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

@rosie39forever.. that's a very good point and the fact you noticed i said this when it's so ingrained in me from my mother...everything was about just getting through like she was trying to get to some place she never found! In fact she ended up getting cancer and dying so my goodness that in itself should be enough to make me see life is not just for getting through but for actually living!
Right i'm phoning the gp today! Thank you for making me see the light

@BooseysMom good luck , have a read of the NICE guidelines on HRT pinned at the top of the thread and maybe even print it off and take it with you to the GP and don’t let them fob you off with antidepressants.

Can I just add that you should be getting your thyroid checked properly and not relying on a herbalist for that. GPs are pretty shit at thyroid, but better than someone who is not medically trained. Some of the symptoms that you have described also fit thyroid problems and they can often appear/reappear during menopause.

@rosie39forever - I do have symptoms from a condition and guess what - I have to just put up with them, as nothing stops them. That's why some of us don't go on HRT. It disagrees severely with my BP, too and that is enough of an issue on its own without adding further complications.

You know why the herbs they give you help somewhat? Because they raise your estrogen levels! It's true. That's why a good Chinese herbalist, for example, will be able to help you with peri symptoms. The herbs basically do a similar thing to oestragel, but will cost you more, so it's not really like "natural" versus HRT situation-both options are helping in the same way.

If you opt to take herbs and they help that's your choice, but for me unregulated, uncontrolled herbs or rigorously tested, reviewed and monitored HRT is a no brainier for me.

I have a Mirena(reluctantly but it has worked for me)and oesrgel.I no longer have night sweats,uncontrollable bleeding,brain fog,irritability,exhaustion.I still have some joint pain but it is improved.My hair is thick again.
You can always stop if it doesn't help.It took trying 3 types for me to find what worked for me,well the first one did but the patches wouldn't stay on.

@LittleCandle Have you ever used HRT? I'm puzzled by your comment that is disagrees with your BP- what do you mean?
Most modern HRT does not raise BP and is in fact beneficial to the heart and arteries. It reduces plaque in the arteries by up to 50% ( plaque is the stuff that causes strokes .)

If you have high BP it needs managing regardless of HRT- through diet, lifestyle and maybe medication. It's not a reason to avoid HRT.

You say you just put up with symptoms.

How long are you prepared t do so? (And would you say the same about a terrible migraine or another health issue?)

My mum had flushes and night sweats for over 30 years after her menopause at 51. Her GP would not give her HRT at 60 when she asked as he thought it was too late.

Now, in the UK, you can get HRT at 60+ for the first time, if it's a low dose and transdermal. My consultant has women in their 90s using it.

The symptoms of meno are not always short lived. And once the flushes etc have gone - if they do- the later stages of meno kick in. Increased risk of heart disease, osteoporosis and pelvic atrophy.

Avoiding something that can help- like HRT- is pointless in my opinion. Live for today- tomorrow may never come, You deserve the best quality of life you can have and research shows that not only do women using hrt have better quality of life, they also live longer.

@JinglingHellsBells, yes I was on HRT. My BP climbed steadily whilst on it, despite medication, and only came under control when I came off it. I am prepared to suffer symptoms for my health condition because this is as good as it gets and there's nothing else that can be done. My menopause symptoms are not that severe, comparatively, and some of them are also symptoms of my health condition. So I shall continue to soldier on through it.

I have had my thyroid checked, first thing I did. Am hyper aware of my thyroid due to previously being overactive and living through my own personal hell. Really cannot handle going there again.Trying to get my T3 & T4 done is more problematic though, TSH seems okay.

I have been reading and reading and am concerned about side effects. Primarily these seem to be more from the progesterone (uregeston) side of HRT. I am leaning towards the mirena being a better option for that hormone, but still not sure.

My symptoms so far, having thought about it are:

No libido
Constantly tired
Low mood
Low motivation
Nausea - seems to be cyclical
Hot and sweaty on slightest bit of exercise - day of cycle dependant
Hot in bed - day of cycle dependant (which varies)
5 weeks of anxiety - which has tailed off now thank fuck, but will it come back?
Periods vary from 18/22/24/25/26 days, with the odd 36/30 day cycle thrown in
Periods are light, only last a few days - this is a positive imo!
Can have a good nights sleep and still wake up exhausted

So not horrendous (apart from anxiety, which I cannot cope with)- is it enough to justify HRT though? My DH said why wait until things get worse, as the road back will be harder. I just don't know now. Have been reading the menopause matters forum, and thats made me more scared!

@rosie39forever. Thank you yeah been there done that re. anti depressants!

You have a sympathetic go so talk to her.The doses are very low.The advantage for me of the Mirena is that my periods stopped.And you can stop in f it doesn't help.
It only takes a few months to settle in and then you could review.

@probablynotrelevant that's quite a list of symptoms considering you don't think it's enough to justify HRT! If any of these symptoms are interfering with your life then yes HRT is a consideration. You say you are worried about utogestan then don't be there are many alternatives, you don't have to take oral progesterone at all You can get both hormones through a patch (most patches contain norithresone not utogestan) or a Mirena coil. The mirena has been perfect for me localised progesterone with no side effects at all.

There is research to suggest all menopausal / perimenopausal women benefit from HRT in some form. It can prevent osteoarthritis thus keeping women active for longer.

It also protects your heart and circulatory system, latest research suggests protection against bowel cancer, Alzheimer's and dementia.

Rosie39forever reading it back, it does look bad. I hadn't sat down and thought about it before.

I spoke to the docs today and she said I don't sound happy about HRT right now, so best to do nothing. But I can change my mind at any moment. Having read loads over the past few days, I would maybe lean towards the mirena and gel, given a choice.

The anxiety is the swing for me, so I am hoping that it has calmed down again. If it comes back I will have to try HRT as I can't function otherwise. Being a woman sucks, seriously!

It certainly sounds good, and I love the idea of having better hair, skin, mood and energy. But reading about how many problems women have it gave me the fear.

@probablynotrelevant HRT is not a one-way street. You can try it for 6 months or a year and stop if it's not for you.

Meno Matters forum is a place where women offload. Women who have no issues with hrt post on forums. They are just getting on with their lives !

I don't want to sound unsympathetic to women who use that forum but....being really honest- some post are about very very trivial things and also the women posting sometimes have an established history with mental health pre- meno.

It's also a bit catching....if you read negative posts, then you tend to look for and anticipate problems- and as the mind is so powerful it becomes a self-fulfilling prophecy.

I've used hrt for 12 years. I was given gel and a separate progesterone pill by my consultant and felt absolutely fine other than for the bleeds. I swapped to Utrogestan 6 or 7 years ago and again, feel fine on it mainly.

Yes, I get a bit 'dopey' after a few days of it, but I'm using it long cycle under medical supervision, so not taking it monthly.

On balance, the few side effects I have - such as being slightly sleepy in the mornings or maybe a bit hotter at night - are not worth posting about.

I really think you ought to stop reading other women's scare stories and try it for yourself with an open mind.

JinglingHellsBells yes, I think you definitely have a point. I have agreed with the doc to wait until I can get my T3 & T4 bloods done, which is end of next week, and then look at it again.

I am trying to be positive, and would much rather hear of people's good stories rather than bad.

probablynotrelevant it's reassuring to know that your GP is on the ball and understands your symptoms, as jingling said the internet is full of negative stories because all of the women with positive outcomes are just getting on with their lives. I can only speak from my own experience of HRT and it's been a life saver and couldn't manage without it.