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?

I was told in no uncertain terms to take HRT to protect my heart and my bones. What with my horrendous symptoms it was a no brainer. Been on high dose for 12 years, consultant wants me to lower my dose when I’m 60 but staying on it with annual mammograms for the foreseeable.

You’ll only gain weight if you eat more, it can increase appetite but it doesn’t just add weight. The benefits are worth it

I was also terrible on the Pill but HRT has been amazing.

I love HRT. I have no symptoms at all now.

it also has protective effects eg muscle mass, bones but that’s not why i take it. I think I had every single symptom. Agree that avoiding caffeine / alcohol / spicy food etc does help.

Why do people think HRT causes weight gain? I can't imagine why anyone would try to rawdog menopause if they don't have to. Get the hormones. Your body needs them.

If you’ve already had a uti due to vaginal dryness, even if you don’t want systemic hrt, do get the vaginal oestrogen pessaries. These stay local to your vagina and will save you from the misery of the uti problem potentially getting far worse if you don’t address this.

I don't blame you OP

There is some new research that shows an increased risk of heart disease, heart attack, stroke and blood clots apparently. For me personally its not worth the risk but I appreciate everyone is different.

In theory everyone should use vaginal oestrogen, it's localised and preventative for UTIs, vaginal atrophy, etc. I find HRT hugely helpful. You absolutely can choose to avoid it, but make sure you're doing so from a well informed place. There's a lot of misinformation and fear mongering out there.

I cannot believe I waited so long to get on HRT. I was massively reluctant and in fact waited until I was post menopausal. I use gel in a morning and a tablet at night. My night sweats and hot flushes stopped almost immediately. I have had no arthritis symptoms since I started HRT. I can also feel a massive change in my physical strength. And I have had ZERO weight gain.

Like several PP I would also suggest localised oestrogen vaginal cream as that’s not systemic and is very helpful for dryness and UTIs.

I’d encourage you to give HRT a try though… it saved my sanity, got rid of my crippling anxiety and I can now sleep again. Brain seems to be functioning a little better now, too.
I’ve also lost weight!

I am also very sensitive to contraceptive hormones. It also took me a while to get my HRT to the right place but that was due to caution on dosage !!

It's probably worth you doing some research on both HRT and oral contraceptives. They are very different. They have very different levels of hormone and have very different effects on your body as a result.
I'm not saying take HRT, I firmly believe it's for each woman to decide what is right for her. I'm just saying do the research as sensitivity to one won't necessarily read across to the other.

What I find weird, OP is that after having combined pill, copper coil, mini pill then back to the combined pill for the oestrogen in my late 40s, which I stopped taking at 49, at 50, nearly a year after stopping taking anything at all, I feel better than I have for 15+ years.

I have been taking Mounjaro for six months and have lost over two stone. When I was 46/47 I had vaginal/vulva issues with low oestrogen, brain fog (even back on combined pill). Recently I've felt much sharper and have no low oestrogen issues and no periods (hurrah!). Maybe I'm through menopause now, and maybe Mounjaro is masking things, but I'm amazed. My pelvic floor feels like before I had children.

OP I suffered at first with mood / PMT-like symptoms when I started HRT, but a helpful Dr suggested I switch to taking the progesterone as an pessary and those symptoms disappeared. Apparently it’s quite common.

That is pretty much the opposite of what my GP told me. She said it reduces your risk of heart disease and osteoporosis..... (and it a few other benefits which I have now forgotten)

The research was published in the BMJ - data from 138 trials/studies over 13 years involving 900,000 women so seems pretty comprehensive tbf.

Its a personal choice. Everyone's circumstances are different but I have family history of heart disease and strokes etc...so that was enough to tip me the other way.

Definitly the decision to have HRT or not is very individual. I certainly know several women who have been advised by doctors not to have it .

https://bestpractice.bmj.com/patient-leaflets/en-gb/download/1590062595847/Menopause:%20should%20I%20take%20HRT%3F.pdf

I just had a very Quick Look on the BMJ and it says that the it is not straightforward with heart disease and HRT. Apparently , it can either be protective or the opposite. In particular, it mentions the age at which you start HRT makes a difference.

Thank you so much to all of you who have posted a comment. I do feel a bit more enlightened and encouraged.

I'm not on HRT mainly because it gave my mother an aggressive form of breast cancer which she died from.

However I've sailed through the menopause apart from the odd hot flush which I haven't have any for the last 4 or 5 years .

You can do whatever you like, OP. HRT isn't compulsory and, like all medications, has pluses and minuses.
I'm 60. I've never taken HRT (nor anything else re menopause). I'm fine.

You do you.

I plan to stay on HRT forever. The many benefits outweigh the few, and tiny, risks.

Plus, I believe it keeps you young. You need oestrogen for collagen and it keeps your hair thick.

I’m under a consultant for another reason and she actually recommended HRT because it can help protect your heart.

It's well worth trying it if you are having alot of symptoms , the side effects are relatively low and it can have a massive impact on your life.
It's been brilliant for my joint pain , insomnia and brain fog. Also I've lost loads of weight on it so weight gain isn't a given.
(Not sure why you would have to spend ages at the Drs either....I got everything sorted with a couple of phone calls!).

Yes, my friend is seeing a cardiologist and he has put her on HRT and says it’s unfortunate she has started it late, at 50.

You need to do what's right for you.

For me personally the amount of women in the research plus my own family history meant I feel more comfortable not taking it.

Thanks for this link, good reading. I found the calcium calculator it listed from the article from the University of Edinburgh and posting link here if anyone else wants to have a check. I’ve ordered a chewable Calcium supplement today (just as well as according to the calculator am under the recommended adult daily amount)

https://webapps.igc.ed.ac.uk/world/research/rheumatological/calcium-calculator/