Meet the Other Phone. Flexible and made to last.

Meet the Other Phone.
Flexible and made to last.

Buy now

Please or to access all these features

Menopause

Mumsnet doesn't verify the qualifications of users. If you have medical concerns, please consult a healthcare professional.

Anyone choosing NOT to use HRT?

653 replies

WandaWomblesaurus73 · 11/01/2022 11:28

Does anyone feel that HRT isn't for them or feel happier without it?

OP posts:
Thread gallery
5
SueSaid · 21/01/2022 08:09

'was thinking of the people reading this thread accepting some of the misleading nonsense being spouted by unqualified but enthusiastic participants'

Please stop being so rude.

A link to a recent BMJ report is not misleading nonsense. They can conclude the risks may be low but anyone who is on combined hrt after 10yrd may understand a 19 % increase in risk should not be dismissed .

whowhywhenwhat · 21/01/2022 08:15

Googling medical papers with no medical background gives you questions to ask a medical professional who can then explain further. It does not make you an expert.

This cuts both ways. It can end up with a berating of GPs if they don't give the desired prescription and recommendations of preferred doctors in private practice. The 'experts' it seems also have their own biases. GPs are generalists which means they look at someone's health overall, gynaecologists are specialists which primarily look at one aspect of health. Which advice you need, if any, is dependent on your own health issues.

JinglingHellsBells · 21/01/2022 08:16

I feel quite sorry for any 'lurkers' who are genuinely looking for info and advice on this thread- which, as always, has become a bit contentious. No surprises there!

There is a LOT of misinformation on this thread from some posters.

The most recent is on dementia.

The reason for misinformation is this:
Some websites are out of date. New research supersedes old, and not all research is equal.

The research which I think was quoted by @JaniieJones has been updated (and not all charities like Alzheimers get their websites up to date quickly.)

This is a recent report on dementia .www.theguardian.com/society/2021/sep/29/hrt-not-linked-to-increased-risk-of-dementia-says-study

QUOTE from the above link

To try to end years of uncertainty, researchers at the University of Oxford, Southampton and Nottingham set out to investigate the risks of developing dementia for women using any of the forms of HRT commonly prescribed within the NHS.

Their study, involving more than 600,000 women over three decades, concluded that HRT is not linked to an increased risk of dementia. The findings were published in the BMJ

This large observational study found no overall association between use of menopausal hormone therapy and risk of developing dementia,” the authors wrote. “This finding was consistent across different types of hormones, doses, applications, and time of hormone therapy initiation

The researchers added that the study “brings clarity to previously inconsistent findings and should reassure women in need of menopausal hormonal therapy

Likewise I saw a statement (which was an opinion, presented as a fact) that 'it's not advisable to take HRT forever.' This is not fact.

There are women in their 80s and 90s still using HRT (consultants are on record in interviews stating this. I can link if anyone wants!)

This is the BMS statement on HRT thebms.org.uk/publications/consensus-statements/bms-whcs-2020-recommendations-on-hormone-replacement-therapy-in-menopausal-women/

To counteract the misinformation, maybe it's best to copy and paste the entire key points. (Apologies it's such a long extract!)

-All women should be able to access advice on how they can optimise their menopause transition and the years beyond.

-There should be a holistic and individualised approach in assessing menopausal women, with particular reference to lifestyle advice, diet modification as well as discussion of the role of HRT.

-The decision whether to take HRT, the dose of HRT used and the duration of its use should be made on an individualised basis after discussing the benefits and risks with each patient. This should be considered in the context of the overall benefits obtained from using HRT including symptom control and improving quality of life as well as considering the bone and cardiovascular benefits associated with HRT use.

-The HRT dosage, regimen and duration should be individualised, with annual evaluation of advantages and disadvantages.

-Transdermal administration of estradiol is unlikely to increase the risk of venous thrombosis or stroke above that in non-users and is associated with a lower risk compared with oral administration of estradiol. The transdermal route should therefore be considered as the first choice route of estradiol administration in women with risk factors.

-Evidence from large observational studies and case-controlled studies suggests that micronised progesterone and dydrogesterone are unlikely to increase the risk of venous thrombosis and are associated with a lower risk of breast cancer compared to that noted with oral progestogens.

-The potential benefits of bioidentical hormone therapy can be achieved using conventionally licensed products, without having to resort to unregulated compounded varieties from specialist pharmacies.

-Arbitrary limits should not be placed on the duration of usage of HRT; if symptoms persist, the benefits of hormone therapy usually outweigh the risks. [This means you can take it for as long as it's working for you which may mean forever.]

-HRT prescribed before the age of 60 has a favourable benefit/risk profile.

-HRT initiated before the age of 60 or within 10 years of the menopause is likely to be associated with a reduction in coronary heart disease and cardiovascular mortality.

-If HRT is to be used in women over 60 years of age, lower doses should be started, preferably with a transdermal route of estradiol administration. Evidence from the Cochrane data-analysis as well as that from the long-term follow-up data of the WHI showed no increase in cardiovascular events, cardiovascular mortality or all-cause mortality in women who initiated HRT more than 10 years after the menopause.

-Women with POI and early menopause should be encouraged to use HRT at least until the average age of the menopause.

-HRT and the combined contraceptive pill would both be suitable options for hormone replacement in women with POI. However, HRT may result in a more favourable improvement in bone density and cardiovascular markers compared with the combined contraceptive pill.

Another poster also said that the links were very 'basic'.
These consensus statements by the BMS come after they have researched hundreds of research trials. The statements are a summary. On the BMS, you can find links to many research papers.

If you are going to provide links, please make sure they are the most recent.

Also make sure you know
-the difference between observational research trials
-retrospective and prospective
-between meta analyses and Cochrane trials
-between random controlled trials /double blind trials
-who did the research and who paid for it.

Most importantly that a LOT of the research that is behind the big, bold statements that hit the press is OLD data that has been disproved.

The Lancet report that came out in 2019 and supposedly showed higher risks, was based on the WHI and Million Women research from decades ago (both now shown to be flawed) and it also used research that was not even peer reviewed so highly unreliable. Neither did it include women using micronised progesterone, so the stats are not relevant for those women.

I hope this thread has provided the right facts for women who may be reading (and not posting.)

JinglingHellsBells · 21/01/2022 08:17

@JaniieJones

'was thinking of the people reading this thread accepting some of the misleading nonsense being spouted by unqualified but enthusiastic participants'

Please stop being so rude.

A link to a recent BMJ report is not misleading nonsense. They can conclude the risks may be low but anyone who is on combined hrt after 10yrd may understand a 19 % increase in risk should not be dismissed .

@JaniieJones That report is out of date.
MarshaBradyo · 21/01/2022 08:19

I feel quite sorry for any 'lurkers' who are genuinely looking for info and advice on this thread

I am looking for information and advice. I have been clear on why,

First told that it was wrong not to search ‘go along for ride’ Confused etc now told it is.

There are a few of us responding to the title and wanting to hear more about it. It is so odd how rude and patronising some are being about it.

JinglingHellsBells · 21/01/2022 08:25

On the topic of dementia, can we get away from the assuming that all dementia is Alzheimers?

Alzheimers is ONE type of dementia. There are 4 or more different sub-types. One of my parents died from dementia but it was not Alzheimers.

SueSaid · 21/01/2022 08:28

'That report is out of date.'

The bmj link from 2021 is out of date? But it says clealry no risk with oestrogen only but a 10% risk with combined hrt after 5yrs then 19% after 10yrs. This was from sep 2021.

I understand the authors can then conclude that risk is low overall but surely for those taking combined hrt it would be relevant and not misinformation?

anothersmahedmug · 21/01/2022 08:29

I suspect all types of dementia are distressing to watch

Toanewstart22 · 21/01/2022 08:33

Curious as to whether any female GPs decide against hrt

I doubt none or very very few

Game changer for me

JinglingHellsBells · 21/01/2022 08:33

Just coming back to the report Iinked to in the Guardian. It is the same one mentioned by @JaniieJones BUT the overall recommendation is that on balance, women should not be concerned about a possible slight link to some types of dementia.

Also, and I'd have to dig around for the link for this, some research suggests that any link is only evident in some women who started HRT after aged 60 thereby missing the window of opportunity.

In real life, I don't know anyone who discusses HRT pros and cons as here in the way it comes over on a forum. (It sometimes comes over like a 6th from debating society rather than people who genuinely want information for themselves.)

My friends are either using it or not, depending on their symptoms. We respect each other's choices and reasons for using it, or not. If they want info, they would find a good consultant to discuss it all with and to be honest, that is your best route if you are unsure. Your GP is unlikely to know much as they do not have menopause training, usually.

JinglingHellsBells · 21/01/2022 08:37

@JaniieJones

'That report is out of date.'

The bmj link from 2021 is out of date? But it says clealry no risk with oestrogen only but a 10% risk with combined hrt after 5yrs then 19% after 10yrs. This was from sep 2021.

I understand the authors can then conclude that risk is low overall but surely for those taking combined hrt it would be relevant and not misinformation?

Combined HRT will not include micronised progesterone (I am assuming) as it's a new way of taking HRT for most women. Almost ALL research is done on the types of HRT that many women are no longer using.

Very little research does apart from the research trials purely on it (Of which there are some, mainly the E3N French report which included a large number of teachers, over around 12 years.)

MarshaBradyo · 21/01/2022 08:37

In real life, I don't know anyone who discusses HRT pros and cons as here in the way it comes over on a forum. (It sometimes comes over like a 6th from debating society rather than people who genuinely want information for themselves.)

Seriously what is the issue?

It’s bizarre these constant digs.

Really weird.

WandaWomblesaurus73 · 21/01/2022 08:38

I've been catching up with all the posts and it's amazing. It started out as a single question but along the way it's shown me exactly how complex and varied the responses are. So I haven't posted and run but I'm learning huge amounts which you know three months ago I was clueless about this - I asked the women in my family (eight of them all generations) and most of them said they had been clueless too about menopause, HRT etc until it happened to them. My mum took HRT but the rest were never offered it even if they asked.

OP posts:
WandaWomblesaurus73 · 21/01/2022 08:47

@Newgirls

The discussion around menopause always seems to be about ‘symptoms’ and it lasting a year or two. This really needs to change as the impact is actually for our whole lives.

I think the medical world really need to give this whole topic more research and focus. As ever women’s health seems to be in the dark ages. Why aren’t we being educated about this stuff in our early 40s?

Exactly this - also the trainings I've been on with the company always have a couple of men in them saying "what about men" and then they focus on getting a fan on a desk as the solution.
OP posts:
Esspee · 21/01/2022 09:03

Jinglinghellsbells clearly knows what she is talking about. Why do some people want to argue about it?

Esspee · 21/01/2022 09:06

@MarshaBradyo

In real life, I don't know anyone who discusses HRT pros and cons as here in the way it comes over on a forum. (It sometimes comes over like a 6th from debating society rather than people who genuinely want information for themselves.)

Seriously what is the issue?

It’s bizarre these constant digs.

Really weird.

I suspect Jinglinghellsbells like me is just frustrated at the uninformed misreading and misrepresentation of medical information as fact. It must be so confusing to women just wanting to learn more about the subject.
MarshaBradyo · 21/01/2022 09:09

Esspee I am a woman who just wants to learn more.

And the tone of posts which are rude and patronising is putting me off reading them.

ArabellaScott · 21/01/2022 09:19

@MarshaBradyo

Esspee I am a woman who just wants to learn more.

And the tone of posts which are rude and patronising is putting me off reading them.

Yep. Asking questions is wrong, looking for evidence is wrong, the NHS is wrong, quoting study/evidence from the BMJ is wrong.

We should all 'google' but if we do the evidence we find is wrong.

Esspee · 21/01/2022 09:29

I am happy to be guided by someone who is better informed than me.

MarshaBradyo · 21/01/2022 09:35

Oh I thought you were guiding us too, us mere ‘ladies without knowledge’.

Arabella yep! And all on a thread with the title it has.

anothersmahedmug · 21/01/2022 09:36

I am happy to be guided by

the evidence which I am capable of reading and often understanding myself

By experts who I have reason to trust

By the experience of others , especially those who I feel have an understanding that this is never going to be very simple , that class and individual are different, that each body is different

MarshaBradyo · 21/01/2022 09:48

@anothersmahedmug

I am happy to be guided by

the evidence which I am capable of reading and often understanding myself

By experts who I have reason to trust

By the experience of others , especially those who I feel have an understanding that this is never going to be very simple , that class and individual are different, that each body is different

Good post, me too
Drunkpanda · 21/01/2022 09:58

I know the progesterone I take (utrogestan) is fairly new in terms of being prescribed where I live, when I googled it first there were posts about people not being offered it at all in Scotland. The progesterone I took when trying to stay pregnant was totally different. Just like oestrogen can be given in many ways, some with more long term side effects than others.

Esspee · 21/01/2022 10:09

To use the BMJ article as an example the conclusion the medical professionals came to was that “the current study should provide reassurance for women and their providers”. The first line after the heading reads “evidence is reassuring for women using hormone therapy to treat menopausal symptoms”. At least two people on here have chosen to interpret the findings differently from the medical professionals and bang on about it even after it has been pointed out they are wrong. This is spreading misinformation. Can’t you see that?

Now I have work to do.

Esspee · 21/01/2022 10:11

@Drunkpanda

I know the progesterone I take (utrogestan) is fairly new in terms of being prescribed where I live, when I googled it first there were posts about people not being offered it at all in Scotland. The progesterone I took when trying to stay pregnant was totally different. Just like oestrogen can be given in many ways, some with more long term side effects than others.
So glad you got it Drunkpanda it is apparently the safest form.
Swipe left for the next trending thread