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?

@MrsSkylerWhite

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.

The NICE guidelines say that GPs should not prescribe anti depressants for peri/meno pause. The reasoning is that they can help with symptoms but don’t tackle the cause - which is falling/fluctuating oestrogen.

I see that it has helped you in your situation but just pointing out that it won’t be the right thing for all readers here

Of course taking HRT or not taking HRT is a matter of personal choice. Other women try it, and decide it's not for them. To me, the weirdness I don't understand is complaining bitterly about menopause symptoms of flushes or insomnia or whatever and thinking that you just have to get on with it, and not even considering HRT as an option.

I also agree that the messages I got about the menopause growing up or even in more recent years was that menopause was something that happened for a period of time, you went through it, and then everything went back to normal. And that HRT topped up your hormones until they went back to where they were originally by themselves.

Some GPs are brilliant but the lack of training really does come through in many. The first one I saw isn't an old school GP, he's probably early 30s. He completed refused HRT, said my oestrogen levels were fine, and told me to take folic acid and use Headspace. Second GP's approach (similar age) was completely different he said that if I was over 45 and experiencing symptoms then it was menopause and he'd happily start me on patches to see how I got on.

My GP runs diabetes clinics, and asthma clinics, and continence clinics, and allergy clinics - but when I asked about whether they ran a menopause clinic, the receptionist looked at me as if I had 2 heads. This really needs to change.

Of course taking HRT or not taking HRT is a matter of personal choice. Other women try it, and decide it's not for them. To me, the weirdness I don't understand is complaining bitterly about menopause symptoms of flushes or insomnia or whatever and thinking that you just have to get on with it, and not even considering HRT as an option.

I think the thing that rankles is that this puts women in yet another double bind situation. The attitude that if women don't take HRT they cannot complain about any menopausal symptoms or any other health issues related to old age is hardly promoting freedom of choice and autonomy.

There can be very valid reasons HRT is not suitable for an individual- which incidentally they are not obliged to discuss as they don't have to defend themselves to anyone regarding personal medical choices. So they still might have some unpleasant symptoms which they have to negotiate their way through. Are they not allowed to discuss this? Seek camaraderie? Are they not allowed any sympathy? Because they are not using HRT.

I think this is dangerous ground. We as women should be supporting each other and promoting choice over our own healthcare. Not blaming other women for any of their health problems because they don't make the same choices as ourselves.

And HRT is still not perfect yet. Women should still be able to voice real concerns over using without being shouted down and silenced or made to feel stupid.

@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

It wasn't something they did??? Is it a gp surgery's right to select what NHS prescriptions they offer?

@Newgirls

I think the word ‘pause’ has confused the issue. I think people think it’s a year or two of symptoms and then done. In fact the lack of oestrogen is an issue for health for the rest of your life - brain, bones etc

Also - for those worried about cancer drinking alcohol is a far bigger risk but somehow we ignore that. I think it’s 7 units a week can increase your risk of breast cancer by 25%. Yet hrt gets the blame?

Your stats on alcohol is way off. It's a couple of %. Same as HRT. But I'm with you on the general message of your comment

I have found that people view my taking her as if I'm some kind of merry widow trying desperately to reclaim my youth. Almost akin to their attitudes to having 'plastic surgery'; as though I might be trying to attract a younger lover. Much like the harridans who insist that no-one needs a caesarian section and are being precious by complaining about being left incontinent by a vaginal breech birth, etc etc. As though I am somehow 'cheating' by not wearing my metaphorical hair shirt.

Not her - hrt!

Newgirls

The NICE guidelines say that GPs should not prescribe anti depressants for peri/meno pause. The reasoning is that they can help with symptoms but don’t tackle the cause - which is falling/fluctuating oestrogen.“

In that case, I’m very glad mine went against them. Should I have just tolerated it?

If the lack of oestrogen is a problem for the rest of your life - how do little girls manage to exist pre-puberty? I think people ascribe a lot of normal ageing processes to a lack of oestrogen - which in any case continues to be manufactured, albeit in smaller quantities, by the ovaries and by the adrenal glands, post-menopause.

Much like the harridans who insist that no-one needs a caesarian section and are being precious by complaining about being left incontinent by a vaginal breech birth, etc etc. As though I am somehow 'cheating' by not wearing my metaphorical hair shirt.

Equally, women should be allowed to talk about how childbirth hurts without someone telling her she should have had a caesarean!

There needs to be a balance in all this where women's personal choices over their own healthcare are respected.

@MrsSkylerWhite

Newgirls

The NICE guidelines say that GPs should not prescribe anti depressants for peri/meno pause. The reasoning is that they can help with symptoms but don’t tackle the cause - which is falling/fluctuating oestrogen.“

In that case, I’m very glad mine went against them. Should I have just tolerated it?

Just be aware that perhaps your gp wasn’t right? The NICE guidelines are meant to be followed by GPs.

Alcohol and hrt stats.

The advice I was given by my GP stated that the risk of hrt (bio identical patches) raises your risk of breast cancer 0.02%.

Alcohol of 7-11 units a week raises it 25%. This is for peri women.

So hrt is LESS risky thank alcohol use.

Maisie Hills book Peri Menopause Power is very good on the latest research. Well worth reading. She looks at all sorts of natural and medical ways of dealing with symptoms but also explains this on context of a long life

When you are a young person you have growth hormones in abundance so you don't need oestrogen for body maintenance.
I'm through menopause, as far as i can tell, certainly the worst symptoms that I realise with hindsight were menopausal (anxiety, insomnia, palpitations) not caused by mid life stress.
I have put off doing anything about HRT becausr I am enjoying the feeling of being off the hormonal rollercoaster. I actually feel more like I did as a child, ie. My personality is formed from what I am interested in and what i do, how i interact with others and less about my mood, good or bad.
However, I am having trouble with joint pain and muscle aches that is not helping my efforts to get fit. My libido is also low, although it varies and VA is easily helped with Ovestin.
I have never been Able to tolerate Progesterone, my own or artificial, it brings me down so badly, even the Mirena which is supposed to be such a low dose, i am scared to try HRT as I don't want become a weepy, sad mess, who thinks nobody likes her and struggles to get out of bed (also very painful breasts).
Two aunts died of breast cancer and I have fibrous breasts too, prone to getting lumpy under hormonal influence so that is a niggle.

@nightfairy

If the lack of oestrogen is a problem for the rest of your life - how do little girls manage to exist pre-puberty? I think people ascribe a lot of normal ageing processes to a lack of oestrogen - which in any case continues to be manufactured, albeit in smaller quantities, by the ovaries and by the adrenal glands, post-menopause.

LOL!

How would men manage if they had their balls cut off at 50? They don't need them any more if they have procreated.

Estrogen is needed to maintain the health of the skeleton throughout life. Do you think it just a coincidence that between 1:2 and 1:3 women over 50 have osteoporosis?

I think people forget that until very recently, women died either by 50, or in childbirth (or were eaten by a woolly mammoth.)

It's only through better nutrition, housing, sanitation, drugs like antibiotics and vaccines, that the average life span of women now is around 82.

In terms of evolution, women were expendable once they could no longer produce offspring.

@nightfairy : 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.

No, I'm sorry, but what you're saying is bollocks! Even just a hundred years ago average life expectancy for women was mid-fifties. Most women didn't have much post-menopause life to suffer with symptoms. Now we have about 30 years of it!

Source: www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/lifeexpectancies/articles/howhaslifeexpectancychangedovertime/2015-09-09

[quote Jng1]**@nightfairy* : 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.*

No, I'm sorry, but what you're saying is bollocks! Even just a hundred years ago average life expectancy for women was mid-fifties. Most women didn't have much post-menopause life to suffer with symptoms. Now we have about 30 years of it!

Source: www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/lifeexpectancies/articles/howhaslifeexpectancychangedovertime/2015-09-09[/quote]
It is staggering isn't it that only a 100 years ago our life expectancy was mid fifties!

Equally, the most important ways to improve bone health are good nutrition and regular weight bearing exercise. It's no surprise archeologists can tell from a skeletal remains what sort of physical activity a person may have engaged in or how dramatically the skeletal form can wither with paralysis.

Certain levels of exercise intensity can actually reduce inflammation too.

www.championseverywhere.com/niko-niko-pace-gentle-path-success/

And if you look at people a hundred or so years ago, sadly a lot of people were malnourished.

@Wbeezer

When you are a young person you have growth hormones in abundance so you don't need oestrogen for body maintenance. I'm through menopause, as far as i can tell, certainly the worst symptoms that I realise with hindsight were menopausal (anxiety, insomnia, palpitations) not caused by mid life stress. I have put off doing anything about HRT becausr I am enjoying the feeling of being off the hormonal rollercoaster. I actually feel more like I did as a child, ie. My personality is formed from what I am interested in and what i do, how i interact with others and less about my mood, good or bad. However, I am having trouble with joint pain and muscle aches that is not helping my efforts to get fit. My libido is also low, although it varies and VA is easily helped with Ovestin. I have never been Able to tolerate Progesterone, my own or artificial, it brings me down so badly, even the Mirena which is supposed to be such a low dose, i am scared to try HRT as I don't want become a weepy, sad mess, who thinks nobody likes her and struggles to get out of bed (also very painful breasts). Two aunts died of breast cancer and I have fibrous breasts too, prone to getting lumpy under hormonal influence so that is a niggle.

I think if your periods have stopped them you don’t take hrt with progesterone in it. Might be worth a chat with a GP for advice

My point being there are workarounds if HRT is not suitable for an individual whatever reason.

I think the quest to defend taking HRT can overspill into judging women for not taking it. And equally this will end up happening the other way too.

Why does this always happen with women's choices? Can we not allow each other the freedom and autonomy we would hope to have ourselves without so much judgement of them from others? Why is it women's decisions that become such a free for all for discussion?

@hihellohihello

And if you look at people a hundred or so years ago, sadly a lot of people were malnourished.

Not just malnourished. But antibiotics were not in routine use until the late 1930s. No cancer treatments. High levels of smoking. All sorts of illnesses which are treatable now killed people 100 years ago. Of course there were people who lived into their 70s or older but not the norm.