HRT tablets

[MidlifeK]

My doctor is keen to prescribe me HRT tablets.. citing easier, no patches etc. I’ve read body identical gels etc can be safer than tablets.

Just wanting feedback from anyone on HRT .. did they make a difference ? Did you have success on tablets or did you prefer the gel? Why ?

For background although I know not always reliable, my blood tests for tiredness showed my hormone levels are low. So doctor now suggesting HRT.

I am suffering extreme tiredness, loss of libido, anxiety, brain fog and just feeling out of my depth. I’m 50. Thank you for any advice/experience sharing.

One thing worth considering is that tablet HRT can cause liver problems. Admittedly you'd have to be unlucky but it's not impossible. That's why there are transdermal options too.

(Your patients- are you a HCP?)

No that's not correct as far as I know @hashbrownsandwich.

It's not a risk of liver problems, it's that all drugs bypass the liver first and because of how the liver converts the drug, it can raise cause blood clots.

@MidlifeK Many GPs now are being 'advised' to provide transdermal as the first option for the above reason.

Ideally, it's your choice. The GP should discuss these options. If you are a non smoker, not overweight, or have any other health issues, tablets are ok if that is what you prefer.

Blood clots are rare, but for women who start HRT over 60, or who carry on beyond 60, transdermal is always prescribed.

Gel is easy to change the dose- unless patches which need a new prescription if you want to g up or down with the estrogen dose. With gel you also need to use micronised progesterone - Utrogestan, (tablets) where with a patch you can get both estrogen and progestins in the patch.

it's that all drugs bypass the liver first

Just for clarity- drugs that are taken by mouth and go through the digestive system. Drugs that are administered through the skin, go straight into the blood stream with being converted in a different way by the liver.

HCP yes @JinglingHellsBells

I'm on tablets and do hope my liver is ok!
I like a glass of wine as well...
I am not overweight however, and so far blood pressure fine and just had clear mammogram so... risking my Femoston 1/10 . I am on my 4th month and it has improved my sleep massively.
Still have some brainfog, get very tired in the evenings. Still get some pmt type symptoms and my 'bleed' bigger than was before HRT.
So far, think right decision however, as excrutiating anxiety peaks seem to have subsided.

@hashbrownsandwich

HCP yes *@JinglingHellsBells*

Well, I'm sorry to sound critical. but what you posted is incorrect. I think you are confusing the risk of blood clots, (where oral estrogen is metabolised via the liver and this can raise the risk of blood clots) and 'liver damage'.

The benefits of transdermal is because of the higher risk of blood clots in older women or women at higher risk of blood clots, if they use oral tablets.

This is from the British Menopause Society info for HCP.

Venous thromboembolism (VTE)
It is well recognised that unlike oral estrogen, transdermal estrogen does not appear to increase the risk of VTE. Observational and case control data suggest that the use of certain progestogens e.g. dydrogesterone and micronised progesterone (D/MP) may reduce the increased risk of VTE conferred by oral estrogen, compared to that noted with other synthetic progestogens.

thebms.org.uk/publications/consensus-statements/bioidentical-hrt/

@DinkyDaisy You'll be fine. I think the other poster is mixing up some issues.

Thank you Jingling.
Also, dydrogesterone in Femoston which seems to get a general thumbs up!

Femoston is one of the best tablets as the progestin in it is almost the same as our own. It's very similar to micronised progesterone.

Unfortunately, it is not available now as a separate tablet which is why women used micronised progesterone (which they either love or HATE!)

I see.
I am also looking forward to the time when I don't have to pay double prescription charges.
Really, they should have the progestin available separately for those women who would prefer that.
From the way you have worded your post, sounds like they used to.
My GP started me first on Femoston as said kindest progestin.
Very glad he did rather than with an HRT with other forms of it.

Have you had your thyroid checked also ? I put a lot of my symptoms down to menopause but was then told it was under active thryroid. Feel 100% better since on thyroxine.

Thank you all for your replies.. yes thyroid was checked in the blood tests and normal. I was originally prescribed anti depressants but had awful side effects. So not on those.

Blood tests showed low hormones so it’s almost by a process of elimination that I’m thinking HRT could help as all my other results were ok.

I know high blood pressure can be an issue with tablets but right now I’d try them regardless if they made me feel better!

Thanks Liverpool gal I am watching some of Dr Bergs videos on Thyroid now as although my blood test is considered normal dr very says they are using inaccurate parameters so in his reconciling my thyroid is abnormal. The issues I am experiencing also fit with his explanation of what a ‘body type thyroid’ would experience. I’m curious have you seen his videos on Thyroid ?

It's far more likely at your age (!) that this is hormonal. It may well be thyroid too, and Mn is always quick to mention this, but it's certainly not as common as menopause symptoms.

I know high blood pressure can be an issue with tablets

its not :)

HRT tablets rarely cause high BP.

This was more common with the old types - Premarin etc- which are not prescribed now.

The estrogen in tablets is exactly the same as your own and is simply replacement.

No I've not seen any videos on thyroid. The reason I was quick to mention it is because I'm sharing my experience. If you're saying you're now being told it's abnormal maybe it's a combination of both. What were your thyroid levels then- do you know?

Symptoms for me were, weight gain, very stiff/sore joints especially first thing getting out of bed, nails breaking flaking, hair going v dry and exhaustion. Thyroid med sorted that out and I felt normal again - then a small while later I was put on Tibolone
HRT (
as im having to be on a monthly Zoladex temporary for a separate issues) and the HRT has been great also, no more hot flushes, moods better. I've upped my exercise and back to swimming and long dog walks so feeling better than ever now at 50 then I did in my 40's.