If they don't test for diminishing oestrogen, how do you know you need HRT?

[BeccaSpoon]

I'll explain a little more

I'm 50 and have little in the way of peri menopausal symptoms. A bit of stiffness maybe and heavier periods but that's about it

I'd like to take HRT though, for both preventative benefits and in the Hope it would perhaps ease the morning stiffness!

But how do you actually know you need it? My dr is happy to prescribe it preventatively and says that at 50, the assumption would be made that oestrogen was lower

Thoughts on this?

Presumably because previous studies showed lower levels in women over a certain age?
they don’t do FSH menopause blood tests in women over 45 any longer either because, seemingly, it’s already a given that you’re sliding towards menopause!

It's really a personal matter in a way - do I have symptoms I think HRT might help with? You should be assessed on that basis too. People like to think blood tests will reveal things but not reliable for this. (I think low testosterone is discoverable). Obviously there are different schools of thought about the risks of HRT v the benefits but if you are ok with all that, then the best way to find out is to try it and see. If it seems to do nothing you can just stop.

@BeccaSpoon The latest guidance from the BMS states it is not to be prescribed as prevention other than for low bone density (which exists already) or for premature menopause. This statement came out about 2 weeks ago.

I don't know how long this might take to filter to GPs or if they will take notice :)

Most women start when they have erratic periods and typical meno symptoms.

Maybe think of it as HRT is to treat symptoms and erratic periods, which are the first sign in many women of declining fertility which means no egg release and lower estrogen levels. It's not a case of 'low estrogen= need for HRT', it's symptoms warrant treatment, and HRT is one way to do that.

Thanks for the replies

I'm thinking it may be wise for me not to take it, on balance. I do not have symptoms - or not any I can really put my finger on. Not yet. I can make things 'fit' but I certainly don't have flushes or mood swings or brain fog etc

I think I was under the impression that all women SHOULD be taking it at my sort of age

I was 50 when I went on HRT. No blood tests were done by the Gp. They asked what my ailments were, looked at my age and automatically prescribed HRT. I'm guessing the same as others have said it's a given that oestrogen levels are declining at 50 so HRT is the obvious solution. HRT has helped with every ailment I had other than migraines, sadly it's not helped them at all.

I started HRT when I was 49 and a half after having increasingly bad symptoms since I was about 48. I had a hysterectomy 6 years ago and obviously don't have periods. Because of this the first (useless) GP who I saw ordered blood tests, declared that everything was fine and prescribed me folic acid. 🙄

After a few more months of the awful anxiety, sweats, insomnia, repeated UTIs, vaginal dryness etc etc I went to another GP who took the "if you're having symptoms I'm happy to prescribe" route.

My take on it is that if you think you are having symptoms then HRT should be the default choice. If you're managing OK, then you don't need HRT.