Menopause without HRT?

[twoheaped]

Is it possible to go through the menopause without HRT?

I have never taken the contraceptive pill, or used a chemical device as I just didn't really fancy the idea of taking hormones.
Now I guess the menopause will be coming in the next few years and I have found little information on going it alone, as such.
Can it be done? I'm still not keen on the thought of taking hormones.

if you think this, can you please copy and paste what you feel are emotive comments showing mockery and ridicule? Because these sorts of accusations as offensive as the allegations.

Polly, Jenni Murray's article about her lived experience, which I linked upthread, was certainly mocked and ridiculed and not tolerated. This is the kind of thing I mean. If a journalist can't share her lived experience with menopause and HRT, who can?

Why can't we have one uninterrupted discussion about pharma-free menopause or alternative remedies without mockery or interference?

That is so funny Alizon (About J M being a journalist.) Why does it matter what she does (for a job?) If she wants to write about herself that's fine but it's only an opinion. Does being a journalist give her special status?
There are people on MN who are journalists.

What you seem to be saying is that if you post about alternatives to HRT you don't want to be challenged. yet it's fine for you and a few other posters to be rude to people who question those alternatives.

JM is on record as blaming HRT for her cancer. A meno consultant told me there was no way JM or any doctor could single out HRT as the 'cause' of her cancer? The fact she was obese for years (now has a gastric band) and drank a lot were not possibly contributors to it?

What I see here on this forum are posters who have some chip on their shoulder about HRT. I don't know why it's so emotive. It strikes me as misogynism. Is it because some women think other women ought not to 'preserve their youth' (FFS) or be martyrs?

If you want to talk about non-prescription treatments for menopause, do that! (And maybe stop using the word 'pharma' because that word in itself is emotive due to the implications around 'Big Pharma').

But you need to accept that anecdotal and disproved 'remedies' will be challenged as part of the debate.

Right- got better things to do with my day now!

Polly, you are now accepting that some alternative remedies do have evidence, rather than mere anecdotal benefit, behind them? As shown in Cochrane report link I posted.

Sorry to press you on this point but I think it is important.

I'm completely bored with this now tbh.

If women want to try alternative stuff, go ahead. I've not 'accepted' anything. I said if people want to post about alternatives fine, but don't expect not to be challenged if there is no evidence on efficacy .

I have posted a link (many times!) to the RCOG patient info leaflet on alternatives to HRT, for the benefit of women who want to see a guide as to what may work and what doesn't work. If you care to read it, there is very little that is shown to work. At best, they say 'possibly but more evidence needed.'

I really don't care what women choose. But what I do object to is misinformation which confuses women already confused, whether it's about HRT or alternatives.

The Cochrane summary says this:

No conclusive evidence shows that phytoestrogen supplements effectively reduce the frequency or severity of hot flushes and night sweats in perimenopausal or postmenopausal women, although benefits derived from concentrates of genistein should be further investigated.

Yes. Exactly.

This is from the RCOG paper on alternatives. Sorry about the way the lines break up- this happens with copy and paste sometimes from docs.
***

Despite further research into alternative preparations, their efficacy continues to be lower than with traditional HRT (maximally 50–60% symptom reduction compared with 80–90% with traditional
HRT). The trials on alternatives on the whole remain small and of short duration and are therefore of
limited value in determining efficacy and safety. Alternatives are not without their own adverse effects
and risks, which have necessitated warnings being issued by regulatory bodies for some products.
Legislation has been introduced that will make it mandatory for herbal preparations to be registered (but
not licensed) with the Medicines and Healthcare products Regulatory Authority in the UK. This will
allow some control over what is being sold over the counter. However, this directive is currently only
operative in EU countries.
There is considerable doubt and conflict in the literature regarding the efficacy and safety of soy, red
clover and black cohosh; more trials are required. There are increasing data for SNRIs and their
metabolites. New techniques such as stellate ganglion blockade are showing promise for refractory
symptoms. While the initial data are encouraging, further scrutiny is warranted with well-designed,
prospective, randomised controlled trials in order to confirm both efficacy and long-term safety.
Ultimately, it is hoped that some of these products will have sufficiently robust data to be licensed by the
Medicines and Healthcare products Regulatory Authority, the European Medicines Agency and the US
Food and Drug Administration, thus providing health professionals and their patients with affordable
alternatives to HRT that are safe, efficacious and licensed for the indication

Bottom line is only HRT can expected to be superior to anything else ' on the market ' and yes one would expect it to carry a small excess risk not unexpected if taken longterm but thus does need to be balanced/ taken into context against the risks of obesity as fat releases unopposed oestrogen which provides a continual 'unchecked adverse ' stimulus which pales HRT risks into insignificance

So, alternative preparations offer up to 50 - 60% symptom reduction of symptoms associated with the menopause. That's higher than I thought. With that figure in mind, I think that alternative preparations offer a valid alternative. As I have already said on this thread, I used Macca powder for up to 2 years post menopause with success. Only after 2 years did my symptoms start to return and that's when I turned to HRT.

I agree @alizondevice it is always hard to discuss alternatives to HRT. All comments on here are opinion only as this is not a medical website but posts are by women who have have or haven't used HRT/alternative remedies. We are not medical professionals but some posters have had positive experiences and have said what their consultant has advised them.....but the point is that it was advise to their specific issue. We are all aware that everybody is different and one thing does not work for all and some, when able, do not want to go down the Pharma route.

Why is there always a need to challenge?

Thank you for the information 50 - 60% is a good rate.

I don't know what you mean by various symptoms being linked to getting older. What kind of stuff?

Endless, just from last 3 pgs of this topic (any one qualifies):

pain, sweats, memory loss
anxiety
weight gain
muscle aches
mush brain
(relatively very slight) memory lapse
mood swings
fatigue
depression
insomnia
clumsiness
migraine changes

Any woman who has any of those AND is age 40+, perhaps with changes in periods, gets told to take HRT. HRT is quite the miracle drug. I don't know why it isn't prescribed to 20yo women & 65 yo men with any of those symptoms too.

The thing is not everyone can take HRT. I have been diagnosed with breast cancer and the chemo might send me into menopause.

So please, people, don't go on and on about symptoms, too much! I get it, HRT is great for some women. But please remember not everyone can take it.

ps: and no, chocolate & cake ARE NOT linked to bad health outcomes in the same ways that alcohol & HRT are. Yes you can have chocolate cake to excess which can cause harm, via obesity for instance, but that would be like taking 5x the recommended dose of HRT or 3 bottles of wine a day, not a relatively moderate exposure.

Does HRT work in a linear way: is a small dose useless or does a small dose still help just a little? It sounds so technical on here to get right HRT, like you either get enough or there is no point at all. Whereas I can enjoy one square of chocolate a week, or one glass of wine a year (meaning to say, I still get some benefit even at very low exposure).

ljkk, if you get symptoms of that kind that are incontrovertibly linked to your menopause, it's very different, as I'm sure you know, so you're being rather disingenous posting that list.

I've always suffered intermittently from insomnia, but the menopause induced insomnia was something else. It wasn't an inability to get to sleep per se. It was a lack of sleep resulting from waking 5 -6 times a night with a panic attack, immediately becoming drenched in sweat and then taking 20 minutes to calm and cool down enough to try to sleep again.

Again, sweats related to menopause are qualitatively quite different from any ordinary sweating. Any slight change in temperature led in my case to a scarlet, embarrassing flush over the whole body and dripping sweat. Embarrassing in any situation, mortifying and humiliating when meeting, for example, a new client for the first time.

The anxiety was very different too. Yes, there was a generalised anxiety caused by the embarrassment and physical discomfort of the sweating, and by the tiredness caused by the lack of sleep. But there was a specific, aura-type dread that preceded every hot flush that was absolutely horrible.

I never had any specific aches or pains or forgetfulness. Most of my problems were solved by sleeping well again.

Added to that the family history of osteoporosis and my early menopause, after several years of trying various alternatives, HRT was a sensible solution in my case.

I'm sure it's not right for everyone and I know it's contraindicated for some people, but to suggest that menopausal symptoms are the same as general aging symptoms is very misleading.

Does HRT work in a linear way: is a small dose useless or does a small dose still help just a little? It sounds so technical on here to get right HRT, like you either get enough or there is no point at all

HRT is available in tiny doses- think the lowest is 0.3mgs. This is called ultra-low HRT. The advice of NICE and menopause experts is use the lowest dose to get relief. With something like estrogen gel, the dose can be as little as half a measure (pump bottle) to 4 whole measures.

If you want to read about ultra low dose HRT google Nick Panay who has done research on this. He's one of the main researchers into HRT in the UK.

I have a question, can i use Oestrogel gel safely, say 2 pumps per day on top on my normal dosage of 1/10mg Femoston per day ? Would it be safe ? My aim obviously is to add a bit more oestrogen in an already small dose of Femoston.

Why can't you increase the Femoston to the 2mg higher dose?
The risk is that you will possibly be using too much estrogen compared to the progestogen in order to protect the endometrium. what is the amount of progestogen in a 2mg Femoston pack?

2 pumps of gel = 1.5mgs estrogen PLUS 1mg in the pill - 2.5mgs. That is higher than is available in any pill form or patch.

You need enough progestogen to offset that.

oh i thought i could take more oestrogen with the same amount of Progesterone, Femoston comes also in 2/10mg so double the oestrogen but unchanged amount of Progesterone, didn't i read somewhere on one of these threads that as long as you take the Progesterone even in small doses you will still have a bleed even if oestrogen has been increased, i am only learning at the moment,so please forgive my errors even if they sound silly !

Incontrovertible? Oh what BS.

People routinely post on MN:

"My periods have gone a bit funny, and -
..I'm feeling fuzzy headed all the time. Is this perimenopause?
..I have all these aches & pains I never used to have. Is this menopause?
..I have loads of anxiety. Is this menopause?
...I feel depressed. Do you think it might be menopause?
...I have put on lots of weight. Is this start of menopause?
ad infinitum.

There's nothing incontrovertible about each situation but the reply is still "Yes that sure sounds like menopause, you should talk to your GP about it."

I can't be arsed to post links to the million threads like this.

HRT is quite the miracle drug. I don't know why it isn't prescribed to 20yo women & 65 yo men with any of those symptoms too.
Umm, maybe because it's role is to replace depleted hormone levels
in women 40/50 plus?

But in my case they were incontrovertible. It wasn't a slight fuzzy feeling. So when I recommend HRT based on my experience, it's for the obviously menopause related symptoms, not for feeling a little more tired than I did when I was 25.

Disco maybe you could start a new thread for this as it's a bit confusing in the middle of this thread on merits of HRT :)

There's nothing incontrovertible about each situation but the reply is still "Yes that sure sounds like menopause, you should talk to your GP about it."

Don't understand the point of this comment

It's taken decades to inform women of all the signs of peri meno (the list runs to 34 or thereabouts.)
Is this a suggestion that the clock is turned back and women are left wondering why they are having these symptoms?

I tell you what, this thread has really depressed me 'cos it seems there are some posters who can't or won't debate a serious topic without resorting to sarcasm and snide comments, and get huffy if they are disagreed with.

Night night all- and whatever you choose I hope it works for you.