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

@Am2015, after reading, suggested plan of action:

1. Print off all or relevant bits of the NICE guidelines (see Jingling's link above)
2. If your symptoms are anxiety, do not be fobbed off with SSRIs (antidepressants) which some Drs like to prescribe
3. Instead, state symptoms and discuss HRT. If not offered ask for blood tests.
4. You mentioned bones - perhaps request a blood test for calcium, vitamin D etc. If needed a FRAX risk assessment score could be done and DEXA scan following if needed.
5. Explain you have read up on HRT from reliable sources (quote the above BMS etc) and understand the risks. Discuss any health conditions you or close members of your family have had that might be relevant.
6. "Gold" standard of HRT is patch or gel for estrogen taken transdermally - either x2 a week for patch or every day for gel - and utrogestan for progesterone - taken daily orally (can be taken vaginally too). Patch as said is in short supply atm so gel would be easier to get. Both are body identical and have benefits for bone health and CVD
7. Other option is Mirena coil for progesterone part. Synthetic, but put in and forget for 5 years. Currently my preferred option

Self help is eating healthily - calcium/oily fish/green leafy veg etc. also recommended that we all take Vitamin D supplements in winter.

Good luck and let us know how you get on. I went in armed with info to my GP with a request for something menopause related and found she was actually very knowledgeable. A lot of GPs are but unfortunately there are many who aren't. There is a big push for them all to be well informed
www.change.org/p/penny-mordaunt-mp-make-menopause-matter-in-healthcare-the-workplace-and-education-makemenopausematter

Omg once again thank you for sending this through I’m so touched for this support x

That's all great advice @AM2015 but with POI you really shouldn't need to have to beg or go into detail other than say your last period was at 39 (?) and this is classed as premature menopause, for which NICE guidance is HRT to 51-52 at least.

Some women are offered to oral contraceptive Pill at your age and that is another useful option. It gives more estrogen that HRT and can be used up to 50 as well.

Some GPs will know this but not all.

Thanks again - roll on Weds x

@Am2015 hope the appointment goes well today. I remember my initial GP appointment having to discuss the highs and lows with some young male doctor who at first glance I thought would be a complete waste of time.. turns out he was very much into women's health and especially HRT and our discussion was fantastic. I've tried a few now and settled with patches (which are in dire short supply) they have worked very well and I am starting to feel much better. Go armed with info and you won't go far wrong!

Thank you - it’s at 2.30 eek!! I’ll let you know how I get on xx

I’m a bit emotional so I saw the doctor (female) and age started to recommend anti depressants. I explained NHS guidance and NICE guidelines however she persisted I tried anti depressants. I stood my ground and explained that I’d researched and wanted the patches. She pauses and signed listen to my protests then prescribed the patch!! Whooo hoooo

Well done you! I've heard that some GP's try prescribing AD - something I haven't tried and would be reluctant to do so (I had a friend who once had a terrible time with them).

Which patches did she give you?

Good for you What did she deign to grant you?

(I had to get a consultant gynecologist to write to my GP practice to alter my HRT dose!)

That's great news. Maybe you can also persuade her to go on a menopause training day hosted by the BMS! She certainly needs it.

I can tell you that menopause specialists are completely beside themselves with the behaviour of GPs who know nothing about HRT and menopause.

There is a huge training program going on via the BMS and certain consultants who are giving their time to train GPs but it is not yet mandatory training.

To be honest I would consider drawing her behaviour to the attention of someone more senior.

Any GP who doesn't know that early and prem menopause needs estrogen treatment ought not to be practising. It's doing patients harm.

I am also on Femoston and haven't had a single bleed whilst being on it. Think that's rare though but I'm not going to complain.
It has been brilliant any stopping my peri symptoms.

Hey ladies thank you all for you comments and support. I was prescribed Evorel (combined HRT) low dose. I felt like crying when I finally found a chemist that had it x

I've been on Femoston since last Monday and can't say I'm noticing a single thing yet but there are a lot of other things going on, plus I have fibro. I've an appt at the docs after a month to see what he/I think so far

Hope it gets better Yoga. So now I’ve gotta work out where to stick this patch!! I asked the pharmacist and she said anywhere on the body, when I read the leaflet it said below the waist!! WTF how inept are the NHS!!

That’s fantastic news AM2015 - well done you for holding your ground!

I was a little concerned when I read you’d beeN prescribed the patch but see you managed to get some - excellent.

So...as for where to put it..l do buttocks and thighs alternating. So left buttock, then right buttock, then left upper thigh then right upper thigh...and repeat. I change mine Friday and Monday. I take one off just before a shower and remove the glue rectangle residue with baby oil on a cotton wool pad. I don’t put on a new patch straight after a shower as it can apparently work too fast on hot skin, so leave about an hour.

I hope your symptoms start to improve though might take a little while. If you come up against resistance again just keep on quoting NICE guidelines! This is exactly why everyone should sign the petition above so that can all get the care we should when entering menopause, at whatever age.

Thanks my over50andfab!! You know this group helped me get what I want so thank you so so much. I’m still perplexed that the dr felt it right to treat the symptoms with anti depressants!!

Thanks for the patch application tips. I put mine on before bed - slept really one until my 4 year old woke me up for a cuddle, bless x

Unfortunately some doctors do, and a lot still believe the cancer stats/myths from the past 🙁. All medication is risk vs reward - and whether the risks exist or not. You benefits now include that you’re protecting your bones and have improved CVD risk.

AM2015 enjoy your toddler!

It's bloody shocking the way women are (not) treated for menopause. I had to do all my own research and ask American friends for advice. Women are regarded as a nuisance. My husband (similar age to me) gets much better service from our local GP surgery. They fawn over men and it's all about them. Women can just piss off.

Dreadful.

I am 52, still have monthly bleeds but have felt shite for years now.
I tried femoston a few years back but the progesterone part was so awful I stopped.
I have been using the gel for a month now and have just started the progesterone tabs.
I definitely feel less foggy headed and anxious. Hair fall has really slowed down too.
My GP was absolutely useless advice wise. She tried to prescribe patches and I had to point out they weren’t available. The doses she gave for gel and tabs were also odd I have since found out from the wise women on here. She is supposed to be a menopause expert

I had an early menopause when I was 41. Had list of symptoms as long as my arm was horrific and I was a mess, doctor said anti depressants. Didn’t try those but got HRT. It was a life changer for me literally, am on kliofem. Been on it 4 years with no issues. However my doctor has now advised me to stop the HRT as the latest survey suggests increased risk of breast cancer associated with taking HRT. Confused....

@ilovebrie8 Your GP is incorrect. I assume that they are going along with some new research published in the Lancet showing an increase in BC. some specialists think it's not accurate research. It's very easy for GPs to look at the scary headlines without digging into the facts.

The research was done using types of HRT that are no longer widely used in the UK and haven't been for years and did not include the type of HRT that IS used by many women now.

The British Menopause Society and the breast specialist Prof Michael Baum have made it very clear that they are not happy with the way that research was reported and have questioned it . There are copies of the letters the BMS has written to the Lancet on their (BMS) website because they are extremely upset at how women may be scared off HRT and how GPs are recommending stopping it.

The basic advice is still that any women with an early or premature menopause should use HRT up to 51 at least. If not, the risks of heart disease and osteoporosis far outweigh the very tiny risk of BC.

After that time, it is your own choice having weighed up the pros and cons.

If ( and it's a BIG if) the research is correct, the risk of BC increases by less than 1 per cent.

If your GP isn't confident about prescribing you ought to ask to be referred to a menopause specialist who understands the finer details of research not just the headlines.

Thanks jingling. I suffered a lot and didn’t get HRT til I was 46. Despite having an awful lot of symptoms and quality of life was awful. They kept pushing antidepressants...that was their answer. Finally I got HRT when I was at breaking point and it literally changed my life and saved me and my sanity...apart from all the other symptoms I’d not slept properly for so long due to horrific night sweats. I’m now 51 and don’t want to stop as I’m worried what will happen...the doctor was clueless here is a leaflet printed off the internet and we as doctors are being told to advise patients to stop HRT die to most recent study and link to BC..that was it...the printout I was given was from the MHRA dated 30 August 2019...the headline is HRT further info on the known increased risk of breast cancer with HRT and it’s persistence after stopping. It’s 3 pages. I was given that and told to stop end of...

Sorry, clueless person here with personal questions.

I am 46 with monthly bleeds, but cycle getting shorter and hormones definitely changing a bit. Also I find I've started forgetting words and my short-term memory is deteriorating, which worries me.

If I want hormonal treatment, would I need to go on the pill rather than HRT? What pill is best for this?

I get hormonal migraines, which have become more frequent but less severe in the last couple of years since my hormones started changing. This is a change for the better in my opinion and I'm worried the pill may worsen them again (they have previously been worse when I was on Dianette, which is why I haven't been on the pill for 20 years. But I've never tried other versions of the pill.)

Sorry to come in with new questions, but I'm tempted by the wise advice on here...

OMG you ladies are magnificent!! Your knowledge and experience is just overwhelming!! If I could meet you all for a hug I would!! In fact let’s have a menopause meet up!!

So I had the patch on all night (just below my ass) and I felt a little achy in the hips area and felt really sleepy......couldn’t wake up!

Now, I feel fine - I think I’ll need to assess the sitch in a week.

Guys what are we gonna do about the lack of support/advice for our sisters out there who won’t have the support from groups like this? X