HRT pros and cons

[Gonnagetgoing]

So I’m between peri and menopause I think. Have occasional insomnia etc. One friend swears by HRT which is good for her. My mother bypassed menopause or had a very easy one due to removal of area around womb/Fallopian tubes etc - unsure what exactly. I’ve also heard horror stories from a close older friend and another friend about starting HRT, it being great but then when they wanted to come off HRT symptoms of menopause were much worse and they were on and off HRT.

So do I suffer or not with menopause and treat as I do now naturally or do the HRT route?

Suggest you spend a day reading all the info on the website My Menopause Dr by Dr Louise Newson. Loads of fact sheets, podcasts with menopause experts, and videos.

It also covers the myths around menopause which you mention like HRT delaying symptoms, making them worse when you stop, etc.

Basically, it treats symptoms. If you stop the symptoms that 'come back' are ones you would have had anyway without HRT, and are still there when HRT is stopped.

Some women have these symptoms for life. No one knows how long theirs will last for. Might be 2 years or 20+ years!

thanks! interesting! just out of interest, how long can you take HRT for? indefinitely?!

Yeah it does seem like a life sentence, once you're on it, you tend to stay on it for life (anecdotally) to prevent unpleasant symptoms. Also the side effects are so variable that you don't know what you'll get until you try it.

An MNer was writing other day about painful breast cysts that did not desist after about a yr of HRT.

NHS lists these side effects but says they often settle down within weeks.

MNers often talk about having to try several different versions to get one that seems to work well to address most of their symptoms.

The version matters because sometimes (especially some versions of) HRT link to slightly increased risks of reproductive cancers; no one can say for you if that increased risk is worth improved quality of life that HRT could get you. You have to decide for yourself but GPs are supposed to be able to help talk you thru that decision.

MNers often say it's not free, you have to pay, so there's ongoing cost to consider.

MNers often say it's not free, you have to pay, so there's ongoing cost to consider.

??? what's not free?

On the NHS it's 'free' to see your GP.
There is a prescription charge for HRT like all medicines unless you are exempt for any reason including age.

You can take HRT for as long or as little as you need to.

The best way to test is to stop using it for 3 months and see if your symptoms come back. If not, great, if they do, you can choose to carry on.

It's also sometimes used to prevent and treat osteoporosis in women at risk of these and then it's used long term.

@JinglingHellsBells

MNers often say it's not free, you have to pay, so there's ongoing cost to consider.

??? what's not free?

On the NHS it's 'free' to see your GP.
There is a prescription charge for HRT like all medicines unless you are exempt for any reason including age.

You can take HRT for as long or as little as you need to.

The best way to test is to stop using it for 3 months and see if your symptoms come back. If not, great, if they do, you can choose to carry on.

It's also sometimes used to prevent and treat osteoporosis in women at risk of these and then it's used long term.

I am lucky in a sense as I have an underactive thyroid (medicated) but I would potentially take HRT and pay via prescriptions if it benefitted me.

My maternal grandmother had osteoporosis but she lived through WW2 and also was slim, petite and dieted a bit I think. So maybe didn't eat much calcium rich food.

My main issue is I've managed up until now (almost 50) without HRT. I take a well woman vitamin but not a menopause one yet, plus Sage, iron tablets, gel capsules for dry eye (omega?), and have taken an evening primrose oil tablet on top of that. Am also taking Floradix Magnesium to help with sleep. Plus I do yoga weekly. and exercise etc.

I've noticed I've got a bit more ragey lately but unsure if down to everyday life stresses or just menopause ramping up?

My main point is I really do not want to be on and off HRT for the rest of my life as older female friends have been and have found it hard to come off.

Maternal grandmother (mother's side) AFAIK didn't have PMS but had hysterectomy at 50 and got osteoporosis.

My mother (daughter of above) had a big op which removed ovaries etc following a complication - think burst fallopian tube following an ectopic pregnancy so missed out menopause I think. She also didn't have PMS or very mildly.

My paternal grandmother don't know her history but no hysterectomy but think she may have had early menopause as only had one child.

My maternal great grandmother (on mum's side) - I recall my grandad (father of mother) saying she had what was then undiagnosed PMT and terrible mood swings.

I have had bad PMT almost all my life from puberty but this was never diagnosed as wasn't recognised (in 1980s) so apart from BCP to treat it until I was 30 when I came off it it has been on and off an issue. I also had an underactive thyroid which I believe causes mood swings if not medicated and diagnosed in late 30s.

To be quite honest I'd be pleased if I could just take a tablet/have an op or something and be rid of female symptoms to do with menopause as they can be so tricky. But I do think I've had a relatively easy peri menopause and menopause up to now.

Osteo will be the one to watch for you. You can get regular scans to check your bone health?

Most women don’t take hrt so you don’t have to. But saying that many women get heart and bone issues later on so it might be a case of when/what meds you take - prevention or cure. Wish there was more advice on this out there!

My main point is I really do not want to be on and off HRT for the rest of my life as older female friends have been and have found it hard to come off

But you aren't your friends. You don't know what your body will do.

HRT isn't an 'addiction'. It just stops the symptoms for as long as you use it. If your symptoms are not too bad, then you don't need it anyway.

Some women actually embrace HRT for life (Mariella Frostrup had an article in the Mail yesterday saying after 7 years on it she has no intention of stopping.)

You might only need it for a few years but as @Newgirls says, you need an assessment of your bones and osteoporosis.

This is just my personal opinion, I'm not expecting everyone to agree with me .

Pros - protection against osteoporosis (only for as long as on it), may reduce risk of other conditions like dementia but studies are conflicting and some suggest it may increase the risk. Mood, sleep etc may improve. Beneficial effect on skin which imo may be one of the reasons botoxed celebs seem big advocates.

Cons - constant prescriptions and the ongoing cost (for each item), reviews, over analysing of body changes (not 'symptoms' as it isn't a disease. We don't get 'symptoms' in puberty for example, we have hormonal changes). Side effects of utrogestan (micronised ‘body identical’progesterone - the safest kind) which sounds unpleasant. Seems counter productive to take a drug that makes you feel sick, dizzy, fatigued, moody, even jittery in some cases etc to 'treat' the effects of hormonal changes. The small but still very real increased risk of cancer.

I often read up on this and if conclusive data proved the benefits do outweigh the risks I’d consider it, yet evidence is all so conflicting . Attention to self care is important, limiting caffeine and booze for example so you sleep properly, ensuring you have daily physical activity again so you sleep properly, topical oestrogen for VA which is effective with absolutely no risk, healthy diet etc all contribute to managing the menopause. It doesn't need treatment and doctors appointments. I understand some struggle more than others but without sounding patronising I think perspective is important and also women need to prepare, things change once you get over 40! Sleep etc all goes a bit haywire. We can't carry on living unhealthily, drinking etc and expect our bodies to cope like they do in our 20s and 30s.

In a recent Mail article Mariella Frostrup glibly talks about 'a daily squirt of gel and a nightly popping of a pill', minimising it and seemingly suggesting it's all just like cleaning your teeth and putting some face cream on. No, you are taking hormones/ medication whether it's popped or squirted. Some people then seem to get very reliant on it and daren’t come off it.

Yes I do agree with we do need to understand nutrition, alcohol, sleep etc far more in our 40s. It all has such an impact on everything.

I gotta say though that I know lots of women who are pretty good at all that and still needed hrt. Including yoga teachers, health professionals and nutritionists! But yes on whole if we drink and eat like our 20s it ain’t going to help!

So I’m now suffering sleeplessness! And wondering if HRT might help but really erring on the side of not wanting to get on that merry go round. I’ve ordered some A Vogel menopace max I think it is and might do the HRT if it doesn’t work!

Magnesium is great for sleep.

@Gonnagetgoing The conclusive data ( mentioned by a PP upthread) says that for women under 60, the benefits outweigh the risks.
You can find this info on Menopause Matters (HRT risks and benefits)and it is also confirmed by the British Menopause Society and the International Menopause Society as well as all other menopause experts in the UK.

This overall benefit outweighs other small risks.

Most women who use HRT do so after trying every single other lifestyle measure and find they are not working.

It's your choice but you are in control of how long you use HRT. You don't know if you will have symptoms for 2 years or 20 but it's your choice how long you use HRT if at all.

HRT sorted my insomnia within a few days along with mood swings, anxiety, dizziness & hot/itchy hands. I also take topical oestrogen for vaginal atrophy

People will have to prise my HRT from my cold dead hands!!

Same here, Theeyeballsinthesky! I know it's a bit of a menopause cliché now, but since going on HRT I feel like a different person. No, scratch that, I feel like the person I was before I started going through perimenopause. And it's bloody marvellous.

But OP, none of us can tell you what to do, as everyone's experience of menopause is different. It has to be what you feel comfortable with. As someone up the thread said, there's more to consider with HRT than just slapping some gel on and popping a pill (although that's what it boils down to for me!) and if it doesn't sit right with you filling your body with hormones, then carry on as you are, it sounds like you've got a handle on things anyway. FWIW, I don't know anyone who had issues weaning themselves off it once they were through the other side of menopause, but I plan to take it for as long as I can.

The idea of weaning yourself off it OP and symptoms coming back.

If your symptoms come back, you would have had those symptoms anyway without HRT. So if you are one of the women who have symptoms for 10 year and took HRT for 5 years, you'd have 5 good years out of the ten.

Women who carry on long term do so because they still have symptoms. HRT doesn't 'cure' flushes etc - it treats them.
It's not an 'addiction'.

@Newgirls

Magnesium is great for sleep.

Trying and sort of seems better. The liquid.

[quote JinglingHellsBells]@Gonnagetgoing The conclusive data ( mentioned by a PP upthread) says that for women under 60, the benefits outweigh the risks.
You can find this info on Menopause Matters (HRT risks and benefits)and it is also confirmed by the British Menopause Society and the International Menopause Society as well as all other menopause experts in the UK.

This overall benefit outweighs other small risks.

Most women who use HRT do so after trying every single other lifestyle measure and find they are not working.

It's your choice but you are in control of how long you use HRT. You don't know if you will have symptoms for 2 years or 20 but it's your choice how long you use HRT if at all.[/quote]
This is great. thank you.

@JinglingHellsBells

The idea of weaning yourself off it OP and symptoms coming back.

If your symptoms come back, you would have had those symptoms anyway without HRT. So if you are one of the women who have symptoms for 10 year and took HRT for 5 years, you'd have 5 good years out of the ten.

Women who carry on long term do so because they still have symptoms. HRT doesn't 'cure' flushes etc - it treats them.
It's not an 'addiction'.

Thanks for this. This puts things more into perspective.

I've suffered on and off and coped sort of through perimenopause. Have been taking sage for the past probably six to nine months but would quite like sleep back and less rage. I will see my doctor so thank you.

I found it really helpful - I had appalling anxiety, depression, anger, sleeplessness and awful night sweats. Having to change the bedding 2 or 3 times a night.

HRT has nipped all that in the bud, I'm eternally grateful to it.

If you symptoms aren't so severe ... then you might not need it.

So I think I will try HRT. I think I haven’t had a period for a year but can’t be sure. 50 tomorrow. Feeling bloody awful generally can’t sleep or if I do it’s with exhaustion. Mood swings rage etc… can’t go on like this!

I had to try 3 types before I found one that suited. But it really helped when I did land on the right one. Femeston for reference.

I also tried Agnus Castus for the rage while the HRT was kicking in...that seemed to help.

And wool duvet for the night sweats.

Hang on in there. It's just your hormones - replacing them will help. (don't get fobbed off with anti depressants unless there's a good reason).

@BarkingUpTheWrongRoseBush

I had to try 3 types before I found one that suited. But it really helped when I did land on the right one. Femeston for reference.

I also tried Agnus Castus for the rage while the HRT was kicking in...that seemed to help.

And wool duvet for the night sweats.

Hang on in there. It's just your hormones - replacing them will help. (don't get fobbed off with anti depressants unless there's a good reason).

thank you!

I feel like I'm going mad at the moment!

HRT has been like a miracle for me.

Hot flushes, terrible sleep, rages, aching joints, (including bunions.) All went with HRT; I’ve been on it for 5 months, my sleep improved within 3 weeks, hot flushes completely disappeared within a month, my
Aching joints, including very painful bunions, much better within 2 months.

My Sister had been advising me to start HRT for three years but I always had in the back of my mind that I should just get on with it. I then heard about Dr Louise Newson, spent a weekend watching her information videos and reading her Fact Sheets and made a Drs appointment straight away. The dr tried to give me Antidepressants but I told him they weren’t suitable and I wanted HRT.

It’s all been very positive so far, my only regret it not stating HRT years ago!

Does anyone have short term fixes for crying/rage? Seeing doctor this week. I feel constantly on edge but it’s not good and I hate feeling out of control. I can kind of control it but feel like a coiled spring/cobra! Heat not helping sleeping!

@LizzieSiddal

HRT has been like a miracle for me.

Hot flushes, terrible sleep, rages, aching joints, (including bunions.) All went with HRT; I’ve been on it for 5 months, my sleep improved within 3 weeks, hot flushes completely disappeared within a month, my
Aching joints, including very painful bunions, much better within 2 months.

My Sister had been advising me to start HRT for three years but I always had in the back of my mind that I should just get on with it. I then heard about Dr Louise Newson, spent a weekend watching her information videos and reading her Fact Sheets and made a Drs appointment straight away. The dr tried to give me Antidepressants but I told him they weren’t suitable and I wanted HRT.

It’s all been very positive so far, my only regret it not stating HRT years ago!

Definitely my reasons for wanting HRT now too. Just don’t want weight gain but to feel a bit more normal now would be heaven!