Anyone successfully reduced HRT dose?

[FirstGirlonMars]

I've been on Femoston 2-10 for a couple of years and it's suited me well. My doctor has been talking about reducing the dose, which I'm willing to try, so I'm curious: has anyone else reduced successfully?
My doctor's suggestion was Femoston 0.5-2.5, but meanwhile Lenzetto (oestrogen spray) has become available here (I'm not in the UK) so I'm trying that with Utrogestan instead - initially at the equivalent of Femoston 2-10 dose to see if it suits me, then reduce from there later.

I suppose the real question is why does your dr want you to reduce your dose after just 2 years?
Which country are you in?
If your dr thinks that eventually you should come off HRT by reducing it further, this isn't the protocol in the UK of the experts.
There is no link as far as we know between dose=cancer risks.

Going from 2mgs estrogen to 0.5 is a huge jump.

How old are you and what symptoms is HRT for?
If you stop, or reduce, you may get symptoms back, you may not.
It all depends on why you are using it.

Thanks for the reply, yes I thought it was a bit odd...do you have any links to research on the lack of correlation between different doses and cancer risks by any chance?

I'm 56, was 54 at meno and didn't take HRT until my periods had stopped completely. Had truly dreadful symptoms, but now I feel great. Having done lots of research on the body's need for oestrogen meanwhile, I don't plan on ever stopping taking it, unless it's a medical necessity.

My doctor is not anti HRT at all, far from it, but she might have some old-fashioned ideas about the 'lowest effective dose'. She did however say that I don't have to reduce if I don't want to, she just thinks a lower dose would be enough?

I'm sorry, I don't. I have seen 'asides' in a lot of research papers where they say there is no research either way on dose and side effects.
what there is evidence of (and you'd have to dig, I don't have saved links of any of this) is that the synthetic progestogens have a higher risk /incidence of breast cancer, compared to Utrogestan and Dydrogesterone (in Femoston.)

You have done the right thing by changing to a topical estrogen rather than a tablet, as there is good valid research showing a slight increase in blood clots with tablets as women get older.

In the UK the new guidelines say women under 60 gain more benefits than there are risks, the risks of breast cancer are very low for up to 5 years' use, after that there may be a small increase with some progestogens but maybe not all.

The overall consensus is that at any age, if the benefits are relieving symptoms and there are no other risk factors, you can take it for life, with an annual review.

No I cut mine down then out and felt dreadful again within days

Thanks Jingling, I know about the progestogen research. I was also planning on trying the Utrogestan vaginally, which I understand is possible (not so with Femoston obviously). I'll stick at my current dose for a while just to assess the new mode of delivery, then see about gradually reducing perhaps.
Sorry your symptoms came back InfiniteSheldon, after how long was that and did you start HRT again?

@Firstgirlonmars
I have tried cutting down- have used between 2 and 1.5 pumps of estrogen gel for years (11.)

I tried dropping to 1 pump which would be 0.75mgs estrogen and felt the difference- mainly in my sleep (or lack of it!)
Discussed with my doctor (one of most respected menopause drs in UK) and he simply said don't bother- no point reducing. no benefits. There is also a minimum amount required for bone density if that is applicable - the gel dose is 2 pumps for that protection.

@ jinglinghellsbells Thanks, that's useful to know. Insomnia was one of my worst menopausal symptoms. I see that each Lenzetto spray has 1.53 mg of oestrogen and my doctor has told me to start off with two a day, plus 2 x 100mg utrogestan for 15 days once a month (I could take it daily but don't want to as I want to be sure how I react to each individually). So if I'm not mistaken that's actually upping my estrogen, rather than reducing it, from Femoston 2-10? But I guess then I'll be sure it's working, and if it doesn't suit me that won't be down to dose reduction.

Yes that would be upping is quite considerably! Femoston is tablet form so even with 2mgs taken orally you won't be absorbing 2mgs as a lot is lost in digestion. the obvious step down would be Femoston 1mgs, unless you prefer transdermal and Utrogestan which are safer.

@jinglinghellsbells hmmm, I don't feel like I need to up my dose, all my symptoms are currently under control. It sounds like it would be better to start off with one spray of Lenzetto. I presume that I'd still need the 2 x 100 mugs Utrogestan for 15 days?