60. HRT for 8-10 years. Shall I stop?

[Fordian]

I was on HRT from I think 50/51, patch and progesterone, til I got a coil so stopped the Utrogestan, about 3-4 years ago.

HRT wasn't life changing for me; tho I do not know how I would have been without it, do I? Before, it was drenching night sweats, and day sweating. Joint pain. Brain fog. The fog is still there- might it be, anyway?- but I only get a bit of sweating if I'm a day or two late in changing my patch.

My estrogen patch brand has varied due to Brexit; but same dose.

I am wondering whether I should now stop HRT. I'm on it, but I leave one patch on for 1 week, not 3-4 days. I get the very occasional flush. Given that HRT hasn't transformed my life otherwise, should I just quit?

Only you can decide!

What are the reasons you might want to stop?

You can't say that it hasn't transformed your life because some of the benefits are not visible.

You probably have better bone density and a healthier heart than if you'd not used it. And you may have reduced your risk of diabetes and colon cancer (both show a reduction in the stats.)

The fact you still get some symptoms if you are late in changing your patch may get worse if you stop.

If you come off it to see how you are, you can always go back on it.

Fair points. I genuinely can't say what other benefits I've enjoyed, because there isn't an alternative me, in order to judge.

I've hated/ been indifferent to the last 8-10 years of my life. I just cannot be arsed. I have zero enthusiasm or excitement for anything. I'm grateful to not have sweat physically pouring off my face , at work; that's a bonus. I think thanks to HRT.

Heaven knows how I'd've been without HRT.

For me the mental symptoms and cba feelings of meno were the worst. My physical symptoms have increased now I’m a bit older. I had a much needed holiday and a rest recently and feel revitalised. How much the HRT is making a difference for me I, like you, can’t be sure. I take supplements and try keep my lifestyle healthy too. Maybe try without and see how you get on? I might be doing the same in a few years time.

That sounds a terrible waste of life @Fordian if you have not found any pleasure or fulfilment in 10 years - your 50s.

That's not a 'normal' way to live.

Might be worth considering that the coil isn't helping, as some women find it affects their mood. After 4years it will need renewing anyway (as part of hrt.)

Maybe your dose of estrogen is too low?

Hmm. Good point. I wish we weren't at the mercy of our GPs for HRT; one size fits all.

I wonder whether you are under-medicated.

I thought it was best to take the minimum dose of HRT that kept symptoms to a tolerable level. I went on to develop vaginal atrophy, and for a while added Ovestin to my HRT regime. It did not help enough, so the GP persuaded me to try increasing my general HRT instead.

Wow! What a difference that made! It wasn't just the physical symptoms of menopause that improved, but also my sense of self, my sense of life, my desire to engage in life.

I'm on an oestrogen HRT patch, mid fifties, following cancer surgery, and have no intention of ever stopping. Others have mentioned the benefits, particularly with bone density and the prevention of osteoporosis.

You sound undermedicated like I was. I was plodding through my days on the minimum dose and whenever I brought it up in my annual medication review I was told to get a script for antidepressants. That surgery also wanted me to come off HRT because of the "risks". So outdated.

After chatting to a friend, I looked into it, decided to double my dose as an experiment, and felt amazing! So I changed surgeries to one that has a menopause expert and am now much much happier on a higher dose.

I feel like I'm properly alive!!

This completely changed for me, like a PP said: my sense of self, my sense of life, my desire to engage in life.

Those of you who increased your dose of hrt, what did you increase to? What regime are you on ? I feel I'm on too low a dose too and trying to figure out what to do. E.g swap product or increase patch.

If you are seeing a specialist, ask her advice ? She ought to be helping you work through this.

The highest licensed dose for patches is 100mcgs.
You mentioned the Mirena. That can have a negative effect on mood so if I was you, I'd consider having it removed. I have never tried it but was offered it years ago on the basis of 'try it for 3 months and see how it feels.'

Tablets only go to 2mgs estrogen max.
Gel- licensed max dose is 4 pumps= 3 mgs
patches- 50mcgs= 2 pumps gel. 75mcgs= approx 3 pumps gel.

@Goldpaw For the benefit of other posters, (one was asking this a few days ago) was your cancer breast cancer? Please don't feel you have to reply if you'd rather not, but it's a question that keeps on coming on the forum.

HRT is not contraindicated for other cancers as far as I know.

I’m mid 60s, late to hrt so I’ve been on it for around 12 years. Family history of severe, debilitating osteoporosis.

I have had Mirena's, which due to problems with my shape, were inserted under GA. The last one was removed about a year ago and the hospital convinced me to swap to Utrogestan, which has not agreed with me at all. My symptoms on this lead me to have an ultrasound and biopsy as my gp was convinced something else was wrong. These came back clear.

I am now on a waiting list to have a replacement Mirena inserted at the hospital. I spoke to them last week, apparently I am only 'routine' so there is a 73 week wait. I am prepared for them to try without the GA, but this doesn’t seem to make a difference. I’m not expecting to be a priority but it was the hospital themselves that recommended my gp referred me back to them for the Mirena. I really wish I’d never been persuaded to try the Utrogestan.

There is now a smaller coil which is similar to the Mirena. It's much smaller and although it' s for birth control it can also be used for HRTmight be called Jaydess? There may also be another similar one too. You could try it without a GA?
Having to wait 18 months is ridiculous.

Other option is to go to a specialist gynae/surgeon and have it fitted privately with no GA. There is definitely a technique to fitting these things as well as doing investigations.

You aren't especially late on hrt, I started around 53 and am roughly your age.

@JinglingSpringbells I can't risk having the mirena removed unfortunately, as I have had lots of bleeding issues on oestrogen and utrogestan. The mirena has stopped that problem at least.

@Runaround50 Yes, bleeding is one of my main problems on utrogestan , but it has made me feel generally unwell.

@JinglingSpringbells That’s interesting about the alternative coil, I’ll look into that.

No I had ovarian cancer and major surgery to remove everything which plunged me into menopause in my early 40s.

From the start my surgery were wanting me to plan to come off hrt (estradiol) at 50 and go through menopause because of the breast cancer risks. But they're so minimal that I never wanted that and the support from new surgery has been transformative. Expert doctor says why would you stop hrt just at the age when other women are starting. There's a lot of outdated thinking about hrt still swishing about, unfortunately.

Jaydess and Kyleena coils weren't licensed for use as part of HRT when I last looked into it (18 months ago) but that might have changed. Mirena was the only option for a coil for HRT use on NHS.