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?

You'll prise my HRT from my cold dead hands!
I had vaginal atrophy, palpitations, vertigo, muscle aches and huge anxiety. Doctors never put any of these symptoms together and considered that I might be peri menopausal. I started HRT after a particularly painful experience that felt like a UTI but with no infection. The dr did a blood test and saw I was in peri menopause. HRT has vastly improved all my symptoms (although the vaginal atrophy is particularly resistant to fixing).

It makes complete sense to me that women should be replenishing dipped oestrogen if they can.

I completely agree that it’s not for everyone. Some people don’t get on with it, others have to try several combinations before getting the right one. Other people float through menopause without a single flush.

What I don’t understand is women complaining bitterly if symptoms and ruling out HRT full stop. Without speaking to a GP or trying for 3 months to see how they get on.

@JinglingHellsBells
Not sure where you are getting your info from, but you are incorrect.

I cut and pasted direct from the current NICE guidelines which I linked. They look at the evidence of all papers, so posting one single study isn’t as reliable as the NICE summary, imho.

I’m on HRT myself, but I find it ironic that you’re going in about women being uneducated when they choose not to use it but are posting very questionable claims not supported by the NICE guidelines.

I also accept that my attitude about “hormones” may be skewed as it’s oestrogen only on my case and I’m also on thyroxine which is a hormone, and one I’ll be taking for the rest of my life too.

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

According to the NICE guidelines, updated in 2019, so more current than your 2012 single paper:
“If you start HRT before you're 60 it does not increase your risk of cardiovascular disease”
www.nice.org.uk/guidance/ng23/ifp/chapter/benefits-and-risks-of-hrt

(Cardiovascular disease is heart disease and stroke.)

@EmpressCixi

NICE exists to make decisions on cost/ benefits of drugs on a large population level. It is not concerned about optimising health or preventative treatments. It is not going to 'recommend' HRT as a prophylactic. That's not the role of NICE.

I am happy to take the advice of my menopause consultant, and listen to the British Menopause Society website videos.

Maybe you'd like to watch this one by Prof John Stevenson on CVD? He makes it very clear that there are benefits to the heart with estrogen. it's 2 minute interview so won't take long to listen:)

Scroll down and it's near the bottom right.

Hope this helps

thebms.org.uk/publications/bms-tv/

[quote JinglingHellsBells]@EmpressCixi

NICE exists to make decisions on cost/ benefits of drugs on a large population level. It is not concerned about optimising health or preventative treatments. It is not going to 'recommend' HRT as a prophylactic. That's not the role of NICE.

I am happy to take the advice of my menopause consultant, and listen to the British Menopause Society website videos.

Maybe you'd like to watch this one by Prof John Stevenson on CVD? He makes it very clear that there are benefits to the heart with estrogen. it's 2 minute interview so won't take long to listen:)

Scroll down and it's near the bottom right.

Hope this helps

thebms.org.uk/publications/bms-tv/[/quote]
Funny that, the NICE guidelines I’ve linked to are the ones for the public to read so nothing to do with cost. And also funny, but they do recommend HRT as a prophylactic against bone density loss:

“Your GP should explain that for women around menopausal age the risk of breaking a bone is low, and HRT reduces this risk further. This benefit only lasts while you are taking HRT but it may last longer if you have taken HRT for a long time.”

So stands to reason that any other benefits would also be listed too? Sources of information are very important, but don’t assume women are uneducated if they’re using different sources from you and come to the same or different decision from you.

NICE has a better reputation for scientific rigour than the British Menopause Society imho.

I don’t like the idea of it, I fall into the ‘don’t like taking paracetamol’ camp but also can’t get on with other hormone meds - mirena nearly drive me to suicide. So if I can avoid it I will.
I hate the fact that some people seem to try and force it on you, very evangelical.

I'm nearly 42. I am constantly wondering how people know that they are peri menopausal? More recently I seem to have a really short temper and I have zero sex drive, but I also have three little kids so that could be a factor there! Still have regular periods.

What should I be looking out for?

On the HRT thing, I would happily take it. Also in Scotland so probably will come up against the same issue as a PP re the NICE guidelines.

@EmpressCixi So you choose to ignore the video with a top Professor. Did you even bother to watch it?
And bang on about NICE.

Why is that?

Can't be bothered debating with you. Sorry.

The menopause is not a natural process we are meant to procreate and then die. Obviously life expectancy improvements means the menopause happens. I don’t know anybody my age that isn’t on HRT. I would prefer to be on HRT than on anti depressants which GPs seem to love to hand out instead

@ImAvingOops have you tried ovestin cream? I found it transformational. Have also had my patches doubled and switched to oral progesterone from an Mirena, and started testosterone, and one or all of those have substantially increased my vaginal secretions (sorry if TMI).

I’m 46yo and interested in hrt but am most worried about weight gain. Is that a thing

[quote JinglingHellsBells]@EmpressCixi So you choose to ignore the video with a top Professor. Did you even bother to watch it?
And bang on about NICE.

Why is that?

Can't be bothered debating with you. Sorry.[/quote]
@JinglingHellsBells you ‘can’t be bothered ‘. debating when someone challenges you …
You quote NICE when it suits you, rubbish them when it doesn’t .

I’ve read these board for a while and sadly my advice to any woman reading here is find another forum. There is no real debate here

@Republicplease I can't be bothered talking to someone who doesn't even watch or read eminent medics discuss the issue she is bringing up. Far better she makes an appt with one of them and takes them on, rather than shooting the messenger.

To dismiss the BMS, composed of world-class experts on menopause is rather unfathomable.

To 'blame me' for reporting what they say is also rather odd.

Posters can find as many forums as they like to discuss things. I'm sure they don't need a push from you to do that.

This is my Mums attitude. It’s a natural process - get on with it. Yeah Mum I remember living with you when you were going through it. It wasn’t pleasant. I take it l, feel better and I haven’t looked back!!

My sister has advanced breast cancer at age 56 due, we believe, to HRT. No family history.

What's right for me might not be best for everyone, but, I have honestly felt such a positive difference by going on HRT. I wasn't having hot flushes, but the same bio-mechanism produces adrenaline rushes and having a panic attack every 20 minutes was not enabling me to be productive in any aspect of my life.

It takes a little fine tuning but if I needed thyroxine or insulin or any one of a number of things, I'd take it. Why should HRT be any different.

The protective effects of oestrogen in HRT are VERY important to understand. It's now known that your risk of osteoporosis, cognitive decline, dementia and heart problems, amongst others, are much reduced if you're on HRT. It's not all about 'sailing through ' it. Longer term protective benefits are a key reason why I take it.

It just makes sense, surely, that messing around with hormones is not a good idea. It's best avoided, just like all drugs are best avoided.

It’s often ignorance. Bone density keeps women active for longer which can reduce the risk of heart disease and the risk of dementia.

Also the increased breast cancer risk for some women is not fully understood yet. The quality of the data 15-20 years ago was shit and at the time it was mainly white women who took it / were studied & the risk of bc (including genetic types) has always been higher in this group.

Not suitable for me, previous breast cancer, but there are individual treatments available for specific symptoms.
I only had one really bad symptom which is dealt with by separate prescription so wouldn’t have been interested in HRT anyway.

@Waterfordaston

But Nellie that’s been debunked.

Widely debunked, possible (probably) via conflicts of interest, or what's right before my eyes?

@halfsiesonapotnoodle

The protective effects of oestrogen in HRT are VERY important to understand. It's now known that your risk of osteoporosis, cognitive decline, dementia and heart problems, amongst others, are much reduced if you're on HRT. It's not all about 'sailing through ' it. Longer term protective benefits are a key reason why I take it.

This. The impact on bone density is most felt in south asian women who often have bone issues anyway. In my own mum’s case - HRT could have prevented her osteoporosis entirely. But she was too scared of the dodgy data around the breast cancer risk & her Gp, as always, doesn’t know enough about general medicine to give the right advice