Anyone have experience of coming off HRT gradually?

[hackmum]

Am in my early 50s, and have been on HRT 10 years. Doctors have always told me that I would need to come off HRT at about 51 or 52, because of the increased breast cancer risk.

Have tried coming off it once or twice before, but hot flushes and night sweats returned so I went back on it. Last week I saw a locum GP and discussed it, and she said I should try coming off "gradually", ie taking a tablet every two days instead of once a day. She said this would make the symptoms less likely to return.

Now I'm a little bit sceptical about this. No other GP has ever suggested this to me, and my understanding is that all HRT does is essentially to mask the menopause symptoms. If you come off HRT, whether gradually or cold turkey, surely the symptoms will return if the menopause isn't over?

So v. interested to know whether anyone else has had this advice and, if so, what their experience has been.

And another thing she said was that that there are now "non-hormonal" drugs that can treat hot flushes and I could perhaps try those. Again, no other GP has ever mentioned this to me. Does anyone have any more information?

No personal experience but can only tell you what I know about- which is that my consultant says it MUST be gradual- over 3-6 months. He also suggests taking a supplement like Menopace for 3 months before even reducing the HRT.
Evidently 50% of women have a return of symptoms and some ( like my mum) never ever get rid of the hot flushes even in their 70s. :(

That aside, you don't have to stop at your age. If you took HRT in your early 40s for an early meno, then those years don't count in terms of risk.
You only start counting from age 51-52 - the age of the normal menopause.
So the fact is that you do not have to come off HRT now anyway.
The latest recommendations from the British Menopause Society are that for women under 60 the benefits of HRT outweigh the risks. You can read this here

www.thebms.org.uk/statementpreview.php?id=1

The BMS are currently running conferences for GPs who on the whole are not up to date with this latest research and recommendations.

You can also see more info here about HRT taken before the age of 50- see How long can I take HRT.

www.thebms.org.uk/factdetail.php?id=6

Thanks very much, Missbopeep, very useful. Hadn't heard anything about that before (ie the importance of coming off gradually).

Also GP's view seems to be that the risks outweigh the benefits, ie better to come off at the normal age of the menopause. In her words, "We don't prescribe HRT to protect against osteoporosis any more" (one of the reasons they put me on it in the first place).

They don't prescribe it as a first line treatment ( unless you can't take other meds if you already have osteoporosis) but they can prescribe it well beyond 50-ish if you have meno symptoms.

I don't think anyone knows how they will feel when they come off it- I had 2 friends who were on HRT for 10 years and they did have symptoms when off it but said they didn't last too long. On the other hand my mum was never on HRT and had terrible sleep issues, flushes and sweats in her 50s, 60s and even now in her 80s has hot flushes.

It's a real shame that most GPs are out of date which is why the BMS is running training courses for health professionals to update them.

If you feel you want to carry on with HRT then you could print off the info from the BMS and show your GP. The rule now is that it's a personal choice of the woman once she is aware of the risks, unless there are really serious reasons why she cannot take it- pre existing conditions etc. and that GPs should not refuse to give HRT unless there is a very good reason.

Thanks again, Missbopeep. This is very helpful. What I've found with GPs in the past is that they tell you a variety of different things, and the latest one was very much of the "Well, what do you want to do?" persuasion, to which my (unspoken) answer is, "I'm not the doctor, you are!"

Ah- don't expect GPs to know everything about everything- they are generalists not specialists. Don't want to go on but my specialist is constantly frustrated at how some/most GPs know so little about meno and women are given conflicting advice and info.