attitudes to hrt - people desperate to avoid it?

[CharityShopChic]

I am 50 this year and so many of my friends are on HRT. I started using patches in January and have seen a huge improvement in my anxiety, sleeping and furious temper.

I am in another online group with people of all ages, although tending to the 40+. Comment made in the Facebook group yesterday about hot flushes and how if the national grid could harness menopausal flushes the energy prices would half. Lots of chat about how awful flushes and other symptoms are. I commented that they should give HRT a try and the patches for me have been life changing.

Nearly everyone in the menopausal age bracket was oooooh no, that's not for me, I'm trying to manage without it, i'm hoping to avoid it etc etc.

What is going on here? I haven't come across this attitude in real life, that succumbing to HRT is some sort of failure? And that it's best to power through without , even if you feel crap? Or are they all just menopause-bonkers?

@Northernsoullover

Some of my friends are very anti hrt. They seem determined to go 'natural' as if taking HRT is some kind of moral failing. Its done nothing for my libido as I don't have one (am single though so who knows if it's there lurking) but I feel happy that my bones are being protected. To the poster who mentioned the alcohol and breast cancer risk, you are so right! I've given up booze too. I know we can't live forever but whatever I have left I want to live well.

I have friends who also say they want to be natural and not take meds but happily drink a lot.

I think it’s partly not wanting to admit in any way that we are aging. That meno is something old women do when it’s all of us of course!

www.balance-menopause.com/menopause-library/

For those who’d appreciate more info there lots of useful stuff in this website.

I initially thought I’d try to avoid hormones having hated hormonal contraception. But after learning more about it, I’ve decided to try HRT. Not least as my symptoms make it so difficult to do my job well, but also for the long term health benefits.

@Gettingthereithink

I was in the 'I'll avoid hrt if possible, my symptoms aren't unmanageable' camp until chatting with a friend recently who said that women used to die not long after their fertile years. Now we're expected to live for 30 odd years with these symptoms. The symptom currently upsetting me most is my ears! So itchy and dry, doing my nut in!

Is that really a symptom of the menopause because if it is I had really itchy ears for about a year whilst going through the menopause. Ultimately I have lost some hearing in one ear. I just thought it was another eczema flare up. (Another thing that all drs I have had over the years find hard to do and that is send someone for an allergy test) Only got a test because of Covid and refusing the vaccine until I has been tested. Which it turns out that I was right to refuse the vaccine. As not only ami allergic to all Covid vaccines. I am allergic to all vaccines. And even the needle. It explains why after I have had any vaccine in the past I have been so ill after and the enormous reaction I get around the injection site.

@LargeProsecco

I'm wondering if I'm missing out on something..... 50 next month 😲and haven't had a period for 9 months now (and prior to this they were scanty/light).

No hot flushes. Sleeping isn't brilliant but have recently separated & moved home, work is stressful.

I'm also overweight & I believe that in combination with HRT increases risk.

And I can't face the thought of monthly periods again.

I think GPs are reluctant to prescribe if very overweight.

Mid life feelings of stress etc can be made worse by fluctuating/falling oestrogen levels so go easy on yourself x

And to add to what @Newgirls just posted I also want it as I’m fed up feeling old before my time !!

My DM had breast cancer and was on HRT for a few years in her 50s - but even she'd have to admit that she smoked most of her life, was overweight, and did zero exercise. I looked at the comparative HRT risk increase for women in their 40s and decided that as a non-smoker/rare drinker it was worth keeping up my gym attendance and focusing on my weight, in return for sorting out the terrible perimenopausal brain fog/lack of joy/weariness that was genuinely threatening my ability to do my job. Both my DGM had oesteoperosis too, which I'm hoping the HRT/Body Pump will help avoid.

Quite a few of my late 40s friends are now on HRT. When it's come up in conversation, a couple have said, Oh, but I'm still having periods, so it's not for me yet - so maybe there's still an assumption that you have to be well into hot flushes and no periods to be prescribed it. Whereas my GP leans towards starting it slightly earlier, in perimenopause, for the osteo/heart benefits down the line.

Falling oestrogen impacts on various fluids and tissues in the body hence vaginal dryness and also itchy ears! Skin dryness etc. it’s basically a lubricator.

Brain fog is another impact of falling oestrogen which is why mid life women can lose confidence at work. Yay aren’t we lucky

@NotEnoughTeaYet

My DM had breast cancer and was on HRT for a few years in her 50s - but even she'd have to admit that she smoked most of her life, was overweight, and did zero exercise. I looked at the comparative HRT risk increase for women in their 40s and decided that as a non-smoker/rare drinker it was worth keeping up my gym attendance and focusing on my weight, in return for sorting out the terrible perimenopausal brain fog/lack of joy/weariness that was genuinely threatening my ability to do my job. Both my DGM had oesteoperosis too, which I'm hoping the HRT/Body Pump will help avoid.

Quite a few of my late 40s friends are now on HRT. When it's come up in conversation, a couple have said, Oh, but I'm still having periods, so it's not for me yet - so maybe there's still an assumption that you have to be well into hot flushes and no periods to be prescribed it. Whereas my GP leans towards starting it slightly earlier, in perimenopause, for the osteo/heart benefits down the line.

Women now in their 60/70s would have had very different hrt products to what’s avail now.

This is why we have to look at new, current research and data and not rely on what our mums tell us

Im 47 and have had v heavy periods the last year or so since stopping mini pill. Over the past year I have felt increasingly yuk and hormonal flip flopping angry/emotional and I hated it.

Started HRT sequential patches 2 months ago and the difference is amazing. I feel 'me' again, and yes still bleed and it is heavy and have to take tranexamic acid to slow the flow.

Menopause is awful for some, not bad for others and some people sail through.

I will monitor how I feel and learn more as I go no doubt. Have to say the first 2 weeks patches (50) are so much better for me than the last 2 weeks ones. I will discuss that with GP at my 3 month check.

Im also v overweight now.

sorry, meant to say I am classed as perimenopause phase.

I’m off to work in a mo but one more thing!

The ‘sail through’ phrase always makes me roll my eyes. It implies that peri/meno is just a year or two long. We need to debunk that.

Women who have sailed through have no idea what their health will be like age 60/70/80 so can’t know if hrt will have helped them prevent osteo etc.

Periods stopping is only part of this.

Thanks for the link @Suretobe

@Kennykenkencat I'm 64 this year and have just tweaked my hrt to add testosterone - I don't know how old you are but if it's going to help you and you do your research then why not?

Well it's not for everyone. Progesterone leaves me feeling suicidal and I'm not alone. So for me it's a choice between sleep/no night sweats and feeling suicidal or suffering the insomnia and night sweats. GP has no other ideas!
I have a lot of menopausal friends, some take hrt and some went down the natural route. Its a tad patronising to be telling grown women what's best for them.

Every woman should have regular bone density scans once she is menopausal. The risk of osteoporosis is far greater when we lose oestrogen. I came off HRT a few years ago because my GP was droning on about breast cancer risks. My osteopenia (precursor of osteoporosis) deteriorated so that the next BDS I had three years later indicated I had full-blown osteoporosis.

I insisted on being referred back to the Menopause Clinic at Chelsea & Westminster Hospital who put me on oestradiol and progesterone (to protect the womb) and when I had another BDS 18 months later my bone density had improved to the level it was previously.

Do not be fobbed off by unknowledgeable and unsympathetic GPs, many of whom will not mention the risks to our bones becoming fragile post menopause and leading to great pain and even death. So more risk than breast cancer I suspect.

@Waterfordaston

But Nellie that’s been debunked.

No it hasn’t. HRT that is oestrogen plus progestogen may increase risk of breast cancer. There are other risks to HRT as well looking at the NICE guidelines. www.nice.org.uk/guidance/ng23/ifp/chapter/benefits-and-risks-of-hrt

HRT is a way of dealing with the menopause & there are other options as well. It's not a failure to take it - it can make all the difference to some women whilst other women don't need it.
Certainly I wish my GP had listened to me sooner as HRT would have helped me, not just with all the night sweats, hot flushes, etc that started in my early 40s.
Starting to take it at 46 helped with all those but at 49 I now have osteoporosis & vaginal atrophy that despite both HRT & topical HRT means that I will never have PIV sex again.
I'm hoping to take it for the rest of my life...

I do wonder if women who sail through the menopause without needing HRT will have future problems caused by the lack of oestrogen such as osteoporosis but again, we're all different so they might be lucky!

@Kennykenkencat

I wish I could have had HRT but my GPs surgery said it wasn’t something they did

OTOH I sailed through the menopause, (vegetarian/vegan) a couple of hot flushes that just felt like I was a bit hot for a couple of minutes.
The problems I am having are more long term insomnia. (GP don’t prescribe sleeping pills). My friend (a little younger) and I both felt really creaky and it physically was agony standing up from a seated position, getting out of bed in the morning. I read that HRT could help. She had in the meantime gone to her GP who had prescribed HRT to her and she was no longer in pain. I am sure there are a lot of other little niggles that would be better if I had been put on HRT like the skin on my face sliding off my skull and ending up in sags around my chin and neck. My ADHD, which despite being on huge amounts of medication my brain still struggles to focus. and many many more things that I don’t really notice as I have learned to live with them. I think my life would have been more better if I had been prescribed HRT and not been sent away with the recommendation that I try lavender oil which

A. Did nothing and
B. It turns out I am allergic to

wish I could have had HRT but my GPs surgery said it wasn’t something they did

This is nonsense.
A dr is not allowed to withhold safe and effective treatments if it's not medically contraindicated. This is pure misogyny. I'm shocked you didn't hold them to account @Kennykenkencat

Would drs tell men they 'didn't Do Viagra, or prostate drugs, or drugs for low testosterone...'

No.

Women now in their 60/70s would have had very different hrt products to what’s avail now

@Newgirls I am well into my 60s, been on HRT for years and have used exactly what is the best HRT all along.

Body identical HRT has been around for longer than you think- at least 15 years.

Sadly most GPs are not up to speed and I've never used one for HRT.

I think I am probably menopausal, given my age of 56 & a few other indications, but I have absolutely no intention of taking HRT. Menopause is not an illness, just a normal stage of life, so I see no need to medicate for that. Plus who wants the absolute faff of doctor's appointments, prescriptions etc? I've managed to not need to see a GP for the best part of 20 years, so I intend to keep it that way unless & until something important crops up!

There are multiple factors why most women don't use HRT.

Sadly, lack of knowledge/ education is one of the main ones, both for women and GPs.

It's the over-emphasis on risks, and the under-appreciation of what NOT using HRT can result in years down the line.

And there are lots of women with all kinds of health issues who don't make the link with loss of estrogen ( sore joints, arthritis, etc.)

Some women do not appreciate (and it's been mentioned here now) is that the 'silent' risks of menopause like loss of bone density, heart disease and possibly dementia, all appear 10-20 years later.

Menopause is not just flushes, sweats, brain fog and moods.
These may pass quickly ( although around 15% of women have them for life.) But the longer term risks of loss of estrogen are not talked about or even understood.

The risk of BC is there, but it's a much smaller risk than drinking alcohol and being overweight.

Yet some women are happy to joke about their drinking, and are often above a healthy BMI. Yet don't appreciate these are key risks for BC. This isn't being judgy- it's medical fact.

Also, a lot of women TRY HRT and the dose or type doesn't suit. This sometimes comes down to poor prescribing by the GP, OR willingness to refer women to specialists.

Meno specialists (consultants) have cards up their sleeves, allowing them to change the dose, off licence. A GP isn't allowed to do this.

I'm fully pro-choice BUT given most female menopause consultants (that I know of) use HRT, they can't all be wrong.

It's fine if you don't need it, and plenty of women don't, but it's not fine surely to spend 30+ years with a miserable quality of life when something that's safer than 2 drinks a day could help.

@Hbh17 Your argument is one that crops up a lot. There is so much to argue against it! No, it's not an illness BUT loss of estrogen causes illness. It's normal stage of life that leads to other diseases. And until about 200 years your life expectancy was 45 not almost 90.

Do you know that 1:2 women over 50 develop osteoporosis? You might, but you won't know till you break a bone or your spine fractures and putting it right is almost impossible AND the drugs have worse risks than HRT.

I think you are exaggerating about 'faffing about' with drs appts. Most women have 2 appts a year or even just one, as a review, with HRT on repeat prescription.

@JinglingHellsBells
Some women do not appreciate (and it's been mentioned here now) is that the 'silent' risks of menopause like loss of bone density, heart disease and possibly dementia, all appear 10-20 years later.

But HRT only protects against one of these- bone loss.

HRT does not affect your risk of dying from cardiovascular disease.- so zero protection against heart disease.
HRT tablets (but not patches or gels) slightly raise the risk of stroke.
It is currently unknown whether HRT affects the risk of developing dementia.
www.nice.org.uk/guidance/ng23/ifp/chapter/benefits-and-risks-of-hrt

OP - I tried to speak to my GP (female) last year. She was anything but supportive. She wanted me to consider going on anti-depressants or manage using herbal supplements instead. She went on and on about breast cancer risks and they would not let me be on HRT longer than 5 years.

I'm in Scotland - the NICE guidelines don't apply here and because prescriptions are 'free' they will only prescribe certain HRT products - not the full range that are available to women (approach differs by Health Board area - mine is really restrictive). GP refused to refer me to menopause clinic. I cannot move GPs - no the GP near me are accepting new patients. I am too weepy and tired to advocate for myself and am saving up to have a private consultation.

[quote EmpressCixi]@JinglingHellsBells
Some women do not appreciate (and it's been mentioned here now) is that the 'silent' risks of menopause like loss of bone density, heart disease and possibly dementia, all appear 10-20 years later.

But HRT only protects against one of these- bone loss.

HRT does not affect your risk of dying from cardiovascular disease.- so zero protection against heart disease.
HRT tablets (but not patches or gels) slightly raise the risk of stroke.
It is currently unknown whether HRT affects the risk of developing dementia.
www.nice.org.uk/guidance/ng23/ifp/chapter/benefits-and-risks-of-hrt[/quote]
Not sure where you are getting your info from, but you are incorrect.

There are plenty of papers out there if you read them.

Using HRT within 10 years of the menopause reduces heart disease.

This is well established and I suggest you read the papers that are out there on it.

I don't have time to link to all of this but if you interested it's all out there.

This is from the BMJ.

HRT taken for 10 years significantly reduces risk of heart failure and heart attack
(Published 10 October 2012)
Women who take HRT for 10 years following menopause have a significantly reduced risk of mortality, heart failure and heart attack without any increased risk of cancer, DVT or stroke, a study published today on bmj.com suggests.

www.womens-health-concern.org/2021/03/hrt-and-heart-disease/

thebms.org.uk/2012/10/hrt-and-cardiovascular-prevention/