What happens without HRT?

[ByersGreen]

Are there any concerns about doing nothing.

I don't sleep well and have flushes. Weight is fine. Bit down tbh.
This will all pass I assume.

Is there a long term negative to seeing this through without any medication?

@awishes

I've taken nothing, sailed through menopause and felt liberated BUT 10 years on I'm worried about the health implications of being so deficient.

I had surgical menopause and everyone was surprised that I had no problems. Due to previous EMCS I didn't even have a new scar as they just used the old one (not sure how that works) so I sometimes wonder if they did anything. Twenty years on I recently had a bone scan which was OK for my age, very slight issue in one area so I take calcium and vitamin D to protect my bones. I have recently broken my ankle but doctor was sure it was nothing to do with bone density, just an accident.

I do think the current discussions about menopause problems is good but I do think it needs to be more clear that some of us have no problems or very minor problems. I think some younger women must be terrified listening to some of it and they might sail through it when it happens.

Also, it increases the risk of bc and ovarian cancer but 'only' a by a bit always sounds questionable to me.

But what if it is only a bit? Theres no getting away from the fact it does increase the risk, but it is by a tiny amount.

@EvilPea

there seems to be a strong sense of pride in some women about doing it the "natural "way, as if anyone is giving out prizes!

Its like childbirth isn't it, Women really can be women worst enemy

I'm not proud of it. Just with it being a menopause board and not a hrt board it's surely useful to say issues can resolve or be managed without prescriptions.

Or should we all just parrot listen to Dr newson and take medication it's the only solution?

Also, it increases the risk of bc and ovarian cancer but 'only' a by a bit always sounds questionable to me.

What are you actually saying?

So the stats are wrong?

Funny how people will get in a car and drive 300 miles and not think about the 2000 road deaths a year. Or pedestrians killed by cars. Or people killed by accidents in the home.

Yet the focus on a risk of 3 extra cases per 1000 in 10 years.

That's 10,000 women years so (if my maths is right) an added risk factor of 0. 0003%

Also, no women has a zero risk of breast cancer. It's not 'no risk v big risk.'

It's a baseline risk, increased by around 0.0003%.

For some women, that's too big a risk.
For others, it's acceptable if they need bone and heart protection along with a better quality of life.

I welcome the recent discussions about HRT / menopause. I feel extremely badly informed about this area of health despite the fact I'm in peri now. I think women have been expected to put up with menopause / peri symptoms because it's 'natural'. Lots of other things are natural processes of aging but people somehow seem less inclined to accept these. There is also very little in the way of research (because women's health is never prioritised). So it's difficult but I think I would rather take HRT then some of the herbal substitutes which are basically plant oestrogens ...

I'm not proud of it. Just with it being a menopause board and not a hrt board it's surely useful to say issues can resolve or be managed without prescriptions.

Do you really think this or are you just enjoying a heated debate?

To call women 'parrots' is deeply insulting. You ought to step back if that's the best you can offer as support.

'Do you really think this or are you just enjoying a heated debate?'

Is it heated? I've been pleasant throughout! I didn't call anyone parrots, I said 'parroting listen to Dr Newson' which is often said on here. It's a figure of speech.

I'm open to debate but you too should be open to other people's opinions. There is such conflicting information on hrt and menopause let's share our experiences and advice in a constructive way.

@SummerLovingHadMeABlast I think I agree with what you've said.

I'm almost 50 and so far I don't think I have any symptoms - I actually find it concerning that so many women will try hard to make any old symptoms 'fit' with the menopause when it could likely be something not connected at all.

I would take HRT if I felt I needed to and if advised to do so, so I don't subscribe to the point of view of battling through, HRT free, whilst really suffering

But I don't think it should be a first port of call and some of the evangelical posts on here about it, from posters whose names I recognise for doing so a lot, concern me sometimes.

It is not a given that you'll break your bones if you choose not to take it or that basically your face will fall off etc etc. That's scaremongering. Genetics play a huge role in your menopause experience

Everyones periods are different, everyones lives are different, why would the menopause not follow that.

This. Apparently 25% of women go through menopause Apparently symptom- free, apart from periods stopping. But then periods can vary from very regular, fairly light and pain-free to irregular, very heavy, painful, clotting, throwing up and fainting. There could be other conditions like PCOS or endometriosis, which may or may not have been diagnosed, because it often does go undiagnosed. And some may never have been pregnant, or had recurrent miscarriages, or successful pregnancies or a mix. Some women will have found hormonal contraceptives the greatest thing ever, putting them in control of their bodies, and others will have had constant bleeding and felt they were going mad. And then you might be currently slim or overweight, regularly exercising or not, eating a healthy diet or not, and on top of all that, your own particular genetic risks or benefits.

So it makes complete sense it won't be the same experience for all, and available treatments should reflect that and be tailored accordingly. I'm 49, and to date, apart from periods getting heavier through my 40s, I've had no noticeable symptoms. I won't discount the option of HRT in the future (my mother was a nightmare around this age, but she had alcoholism in the mix, so who knows how much I'll follow suit on meno symptoms?) I have friends who feel their lives have been transformed very positively with HRT.

I think it's good that there's a lot more discussion around it, so women and medical staff can be more informed, rather than suffering in silence, but there's still a long way to go.

breastcancernow.org/information-support/have-i-got-breast-cancer/breast-cancer-causes/hormone-replacement-therapy-hrt-breast-cancer-risk

This is an example of the confusing information. From this link re BC risk
'63 in every 1,000 women who have never used HRT'
'83 in every 1,000 women who use combined HRT for five years from the age of 50'

Now that looks like an extra 20 in 1000 to me, an extra 2 in 100. Which isn't a small risk at all.

Happy to be proven wrong and for this link to be out of date/ not relevant/ discredited etc but my point is this is the data available when we Google so it is no wonder many women are confused about hrt and the risks.

I didn't think the info on HRT was conflicting? I thought the info had been updated based on newer research? It is always funny to me how when we were young doctors couldn't put us on the Pill fast enough, and the risks were totally glossed over (or at least I don't remember any debate about whether young girls should be on the Pill).
The Pill helps nubile young girls have sex but no babies. Whereas HRT helps older women cope with life in general, be able to sleep, do their jobs, not kill their teenage kids as well as have sex sometimes, and suddenly it's "oh the danger!"
Hmmm

I started with symptoms at 48 and all was manageable for a number of years.

However I'm now mid 50s and started getting debilitating migraines last year - lasting on and off for up to 10 days - which were attributed to peri menopause so I reluctantly went onto HRT.

It wasn't complicated at all. A patch changed twice a week and a tablet every day. The migraines stopped and so did the hot flushes, anger, brain fog and joint pain I'd thought were just all part of getting older. I feel so much better.

I'd been determined not to take HRT as none of the women in my family had and I was scared of getting breast cancer. Having read more about HRT and watched Davina! I'm a lot more relaxed about it all and would recommend it to anyone struggling with unpleasant symptoms.

I still have periods so goodness knows how much longer this will all go on for but for now I'm happy with what I'm taking. I also do Pilates, go swimming and have cut down on alcohol and caffeine - so I'm hopefully helping from all angles.

I am 65 and have never taken HRT. Perhaps I've been lucky. I am perfectly healthy. My skin is good and there's nothing wrong with my bones, so far anyway. I don't sleep well but I haven't since I was in my twenties so I don't think that's anything to do with menopause. I am a bit overweight but I eat too much. That said I eat a healthy diet most of the time and have never smoked. I have had my best years since going through the menopause and I think younger women should keep in mind menopause is not a problem for many women.

I think younger women should keep in mind menopause is not a problem for many women

And l think younger women should be aware that up to a third off working women leave their job due to menopause issues. As l had to.

Brain fog is my worry and possible links to dementia. Terrifies me.
I forget words and have to change my sentence.
Today I emailed my surgery with my worries. Covid has prevented me doing so before and apathy before that. I am 55 and still having periods.
Surgery emailed straight back and my doctor going to contact me when he is back from holiday in about 10 days or so.
I don't like taking any medication but my fear of dementia making me very anxious so now open to discussion.

I am 41 and have spent the last 6 years retraining for a career in a male dominated field. I am the only female in my company and terrified that at some random point in the next x number of years all my hard work will be out of the window and I will be left "crying at bananas in Morrisons" (as my MIL tells me will happen). My dm had a hysterectomy when I was a small child and won't speak about these issues anyway so I don't know when I can expect it. I feel like a ticking time bomb which adds to my (usual) anxiety.

[quote DramaAlpaca]@Naaaaah that sounds horrendous, I'm sorry. Have you tried combining Vagifem with Ovestin? That's what I do and it's made all the difference. Vagifem alone, even every two days, just isn't enough.[/quote]
Thank you. I'm going to contact my gp to ask for ovestine as well.

[quote EvilPea]@Naaaaah

Oh my god a penny has just dropped for me with your post, my last smear was agony. Like proper agony and the nurse did her best but was clearly irritated by me. But this was why wasn't it.

FUCKING HELL
This is why we need to talk about it.[/quote]
I know. It's only from reading on here that I knew it was even a thing. So many women suffer in silence. It can be such a difficult subject too. Who wants to admit that their vagina is letting them down! Ageing is tough and to accept that yet another part of your body is ageing too is difficult, especially a part that's so closely linked to your own sexuality.

@JaniieJones The problem is that you constantly query the risks as shown on many of the main websites like the BMS and the Women's Health Concern and express doubts about them.

The stats you quoted show that for 100 women, 6.3 will get breast cancer anyway over 5 years.

For 100 women using HRT this increases to 8.3 , so 2 more over 5 years.

That is for combined and continuous HRT.
The figure for sequential regimes is less - it's 7.3 over 5 years.

Additionally, those figures [possibly from the Lancet] are based on outdated forms of HRT, not the current sort which includes Utrogestan, where the risks appear to be lower, shown in trials.

Dr Newson is not saying anything that other menopause experts across the UK say. She may be talking to the media more, but they are all singing from the same hymn sheet.

No one takes HRT lightly.

But it's a personal choice.

Life is not without risks. Everything we do has some risk. You could be obliterated in your car next time you go out. Does that bother you? or do you prefer the convenience it affords?

It's about choice.

'Everything we do has some risk. You could be obliterated in your car next time you go out. Does that bother you? or do you prefer the convenience it affords?'

Yes everything does come with risks but the risks with most things don't vary depending on what you read! I really don't like the way you patronise people that query this, of course I like the 'convenience of going out in my car '. I would happily take hrt if I felt the benefits do outweigh the risks. I'm as always trying to pick through the conflicting info and if anyone on here asks what happens without hrt I think we should all be able to reassure someone that some of the unpleasant issues that can start in our early 40s can resolve as the body adapts to change.

Why don't you think PHE recommend hrt for all menopausal women if the osteoporosis protection is worth the extra risk of BC?

You said 3 in 1000 women had a increased risk of BC. The link I posted showed an extra 20. That equates to 1 in 50, it really isn't an insignificant risk. Micronised progesterone may well bring these figures down but the point is we don't have that evidence do we?

You must accept that we are allowed to debate the conflicting information as we wish whilst hopefully seeking more definitive evidence with up to date stats.

It's not patronising to ask anyone to consider the very real risks they take everyday without even thinking about it.

I'm sorry but you aren't reading the stats correctly. You are ignoring the fact it's a 5 years timescale
Here is it in a diagram

www.menopausematters.co.uk/pdf/Understanding%20Risk%20of%20Breast%20Cancer.pdf

The up to date stats show that there is no increase in breast cancer with Utrogestan, for at least 5 years. There IS evidence, yes- just google it.

Are you considering HRT yourself and wanting more reassurance?

Most women who use HRT do so because they have tried everything else, and are willing to accept the very small risk (which ALL meno drs have told me is the case!) and have quality of life.

Just like you do all kinds of things that have risks and never even think about it. Your choice, Their choice.

It's really hard to debate it on here without getting shouted at. And being pushed to go to private expensive clinics

"And l think younger women should be aware that up to a third off working women leave their job due to menopause issues. As l had to."

Me too. I was in Investment Banking. Complex Anti-Money Laundering stuff. Couldn't do it any more. I got frightened of going to work. Luckily I got Voluntary Redundancy.

I think the worst thing about all this is the almost complete lack of education/information about the whole process. Growing up I used to hear about 'the change' and women having hot flushes..and that was it. I had no idea about any of the other symptoms at all. I thought I was going crazy. Plus my hypothyroidism confused the issue because I put a lot of it down to that. Even the perimenopuse...I didn't know that there was such a thing. I started flooding really badly and they fitted me with a Mirena Coil..so I have no idea when my periods actually stopped.

@Bryonyshcmyony One of your posts was deleted for being offensive. Who is shouting at whom?

I also think you confused me with another poster (and you were being rather unpleasant ) because your posts to me made no sense.

This is just a mad thread. We have a 2 tier healthcare system in the UK.

If women can't get any sense out of their GPs who have 1/2 day training in menopause, at med school, they are within their rights to seek another dr even if that means paying.

FFS don't start having a go at even more women for taking control and trying to sort out their health!

I'm leaving this now. It's too unpleasant and unhelpful.

Beguilingeyes, yesss

I got ill health retirement. I was a teacher, just couldn’t deal with the endless stress. I became phobic about going to work. I’d been there 25 years. The last 10 were hell.