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 think it’s hard to generalise as everyone reacts differently to each drug.

I was on one called Angeliq for 6 years and had nothing but benefits. The company stopped producing it and for the last 4 years I’ve yet to find anything as good. Every alternative has caused bleeds (this latest one (utrogestan and oestrogen gel) every few days and PMT symptoms and I’m on month 6 of taking them. I’m 60 and feel too old for this shit but the perpetual hot flushes and night sweats and aching joints are bad enough to make me still keep looking for a decent alternative to the original drug I was on.

Is it possible to get HRT if you if don't have any symptoms? I did have some hot flashes and nigth sweats when I first started perimenopause but they didn't really bother me so didn't start HRT at that point. The hot flashes and night sweats have now stopped and I have no other symptoms, or if I do they're not ones I have noticed and they're not causing me any problems at all. I have a fairly decent diet, and am doing weight bearing exercise to help my bones, but not sure if I should be on HRT or even if I can be. I've never taken hormonal contraception of any sort so taking hormones would be brand new to me. I also have zero experience of taking medication which has to be taken daily (I aim to take vitamin D daily but often forget) so might well end up forgetting to take HRT.

Stickytreacle

I find that really hard to believe, surely there is a synthetic version now if it ever was true?

I'm slim and have taken in for a year, feel fine and no weight gain, has taken away the hot flushes which is wonderful.

@Stickytreacle

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

No, its made from yams now, not horse urine.

@Stickytreacle

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

As PPs have just said, the type of estrogen made from mares' urine is rarely used now. It's used more in the US and comes under the names Premarin and Prempak.

Very few UK drs prescribe it as it's out dated. (And if you were offered it, you could refuse and ask for a newer type.)

The estrogen in all other HRT is made from yams, as is the progesterone in Utrogestan.

@RichardMarxisinnocent You might want to get a bone density scan to see how your bones are. Unless you have a high risk the NHS won't offer it but you can pay for them privately, around £200 and they need doing every 3 years.

@Stickytreacle

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

Please update your knowledge of HRT as used in most of the UK and Europe as you may discourage women who badly need a safe treatment for horrendous symptoms.

I couldn’t take any hormonal contraception, not even mirena; they made me emotionally very unwell. I am also fat and have been so all my life, with the result that my metabolism is banjaxxed and I put weight on very easily after a lifetime of disordered eating and I have t2 diabetes. I started HRT early this year and it’s been brilliant. There was a surge of superness, when my skin improved, my joints stopped hurting, my constant rage disappeared. Since then it’s settled down a bit but I’d say generally I feel 60-70% better than I did, and I have lost 4.5kg relatively easily.
Still no libido but that’s probably because I mostly want to murder dp.

[quote JinglingHellsBells]@RichardMarxisinnocent You might want to get a bone density scan to see how your bones are. Unless you have a high risk the NHS won't offer it but you can pay for them privately, around £200 and they need doing every 3 years.[/quote]
Thank you, I'll look into it. If a scan did show issues with my bones, would that class as a menopause symptom and mean I could get HRT if I wanted?

There's nothing wrong with my knowledge of hrt thanks.

It just shows that people aren't aware that this is still available, surely if people are aware they can make a decision to use a different one, it doesn't
mean that I am deliberately putting women off hrt, but pointing out a potential downside that they can change, here I am thinking people want to be informed when there are people who don't even believe it exists 🙄The current bms updates:- <a class="break-all" href="https://www.google.com/url?sa=t&source=web&rct=j&url=thebms.org.uk/2021/09/british-menopause-society-further-update-on-hrt-supply-shortages-15-september-2021/&ved=2ahUKEwiHgr7djsfzAhVd8rsIHd1_CrsQFnoECAgQAQ&usg=AOvVaw1VWJa2tou3MAwkOJbJsocS" rel="nofollow" target="_blank">www.google.com/url?sa=t&source=web&rct=j&url=thebms.org.uk/2021/09/british-menopause-society-further-update-on-hrt-supply-shortages-15-september-2021/&ved=2ahUKEwiHgr7djsfzAhVd8rsIHd1_CrsQFnoECAgQAQ&usg=AOvVaw1VWJa2tou3MAwkOJbJsocS

Link seems not to work, but here's the info from British menopause society
PRODUCT RECALL (as referred to in the previous BMS HRT update): Duavive. Conjugated equine estrogen 0.45 mg + 20 mg bazedoxifene

In 2018 Pfizer communicated that it planned to discontinue Duavive in the UK. Pfizer have continued to supply Duavive to patients since then but now all remaining supplies have been exhausted.

Doctors and/or Healthcare Professionals are best equipped to advise on alternative options. Impacted patients should follow local GP surgery guidance on the best way to contact them during this time.’’

Please see information on the availability of Pfizer’s other HRT products below:

Premique available

Conjugated equine estrogen 0.3 mg + medroxyprogesterone acetate 1.5 mg. Available

Premarin conjugated equine estrogen 0.625 mg and 1.25 mg. Available

I have been on HRT patches for about 5 years. I had to do lots of research prior to seeing GP as I found the GP’s knowledge was minimal! I was originally offered a drug which contained horse urine, I refused it. Asked for patches and luckily gp said fine.

I have had no side effects and will fight to the death to stay on as long as I can

Women are constantly treated as second class citizens where health is concerned, if you are not able to do your own research it is so easy to be fobbed off by a GP.

@Stickytreacle Duavive was only available in the UK for a very short time. It was a very different type of hrt which used a new type of progestin.

Very few GPs and certainly no meno specialists prescribe the ones with conjugated estrogens these days.

Natural body-identical estrogen is the preferred type, for safety.

The concern would apply (surely) only to women who are vegans as many products, include animal bi-products.

@RichardMarxisinnocent HRT is licensed as a treatment for the prevention and treatment of osteoporosis or osteopenia ( precursor to osteoporosis.)

You might like to google a very good podcast between Liz Earle and Nick Panay (one of the best menopause experts in the world and he runs a large London NHS meno clinic as well as doing research.)

Liz asks him towards the end of the interview, if he would prescribe HRT to symptom-free women who want the long term health benefits. His reply was YES.

Your average GP probably won't but if you can afford a private appt with a consultant, they would if they are thinking like he does!

My point being that conjugated equine oestrogens are available for prescription, so worth having the knowledge that they exist at least in case you do get prescribed it. That list is from September this year highlighting hrt shortages,.
Anyway I'm going to leave you all to it, I hope everyone stays well with hrt or not.

@Stickytreacle

My point being that conjugated equine oestrogens are available for prescription, so worth having the knowledge that they exist at least in case you do get prescribed it. That list is from September this year highlighting hrt shortages,. Anyway I'm going to leave you all to it, I hope everyone stays well with hrt or not.

Are you going to have your bones checked out considering your mum has osteoporosis? It gives you an added risk factor along with your surgical menopause.

My GP told me that literally nobody's going to go to their GP and be routinely prescribed Premarin.

She said she'd be surprised if anyone in the NHS has prescribed Premarin for a decade at least.

She wasn't even sure if it was still on the system.

I'm one of the people who doesn't really have symptoms yet apart from changes in my periods, but I am considering HRT for the long term protective health benefits.

A significant chunk of my friends seem to have fractured a bone in the last year or so, just falling over in mud at park run, or dropping a weight on their foot at the gym or something

And I've been reading about the dramatic rise in heart disease in women after menopause.

Well just to add to the debate, you cannot get utrogestan prescribed in scotland (unless as an exception and under care of a consultant in certain board areas) so the options are limited for NHS prescription. The Scottish Medicine Consortium is still listing Premarin for women with a uterus who only need a low dosage of HRT so I'm not convinced it isn't being prescribed.

I was also directed to antidepressants as a viable alternative. I declined and have done nothing apart from buy Menopace tablets.

Here are the NICE listed benefits and risks. Only listing risks as that is what OP asked for
www.nice.org.uk/guidance/ng23/ifp/chapter/benefits-and-risks-of-hrt

“HRT tablets (but not patches or gels) are linked with a higher risk of developing a blood clot.”

“Studies show that:

If you start HRT before you're 60 it does not increase your risk of cardiovascular disease.

HRT does not affect your risk of dying from cardiovascular disease.

HRT tablets (but not patches or gels) slightly raise the risk of stroke. However, it is important to remember that the risk of stroke in women under 60 is very low.”

“Studies show that for women around menopausal age:

Oestrogen‑only HRT causes little or no change in the risk of breast cancer.

HRT that contains oestrogen and progestogen may increase breast cancer risk. This risk may be higher if you take HRT for longer but falls again when you stop taking HRT.”

The progesterone - I can not tolerate Utrogestan and it's making me think about giving up on HRT altogether.

I'm about to try Cyclogest which is another form of progesterone, apparently some women tolerate it better.

The main disadvantage of HRT from my point of view is that it would be the first regular medication for me.

I've never taken anything before, and part of me is a little anxious about starting to.

What I'm on comes with an increased risk of stroke. I don't dismiss that (I have a younger friend who had a stroke so I am all too aware that behind each statistic is a real woman who was unlucky). I try to keep all my other risk factors for it down though. I was seriously unhappy before I started taking the magic drug.

Thanks all. Very informative. I think I will make appointment with GP. I read here about some women getting testosterone prescribed and I must admit their accounts of the advantages were compelling.....

For me the menopause has been beneficial in that I seem to be more clear headed ( used to get terrible brain fog with PMT), have more energy, lees moody/depressed.

But I suffer terribly with dry eyes (which optician thinks is related to Meno) and arthritis. But also possibly auto immune. The various docs/consultants I have spoken to about possible link to menopause seem uncertain. So I think I need a Meno expert.

hi OP, re dry eyes. This is unfortunately a common symptom of ageing - oil glands get blocked more easily. DH was told by his optician to get an eye mask that you can warm in the microwave and apply for a few minutes each evening. It has apparently made such a huge difference I'm tempted to get one. The one I got was less than £10

I love my hrt and found it improved all my symptoms quickly. The only disadvantage for me was that I had sensitive breasts for about 2-3 weeks initially, but that stopped completely. By sensitive I mean my boobs were really sore all the time, wearing a bra hurt or moving about at all. Was quite bad but absolutely worth it for everything else - small price to pay!