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?

From the study you are trumpeting: "Compared with not starting menopausal hormone therapy, starting oral combined continuous therapy or tibolone was associated with an increased risk of ischemic heart disease. This translates to approximately 11 new cases of ischaemic heart disease per 1,000 women who start treatment with oral combined continuous therapy or tibolone over one year.
No increased risk of cardiovascular disease was found for transdermal treatments, which include skin patches, gels and creams.
An increased risk of blood clots was also found for oral combined continuous, oral combined sequential, oral unopposed oestrogen, and transdermal combined therapy."
Tibolone and oral combined or oral oestrogen are old HRT and very rarely used.
The common HRT -" No increased risk of cardiovascular disease was found for transdermal treatments, which include skin patches, gels and creams." This is what the vast vast majority of women are on.
You are ill informed about HRT prescribing practices today so you present this study as proof that HRT is bad for the heart, when in fact it explicitly says that the most used HRT has no increased risk!

I am on patches. I have loads of friends on HRT and nobody is on tablets, it’s all transdermal.

It's not that it's not valid, but it refers to a specific type of HRT.

They consider it valid for the results of that type of HRT, which I don't believe is prescribed any longer, or at least, not very frequently.

The decision whether or not to take HRT is completely individual, but I would hate to think that someone who's suffering would continue to suffer based on inaccurate conclusions.

So, according to the study quoted above you, an increased risk of blood clots e.g. pulmonary embolism, stroke.

Not necessarily. Here's the problem again with ill informed opinions. Patch can be combined or oestrogen only and you can get your progesterone from tablet or mirena. It'd be interesting to know what the risk specifically is for the combined patch outside of the oral ones. The oral ones are definitely aligned with clots, that's known and accepted. Many women use the oestrogen only patch and supplement separately with progesterone/progestin, so not an increased risk at all.

No, transdermal hrt like patches is not associated with an increased risk. And even if it were, the benefits of me not wanting to kill myself, being able to sleep, and not being too anxious to function are worth that risk.

And I’ve had a hysterectomy so my patch is estrogen only.

Yes - the article specifies that the gels etc do not seem to have any impact.

OP - taking HRT is your own decision, but I highly recommend that if you are making that decision, you do so fully informed. As others have pointed out, the vast bulk of HRT being prescribed today is NOT synthetic. This makes a huge difference and studies have repeatedly shown that the risks are reduced as a result. Alongside many studies demonstrating that there are clear and measurable benefits.

Same for me. I couldn't take the contraceptive pill at all: it turned me into a psychopathic mess, but I've been fine on HRT, and in fact I wouldn't come off it now unless there was a significant medical risk in remaining on it.

Other things that have really helped me:

• Magnesium -- combination of this and HRT has totally eliminated sleep problems
• Cutting out alcohol -- I've almost completely stopped drinking and it helps with everything: sleep, brain health, physical health
• Exercise -- I run three times a week and do weights. Exercise is a huge boost in managing menopause.
• I've also started taking creatine as I've been told it helps a lot with both energy and brain fog and is good for muscle building. Haven't really noticed a difference yet.

@Howszaboutthat I hope that the main thing you take away from this is that you can't trust HRT information you get from Mumsnet users or headlines. Go to a GP or menopause specialist or NHS resources or the British Menopause Society and get proper facts and a proper assessment of any risks, plus all the various options. You need a rounded assessment. For me HRT got me back exercising, I stopped drinking alcohol, I'm sleeping well, eating healthily, controlling adenoymosis, etc. My mood is transformed. My own personalised treatment is a personal risk and reward decision. As such I happily understand and accept any actual risk because I've taken an informed opinion. All in all I am a way healthier and happier person with it. Do yourself the service of getting proper advice and avoid the misinformation you'll find here.

I would definitely agree that for many women HRT gives you the oomph to make other lifestyle changes.

I'm sorry but I strongly disagree with this. Its very much a piece with the natural birth nonsense: designed to make women feel they have to soldier through painful or difficult events when it isn't necessary because they are "natural".

No one argues that men are "medicalising" headaches by taking paracetamol or using creatine when they life weights or taking viagra for sex. They just get on with it and accept the help where they can find it.

Menopause is indeed natural. Childbirth is natural. Cancer and death are sadly also natural. Only a crazy person would advocate a "natural" approach to treating cancer.

If there are genuine reasons not to take hormones, linked to cancer or cardiovascular disease then fine, but otherwise why the pressure to resist taking safe and validated medicines to make things more bearable?

I’m posting for now so I remember to come back to this thread later. Interested in responses regarding HRT.

I won’t touch the stuff. Every incarnation of the pill made my migraines worse. Treatment with hormones for fibroids gave me vertigo so bad that I could not function at all and the treatment was cancelled by the doctor.

it’s a phase of life, not a medical condition. Eat well, exercise, and try to prioritize getting enough sleep. I can’t push as hard as I used to. I’ve been doing just fine when I manage to practice good self care. It’s when the stress of parenting, work, and dealing with elder parents all piles on and I neglect myself that I start to feel the impact.

The “oh you just breeze through this natural state of life with a bit of healthy eating and positive thinking” bollocks makes me feel stabby,

If its ever something you are no longer managing well, know that for many women, including myself, it was totally different to the pill. I don't want to influence you, just make sure you are not basing it off an incorrect assumption. I hated the pill and love HRT.

Yes. Also I had a hysterectomy so my oestrogen was turned off like a tap.

HRT saves me from murdering my family or going into depression.
If only it didn't make my breasts and belly balloon up.

Ha ha. I raise an eyebrow at it! As I particularly was very fit, lovely muscles from weight training, high fibre diet, loads of walking and 'being in nature' as we live in the countryside.

But when I started crying every time I went for a walk, crying whilst doing my weights (actually happened) and waking up several times a night drenched in sweat, I knew that healthy living wasn't going to help one bit and I ended up on the highest prescription for oestrogen 4months later!

However if a person isn't already healthy, maybe getting healthy could help the symptoms without HRT. Who knows?!

Oestrogen is ESSENTIAL for the entire body - your body runs on hormones - I was stupid and didn’t take any hrt and have ended up with a lot of other medical conditions and now need multiple surgeries all because my oestrogen levels were too low

Agree. Whenever someone says something is "natural" I always brace for an onslaught of unscientific woo.

Natural doesn't automatically equal good or easy. Chemicals are everywhere and you can't avoid them. Drugs are not always bad.

There are perfectly legitimate reasons for not taking HRT but wanting to be "natural" isn't one of them.

This is only for a certain tablet that is rarely prescribed. Current preferred HRT is transdermal and body identical and is not included in this study.

I have chronic migraine and I'm on HRT. If anything they are more stable now than before I started it but had all the symptoms I hated.

Menopause is the 'natural' process of female bodies starting to deteriorate after their reproductive purpose has finished and they no longer 'need' strong bones, energy, sleep etc
I personally am not willing to voluntarily age into inutility because it's 'natural' when I can top up my missing hormones and maintain a decent quality of life well into my 'naturally useless' infertile years.

Agreed.

Last year I begged for help because I was so afraid of my own responses to minor things that I was certain I was going to end up in prison for murder. I was terrified of myself.

Add in recurrent UTIs, the bloody ITCHING and my hair suddenly going curly... and I was desperate not to end up under MH section in hospital or banged up in prison.