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.

The other thing worth factoring in is your musculo-skeletal system. I've been being treated for bursitis recently, and the first thing the physio said was "are you on HRT?... yes?... good!" A lot of the decline in muscle tone and bone health from a woman's fifties onwards is down to declining oestrogen.

In addition to the menopause from hell, my mother was crippled by osteo and rheumatoid arthritis and ankylosing spondulitis (sorry, spelling all over the place), so given my family history, protecting against these is way, way higher up my list of priorities than worrying about cancer (which doesn't run in my family).

Just to say, I was about 54 when I had my last period (I didn't start till I was 16). And it really just stopped like that. A period. Then nothing. After a few months I just assumed that was that.

So not like people who start symptoms in their early 40s.

Thanks OP and MNers, this has all been very informative. I'm 49 and still have periods, some fatigue, no libido, recently heavy periods and suddenly am having a lot of trouble sleeping. I hadn't realised that sleeplessness is a symptom. I'm going to mention it to my gp.

Where do we stand on hrt and breast cancer? My mum had bc in her 70s, I have a slightly increased risk (no kids, early menstruation, bc on both sides of my family, incl premenopausal bc on my dad's side) and I have no idea where to begin to parse the info. Don't want to be passive in this matter but not sure where to start.

And re hot flushes, I have begun to get a hot, red, sweaty face when walking (barely exerting myself but I look like I've been for a run). Is this likely to be hormonal (if you don't mind me diverting thread OP)?

I had all the annoying symptoms but wouldn't dream of medicating for something that's just annoying. It doesn't last forever and I've felt great ever since (several years now)

You were lucky!

Sadly this is just not true.
When I told my lovely consultant that my mum swore she still had flushes in her 80s, he said some women never ever get rid of them.

It's far from just 'annoying'! Women who find symptoms annoying are clearly functioning okay without HRT. (I don't consider it medication because it's a naturally occurring hormone and if I'm asked if I am on any meds, I say no unless the person asking is a dr. It's ^replacement'.)

The other thing is that estrogen supports every organ in the body. Flushes are quite 'minor' in the scheme of long term health.

I know lots of women who have all kinds of health issues in their 60s but don't actually connect them to loss of estrogen. eg painful backs caused by loss of collagen, heart issues, pelvic atrophy, bladder issues.

I'm using HRT not just for the annoying stuff, but so I can function doing my job, and also protect my heart and bones. Latest research has shown a 50% reduction in arterial plaque in women using HRT for a few years.

(Where do we stand on hrt and breast cancer? My mum had bc in her 70s, I have a slightly increased risk (no kids, early menstruation, bc on both sides of my family, incl premenopausal bc on my dad's side)*.

I will tell you what my consultant says.
BC risk applies if 2 first degree relatives (sister or mum) had BC under the age of 45. I don't think over 70 counts and genes only account for 5% of cases anyway.
Obviously you have to decide for yourself if it matters to you.

I know that some oncologists allow women who have had BC to use HRT (again, told this by my dr) but only certain types (micronised progesterone not synthetic progestogens.)

I don't have a link but google will find it for you- there is an online tool which is easy to use to assess your risk of BC.

Re breast cancer and HRT. I was referred last year (age 55) for a mammogram and scan after I found a lump in my breast. I'd been on HRT for 3 years. The tests were fine, just a fatty area. The consultant said that I was low risk but to come off HRT after 5 years as taking it for longer than that did increase your risk of BC. My 5 years is up a year this month. I'm dreading it as HRT has made something that was really grim, cope-able.

PollyPerky thanks. I've been assessed via my local breast unit. Having a first degree female relative doubles your risk. But in truth they don't know more than they know.

I'm sure either gp or breast unit will be able to help me figure it out. My mum was on hrt and feels guilty because she thinks it played a role in her bc (though none of her medical pros agree).

Thanks again. I will watch this thread with interest.

LetZygonsbeZygones sorry to hear that. Maybe you'll be far enough along that it won't be as bad coming off it she said hopefully - ?

It is such a shitty set of choices isn't it?? The more you know the worse it all looks (though of course it's good to have the choice, modern medicine blah blah etc).

let Maybe get some other opinions as well? I think the issue is that the consultants can't agree with each other! You will get gynaes saying it's safe and other consultants saying not! the 5- yr rule doesn't apply any more and it has to be your choice in the end.

The other thing to talk through is that not all HRT is the same. It's the synthetic progestogens that are the link with cancer. You can use other types and even go long cycle which means you only use them once every 2 months (under medical supervision) so there are all sorts of variations which can reduce risk.

I dread BC as much as anyone but we have to put risk into perspective. Drinking 2 drinks a day , being overweight and being sedentary all carry GREATER RISK of BC than HRT.

Considering 60%+ of women are overweight, how many are actually thinking about the risks that has? And how many drs are telling women they must stop eating and lose a stone or two?
HRT is always made out to be the bad cop when other lifestyle factors are riskier.

danTDM I haven't researched HRT because I don't intend to take it. If life does become unbearable, I will research it then and re-evaluate my position.

The responses to this thread have reassured me that it is entirely possible.

One thing I forgot to mention is that consultants now believe (having looked at the research) is that HRT does not cause breast cancer, but promotes the growth of existing cancer (which was too small to be detected.) My own consultant says this categorically. It's like watering a plant when the plant already exists in the ground, not watering bare earth and expecting a plant to grow.

There is more on this on the Menopause Matters Home page, in a blog written by consultant Dr Currie.

The thought of menopause without HRT makes me laugh hysterically. i tried it once, my colleagues ganged up on me and told me I was a bloody nightmare. Went on HRT and peace and friendships were restored immediately.

Re breast cancer - I had pre-menopausal cancer, both breasts, at 36. Tested positive for the BRCA2 gene, something like a 80% chance of cancer.
I also became menopausal at around the same age due to ovary removal.
My oncologist wasn't happy to prescribe HRT but I was referred to my local menopause clinic who were very helpful and prescribed citalopram - worked wonders on the flushes and handily lessened any anxiety too!

Makes me laugh though, so many friends said I want a completely natural birth and I'm going to do this and that and they were hollering for an epidural after one contraction Pretty much the same with the menopause in my experience.

Don't know if anyone has already mentioned Marilyn Glenville's book on ways to avoid hrt through menopause. Her writing is based on nutritional approaches and is grounded in scientific research. She's also written a new book about avoiding dementia through nutritional approaches. She's very balanced in her approach and recognises some people will need hrt and support it gives but helps put you in the best position not to need it.

@twoheaped: I feel the same about trying to avoid pills if I can, too. Best of luck! :)

Can I ask a stupid question please? If you start HRT how long do you stay on it ? Do you just defer the symptoms then till later, or should they have gone by the time you come off them

Not stupid!

You can stay on it as long as you want if you still have symptoms. That means for life. It continues to help maintain bones and heart health , and reduces bowel cancer risk. I know (of) women in their 80s and even 90s on it (confirmed by my consultant.)

Everyone is different. Symptoms tend to be worse when in peri and for a few years afterwards. A lot of women stop HRT as a trial then restart it if symptoms are still there.

I've used HRT for 9 years. I have tried reducing the dose to half and I end up with insomnia again.

I am hoping to use it long term for overall health and accept there is a small risk with it, but the type is also given to some women who have had breast cancer, so I'm hoping for the best. Quality of life is what matters.

This post has been very informative so I would like to thank you all for your input. I've also read an article this morning in The Guardian from Mariella Frostrup, couple of years old but well worth the read "HRT opened my eyes, and gave me my life back". I definitely need help as my mood swings are ridiculous and if only to save my marriage. I also feel like an old woman with aches and pains and I've only just turned 43 for goodness sake!!! I have booked my app to see the doctor and I will try HRT, if it doesn't work then at least I have tried it.

I'm just looking forward to being me again!!

I am finding this thread so very useful as I have just had my tubes and ovaries removed after they found borderline tumours. As I am 42 my consultant made me promise to go onto HRT as soon as we have the results of the surgery. He made it sound like there are so many different types I feel slightly overwhelmed but i have no hesitation that it is the right thing to do.

I just posted this on another thread but hope ok to post here too :-
"I have to say that when I've attempted to read up on here and MM website about the different types of HRT I've found it incredibly confusing (so many different types) and I'm not convinced my GP's surgery will be very helpful (constant revolving door of locums).
Is there a dummy's guide to HRT and advice on how to approach GP? For me fatigue is probably the most debilitating symptom."

It has struck me this morning that while I can cope with the dodgy thermostat that the fatigue is a problem for me. I could make appt at GP's but feel before I do so I need to be well-equipped with knowledge because I don't trust them not to fob me off.
What usually happens when you go to GP re menopause? Do they prescribe or is it standard or necessary to be referred to a consultant? I'm guessing we'll women's clinics are a thing of the past?

I think you need to tell your GP what you want- ie patches, pills or gel (plus Mirena/ Utrogestan.)

Most don't know much about it. Go in and be assertive but polite.

I've never had HRT from a GP- was seeing a consultant for other things and it just followed naturally when symptoms got worse. I said i was fed up with not sleeping and flushes. He said 'This is great, this is what you should use...' and said why.

"Before taking HRT I had a couple of years taking a natural remedy which worked well. Unfortunately it stopped working over time, and that's when I turned to the HRT remedy."

What was the remedy please?

@RolfNotRudolf Menopause Matters is one of the best, straightforward sites to get information from.

My main guiding factor when choosing my latest form of HRT was to try to avoid ones with androgen-derived progesterones - I've gone for Femoston.

Re. the GP, the main thing to know upfront is that current NICE guidelines are to treat menopause with HRT unless contra-indicated for clinical reasons (mainly elevated risk of cancer). So if your GP tries to fob you off with, say, anti-depressants, they are not following NICE guidelines.