Is it normal for HRT efficacy to wane after a year?

[stirling]

Or indeed after covid. I was doing really well on it until April of this year when I got covid. Since then, some of the symptoms like arthritis in my hands and severe anxiety have returned. Plus the periods have gotten lighter, or rather the 12 days on Utrogestan isn't inducing a period so readily!

I'm on 1mg sandrena along with two Utrogestan tabs 12 nights a month. I have been reluctant to increase because of dense breast tissue with "a lot of activity", and a bulky uterus with recurring polyps.

Started hrt out of desperation for bladder symptoms and mercifully, those are still at bay with 1 mg sandrena

Thank you

Is it normal for HRT efficacy to wane after a year

No.

It is more usual to need a bit more as your own levels fall even further.

How old are you and how far into peri/ post meno?

Can you explain the comments about your breasts? Have you had mammograms (for the over-50s unless there are reasons for one earlier) that have flagged up some issues (before starting HRT?)

The evidence out there at the moment shows that the estrogen dose is not a factor in breast cancer, and women who use estrogen-only HRT have less breast cancer than the general population. It's thought that it is the progesterone side of HRT that is linked to cancer and Utrogestan is safe for 5 years at least ( statement by the BMS.)

Would you consider the Mirena to deal with polyps?

Thanks JinglingXmasbells I'm 51 and yes I've had lumps found (cysts) which prompted mammograms (three in total throughout my 40s, each breast consultant saying the same thing : there's a lot of activity in your breasts which are dense too, avoid hrt.

Only took it because of my bladder, I could tolerate everything else.

I had avoided mirena for a few reasons. I think I might have a TV scan again as I have a feeling the polyps only recuured as I was taking sandrena and plus had an estring in. Everything calmed down after it was removed.

I don't 'feel' like I have a bulky polyps prone uterus anymore, ie that bulging heaviness, pressure like a baby sitting on my bladder...

@stirling If it's just for your bladder, could you get away with vaginal estrogen- each Ovestin or Vagifem?

I can see it's a dilemma, but all the menopause statements from the BMS say that micronised progesterone is safe for at least 5 years ( for breasts) as it doesn't cause proliferation.

the BMS say that micronised progesterone is safe for at least 5 years ( for breasts) as it doesn't cause proliferation.

That is very reassuring! I think I'll stay on my regime and up the estrogen. Local, tried them all for a couple of years before systemic but always caused huge flares.
Systemic has been very healing...
Thank you again

It's thought covid can affect oestrogen receptors for 3-6 months. Women who were on hrt for surgical menopause reported return of symptoms.

However in my experience I also needed more. Whether that is also linked to covid or not, I've no idea

• I had it twice this year. First time I had mild long covid for 4 months, though what was meno and what was covid is hard to work out. (Had odd breathing as one post covid issue.) oestrogen 3 months after covid was really low and symptoms awful again. Could have been normal menopause though.

No idea how I make a bullet point!

Warrior thank you. Yes I had read a thread on mumsnet about covid reducing efficacy of HRT.
It's likely that though my GP always says to start off with lots of estrogen as you need more now than when older...

It's likely that though my GP always says to start off with lots of estrogen as you need more now than when older..

Not always.