What happens after you finish HRT?

[Towardslight]

Hi all

I'm currently wading through information to decide whether I take HRT. I'm 46.

I'm finding it tricky to get concrete info on the future picture. Say I take HRT for 5/6 years. What then? What happens to my bone density (I am borderline normal/ostopenia). I read that all the benefits HRT brings to bone density can be lost once you come off. And what about the meno symptoms that I'm hoping to alleviate...don't they come back?

In my ideal world I'd like to deal with it naturally - I suspect I won't be able to - but I keep coming back to this idea that I'm simply delaying the inevitable.

Sorry for being a pain and asking stuff. I had another thread and people were so helpful

if you have osteopenia at 46 (are you post meno?) then it's a no brainer re. HRT. Your risks of osteoporosis and heart disease are higher. (I think you know this so apologies!
You will get some benefit from HRT used short term ( ie 5 years.) Your bone density will then decline the same as women your age not on HRT. You will be able to improve it with a lot of effort and no HRT by daily exercises, diet and lifestyle. But you would have to really work at it.
(I'm speaking from experience as I improved mine pre HRT.)

There is a lot of talk about 'delaying the inevitable'. The point is no one has to stop using HRT. My consultant says women can stay on it for life if there are no medical reasons to stop. So this idea that there is a cut off point is outdated. NICE says the same thing.

You may find your symptoms come back if you stop, they may come back short term, they may not come back at all- everyone is different.

But the point is however long you take it, you are getting a better quality of life.

My mum still had flushes and sweats in her 70s and 80s- some women do.

You need to decide for yourself what gives you quality of life without putting an end date on it.

I don't get this 'deal with it naturally' idea. Science exists to give us a better quality of life.

Thanks Polly. That's very helpful.

I get why people want to deal with things naturally. As do lots of other people.

The problem with natural' though is that is had its downside as well as the upside. HRT actually prevents a lot of ill health and overall the health of women using HRT is better (this is shown in stats) than women not using HRT. There could be all sorts of reasons for this- women might have more health screening, take more care of themselves re lifestyle factors etc, but 'natural' per se doesn't automatically mean 'best'. It would be natural not to treat diabetes, or low thyroid function, or give vaccinations or antibiotics, or carry out operations. You see what I mean? And the argument that 'women don't die from the menopause isn't true because more women die for osteoporosis complications than all cancers. (just playing devil's advocate here :) )

OP the other thing is that 5 years of HRT won't necessarily 'sort your bones'. (Why do you already have osteopenia? Have you risk factors? Why have you been sent for a scan?)

Bones take years to improve- that's why they only do scans every 2-3 years. It took me 10 years to get my bones back to normal for my age and during those years I was working very hard on them (not just walking but specific exercises with leg weights for my hips / thighs several days a week).

Once in post meno, women can lose 5% of bone every year within the first few years of being post meno. Using HRT will help you create a level playing field compared to women who already have strong bones. So as soon as you stop using HRT your bones will start to deteriorate UNLESS you keep up lifestyle measures.
So....HRT from 46-52 might improve your bones so they are normal or almost normal, but like all women they will start to deteriorate again as you get older.

As part of your decision you really need to keep having DEXA scans every 2-3 years for life really, to see what your bones are doing, with or without HRT.

But natural may be best for how people want to approach their life, their lifestyle, their values?

My mother has osteoporosis. As does my older sister (48). I had a problem with a toe from running and they scanned me and told me I was borderline osteopenia/normal.

This is all helpful, thanks.

I'm reading widely, from both the natural and conventional medicine camp, and have booked a consultation with a leading menopause doc, so can go armed with all my questions/concerns.

At the end of the day, people can only give you the stats then it's up to you to make up your mind.

Personally, I don't see using HRT or any kind of prescribed or even non-prescribed products for health as a 'values' issue. I know this is bordering into philosophy or ethics, but for me, personally, values are about using products that can help my immediate and long term quality of life so I can function fully and not be a burden to those I love and who love me. There are no medals in life for avoiding products that come with a prescription so that's what I don't 'get' about going 'natural' because people who believe that would surely have to extend it to all areas of life from taking an aspirin to antibiotics?. This is not a criticism aimed at you personally, but a general observation.

I don't have any strong feelings over the 'rights and wrongs' of using products whether they come from a health shop or a pharmacy.

I hope you get on ok with your consultation and find the right way forward for you. :)