What are the disadvantages of HRT?

[jewel1968]

I read a lot here from women who say HRT is a game changer. I do sometimes see women say with their family history it isn't suitable for them and they are looking to for alternatives. I am pretty sure the links with breast cancer were overstated in the past but doubt does linger on in some of our heads. But what I am asking is are there any general disadvantages in taking HRT?

I have read some people say it causes weight gain which surprised me as I thought menopause caused weight gain and I would have thought HRT addressrs some of the issues with menopause. I have also read some women argue that in some ways menopause was/is liberating in that they are no longer the woman that is always nice and caring.

So, are there any other disadvantages to taking HRT?

Full disclosure I am thinking of asking GP for it as I have a couple of issues that are likely linked to menopause although not definetly linked. I don't have the classic symptoms of menopause and in some ways I feel better than when I had periods as I used to get terrible PMT. I have also steadily lost weight since being menopausal and have only tweaked my diet slightly. This leads me to think something about my hormones was causing weight gain hence I have a bit of a worry when I hear HRT causes weight gain.

Anyway appreciate any thoughts on disadvantages of taking HRT.

I have to take progesterone as I still have a womb, and I’m very sensitive to progesterone - it gives me dreadful PMT symptoms and awful periods. It’s quite miserable tbh. I’m under consultant care and we’ve been trialling various options but so far none of them have alleviated these side effects.

I’m not sure HRT has been a game changer for me. I haven’t found it easier to lose weight, and I’m still permanently knackered (though I do have something else wrong with me that could be causing that). I think my brain works a bit better though my memory isn’t much improved. The constant rage isn’t there if I skip the progesterone but this isn’t recommended as it raises the risk of endometrial cancer. I don’t get hot flushes now. The main reason I’m persevering is because the oestrogen is protecting me against osteoporosis, diabetes, dementia, Parkinson’s and heart disease. I’m not so sure I’d be taking it if I’d started in my 50s rather than my 30s.

My consultant said really she’d like me to have a hysterectomy but that it’s really hard to get one on the NHS now.

There are 2 medical websites @jewel1968 where you can read the stats and advice from meno specialists

1 My Menopause Dr ( Dr Louise Newson)
1 Menopause Matters ( Dr Currie)

Both have a lot on HRT and risks v benefits- on 1) look at Resources

The risks of breast cancer worry anyone. At the moment, research shows that using micronised progesterone along with estrogen does not increase BC risks for at least 5 years (and some other research says never.)

The highest risks of BC are from being overweight and drinking 2+ units a day.

The medical guidance on HRT is that for women under 60, the benefits outweigh risks.

Benefits include
Reduces heart disease and stroke
Prevents osteoporosis
Reduces risk of bowel cancer
Reduces risk of diabetes and 'bad' cholesterol
May reduce risks of dementia

Ive used HRT for over 12 years mainly to protect my bones (diagnosed osteopenia late 40s) and not put on any weight at all. BMI still around 19.

Do some reading!

Thanks. I have done some reading. I am aware of the benefits as that is well reported but other than the link to BC which is not really supported any more I see very little about the disadvantages. Perhaps that is because there are very few disadvantages? That's why I thought I would ask on this forum as in my experience women here are good at sharing.

You will also find that all the female drs who are experts on HRT take it and some say they will take it for life.

Sadly there is a lot of misunderstanding about HRT - like some women still think it's made from horse urine- and other myths like it only postpones the menopause are reasons why some women avoid it.

I went to my GP twice. It's a clinic so you get different doctors there. The 1st time the GP said I didn't need it and that I needed an antidepressant. I told him I wasn't depressed and he said it would help with the anxiety. Even though I explained about the hot flushes, soaked bed, etc he told me the weather was warm and to open a window at night. The 2nd GP I saw, I was there for something else so asked her, she told me I could not take ANY form of HRT because some of the ingredients are similar to the pill, I can't take any 'Pill', I end up with chest pains. I ended up googling and just went down a rabbit hole with information out there, I don't know what's true and what isn't.

@Thethreecs

I went to my GP twice. It's a clinic so you get different doctors there. The 1st time the GP said I didn't need it and that I needed an antidepressant. I told him I wasn't depressed and he said it would help with the anxiety. Even though I explained about the hot flushes, soaked bed, etc he told me the weather was warm and to open a window at night. The 2nd GP I saw, I was there for something else so asked her, she told me I could not take ANY form of HRT because some of the ingredients are similar to the pill, I can't take any 'Pill', I end up with chest pains. I ended up googling and just went down a rabbit hole with information out there, I don't know what's true and what isn't.

Find another dr . They are talking rubbish.

HRT is made from the same hormones as our own- nothing like the Pill.

It's a disgrace drs are so ignorant. It's 2021.

Its an interesting question jewel. I am on oestrogen only (as I had a hysterectomy) and it does sound like getting the balance right when you need other hormones is more tricky. You have to pay for prescriptions, that's the only thing I can think of.

@goWalkabout yes I thought of prescription payment and also the hassle or remembering to take it or apply it if you are scatty like me. I had a vit D deficiency a few years ago and I really struggled to remember to take my supplement. I did find a routine that worked and am now fairly good and taking my supplement.

I think it is a good sign that people are not coming forward with disadvantages. A friend took it for about a year and found no benefit so she quit. Made no difference to her either way.

I’m on a complex cocktail of HRT. My symptoms are 70% improved. I can’t think of any downsides, side effects etc.

A friend took it for about a year and found no benefit so she quit. Made no difference to her either way.

It's important to appreciate that many of the benefits of HRT are not visible or identifiable, without tests/scans.

Your friend may find that in 10 years, she has osteoporosis.
She may find she has heart issues.

My 'advice' is that HRT needs to be looked at in the context of your family history and your own current & long term health.
I know people who don't agree with HRT will say that bones and hearts are helped by exercise and diet. Yes, they are. But you can only improve bones to a certain extent by exercise and a lot depends on your body mass to start with. Osteoporosis in old age kills more women than almost anything, as does heart disease.

ALL of my mum's close friends now in their 80s have either osteoporosis or heart issues or diabetes. Some have all 3.

I'm not saying all women should take hrt. But I was saying your friend may feel ok but she doesn't know what's going on inside her body.

@jingLingHellsBells yes I agree and I think she is thinking about revisiting it for the reasons you state.

I don't take hrt after a surgical menopause several years ago. My mother is 80 and been on it since she was 49.

Downsides for me would be the fact that I never did well on hormones, suffering migraines etc.

My mum gets panicked if supplies are low, she is so reliant on them and that isn't a position I want to be in personally. She has also developed a breast lump and won't tell the doctors.

Finding the right combination/dose can be a nightmare

The fact that my menopause hasn't been too horrendous makes a difference.

In all I see menopause as a natural progression and I'm happier just going along with it for now, I think.

Everybody is different and reacts differently, the only sure fire way would be to give it a go.

To find the right HRT for me, I did have to go private where the approach was much more flexible and trying out different things. For those people saying they’d rather go with the menopause as a ‘natural progression’ they really, really don’t have symptoms. I was going to have to give up my job I was so exhausted. (And it’s not my ‘lifestyle’ I eat a very healthy diet, don’t drink, exercise, yoga etc etc).

Tbf I never got on with hormonal contraception but I have been fine with hrt.

NHS lists a lot of side effects for HRT, and says that the are often maybe usually only temporary.

@Botherfreedays, oh I certainly have symptoms, please don't make assumptions. I am fortunate enough not to work, so it is easier to deal with and it IS a natural progression for me. Surgical meno isn't plain sailing, and my post wasn't dismissive of others experiences

@Stickytreacle I understand what you are saying as is an interesting perspective. I do wonder how many women who aren't worried about links to breast cancer don't bother with HRT. My sister explained to me that she was so relieved to not have periods any more and to not have to deal with PMT she didn't want to mess about with hormones. She really feared introducing hormones might trigger a PMT type response. And she has osteoporosis.

Sadly there is a lot of misunderstanding about HRT - like some women still think it's made from horse urine-
🤣 Never heard of that one!!

I've had a hysterectomy so would need oestrogen only but I seem ok with the menopause generally, apart from tiredness occasionally and a few aches.
My big issue is weight gain, I'm naturally very slim and would hate to be any different. Ridiculous I know but it's how I feel and because of it I worry that taking hrt would make me put on weight?

I take menopace religiously and also a calcium supplement everyday, so hopefully they help!

I'm not saying all women should take hrt. But I was saying your friend may feel ok but she doesn't know what's going on inside her body.
All women should be told this. Just because you don’t have symptoms, or don’t recognise symptoms, doesn’t mean the damage isn’t being done. Women cannot make an informed choice about whether HRT is right for them without this information.

My mum also has osteoporosis and has regular alendronate infusions, so hrt is still no guarantee that it won't happen, although whether it would be worse without it I don't know.
I feel happier not taking it for now and each individual needs to do what feels right for them, I also really hate having to have medical reviews etc.

As for the horse urine, hrt using conjugated oestrogen such as Premarin is made from this, with the relevant animal welfare issues.

HRT really helped my main symptoms, hot flushes, appalling night sweats, anxiety, anger.

I do struggle with the progesterone - as it makes me very depressed - but it only lasts about a week, I know what it is and it is outweighed by the other benefits.

@Stickytreacle

My mum also has osteoporosis and has regular alendronate infusions, so hrt is still no guarantee that it won't happen, although whether it would be worse without it I don't know. I feel happier not taking it for now and each individual needs to do what feels right for them, I also really hate having to have medical reviews etc.

Have you thought about asking for a DEXA bone density scan for yourself now @Stickytreacle?

Osteoporosis is very common BUT it's also hereditary. A friend of mine was eligible for DEXA scans every 3 years as her mother had severe osteo.

If you have no ovaries (not sure what age you had them removed) it would be sensible to have a bone scan.

The treatments for osteoporosis come with many side effects of their own, so prevention is the best way to go!

I had that perimenopausal second spring. My sex drive absolutely rocketed. It was like permanently being 25 years old on summers day and I loved it! HRT seems to have killed that off, which I am very sad about, though I still have a sex drive so mustn't grumble