HRT pros and cons please?

[yogafailure]

I'm 49, definitely menopausal as confirmed by blood tests. Long story short, managed to get an emergency doctors appointment this morning and he has prescribed Femoston 1/10mg which from reading on this forum is the continuous variety.

He's left it with me to take or not take. I've another appointment in a months time to check my high bloody pressure again and he wants to check how the HRT is going then if I choose to start now. He spoke a lot about increased breast cancer risks but apparently that's not an issue with this initial 3 month trial?

I'm pretty clueless about HRT and despite working in a building full of women of a similar age I don't know anyone who is on it 🤷🏼‍♀️ so any information, pros and cons or articles you could direct me to wpilsk be great.

Thanks in advance

https://www.menopausedoctor.co.uk
Excellent and balanced advice here

Thanks

Femoston is not necessarily continuous.

www.medicines.org.uk/emc/product/5523/smpc

The sort you have is sequential. You will have a monthly withdrawal bleed.

The research shows in general that there is little risk of cancer when taken for 5 years or less. After that there may be a small increase - roughly 2 more cases per 100 women who use it for more than 10 years but these figures are based on some outdated research and old types of HRT which are rarely prescribed now.

Ah thanks for that...I won't be taking them then. I've had a bleed for a couple of days 3 times over the past year and certainly cba with monthly bleeding again. Been there done that. Weird he never mentioned that when he knows how scarce/sparse my periods now are.

A lot of GPs initially (a) prescribe the wrong kind of of HRT, confusing conti with sequi and vice versa; (b) over exaggerate the cancer risk and thrombosis risk; (c) don't talk about patches and gels which reduce the risk to near zero unless you are overweight which is the risk factor mostly anyway; and (d) don't read up on the latest research and NICE prescribing guidelines.

After all, menopause is just something half their patients will go through ... not important or anything.

If you have bled 3 times in the past year you aren't menopausal you are peri, you need to go a full 12 months to be menopausal. You would be prescribed sequential hrt meaning you will get a bleed, though not usually a full period although a fair proportion of women on sequi don't get a bleed at all so it would be worth a try. If you want to get around this during peri you could go for a Mirena for progesterone and a patch for oestrogen ( I have this and it's fantastic, no bleed for 3 years and feel great) Transdermal hrt is by the safest with zero clot risk and near zero breast cancer risk.

I didn't think posters on MN were allowed to mention negatives!
So ... what are they?

@rosie39forever The lower risks of transdermal estrogen apply to blood clots, but not to breast cancer risks. There is no difference in BC rates with transdermal or tablet form.

You can have the benefits of estrogen at your body, heart, bones, skin etc and the negatives of estrogen and progesterone as well, breast cancer risks, thrombosis etc. It depends on the profile of each patient and it is an absolutely individual choice.

Hi - I’m 41 and am menopausal (for around 18 months) I’m done with herbal remedies and trying to do things naturally the menopause is impacting my life so much that I think my only alternative is HRT. Apparently doctors are reluctant to prescribe and if you go in asking for it they’ll question you and expect you to prove that you know the risks and that you’ve exhausted other avenues. Is this true I need some intervention not interrogation.....any help/advice would be greatly received - sorry for jumping in this thread x

At your age hrt is necessary and not just an option. I started hrt at 42 almost immediately. Find a caring and informed gyn.

Thank you Emerald x

At your age hrt is necessary and not just an option. Well I'm 57, have never been on HRT and I'm fine without it thanks.

HRT is not 'necessary'.

I'm 55 and have never touched the stuff.

don't talk about patches and gels which reduce the risk to near zero unless you are overweight which is the risk factor mostly anyway

Its very difficult to get patches at the moment due to supply issues. I sat with my GP and actually read the NHS information on it and the expected dates for supply to recommence (back end of 2020). MY GP wanted me on patches but put me on the tablets and pessaries as it was the only option. Im mid 40s.

Ladies, I replied to Am2015 who is only 41. Sorry for misunderstanding! :)

@ConsolidateTheBiscuits @Flagg

@Emerald was talking to @Am2015 who has had a premature menopause. She said 'at your age' - ie menopause before 41. This is classed as before 40 and early menopause is before 45.

It's medical advice from NICE that women with early meno use HRT up to the age of 50-ish a least.

Thanks guys - my doctor is rubbish no decent advice so I’m grateful for this insight. I’ve got my appt on Weds, I’ll burst into tears and beg for anything to alleviate these God awful symptoms.

Those of you who haven’t required intervention - I’m soooo jealous!! I’ve tried all the alternatives but enough is bloody enough. I swear I have the bones of an 80 year old now

I've never had it either, thinking back I'm pretty annoyed that my GP never mentioned it as an option, I might not have taken it but it wasn't discussed.

I tried some patches. They made me sleepy. On top of MS fatigue I don't need anything else to make me sleepy. So I gave up. I'm sure I need something but I have no idea what.

Was in Peri for about 7 years but have been menopausal for a couple of years now and can honestly say that I feel fine now and take nothing. I could definitely have used some help or understanding a few years ago but didn’t really know where to go for help or advice and am very happy to have come out the other side now.

I don’t feel I’m lacking anything or that taking hormones would improve how I feel now so I tend to carry on as I am. A close family history of breast cancer, thrombosis and strokes means the less I mess with things the better (I think) but it’s entirely individual.

@AM2015 Premature menopause ( that's if your last period was before age 40) is a recognised medical condition. Not trying to scare you, but the risks of premature ovarian failure (POI) are high so you need HRT at least to age 50. This is to protect your bones, heart and brain from loss of estrogen 10-12 years before the normal age for meno.

No GP ought to quibble over this.

It's the recommendation of the NICE guidelines on menopause.

See here- scroll down to find paragraph 1.6 where it discusses POI.

www.nice.org.uk/guidance/ng23/chapter/Recommendations#diagnosis-of-perimenopause-and-menopause

Your GP ought to be able to manage your care but if not you must insist on a referral to a gynae with expertise in menopause.

@Inforthelonghaul HRT actually protects against strokes and heart disease - all the research shows this.

Breast cancer is only an issue if you had / have a mother or sister with it at an early age.

Makes me really worried for women to see so many misunderstandings and myths about HRT still around.

Here are some links you might find useful

www.menopausedoctor.co.uk/videos
(The myths one is good)

This just released by the BMS (British Menopause Society)

(One of a series)

@kjhkj why didn’t your GP offer you Estrogel taken transdermally? This should be available, and as it’s body identical a safer option that tablets. Hopefully patches will be back in soon.

You guys are so lovely thank you for your support. I’ll be reading up and preparing for Weds. x