If HRT protects later health in most women, why aren’t we all offered it, regardless of symptoms?

[Fullyhuman]

I’ve no unbearable symptoms as yet, in early menopause, and am learning about HRT, but am confused by this. Why would only women with symptoms need their later health protecting (heart disease, osteoporosis)?

My comments are personal ??

I stated a fact. Hellsbells thought she would correct me and she stated that oestrogen was not a steroid .
This is incorrect .
I was shocked as I know that particular poster is keen to respond to posters here and to promote HRT .

Then a new poster tried to imply that my mentioning the fact that HRT contains steroids meant I was 'afraid' of HRT. By stating a fact ?

Hellsbells now says :
' in purely scientific terms ' oestrogen is a steroid.

Purely scientific ?? Oh you mean it doesn't sound good .
That's true . And now you'd like to end this discussion by saying it isn't relevant to the OP

'I doubt you have read the BMS or the IMS statements. '

And how would you know what I have read ?
Not only do I read these , I also look to see who is on the panel. I try to see if drug companies have any links .
I read what oncologists have to say . And what public health drs have to say .
I don't restrict myself to menopause societies

In purely scientific terms estrogen is a steroid. However, posting that is completely irrelevant to the discussion and the question asked by the OP

The point is Jingle is very quick to point to posters who post wrong facts. In this instance, she was clearly wrong however you try to twist it it.

It doesn't matter on the scale of things and the purpose of the discussion but one someone make a regular statement to others pointing at facts, it would be good for them to acknowledge when occasionally, they get their facts wrong.

Don’t know if it caused it but the treatment made me forget about my menopausal symptoms rather quickly
Very humbling words This one reason that makes me hesitate giving her ago again because if I were to get breast cancer, I wouldn't want to torture my mind (which I would do because it's my personality) wondering if it was because of HRT and therefore avoidable.

The point is that we are all different. Some people are more risk adverse than others. Some prefer to focus on the present and make the best if it, some prefer to take actions for the future. Some consider a small risk to be not far off to no risks, others will view the notion of any level of risk as something to be avoided.

@antidisestablishmentarianism, I wish you good luck and hope your treatment is almost over and successful.

I am not interested in a fight not do I have time to keep defending myself .

I echo what dontdisturb says below .

Do not attempt to denigrate my legitimate points by trying to say it's a 'bun fight '

I hope reader investigate the points raised .

I would like to add my sincere thanks, as per a pp, to @JinglingHellsBells who has made my life maneagble again.

She has never 'lectured' or dictated, just simply pointed people in the right direction to gain clear information and make up their own minds. Usually these posters have been given the wrong advice or even antidepressants, from the GP.

Thank you JHB.

*excuse spelling

Because for every study we read where hrt may reduce heart disease or osteoporosis they'll be a other disputing these findings.

The only consistent finding is there is a breast cancer link. An extra 1 in 50 which you may think oh so what, but that is an extra 100 in 5000! Stats that should not be dismissed.

The menopause is a natural ageing process. Women need to find strategies to manage these life changes, not take something that may lead to major surgery and chemo.

Links to one menopause expert certainly do not reflect all medical opinion.

The menopause is a natural ageing process.

So is osteoarthritis in your knee, are suggesting people don't get their kneecaps replaced or their hips?

Not being goady, genuinely want to know what you think?

In my case, HRT gave me the energy and inclination to make other changes to improve my lifestyle. Before starting it a few weeks ago I was surviving on very little sleep, no energy to do anything and certainly didn’t have the brain capacity to even think about anything other than dragging myself from one day to the next. I’m now seeing light at the end of a very long tunnel.

@GetOffYourHighHorse

Because for every study we read where hrt may reduce heart disease or osteoporosis they'll be a other disputing these findings.

The only consistent finding is there is a breast cancer link. An extra 1 in 50 which you may think oh so what, but that is an extra 100 in 5000! Stats that should not be dismissed.

The menopause is a natural ageing process. Women need to find strategies to manage these life changes, not take something that may lead to major surgery and chemo.

Links to one menopause expert certainly do not reflect all medical opinion.

For women taking HRT between the ages of 50 and 59, there was only an extra two cases per 10,000 women years. There was no information about the type of cancer or the prognosis of these women.

The above, from Louise Newson, in reference to the BMJ survey linked to below and published last autumn, gives a different risk assessment.

www.bmj.com/content/371/bmj.m3873?cf_chl_jschl_tk=b227e8b7d65a03a14b86787a65e835213c2c8475-1616592926-0-ARRerj5-AALWtg09wd7TCbjzzCK-TSI79eqarC7xsehh_wcjt0U0XPiKp9jhcwRdGjX_vIlWboZg_Q-c0v8TAlPt3US8SlIcdHrGbvtP81Sy59jt8_8YaxxB3HSPAixDXzMgXL3qGMVEse8DMtp_1jvrQ50eQaRd68-qs0m3dxLwGzGZt9SJUal_6y-YKKD6S3fht4gjUVIEgl3dhrTHV19UpYdIYWrr-qWETDjrb_yf8yDv81rGBjyHKIT8qtiTUMkCVCgafYWCns-OzofkI2NCpe-BwvbiM6VhoRsS1BCIUqLeWkOv207Izdv47fUZ7vbiqXbZrgqbgvOoB52TiFIAljpapic1OPfwH9cdu001

The menopause is a natural ageing process. Women need to find strategies to manage these life changes

Just because menopause is a natural ageing process, it is not something that we should simply put up with, particularly if the side effects are debilitating and alter the quality of one's life. In an ideal world I would have loved to find an alternative to HRT but there is not anything remotely comparable.

It is worth remember that for a long time, life expectancy wasn't a fraction of what it is now, and generations did not even make it to menopause age. We live for longer now, and with advances in medical science, there really is no reason to rely on non-medical strategies to manage menopause.

'So is osteoarthritis in your knee, are suggesting people don't get their kneecaps replaced or their hips?'

Of course not, I'm all for medical treatment for disease. If someone's mobility is so severely impacted they need joint replacements they should get them.

However a healthy lifestyle will help menopausal symptoms. It's about managing expectations imo. Exercise will help with mood and sleep problems, topical oestrogen will help with vaginal atrophy, a healthy diet will help with energy levels.

Some teens suffer terribly with puberty, mood swings and acne for example. Would you suggest medication to halt puberty until such time as you think they can cope or would you actually suggest symptom relief instead?

Just to be clear, HRT is a lifesaver for many women. I have seen it in a few friends of mine and the reason why I decided to try it. I was feeling positive that it would give me my life back. It didn't and made me feel worse.

HRT is a miracle for some and worth every risks, it only else marginally for others, and worth the risks for some,not so for others, and it's worthless for some and certainly not worth the risks.

Let's not forget that the majority of women going through the menopause don't take HRT and most make it through ok.

The NHS website sums it up in the most simple way.
www.nhs.uk/conditions/hormone-replacement-therapy-hrt/risks/

Exercise will help with mood and sleep problems, topical oestrogen will help with vaginal atrophy, a healthy diet will help with energy levels
If only if only this was true. I would pay 10k for this to be true!

Sadly it isn't, at least for me. I am an example of healthy lifestyle, so much that my peers often tease me about it.

I do 15k average steps a day.
I swim, I cycle, I run. I dance, I do baddleboard and other sporting activity.

I don't drink any alcohol, nor any caffeine, I don't smoke, I eat healthily. I am not stressed,nor have anything to be anxious about. I go to bed at the sane time every day, weekend included. My bed is really comfy, the window is open. It's dark and quiet...yet my sleep is absurdly atrocious.

Many women do sail through the menopause adopting healthy lifestyle, sadly for others, it just isn't enough.

This is from Louise Newson's site and this is the relevant part of the conclusion of this paper.

It clearly says that after 5 decades there is no absolute proof that HRT caused BC.
d2931px9t312xa.cloudfront.net/menopausedoctor/files/information/394/Menopausal%20hormone%20therapy%20and%20breast%20cancer%20what%20is%20the%20evidence%20from%20randomized%20trials.pdf

It's published in Climacteric- the international menopause journal, 2018.

After five decades of study, no conclusive evidence,
including the WHI CEE þ MPA trial, proves that HT causes
breast cancer and, in fact, the overwhelming preponderance
of data, including the WHI CEE þ MPA trial, show that estrogen þ progestogen therapy has a null effect on breast cancer. Additionally, estrogen alone, as randomized trials
including the WHI CEE trial show, possibly prevents development of and mortality due to breast cancer. The WHI
CEE þ MPA trial clearly shows that HT naïve women who initiate CEE þ MPA therapy have no increased risk for breast
cancer; the typical population of women who initiate HT for
menopause are HT naive. It should also be noted that the 8
additional breast cancers/10 000 women/year of CEE þ MPA
therapy reported across the entire WHI CEE þ MPA trial
cohort and the 4 additional breast cancers/10,000 women/
year of CEE þ MPA therapy in the subgroup of HT naïve
women are rare and similar to or lower than the breast cancer risk associated with a host of other factors including
obesity, low physical activity,

This is from Louise Newson's site and this is the relevant part of the conclusion of this paper
Yet the NHS website and Breast Cancer UK say differently. Why would that be?

And I like how she only references the WHI CEE þ MPA trial to justify her position, yet talks about several research!

Possibly using older research, linked to a cohort of women using older forms of HRT that aren't prescribed as often these days? How long has micronised progesterone (Utrogestan) been prescribed, for instance? I have a feeling it's comparatively recent and yet a lot of us are on it. It would be interesting to see whether a future survey reveals a lowered risk of BC because of this.

I was told 2 years ago I was perimenopauseal but as I was under 40 there was nothing they could do. Well I've now been back to the doctors as issue have continued to get worse. Hormone levels are normal but the doctors still say its perimenopause. I was told there were 2 options anti depressants or HRT. The doctor wanted to go antidepressants route as my mum died from ovarian cancer and apparently HRT increased chances of this. Well I said no to antidepressants as I'm not depressed so it looks like it will be the HRT route . However, now my husband and sister have both said not to go on HRT as I will be on it for ever and I should try natural options first? I'm 40 and now so confused.

There's some really good and thought-provoking information and advice on this thread.

Unfortunately, there is also some utter cobblers.

@dontdisturbmenow

And I like how she only references the WHI CEE þ MPA trial to justify her position, yet talks about several research!

It's not written by her, it was written by a group of researchers. Sorry if I didn't make that clear! IT was posted on her website.

In case this helps others, I started HRT (estrogel and utrogestan) a few weeks ago.
HRT was not a decision taken lightly. My mother had breast cancer following early menopause/HRT in her 40s; she recovered and went on to have bowel cancer in her 60s (from which she also recovered!) so I went to see a senior consultant breast surgeon first.
His view was “premature menopause, as is the case with your mother, significantly reduces the risk of breast cancer. However, HRT simply normalises this and it is unlikely that your mother’s breast cancer was caused by her HRT.”
He also told me that there is a slight increase in risk taking HRT compared to the general population, but also that weight, level of activity and alcohol consumption increase risk anyway. I work hard to keep fit and eat well, and it is an incentive to keep that up.
Personally, I feel a million times better, taking HRT. I was struggling with insomnia, memory loss, aching joints, night sweats, rage and apathy. I feel human again. It’s thanks to people like my enlightened GP, my breast cancer consultant, @JinglingHellsBells, Louise Newson and her website, and others, that those of us who need and want to take HRT have knowledge of the options, and can seize back our lives during and after perimenopause.

@GetOffYourHighHorse

Because for every study we read where hrt may reduce heart disease or osteoporosis they'll be a other disputing these findings.

The only consistent finding is there is a breast cancer link. An extra 1 in 50 which you may think oh so what, but that is an extra 100 in 5000! Stats that should not be dismissed.

The menopause is a natural ageing process. Women need to find strategies to manage these life changes, not take something that may lead to major surgery and chemo.

Links to one menopause expert certainly do not reflect all medical opinion.

Your numbers are wrong. It’s harmful to spread misinformation.

Ageing is natural of course but heart issues, sleep issues, depression, osteo and vaginal dryness are pretty rubbish - not everyone is able to cope with these without some medical help - if you manage those naturally then you are fortunate