Couple of HRT questions

[ChoccyJules]

Started getting what I believe are peri symptoms 18 months ago and after 6 months went to GP. Fobbed off.

Just been back (different GP) after a year and, much more informed, I listed my symptoms. She agreed I could have HRT but said my BP was too high and I had to take a monitor home for the week. Seemed OK on average and I am going back tomorrow to discuss this and hopefully get a prescription.

So my two questions are - what happens after you stop taking HRT? The GP spent quite a while telling me that if I chose to take it I had to be aware it would all come back once I stopped, which she said people ought to do around 60. I hadn’t realised this, I had assumed HRT helped symptoms through the menopause and then was no longer needed. Not that it all came back! Do you then get symptoms forever?! That is what was implied to me.

Secondly, is there a usual brand of patches which the NHS tends to prescribe (I assume cost-related)? Should I initially be wary of a particular brand or try whatever is offered? I ask this because I don‘t necessarily feel the GP is going to know the pros and cons of them, she often prescribes using the computer.

I‘ll presumably be on the ones which give you a bleed as periods haven’t stopped yet. From my reading there seem to be a few big names but I just wondered which was most frequently prescribed.

Thanks, sorry bit long but I thought I’d ask the experts!

Sadly your GP is not an expert. They are talking rubbish.

HRT does not delay menopause (so symptoms do not always come back.)
HRT helps during the transition from peri to post menopause when hormones fluctuate daily.

However, these symptoms can last for anywhere from 2 years to 20+ years. some women never get rid of symptoms.

But most do.

On top of this, are medium to long term symptoms such as bladder issues, genital problems- vaginal dryness and atrophy- and loss of bone density. Some women use HRT for life to couteract these.

There is no need to stop at 60. again, dr out of touch. The 'stop at 60 ' rule was changed about 5 years ago and both NICE and the BMS stress there are no limits on use.

(I am mid 60s and carrying on with consultant approval so far.)

Cost- HRT is dirt cheap. I pay for my own and it's little more than the NHS prescription cost- costs me around £12 a month for 2 products.

You need to do some reading around. Menopause Matters website has alist of all HRT under the sidebar menu HRT.

HRT differs depending on the type of progesterone included. There are main types - Norethisterone, dydrogesterone (only in Femoston tablets) Utrogestan and MPA. There is also the Mirena coil .
You can't get anything other than Norethisterone in a patch- you'd have to use 2 patches- one with estrogen and the other a progesterone tablwt.

Sorry if it sounds confusing but read the list and it will be clear!!

Thanks. I got the feeling she wasn’t as clued up as I‘d hoped, which is why I think I‘ll be given whatever is first on the list tomorrow.

I just had a read on those websites and found some really clear advice leaflets, thank you. Basically they and you are telling me that symptoms won’t necessarily return once menopause is over and HRT is stopped. Which is more along the lines of what I had assumed.

Yes but the point is, if you do have symptoms long term, you can use HRT forever as long as there are no reasons to stop. There are women using it in their 80s and 90s- Dr Louise Newson says she has a 90 yr old still using it.

That’s reassuring thanks

Well, got a prescription. There were two types of patch to choose from and only one currently available supply-wise so the decision was moot. Then the pharmacy didn’t have that one but can get it for me today, phew.
I was a bit worried to see the one I am having has Norethisterone in it as I keep reading negative stories about it but am hoping it des me good. The non-available alternative has a different progesterone in it.

GP still adamant that when I stop, the symptoms relating to lack of estrogen would return, but we chatted and she was willing to agree they may not (she doesn’t believe that though).

A gp saying That the symptoms will return really annoys me. Does the GP think the symptoms are being ‘stored up’ somewhere for later release? Or that you’re stopping the symptoms now but you stop hrt the stop is removed & symptoms come back.

Neither make any sense.

I think your GP needs to go on a meno training course.

If she believes the symptoms will return, due to lack of estrogen, that would mean every single woman who was post menopause would have the symptoms for life. What does she think happens to women who never use HRT? If she thinks HRT delays the menopause she is clearly ignorant.

Yes, some do- but 80% of women find they are okay eventually.

The other thing which really irks me is that only by mentioning random periods and hot flushes did she believe I needed help.

Both GPs just looked at me when I described the brain fog which initially led me to think it must be dementia (in my female line so was getting quite scared). Ditto any other symptoms.

One question I have thought of overnight (it’s on my mind as I started the patches yesterday) is, if lack of estrogen is what causes reproductive stuff to slow down and finally stop, how come HRT doesn’t replace that estrogen and effectively stop the change happening?

hi just wondering if anyone can help.Im 51 and have been peri menapause a few years.I started the envirol sequi patches 4 wks ago.Started my second box last wk and by sat had to take off the patch as my mood was awful.I have been really bloated with sore boobs and pmt symptoms.Can anyone help on this ??

Hi tobygizmo2, I had similar issues with evorel sequi and decided to cut the patches in half. For a while, half doses seemed to work, but over time, the bloating, weight gain and my mood got worse. In the end I stopped taking them.

Am now waiting for an appointment with a specialist (private) so I can get something more tailored to my own body's needs - I do feel that much of, if not all of the HRT offered by the NHS quite simply isn't bespoke enough for many women. One size does not fit all.

@StellaRockafella The HRT you can / will get from a private specialist is exactly the same as all available on the NHS. The only difference is that a specialist may be slightly more imaginative with various combinations- by that I mean they can choose a single source of estrogen and pair it with a separate progestin. However, the products themselves are 100% available on the NHS- they are licensed products. Please don't go down the 'compounded' bio identical route- its really a scam, unlicensed, unsafe and has been in the press this week with warnings from the BMS and other meno experts.

Thankyou for replying as I thought my head was going.I think I will get an appointment for an HRT specialist and see if I can get sorted.I hope you get something to help you.

JinglingHellsBells I appreciate your advice but I know many people who are using bio-identical HRT and it has helped them far more than HRT offered by the NHS.

@StellaRockafella Do you mean bio identical HRT or compounded HRT?

I've used bio identical HRT for almost 12 years . (My dr prefers to call it body identical.) It's Oestrogel and micronised progesterone, all licensed and available on the NHS. I see my consultant privately as he covers all my gynae issues not just HRT but I know plenty of women using what I do, getting it from their GP.

COMPOUNDED where it is made in a private lab based on your saliva results is not licensed . It's exactly the same products- gel and micronised progesterone. You can't guarantee the quality of these products as they are not subject to quality control.

JinglingHellsBells Please leave me be, I'm not interested in discussing this issue with you.

Thank you.

what a strange post @Stella. You prefer to dismiss all the advice of the BMS and the UK's menopause experts?

I am pointing out the dangers for OTHER WOMEN who may be reading your post . If you want to take risk fair enough but it's irresponsible of you to suggest others follow your lead by using compounded (not bio identical) HRT when the medical profession is saying otherwise.

You sound very defensive if you are not even willing to discuss this.

@tobygizmo2 another poster @Stellarockafella brought up the suggestion of bio identical HRT. I'm not sure if she is confused (she refuses to discuss) but if you are thinking of seeing someone privately, it's worth being aware of what bio identical HRT is ( all available on the NHS or privately) and compounded HRT (unlicensed and unregulated.)

For the sake of your health at least read the evidence.

First by Dr Currie- meno gynaecologist

wwwmenopausematters.blogspot.com/2017/01/bio-identicals.html

thebms.org.uk/publications/consensus-statements/bioidentical-hrt/ British Menopause Society explanation

d2931px9t312xa.cloudfront.net/menopausedoctor/files/information/315/Hormone%20Hoax%20that%20Thousands%20Fall%20For%20More.com%202013.pdf

I started taking evoral sequi patches beginning of May 2019. My night sweats have stopped however I am very low in mood, my joints and muscles ache so much, I get anxious, angry, headaches, lethargic, poor concentration etc. HRT has not helped with these issues which were and are still a main concern for me. I still have periods and they are lasting up to a week with couple of heavy days and then complete dry day and bleeding again or spotting for days.

I had appointment with gynaecologist on 1st August and she is arranging for me to have some cells taken from inside the womb to rule out cancer. Ultrasound was clear no fibroids. The gynaecologist is pushing me to have a mirena coil but I am reluctant. I don't need it for contraception also I don't feel my periods are heavy enough to warrant it but she said it would help with all my other symptoms.

I don't have any children and never had anything so invasive. I asked for alternative HRT and she said if I don't have mirena coil then she will see me in clinic to discuss and she could up the dosage on my patches. I don't feel everol sequi patches are working for me.

I am still waiting for my appointment and getting desperate. I am Pilling weight on which is depressing me further.

I also get really bad bloating and consecutive days of period like cramps

I have since took a period and feel so much better and have been off the patches.I dont know if I gave them long enough to work.But I felt rotten on them.