Hi Ameliagray
Well the issues are rather complex but my lovely female GP (NHS) is happy for me to make my own decision as long as I am aware of the risks, and for me as for many women, the benefits outweigh the risks - which seem to be very small. As I am sure you aware there are many of us who are better informed about all the issues than our GPs - because they are just that - General Practitioners.
I have read up a lot about it - well a little compared to experts - but from what I can ascertain the latest thinking is that risks of using HRT are no greater than being inactive, obese/overweight or drinking alcohol.
Members would benefit from reading the latest statement from the International Menopause Society which reports the recent re-examination of the Women's Health Initiative Study - the one that caused the furore and led to many women coming off HRT and doctors refusing to prescribe it. These results - how they were orginally interpreted - have been shown to be flawed and the latest report is a series of paper reviewing the position of HRTY 10 years after this study.
Here is the link:
www.imsociety.org/pdf_files/comments_and_press_statements/ims_press_statement_22_05_12.pdf
Breat cancer
This is what the summary of the paper re breast cancer has to say:
"Breast cancer There is an increase in breast cancer with E+P HRT, but this is small. It has alsobeen exaggerated by press reports, causing fear in many women. They conclude that large numbers of women with substantial menopausal symptoms and low breast cancer risk will benefit from HRT use"
There was an artcile in the Daily Mail about it:
www.dailymail.co.uk/health/article-2147835/A-wasted-decade-How-HRT-scare-caused-thousands-women-10-years-needless-suffering.html
Much of the work in any case involved oral oestrogen - and conjugated equine oestrogens, and a synthetic progestin. Results obtained cannot be generalised to all HRT types and modes of delivery. There seems to be general consensus that for many health conditions transdermal bio-identical oestrogen ( ie patch or gel) combined with bio-identical progesterone provides the route least likely to lead to adverse effects.
Here is what Dr Heather Currie, a gynaecologist and menopause expert has to say:
"Last week's report did not in fact say that there is NO association with HRT and breast cancer, but explained that HRT, like any medicine has risks, but for most women, when it is used correctly, especially for women under the age of 60, there are far more benefits than risks. To pick up on a few of the points raised--
The drop in rates of breast cancer in fact started before the WHI trial was reported and before the drop in HRT use.
The known association in breast cancer risk with HRT used for more than 5 years after the age of 50, is not as great as the known association with being overweight or taking 2 or more units of alcohol per day.
The difference in response to HRT of the older women in the trial, compared to women in their 50s, is in relation to the cardiovascular effect--we know that estrogen is very likely to be beneficial to the cardiovascular system if used in the early menopausal years, when blood vessels are healthy. However, if we wait until later years when the vesselas are already diseased, HRT is unlikely to be beneficial and may cause further harm in a very small numbe rof women.
Finally, the Million Women referred to has since been shown to be extremely flawed and no firm conclusions can be drawn from that study."
Re bleed or no bleed. Again lots of issues. Many women are progesterone intolerant and so the feel good factor of taking oestrogen is diminished by the negative side effects of progesterone ( eg bloating, headaches, anxiety, weight gain - for some etc) which can be made worse with the synthetic progestins used in all the combined preparations - including transdermal.
I have read that sometimes progesterone can interfere with oestrogen's effect on the oestrogen receptors and again lessen its effects.
Personally as we have evolved to have a cycle, I feel it unnatural to take both oestro and prog all the time and feel that metabolically - our bodies are suited to a cycle. My doctor did not recommend or not recommend this - in fact once I had reached 57 and still on HRT suggested I went onto a conti preparation as i would be post-meno. I did for a while then changed back. Most women do not want a bleed and so most take both together.
However if I continue to take HRT into my 60's which I fully intend to do - I can;t imagine having "periods" at 65 - but there is really no reason why not - as you say - it is just weighing up risks and benefits, convenience, quality of life etc
I am not overweight and whilst I drink alcohol do not do so in excess. I do need to take more exercise though!
Sorry this is so long - hope you haven;t all gone to sleep!
Bellaciao x