Best sources of info on HRT?

[3timeslucky]

I'm 52 and somewhere in the midst of the perimenopause.

I want to do some reading/research on pros/cons and options re HRT.

Can you tell me the sources you found best please?

Website

www.menopausematters.co.uk

and the website of Dr Louise Newson

or the book Your Change, Your Choice by a consultant (on Amazon.)

lizearlewellbeing.com/product/the-truth-about-hrt/

This was recommended to me a couple of weeks ago on this board. It was worth every penny of the £4.99 purchase price.

Quora looks like good place to read up.

@FrothandBubble I looked at the LE book online recently after recommendations here, and it gets some bad reviews with people saying some of the medical facts are incorrect.

I don't know if anyone medical helped her to write it as she's not a dr, but I'd be wary of using a book written by someone whose business was cosmetics unless it's been ghost written by someone medical.

It's far better to use a site written by medics.

Your link does show testimonials by drs, so I'd assume she asked them for input or they have checked it.
(I'm a health writer myself so know the way it all works!!!)

Thanks - I'll have a look at those.

I have no idea if I'll want to go down the HRT route but I'd like to be informed properly if I want to have that conversation with my GP. A friend is very much in favour for the cardio and osteo protective values but I've no idea how much benefit there is. Nor do I know anything about the various options. I think I've been a bit of an ostrich!

The British Menopause Society website is helpful too. If on the menu tab you go into PUBLICATIONS, there is a drop down menu of information including the NICE guidelines and their own CONSENSUS statements, which are very helpful.
On the Home page you can see links to their latest information and research.

Re HRT there is no point using it if you are free of symptoms (unless you fall into a risk category for osteo- such as early menopause.) No dr is going to prescribe it as a prophylactic unless you have risks or symptoms.

It's primarily for treating symptoms, but the added bonus is heart and bone protection, along with other health benefits.

How uncomfortable are your symptoms?

I didn’t look into HRT because of previous cancer, risks were increased.
I’m 55 now and after nearly a year of very unpleasant hot, sweaty nights (occasional flushes during the day) it’s all pretty much over with. I appreciate I was lucky, lots of people have horrible symptoms for a very long time.
I have friends who are stuck on HRT long term because when they’ve tried to stop, the symptoms have come straight back, sometimes worse than before. One lady had early menopause after hysterectomy at 37. At 53 she’s tried to come off twice but had to give up because symptoms returned badly.
My own personal experience might suggest
that sticking with it if you possibly can might work out long term.
Either way, you need to have a thorough consultation talk with a GP or well woman clinic though, rather than just reading, to fully understand the long term implications.

@Langrish

With all due respect, GPs are not trained in menopause. The media is full of examples of how women are not being treated by GPs . And there are no well women clinics now. I am in touch with various menopause experts through my work and there is a huge drive to try to educate GPs and also start some kind of mandatory training for them in meno and HRT.

Just to pick up on a few of your points- using HRT does not prolong or delay menopause. So anyone who finds their symptoms are still there when they stop HRT would have had the same symptoms if they had never used HRT.

Your friend of 53 is still only just around the age of the average menopause (52) and I didn't start HRT till I was almost 54.

Some women have symptoms for decades- Dr Louise Newson on her site talks of women she treats who are in their 90s. My mum had flushes/ sweats till her 80s. Everyone is different but there is no way of knowing if you will be one of the lucky ones who suffers for 1 year, or 30 years!

There is a huge amount of information online when it's written by consultants. Far more than your average GP knows. But of course everyone's personal medical history is relevant too.

@3timeslucky

Here is one link from the Dr Louise Newson site. I felt it's worth posting as it's very recent and was part of a talk for GPs.

www.rcgp.org.uk/clinical-and-research/about/clinical-news/2019/march/making-sense-of-the-hrt-debate.aspx

Menopause is not just sweats and hot flushes. Loss of estrogen affects every organ of the body- heart, brain, skin, etc.
Some women who avoid or have short term flushes etc may develop other issues all connected with loss of estrogen so don't just focus on what can be short term symptoms.

I should have said that the symptoms I have so far are mild and manageable - some night sweats, painful finger joints, fuzziness, emotional stuff, periods have been very regular up until this month (maybe that's what got me really thinking) ... still nothing that would have me consider even discussing HRT at this point. But I'm a planner so I'd like to get informed now rather than finding things bad and I'm sitting in a GPs office without even the vaguest ideas of what I want to discuss.

My friend who I mentioned has had her first hot flushes but has a really bad family cardio history and I think is very pro HRT for that reason.

I don't have great cardio history, I know my bone density is slightly below normal already but I've a much worse family cancer history so that definitely plays on my mind. And I've such a poor experience of contraceptive hormones that I'm instinctively disinclined towards doing anything with hormones. But I'd like to be making decisions based on facts rather than instinctive distrust of messing with my hormones (which are of course already being messed about).

Just a few comments on your lastest post.

I don't have great cardio history

Depends a lot on what you mean. Your own or in your extended family?

I know my bone density is slightly below normal already

How do you know? have you had a DEXA scan? If so, how low is it? What has been suggested as treatment/ improvement/ prevention? If nothing, why not? This is a serious issue.

but I've a much worse family cancer history so that definitely plays on my mind

Family history of cancer is not relevant. The only relevance is if you have a mother and a sister who had breast cancer at a young age (before middle age.) No other cancers count.

. And I've such a poor experience of contraceptive hormones that I'm instinctively disinclined towards doing anything with hormones.

The hormones in HRT are completely different to the Pill etc.
The Pill etc uses artificial hormones in huge doses. HRT is body-identical which means it is exactly the same as your own hormones.

But I'd like to be making decisions based on facts rather than instinctive distrust of messing with my hormones (which are of course already being messed about)

You are not 'messing' with your hormones, you are replacing - with a tiny dose- some of what you lose at menopause.

Extended family cardio (my dad and his mum). I've had issues with racing heart but investigations show nothing wrong.
Yes I had a DEXA scan. BMD was 1.098g/cm2 (that was shortly before I turned 52 and the median for woman were given to me as 1.102 for a 50 year old; 1.083 for a 55 year old.
Good to hear that on cancers. No history of breast cancer.
Apologies for flippant use of "messing with" in relation to hormones. I take your point that HRT is totally different to hormone based contraception.

The heart issues are not relevant. Almost everyone dies from either heart disease or cancer (and a few other things) so the odds are all of us have some family history of one or other.

It is though a reason to look after your heart. Palpitations are a symptoms of peri in many women.

How come you had a DEXA scan? No one in the UK gets that on the NHS unless they have a break that seems to show osteo or a hereditary risk of osteo.

I don't understand the mineral density- you should have had those figures converted to a T-score. (Normal is +1 to -1, anything lower than -1 is osteopenia or osteoporosis.)

I'm not in the UK but I volunteered for a health research project at one of the universities here which included it.

That explains it! :)

Re looking at HRT, do bear in mind that elsewhere in the world, there are different criteria and different types (usually the same product but maybe a different name.) There are also some slight differences in prescribing regimes.

Will do! Thanks for all your help.

JinglingHellsBells

Ok. No need to bite

When people have hysterectomies, they usually go straight into menopause, which the friend I mentioned did at 37, hence HRT since then. She was advised to come off if she could because of various other issues and her consultant was surprised by the vehemence with which her symptoms came hurtling back.
My mother started on HRT when she was 49, again after hysterectomy following cervical cancer, and was finally weaned off over time last year, 30 years later.
I’m no expert, you are, obviously, and we can only speak of our personal experiences. I’m 55, I hung on because the breast cancer I had contra-indicated HRT. I stuck with it and after an uncomfortable year I’m well, it’s over and I’m practically symptom free.
I’m simply suggesting that if someone feels their symptoms are bearable, HRT isn’t always the go to.
Our surgery holds what it calls a well woman clinic, so there is one here 🎉

I’m simply suggesting that if someone feels their symptoms are bearable, HRT isn’t always the go to.

I agree 100%

I was never intending to use HRT. I had very few peri symptoms till I was almost 53. But I then had hourly flushes and worse of all, insomnia.

I wasn't biting, I just wanted to stress how little most GPs know. This forum is full of posts from women who have been given poor treatment often by GPs and in some cases even the wrong HRT.

It doesn't surprise me that your friend with ovarian failure after surgery had a return of symptoms when she stopped HRT because she was still only 53. That's only a year 'post meno' (comparing her to the average age of menopause) and up till then she'd been replacing what a woman would expect to have till she was 51-52.

Now, there is no time limit on using HRT. Your mum could have carried on forever, as long as she had no contraindications- things have moved on a lot over the last few years since the NICE guidance in 2015.

I looked at the LE book online recently after recommendations here, and it gets some bad reviews with people saying some of the medical facts are incorrect.

jinglingHellsBells
That’s interesting. Could you link me to these reviews as I’d be really interested to read that information? I found it almost like a perfect summary and conclusion to the information I had found (from various credible sources online) so I would be keen to know which medical information has been misrepresented by her e-booklet.

@Froth I think, to be fair, I'd read the reviews on her menopause book and one of the negative reviews picked up a discrepancy where she contradicted herself.

I assumed when you said her book on HRT you meant the same book.

I assume she quotes medics in her books rather than simply recounting her personal experiences?

I am a health writer , and have to ensure the facts are right which involves asking the experts.

I'd assume she credits doctors in her books for providing medical facts?

@jingling
Ah yes I was referring to the ebooklet (not an actual book) which is specifically about HRT. (It’s called The Truth About HRT). You download it as a PDF. Yes she quotes NICE guidelines and medics and lots from Dr Louise Newton. She uses her own experience as an introduxtion only to explain why she did all the research that she then goes on to cover (with references).

@Froth I see. I guess in principle, I'm slightly wary of people I'd call 'celebs' writing about medical stuff because they seem to want to make money out of it , because they are a known name. When in fact the info is out there, free, for anyone to find. Very few less well known writers could get that kind of book published because the info is out there already. (I'm in the field and know how this works :) )

This is all very helpful. I struggled through being peri menopausal without realising and now have debilitating exhaustion and low mood. A blood test confirmed I am menopausal. A good friend had recommended a specialist menopause clinic at an NHS hospital and after waiting months for an appointment I was delighted when they 'got' everything I was talking about symptom wise.
I was given a list of 3 bio identical HRT meds (oestrogen, progesterone and testosterone) but GP refuses to prescribe 2 of the 3, as one 'comes up red' and the other 'isn't available from primary care'. I've left messages with the hospital clinic and emailed the GP but no one has responded and I am in despair at having had my symptoms recognised but no way to obtain this medication. The hospital hinted GPS are not all up to speed but I had no idea it was this bad. Now have to figure what the hell to do. 😞

I have no idea why you are being refused these meds. They are available on the NHS and are dirt cheap (I see a private meno consulant and pay for my own HRT. The cost per month is very little more than the £8.80 NHS script charge.)

You need perhaps to write to the practice where you go and start asking Qs.

Or change your GP if possible.