HRT - Which type to ask for?

[HemanOrSheRa]

I finally bit the bullet this morning and visited my GP. I've been struggling with peri menopausal symptoms for about 18 months. She was really sympathetic, agreed that I am peri menopausal, no need for blood tests as they are inaccurate and I have all the 'classic' symptoms. She gave me some literature about HRT to read up on so I can decide if I want to start taking it. There's a history of breast cancer in my family. I have to go back on Friday for a fasting blood test to check for anaemia/thyroid problems and then back again on 24th Nov to see one of the GP's who specializes in women's health (she is a lovely doctor!).

I've pretty much decided that I will start on HRT. I'm 43 and cannot imagine being able to cope with the symptoms for much longer. As I understand, the increased risk of breast cancer is minimal. I don't drink alcohol or smoke and I am trying to take regular exercise - when I'm not suffering from crashing fatigue .

But I am really confused about what HRT is should be asking for. I do not want to take oestrogen derived from horse urine. I would rather use a gel, I think. Are there different types of progesterone I should avoid or ask for?

Any advice gratefully received!

What is the family history of cancer? My dr says that first degree relatives ( mum or sister) count but not anyone further (unless there is perhaps a very strong link with your mum. aunts etc.)

At 43 you are having an early-ish peri meno. Early meno is before age 45. Your periods might not stop by then but you are still on the young side now. Sooooooooo.... the risks of HRT don't really apply until you are 50+ because at your age you are only replacing what nature intended.

Almost ALl HRT now is made from plants- ones to avoid are those with Pre at the start (premarin. prempak) and gel is available on NHS.

Thanks Polly. My Mum had breast cancer when she was 48. She was on HRT prior to that so was in her mid 40's when she started peri meno. This was over 20 years though. She died at 54 from a different type of cancer so it's difficult to be precise. My Aunt (Mum's sister) had breast cancer in her late 50's/early 60's.

I've delayed going to the GP for so long because I've been concerned about the risk. But from what I've read on sites like menopause matters the risk is minimal. I've got to the point where I cannot carry on surviving on 3 hours sleep and feeling like a hot, sweaty, raging ball of fury (plus a whole list of other delightful symptoms). I'm also concerned about the osteoporosis risk as I get older. I work with older people and see how devastating it can be.

I'm thinking that Oestrogel is what I should be asking for. Are there any progesterone tablets that are best avoided?

I'm really sorry to hear about your mum and your aunt.

It's a very difficult situation for you.
The risks are tiny if non-existent for you at 43, even with your mum's cancer from what the research shows.

There is some research showing that Utrogestan (micronised progesterone) is possibly safer re. breast health. Maybe if you want to carry on with HRT longer term (when you get closer to age of average meno) your GP could refer you to a consultant who is able to advise.

Thank you so much Polly. You've been a great help and pretty much confirmed all the info that I've found on the internet regarding HRT/breast cancer risk. The problem with this peri menopause lark is the horrible 'brain fog' - I've looked at so much information I've had trouble getting it into some sort of coherent order!

I'll have a look at information around Utrogestan ready for my next GP appointment.

hi im new to mumsnet . iv been using Fem seven conti hrt patches 50 mcgs for 2 weeks now , and im still not feeling much different , still hot flushes , and sleep deprived , also feel that my tummy is so bloated and rock hard , and the patches don't seem to stick , im constantly having to put tape on , can any one recommend any other hrt patches . thanks , x

Ah- so we aren't 'allowed' to say which HRT has safer properties according to research?
That's nothing to do with a personal opinion of any poster, but it's reporting what is in reports such as NICE and other trials.
I'm surprised this is not obvious Lorraine because it's terribly easy to understand. Even an old Gran would 'get' that, surely?