Been offered HRT not sure if I need it

[probablynotrelevant]

Hi - I have been offered HRT by my GP. I have been suffering with anxiety for the past 6 weeks. I am 46.

My periods are erratic, usually 22/24/25/26 days but with the occasional 40/36/34 day cycle (which was my last cycle with all the anxiety). Periods are quite light and trouble free.

I do have times in my cycle when I get very hot and sweaty at the slightest bit of exercise. But this is not all of the time. I see a medical herbalist and she has been treating me for a few years now, for thyroid (had Graves disease, in remission now for 6 years) and general nervous system. She doesn't think I will need HRT and is more for the natural approach to riding it all out.

My mother says she had the menopause at 42. I think I have been peri menopausal since 38 (had a child at 40). My mother has very bad osteoporosis at the age of 76. I had a bone scan recently (private) and my bone density is good.

So, should I take the HRT? It would be oestrogel and the progesterone tablets. I do worry about the future of my bones, and symptoms getting worse with regards to anxiety (i cannot cope with anxiety, it shuts me down) but have been doing fine so far on the herbal route. This could just be a blip or a sign of things to come?

Sorry for the essay, and help/advice is appreciated. Thank you

I have oestrogel and utragestan and it’s been great. Helped me feel calmer and not so hot. Mungo symptoms were never bad but the health benefits of HRT are very strong.

I would go for the HRT, your herbalist is bound to be rather anti. Your issues sound really debilitating actually, and HRT could be the solution.

HRT for anxiety? Is the anxiety because of the menopause?
I'm not sure - I'm against overmedicating but if the gp thinks it will help can you try it for a few months? Are there downsides to doing this and then coming off it?
The women I know who have taken HRT suffered quite badly from menopausal symptoms to the point it was interfering considerably with their work and daily lives.

‘Riding it out’ is a very old fashioned idea by the way, HRT is replacing something you’re losing. Have you looked at Dr Louise Newsome, the Menopause_Doctor on Instagram? She’s brilliant.

The Instagram thread is really informative, OP, and you will see that for lots of women it was anxiety which was the greatest menopausal concern. Anxiety saps the joy out of life.

And I also tried the herbal route and acupuncture before HRT, just so I would know I had done what I could. Frankly, nothing worked as well as HRT.

Thank you for your replies, I will have a look at that instagram page. Predictably, my herbalist has said to keep up with what we are doing. I don't see why I can't do both.

My mother's period stopped when she was 42, she went on HRT when she was 44/45. She wasn't allowed to stay on it, so consequently has terrible osteoporosis.

If I take HRT now, at 46, what will happen when I come off it? Surely it just delays the inevitable?

Abraid yes, anxiety is a killer for me, I hate it, can't deal with it and it sucks the joy out of life absolutely. Horrible. I will do what ever I can to avoid it. Herbal route has been helping immensely, valerian is a lifesaver, but I fear it will not be enough in the long run.

You really need to have a good look at HRT, how long ago did your mother take it? It may be that her bone health was poor before she took HRT.

One of the main issues is that some GP’s are not really well informed, which is why you need to investigate.

No, it provides primary protection against osteoporosis if you take it until age 51. And it's the fluctuations in hormone levels that are such an issue, so later on you can stop and it's not 'going through it' its just phasing out hormones which will no longer be fluctuating. I think that's right.

surely it just delays the inevitable HRT doesn't delay menopause it just stabilises and replaces the hormones you would normally produce. If you are fully menopausal at say 50 you will be menopausal with or without HRT.
You can always try HRT and see what happens and stop if it's not helpful, but if your anxiety is interference with your day to day life what have you got to loose.

Herocomplex my mother took it at age 44/45, she is 76 now. I think she took it for 10 years, not sure, will ask her.

Rosie39forever anxiety is my achilles heel, and if its going to raise its ugly head as a matter of course, then yes, I will opt for the HRT. I can try it and see if it makes a difference. My DH said today that I have been exhausted for over a year now, and it can't all be down to a 5 year old daughter.

I was quite taken aback how helpful this GP is being. I think she is new at our practise, but I like what I am hearing so far. Seemed to be following the most recent NICE guidelines which I have a basic knowledge of from reading on mumsnet.

Just feel like as I am not in a horrendous state, that its not necessary possibly. On the flip side I do not want to end up like my poor mother.

Sorry if I have missed out anyone or anything, seemingly I cannot hold a thought in my head long enough to type it out once I have got to the new post page!

@probablynotrelevant

There are so many things here that I want to tell you!

I don't like the advice of your herbalist. it's a bit ironic really and she does have a vested interest to keep you on the herbs she prescribes. No?

HRT is made from yams. Plants.

Herbs will not protect your bones and osteoporosis is hereditary.
Your bones are okay now, but we lose up to 3-5% of bone a year after the menopause in the first 5 years.

You could get to your early 50s and have lost a lot of bone .

The thinking on HRT for bones is that a minimum of 10 years' treatment is needed.

After this- and during- you ought to be having a DEXA scan every 3 years.

I suspect your Mum stopped HRT too soon. If she only took it till her early 50s - the age of the average menopause- her bone density would have continued to fall.

Her treatment was shocking to be honest.
She ought to have had bone scans right from when she started hrt and stopped and for life so the loss of bone could have ben prevented either with HRT or other drugs (which have worse side effects than hrt, often.)

TBH your situation is a no-brainer.

You have all the symptoms of peri meno and a history in the family of osteoporosis.

Maybe use hrt to your mid 50s, have a scan for your bones and decide then if you will continue with it.

Jinglinghellsbells yes, my Mum's treatment over her lifetime has been shocking all round. She is hypothyroid and that has been mismanaged as well. Her health is awful now, and I really want to avoid following her down the same path.

I think I will try the HRT and see how it goes. Some more energy would be nice and less straw like hair too. Not to mention no more anxiety.

Does anyone get any side effects I should know about?

Oh and feel free to tell me everything! I am very interested in what you know about HRT

I had terrible symptoms pre HRT, a long list, anxiety, palpitations, everlasting flooding periods, brain fog and joint pain so bad I was convinced I had arthritis, but the worst for me was awful insomnia.
I got a mirena coil 4 years ago which completely stopped my periods (I was so anemic I needed a transfusion) and about 18 months ago started using evorel 50 oestrogen patches.
For me HRT has been a lifesaver I feel 'normal' again, no anxiety, way more energy and most importantly I sleep really well.

As far as side effects go I can honestly say I've had none and I intend to use HRT for as long as possible.

@probablynotrelevant I'm not going to tell you of any side effects :)

The mind is a very powerful organ.

If you focus on side effects you may get them.

Just take it as it comes.

I've used hrt for 12 years and can't say I have any side effects worth mentioning other than a bit of PMS annoyance during the Utrogestan phase. Whoops- told you a side effect!

Rosie39forever that sounds awful, really glad HRT has helped you get your life back.

Jinglinghellsbells you are very wise not to tell me. My mind is my worst enemy sometimes!

Rosie39forever.. i have all these symptoms minus flooding periods but know they're in the pipeline as DM suffered this terribly. The insomnia, palpitations and racing heart are the worse atm. But the anxiety and mood swings too I've always had and are becoming debilitating. I even get visual disturbances as well as brain fog. Plus terrible muscle fatigue. The list goes on and on. Havent had the flushes or night sweats yet. I was totally determined to get thru without hrt but reading your post i wonder if i should just bite the bullet. I've never been able to take any pills for long and also the coil as they've made me go mental! I just don't know what to do.

@Booseysmom most hrt now is not pills, it's patches or gel.

@booseysmom I don't understand the getting through it mentality, you shouldn't have get through life you should live it. Ask yourself if you were getting these symptoms from a disease would you take medication to get rid of them and be well...of course you would so why not HRT to get rid of your debilitating symptoms.
You don't have to take pills you can get HRT transdermally through patches, oestrogen and progesterone in sequi if you have a womb or just oestrogen through conti or gel if you don't have a womb.
Peri and meno can last for years, some women have symptoms for life.

• sorry shouldn't be conti if you don't have a womb should be if you haven't had a period for over 12 months...sorry sorry😤