Which form of HRT?

[MrsPiglet45]

Hello! First time poster, and non-mum, but thought this would be a good place to come for some help. Here's hoping!
I'm 44 and have been recommended HRT by my GP after a couple of years of irregular periods, hot flushes, total loss of libido, etc etc. I'm quite keen to take it in pill form for the benefits regarding all the above and osteoporosis given that I'm relatively young.
I just wondered how you decided which pill to take, or were you just given what the GP prescribed? Would you strongly recommend any other form of HRT instead?
Thanks very much!

Hi there

Great to hear that you have a dr who is on the ball and not ignoring this.

There is no difference in efficacy between the different types- pills, patch or gel - they will all protect against osteoporosis and heart disease.

Some things to think about-
There are 2 types of oestrogen available- the first is CEE - conjugated equine eostrogen- made from horse urine. This is different from our own oestrogen and is now considered old fashioned and not the best. It's found in HRT starting with PRE ( eg Premarin)

The second type is bio-identical which means molecular structure is the same as what we have ourselves. (Do not confuse bio identical with 'compounded' HRT which is something different.)

Most bio identical oestrogen is oestrodiol. This is in most types of HRT except the Pre- sort!

Then there are progestins- you will need to take these once a month usually. (Some people are on a 3-monthly cycle but it does depend on the dr.)
Progestins can be bio-identical- one is Utrogestan- but most are synthetic. There are 3 main kinds and some women find they get PMT on some sorts. It's a bit hit and miss- you need to try them and see which suits you.

There are considerations over how to use HRT. Pills are the least effective in some ways because you have to take a higher dose as a lot is lost in digestion. They also have the highest risk for blood clots. Patches and gel are safer. With gel you can alter the dose yourself until you find the level that works.

It's worth educating yourself a bit on all of this because many GPs are not that clued up and reach for the pills- whereas other methods are better, to be honest.

Hi Pinkfrocks! Thank you so much for your reply - that's really useful. I'll be doing a bit of reading over the weekend. Thanks again.

This might help you too- gels aren't here mainly because they are often not prescribed during early or peri meno but there is no reason why you can't ask. (In France most women use gel whereas in the UK many drs ( who are not specialists) reach for the pill form)

www.menopausematters.co.uk/perimeno.php

Thank you! x

Hi im going through early menopause was on the evorel sequi patches for 4 months i have put 5lb in weight on and my tummy was constantly bloated so i was told just to stop them, i am worried i will now get all the moods, sleepless nights and hot flushes again, they just told me come off them for a few months and they will review it, im only 40, does anyone recommend good hrt that doesnt cause weight gain and bloatiness

There is actually- hard to believe I know- no scientific evidence that HRT causes weight gain!
At this time our metabolism slows down, so HRT or not men and women put weight on unless they eat less and exercise more. I've put on about 5lbs compared to the weight I was in my 20s and 30s, but I know it's because I have a desk job and am not running around after the DCs any more. Maybe think about what you are eating and cut down on the carbs and sugar and see how it goes?
You def need HRT when you are having an early menopause, so don't give up on it.

i have taken the patch off so see how it goes hospital said to do this so it must be ok for a while

yes of course. 6 months or so is not going to make any difference long term. But also understand that it takes a few months for some people to 'settle' onto HRT so even if you did have weight gain it would most likely be fluid retention which may sort itself out in time. 5lbs is not much and you could probably lose it with a bit of careful eating over 2-3 weeks.

well will see anyway just wanted someone else to recommend a hrt which didnt cause these issues, i have ibs, and the bloatiness alone nearly put my head away i exercise every day and walked every day but weight still went on,

Have you tried reducing your calories- serious question.

janeybabe - also you may possibly be reacting to the progestogen in the Evorel patch (norethisterone), possibly causing some fluid retention, so you could maybe try a different type of HRT for example Evorel patch with separate progesterone (Utrogestan). You would take 2 x 100 mg for 12 days per cycle.

Definitely have a look at the menopause matters website (link posted by pinkfrocks above) and if you join the forum you will find helpful discussions about the various types of HRT.