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?

@VerityPJohnson

I think this is just another way women judge rather than support each other. We are all individual and have different experiences/make up and we should be free to choose the path that is right for us without women not going down the HRT route warning others off it and those doing it thinking the other group are missing a trick.

What I do think is problematic is the level of misinformation circling, eg that it's just a fixed period of time, or how to be 'diagnosed' as perimenopausal, to the risks of HRT, to what menopause actually even is. It's awful and I don't think it would be the same if this involved men. We all deserve to have accurate information on which to base the decision and we seem very far from that.

Hear hear

It feels like so many women don’t know enough about this - which is so disturbing really. And that GPs get so little training.

Hence why we are on here trying to figure it out between us 🤦‍♀️

@Prestel

Although I think it's great that HRT can help protect women who take it from osteoporosis I think it's worth pointing out for those who can't or choose not to that there are other ways to improve and maintain bone health. Weight-bearing exercise, making sure there's enough calcium in your diet and taking vitamin d supplements can all help.

Yes agree

Also as more of us cut back on dairy for various reasons we need to be extra aware

@JaniieJones

'To me, it seems a bit like the 'natural birth' obsession and how everything other than a vaginal birth is considered a failure and to be avoided at all costs.'

It isn't that. It is more the evidence is conflicting and for every study stating its benefits you'll find another contradicting it or stating risk factors.

Women aren't stupid, I don't agree with this it must be down to education/ knowledge thing. If they have a dm in her 70s/80s in good health, without osteoporosis or dementia who hasn't taken hrt then there is every chance the same will apply to them.

We could do with balanced info. For example if Davina does another doc or when This Morning feature Louise Newson (a Dr with a private clinic so obviously a vested interest) they also need to feature HCPs who don't advocate hrt and explain why.

I have friends and family in peri/post some of us on hrt some of us not. We all support each other, there isn't any judging. Some people seem to tolerate depleted oestrogen better than others.

Women need more definitive, current, conclusive info regarding the risks and benefits particularly the alleged dementia protection.

Yes we really do

The NHS is being run into the ground so not sure how much preventative care we are going to get. Those with access to private doctors will have very different outcomes I think

@Newgirls

I’m not sure whether you actually took my words literally or are being deliberately disingenuous.

Of course I realise that it needs to be prescribed, the point is that it’s viewed by many as the only option and a number of colleagues and friends suggest it at every opportunity regardless of what’s going on.

[quote ineedsun]@Newgirls

I’m not sure whether you actually took my words literally or are being deliberately disingenuous.

Of course I realise that it needs to be prescribed, the point is that it’s viewed by many as the only option and a number of colleagues and friends suggest it at every opportunity regardless of what’s going on.[/quote]
Maybe they think they are being helpful to you? No idea. No one in my real life has mentioned it. But of course on threads like this people will

If they have a dm in her 70s/80s in good health, without osteoporosis or dementia who hasn't taken hrt then there is every chance the same will apply to them.

This so untrue.

If it were true I'd not have been on the borderline of osteoporosis in my late 40s, with no risk factors at all. Had I not had a DEXA scan I'd have very bad osteo now.

I have 2 friends with osteoporosis, both whose periods stopped around 46. They are suffering a lot. Neither of their mothers had it.

As for the research. It is pretty conclusive on lots of points. Nothing is black and white. ultimately if you want to try some medication to help ,you have to listen to the professors and experts who have spent 40 years working in the field and trust their judgement, just as you would for any medication at all.

I have been told by meno experts that there is NO research going on that will make any big difference to women now in their 50s or 60s, as it takes 20+ years to see the long term results. But also there is no money in pharma for HRT, as they focus on other drugs where they can make more money- diabetes, cancer, vaccines.

So if you want to wait for that Eureka moment it's not coming fast!

@mistermagpie

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?

I'm 43 and I'm peri I ve had symptoms for a few years but kept getting fobbed off. I'm about to return to my GP and demand a blood test/HRT My symptoms are Major hair loss and thinning - it was initially put down to very low level vit d and some b's - still happening after that got fixed. My skin is different, drier and really itchy. It looks different too as if I'm lacking fat/plumpness if that makes sense. Mood changes - low mood, anxiety quite severe with no real reason sometimes, easily irritated and short tempered. Tired no matter how much I sleep, sometimes can't sleep have broken sleep. Brain fog which is shit at work. Hormone fluctuation - even though my periods are still mainly normal( normal for me is every 24-27 days and always heavy for 3 days then light for 3) , I'll have the odd month where I go to day 36 or one will arrive on day 22 or they'll be very heavy or much lighter the odd time. I say vaginal dryness but its more my vulva/labia area that seems to have lack of moisture rather than inside my vagina - that will do what it's meant to when aroused. Libido - hitty missy - sometimes it's normal for me other times not but i'm noticing lately it's more on the not side - but that can be linked to how tired I am etc... Much worse PMS symptoms - I could cry at how painful my breasts get for example. I get way worse symptoms around ovulation now too that I never did before. Achey joints I never had before. I often feel I have a UTI but nothing shows up in samples (except blood) but no actual UTI I don't pee as much or with as much of a jet haha even when I'm bursting - it kind of runs out slower. Increased aura migraines no pain just my vision goes and I feel sick. I used to get the odd one but now quite often. God there's loads which I would never ever have linked until doing some research after feeling I was actually going crazy with some of the above. I've tried natural remedies such as black cohosh which I stopped after a year due to the possible damaging effects to the liver and currently take red clover which is a bit kinder to your body - both worked to balance my hormones and help with some of the above but eventually at the same dose their effectiveness wears off without upping the dosage which I'm a bit reluctant to do.

I was always scared thinking I had to do menopause naturally due to not being allowed to take Oestrogen as a contraceptive (hemiplegic migraine) but after researching I've found that is not the case at all - HRT levels are much lower and I am allowed to use the gels or patches so I'm ready to try.

'This so untrue'
I wasn't staying categorically the same will apply. My point was that if someone isn't struggling with issues related to depleted oestrogen and their dm is fit and healthy without crippling osteoporosis we can see why they may think the same will apply to them. More in answer to the op really on why many women don't take hrt.

@BoodleBug51 that's interesting as chemo and radiotherapy for cervical cancer put me straight into menopause at 41.

I'm 44 soon and been on HRT since treatment ended. They were pretty insistent I needed to be on it due to protecting my bones etc.

@JaniieJones

'This so untrue' I wasn't staying categorically the same will apply. My point was that if someone isn't struggling with issues related to depleted oestrogen and their dm is fit and healthy without crippling osteoporosis we can see why they may think the same will apply to them. More in answer to the op really on why many women don't take hrt.

Okay, fair enough :)

@Newgirls Oh, I have no doubt that they’re trying to be helpful. It’s just a bit wearing when it’s the default response (in real life, not on these threads)

"The menopause is not a natural process we are meant to procreate and then die. Obviously life expectancy improvements means the menopause happens. " This is really interesting @redpandaalert. I'd never considered this.

I'm 52 this year and have been in full menopause for about 2 years.

I have largely been ignoring all the symptoms I've had thinking that asking for HRT would be a failure on my part because menopause is a part of women's lives and I should be able to deal with it. This statement has rather knocked me off kilter. But in a good way.

DP says I should see my GP and, having read this thread, I may well do so.

In answer to the OP's initial question - I have been desperate to avoid HRT because:

1. I don't want to take drugs/hormones for the rest of my life. What if I go on holiday and forget them? What if I run out? I just have never wanted to be dependant on any drug.
2. I don't want periods again. I used to suffer from hormonal migraine and the best thing about menopause has been the lack of migraines.
3. I see it as a personal failure. My body (and mind) have failed me. 99% of middle aged women go through this without complaint so I must be weak. I realise this is nonsense (particularly having read redpandaalert's post quoted above and the rest of this thread).
4. Pure ignorance. I am embarrassed that I know so little about what I am experiencing. What would I say to the GP? Do I need a list of symptoms? I have never been to the GP I'm currently registered with (moved 5 years ago) so I have no idea if they are pro-HRT or if I will be sent away as some other women's stories show is all too common.

I also don't want the GP to think I'm wasting their time, particularly when there are actual ill people who need help and the NHS is in such a terrible state already without my adding to it.

3 & 4 are stupid reasons, but my menopausal anxiety makes them big issues for me. Catch-22!

@Waspie

You can download a symptom checker here and fill it in. Either you’ll feel quite relieved you don’t have a full house of symptoms or quite horrified at the stuff you didn’t realise was due to menopause!!

www.themenopausehub.ie/symptom-checker

Waspie your feelings are very valid and completely normal.

1. Many, many people take medication for life and if you ever forget it or lost any you would access the equivalent of 111 and request a replacement. A chew on yes, but doable.

1. You're post meno so would go on a continuous regime without a break and without a bleed.

3 and 4 again completely normal to wrestle with it all but only you know if you want to give it a go. If you do decide to you aren't wasting your GPs time, it is their job to advise and prescribe. Just be assertive, say you're 2 yrs post meno and are finding insomnia anxiety and overheating (if these are you main issues for example) intolerable so would like to try body identical (the safest) hrt. Usually oestrogel and utrogestan. Good luck.

Some people have a history of unacceptable side effects from a range of medications. Some of my family are like that- ill for months after vaccines, side effects of various drugs cancelling any benefits they might have got from them. Allergies to ingredients… Lucky for me I seem to have interited genes from the side of the family that can take pharmaceutical drugs and benefit from them!

@Waspie

"The menopause is not a natural process we are meant to procreate and then die. Obviously life expectancy improvements means the menopause happens. " This is really interesting *@redpandaalert*. I'd never considered this.

I'm 52 this year and have been in full menopause for about 2 years.

I have largely been ignoring all the symptoms I've had thinking that asking for HRT would be a failure on my part because menopause is a part of women's lives and I should be able to deal with it. This statement has rather knocked me off kilter. But in a good way.

DP says I should see my GP and, having read this thread, I may well do so.

In answer to the OP's initial question - I have been desperate to avoid HRT because:

1. I don't want to take drugs/hormones for the rest of my life. What if I go on holiday and forget them? What if I run out? I just have never wanted to be dependant on any drug.
2. I don't want periods again. I used to suffer from hormonal migraine and the best thing about menopause has been the lack of migraines.
3. I see it as a personal failure. My body (and mind) have failed me. 99% of middle aged women go through this without complaint so I must be weak. I realise this is nonsense (particularly having read redpandaalert's post quoted above and the rest of this thread).
4. Pure ignorance. I am embarrassed that I know so little about what I am experiencing. What would I say to the GP? Do I need a list of symptoms? I have never been to the GP I'm currently registered with (moved 5 years ago) so I have no idea if they are pro-HRT or if I will be sent away as some other women's stories show is all too common.

I also don't want the GP to think I'm wasting their time, particularly when there are actual ill people who need help and the NHS is in such a terrible state already without my adding to it.

3 & 4 are stupid reasons, but my menopausal anxiety makes them big issues for me. Catch-22!

Your are believing your own work of fiction.

75% of women have symptoms that disrupt their lives.
The average timescale for this is 12 years.
15% women have symptoms for ever (my consultant has women in their 80s and 90s on HRT as they need it._

Many women never relate their health to the menopause.
Decades ago women in midlife suffered with 'nerves' ( now called anxiety, insomnia etc) They were given anti depressants. Friends of my mum (now either dead or in their 90s) were on these for 30 years or more.

Your (1) is just silly, Sorry. If you pack your toothbrush and clean knickers, you can pack your HRT.

Your (2) is not the case. You would use a no-bleed type of HRT.

That would provide a steady dose of hormones daily with none of the ups and downs of a cycle.

HRT is not a DRUG in the same way that anti biotics etc are.
It's a replacement hormone for one your body is lacking now.
It is made from yams and is the same molecular formula as your own hormones. Totally different to the Pill and 1/5th of the strength.

As PP suggests, maybe do some reading. Menopause Matters site is written by a meno consultant, and the Balance app is available online with videos, podcasts, fact sheets etc.

Thanks all I am currently in a queue on the 'phone to get an appointment!

I've been reading some of the articles on Balance and the Menopause hub and have downloaded the Balance app. I'll start on Menopause Matters next. It is quite a revelation reading the symptoms listed; some I have that I didn't even consider might be related.

I have actually forgotten to pack clean underwear before JinglingHellsBells but that's a different story and I was much younger and definitely not menopausal

The surgery website lists a doctor with particular specialism in women's health so I will ask for an appointment with her.

This is something I should have done 2 years ago I know that, I just needed that extra nudge. Many thanks again

I think many women don't recognise the full symptoms of menopause/peri menopause. Menopause is still seen as when periods stop with hot flushes and mood swings.

I didn't realise that I've been having symptoms for more than 2 years. Put the insomnia down to other things, likewise the anxiety and skin issues. Hair falling out. Still have periods (still regular) and no hot flushes. But the brain fog was getting really bad as was the completely irrational rage I was feeling. And it was the rage that sent me to the doctor. I only sought treatment as I knew my mood and rage was affecting my loved ones. Not for me. How daft is that looking back?

But when the doctor suggested hrt and gave me a list of good websites and books and I read all the symptoms I was surprised how many I ticked. Hrt has been a godsend for me. I actually do feel like me again. The rages have disappeared.

It's just one treatment option and women need to be able decide what's best for them. Hrt certainly won't be for everyone and everyone's experiences are different. I can understand the reluctance to try it. The worry about health issues. But I am grateful I had a doctor who was pro womens health.

You don’t have to have periods on HRT. I have oestrogel and utrogestan (100mg once a night) and the mini pill. I never have any bleeding, ever.

So many myths on this thread….!

Op I haven’t noticed this, when I’ve talked about it most seem relieved and / or positive they are using it.

I’ve looked into it a bit but still no symptoms (47) so not choosing it yet.

@Hbh17

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!

Then you are very very lucky. But there again at 56 I wasn’t that bad.

Today I had to cut my working day short because I was in severe pain and forgot to bring painkillers with me.
I really wanted to go somewhere for a meeting but all I could do was drive home, take 2 painkillers and crawl into bed.

The pain is in my back and my joints. Both my friend and I had similar pains and a prognosis of osteoarthritis.
She is now on HRT and all pain is gone. Meanwhile I am in pain everyday and my dr won’t do anything.
I probably go to the drs more with what are symptoms of the menopause than I would if they had prescribed me HRT in the first place.

Although I am through the menopause the effects of it still have a negative impact on my life.
At 56 you are still relatively young. It gets a lot worse.

[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]
I disagree that HRT only affects bone density.
In a roundabout way it does guard against dementia.
One of the symptoms of the menopause is insomnia
One of the causes of dementia is insomnia or not getting enough sleep.
If HRT helps you to get a full nights sleep then maybe it does protect against dementia.
Also if you don’t have the brain fog and general malaise and you are getting a full nights sleep then maybe eating healthily and fitness wouldn’t seem like a huge mountain that is impossible to get over and your heart and general health would be protected.

Might help someone: my only severe symptom was hot flushes/night sweats. They were debilitating. I wasn’t suitable for HRT because of previous breast cancer.
My GP suggested paroxetine. It’s an anti-depressant. It was discovered by chance, as many things are, that at a much lower dose it also suppresses night sweats and hot flushes. I believe the dose for depression is in the region of 70/80 mg. 10 mg stopped my sweats within two days. I needed to increase to 20 after 6/7 months or so and am still taking that dose 3 years on. I’ve experienced no side effects at all and I’m told that when I decide to stop taking it I should have no ill effects.

@redpandaalert

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

I'm sorry, but this is bollocks. Women and men have been living into their seventies and beyond for thousands of years. It has nothing to do with life expectancy improvements.

I say vaginal dryness but its more my vulva/labia area that seems to have lack of moisture rather than inside my vagina - that will do what it's meant to when aroused.

I often feel I have a UTI but nothing shows up in samples (except blood) but no actual UTI

I don't pee as much or with as much of a jet haha even when I'm bursting - it kind of runs out slower.

You need to get a prescription for Ovestin cream.