to ride this out. But I think I need to re-think. Also I don’t have time to be endlessly up the doctors (we’re not allowed time off work for appointments in working hours)

Any advice? Am I doomed?

Try L-tyrosine. It helped me enormously with brain fog - in fact so effective I can only take it every other day.
I am on the fence about HRT. I am overweight already and doing exercise and trying to eat healthily. I feel any benefits that HRT might bring would be wiped out if I gain any more weight.

Vaginal estrogen only works locally.

Im not quite sure why you associate HRT with being a fat, lifeless blimp? In my case it was the opposite of lifeless it was getting my life back. You’ve essentially described a whole slew of symptoms that sound pretty much like menopause to me but you don’t want to take the medication that can help with those and provide benefits down the line ( bone density etc). Why don’t you have a chat with a Dr about it? If you can afford it I’d recommend a menopause specialist ( but maybe you have a great GP so go there ). HRT is not one particularly things it’s a combination that includes oestrogen, progesterone, testosterone and various gels , patches and pessaries. You don’t have to sign up for the whole shebang (although I tend to think of them as the holy trinity myself. ) You could start small and see how you go.

I’m the same as you. I’m overweight (not loads) and already exercise a lot. I just couldn’t live a life on lettuce leaves if HRT requires it to avoid any more weight gain.

I don’t think you are unreasonable for not wanting to take anything. I felt a bit like this despite being on the Pill for years with no ill effects. I’m just not a massive fan of taking medicines if I don’t have to.

Had awful brain fog and was constantly weeing. I gave it a go as nurse said I could stop if I didn’t get on with it. I wouldn’t say if I had been a game changer with the brain fog like some people find. But has definitely helped. And I’ve had no side effects.

Probably worth at least taking to your GP about the options? I have a oestrogen cream which did massively help with the needing to wee and I think is also for dryness. So might be options without you going ‘all in’ if you didn’t want to?

https://www.drlouisenewson.co.uk/knowledge/do-i-need-supplements-during-menopause

I found this article helpful

Didn’t mean to be rude. I should’ve added more context. Being on contraceptive years ago, in addition to the acne and perma-pmt: massive weight gain. Took me ages to diet it off.

I found HRT a lifesaver (almost literallY) as my menopause symptoms were so bad.

it also has lots of other protective benefits too - oestrogen loss affects your bones, may have dementia effects....etc etc

I can't take it now (reasons) but still have a mirena in.

I found the low dose of HRT nothing like taking hormonal contraception.

Obvs do what’s best for you but was the same with hormonal contraception of all kinds (mad, fat, spotty and no libido!) and still have a copper coil for those reasons. HRT doesn’t seem to have had the same effects- maybe my body’s hormonal profile is different due to peri or maybe HRT isn’t the same as the pill? (I don’t know- I just gave it a try. It’s been really helpful)

I didn’t use it and I haven’t regretted it. No effects that I’m aware of, so far.

HRT for UTIs is usually a vaginal pessary. Localised HRT if you will. I haven't had a UTI since starting it a year or more ago now.

I also have a Mirena coil, again localised hormones.

I do have estrogen gel which I apply to my arms in the morning. No side effects.

In short, discuss it with a specialist as it's not a blunt instrument unlike the pill - do you know if it was a combined pill or progesterone only? Ultimately the range and use of hormones is nothing like that of the contraceptive pills.

You aren't at all unreasonable, your feelings, experiences and worries are yours and are valid
One think to bear in mind is that body identical oestrogen and progesterone in HRT are quite different to the synthetic contraceptives. If you feel your quality of life is really being impacted you could just try oestrogen and utrogeston and see if it helps, if not just stop

I take HRT and it helps improve my skin, energy, mood and libido. But I must also:

1. avoid alcohol
2. minimal caffeine, only in early morning
3. avoid starchy carbs at evening meal
4. exercise every day
5. plenty of protein.
6. loads of fiber

Doing all of these to about 70% keeps my symptoms low. Without HRT, I would be even more strict.

My understanding is that HRT isnt synthetic hormones though, its body identical so just because contraceptives didn’t suit you doesn’t mean HRT wont be okay.
Only way really is to try - its easy enough to stop if it doesn’t help you, but i think you need to give it a few months to tell.

I started HRT on 22 May 2024. It was the patches you put on your bottom, and I ended up in hospital on the 24th with what we now know to be DNSD Dissociative Neurological Symptom Disorder with speech disturbance and then 6 months into that I was diagnosed with emotional dysregulation. Nobody including myself twigged that possibly the HRT causing issues. Then 3 hospital doctors looked at my notes and thought why don't we try new ways to administer the HRT, my GP argued that it was exactly the same hormones so what was the difference but my consultant put his foot down and said he wanted me to have the gel and the progesterone 14 days after my period started for 14 days. Since they changed how it's administered, my emotional dysregulation has disappeared, my DNSD symptoms are not as severe as before and I am no longer this ball of fury waiting to explode at anybody and everything.

So if you do decide to go for HRT keep a diary of how you feel and if there are massive changes to your mood and personality please get checked over.

You don’t need hrt to solve the vaginal dryness. See your doctor, they can prescribe something like vagurix which is a pessary.

HRT was a revelation for me. I don't know why I put it off for so long. Micronised progesterone and spray estradiol for me. I am not a blimp BTW, I think the weight gain is more likely on combined HRT.

I didn’t get on with the Pill and put on some weight too. Not a lot of weight, but enough to surprise me as I’m slim and find it hard to gain weight. But I now take HRT and have put on zero weight! My figure is exactly the same too.

I only take a low dose of HRT but the difference is amazing. The anxiety and brain fog have gone completely, and my skin and hair - which had started thinning horribly - are much better. Basically, I feel like me again 😊

Dont rule out HRT, OP. I was very reluctant to use it but the difference it’s made is incredible.

I never got in with hormonal contraceptives but HRT has pretty saved my life
I I have experienced none of the issues I did with the combined pill or progesterone only pill
the opposite in fact

Yep, I never got on with the pill either. Happy on hrt, combo of coil and gel.

Look at your risk profile, decide what's important to you.

And even if you don't want to go down the route of systemic hrt
vaginal oestrogen can be a literal lifesaver lowering the risks of UTI significantly

Your hormones are dropping
that’s why u have symptoms
HRT replaces / tops up those hormones
you have less / no symptoms
when you were taking contraceptives you were taking hormones to prevent pregnancy and these gave u symptoms -
you need to discuss it with a GP as you need some info here to understand how it all works
and you have some misconceptions that will unfairly limit your choices

e.g menopause causes metabolic changes / risk of weight gain / HRT does not

You can get oestrogen pessaries on prescription that help hugely with the dryness. The hormone stays where it's needed and doesnt 'leak' into the bloodstream.

You can still have vaginal oestrogen.
I recommend the cream and then you can smear it on your perineum and labia too. Sweet relief I promise!

I've never taken it and I'm well past menopause now, I never felt the need to .