Starting HRT 'early' - good idea?

[SilkieChick]

I think I'm about to take the plunge and ask my GP for HRT. Admittedly I don't feel awful (yet!) but I have a lovely GP who's fully prepared to prescribe based on the symptoms I'm already having - and was very supportive of taking HRT early for the various health benefits it provides.

There are so many examples of women who have transformative experiences because they've struggles for ages and suffered terrible symptoms before deciding to take HRT or managing to get a prescription - I certainly don't want to wait until I reach that stage, so I guess I'm just wondering if anyone else has started HRT 'early' and found it beneficial?

For background, I've had various inconsistent symptoms for a year or more - irregular periods (but not always), headaches, bowel issues, irritability, mood swings, low libido (comes and goes). This weekend I've had really noticeable palpatations, and a pretty low mood. I'm finding it hard to motivate myself at the moment and have to really make an effort to find enjoyment in things. Nothing feels 'easy' if you know what I mean? I had a few days at the beginning of this month where I felt energised about life and was ready for anything, but that feeling has plunged off a cliff in the past week or so, which makes me wonder if some hormones would really help stabilise things.

I've hardly stopped thinking about it all weekend as well - I find my mind goes round and round in circles when I'm like this, I'm constantly analysing myself and my thoughts, and my possible symptoms - it's exhausting. Is this kind of overthinking a form of anxiety? Or am I in my own perimenopause echo chamber and magnifying issues which are not hormonal and just normal midlife feelings??

WWYD in my situation - I'm starting to think it's worth a try and if I feel no different, at least I'll know it's not the hormones...

How old are you?

This is really interesting. I'm definitely peri menopausal, getting random aches and pains which come and go, brain fog etc. But I thought it would probably be too early to start on HRT so I'm pleasantly surprised that your doctor has recommended it. I would definitely go for it if I were you, bearing in mind it can be trial and error to get the right combination.

I'm not sure what you mean by 'early'!

Are you very young for peri?

Or do you feel you have to be on your knees almost with symptoms before trying it?

FWIW my only symptoms were hourly hot flushes and poor sleep. I'd got to my early 50s with no other symptoms but those two were enough to affect me quite a lot. I was already seeing a gynae for other things, who was a meno expert, and just asked to try HRT.

Sorry - forgot to give my age! I'm 45.

Well it all depends on how much your symptoms are affecting you and if you are willing to try other things like lifestyle first that may help- exercise, diet, self-help stuff like mindfulness etc.

No one can tell how you feel and when it's the right time. Medically, as long as HRT is started within 10 years of the last period, it gives heart protection.

It's not "early" at all for HRT, and it helps protect your bone and heart health. I've been on it since right before I turned 41 and I'm 50 this month.

It's a very personal thing and if you're not having much in the way of symptoms it's about weighing it all up

I considered it at 45 but I could manage my symptoms just fine and they were very mild

I've started it in the last month as I'm now 51 and was experiencing poor sleep and painful joints so, for me, this age feels about right.

The only thing to bear in mind (and it sounds as if your GP is pro HRT anyway) is that some drs still go by the '5 year rule' (which is outdated anyway). They might insist on stopping after 5 years which means some women aged 50 are not even at the average age of menopause.

I'm just making this point for anyone reading who doesn't have a helpful dr.
I'm not saying women should wait and wait.

I started HRT at 45 but my peri symptoms started around 41. It literally changed my life starting HRT and feel I've got my life back again.

@Aquamarine1029 can I ask what sort of symptoms you were having to prompt you to start taking it?

@JinglingSpringbells I do take your point it's such an individual decision - I don't think I'm imagining any of my symptoms but sometimes I do wonder if I'm building them up too much in my head?

I take very regular exercise, I eat healthily and am making even more efforts with nutrition, trying to include more yoga and relaxation generally.

Why would you be building them up in your head? Are you thinking about this a lot?

For me, it was a very cut and dried decision. I couldn't sleep, and hourly flushes (with clients, many male) were affecting my work.

For background, I've had various inconsistent symptoms for a year or more - irregular periods (but not always), headaches, bowel issues, irritability, mood swings, low libido (comes and goes). This weekend I've had really noticeable palpatations, and a pretty low mood. I'm finding it hard to motivate myself at the moment and have to really make an effort to find enjoyment in things.

This is far more than I had (in number) but it all depends how much it's affecting your quality of life.

I went on it at 45 - my wonderful GP at the time stated that it was a “pre-emptive strike”.

Started feeling like this about a year ago (around the time I turned 45). It progressed to me feeling riddled with anxiety, dreadful sleep, dreadful skin, brain fog quite quickly - maybe 6-8 months. Been on HRT for a few months now and am starting to feel more myself.
I’m sleeping better, my anxiety has reduced, my skin has cleared up.

I’d definitely give it a whirl. Try 3-6 months and see if you feel any better.

I’m planning to start before 45, GP permitting. You get better protection from certain diseases if you start by 45, I believe.

There is no difference in protection between starting early or late unless you have diagnosed osteoporosis, for example. It depends when your last period was.

@JinglingSpringbells that's the problem, it's not cut and dried for me - if it was a case of having hot flushes every day or something very tangible this would be a no-brainer, but it's more like a collection of small physical things and difficult to define mental things! And yes, I do think about it a lot - I'm a bit of an overthinker and my brain can go into overdrive a bit when there's a problem I feel I need to fix.

Thanks for the advice from others too - @Daffodilled, @newfence, @PauliesWalnuts (great name btw!) it's useful to know others at a similar age or stage have found it beneficial.

@SilkieChick I could have written your post word for word the only difference being I am experiencing hot flushes at night which is now really affecting my sleep. I am 44 and have an appointment with my doctor tommorow and I am going to ask if I can try hrt.

OP must have a different GP to me!
I'm 53 and have been extremely peri menopausal for over a year. My GP has said they don't do anything until I've had no periods at all for over a year!!

My symptoms are awful, and periods are really random (always have been due to PCOS) I'm now considering lying and saying they've stopped in order to even talk to someone about the menopause ☹️

Sorry but your GP sounds appalling.

There are 2 very distinct types of HRT

1 For peri meno (women with periods)
2 for post meno (women without periods)

Average age of menopause is 51.

Have you read the NICE guidance- print it off and take it along.

I started at 45 - symptoms weren't unbearable (though I hadn't realised how much lack of sleep was affecting me) but I have a family history of osteoporosis (my mum, dad and both grandmothers) and none of breast cancer so I was very keen to take a precautionary approach. My understanding is that starting before 50 is very low risk. But every year of low estrogen is a year of faster bone density loss.

That's a really good point @UnaOfStormhold - my GP was really positive about the benefits of starting, even with fairly mild or manageable symptoms. Another reason why I don't know why I'm stalling!

@flotsomandjetsome I would echo the above - it definitely doesn't sound right according to the current guidelines - worth pursuing with another doctor perhaps if you really can't persuade the current one.

My GP told me that I couldn't be menopausal as I was having periods. I'd asked about perimenopause and maybe HRT.
She prescribed antidepressants.

I have been on and off HRT for about 10 yrs. My periods started becoming erratic at about 39 and then I started suffering with palpitations so I went on HRT for about 6 years. By 44 my periods completely stopped and my palpitations had gone and I had no other symptoms at all - in fact I felt really healthy and energised but GP changed my type of HRT as my periods had completely stopped and said it was very important to stay on HRT because of my young age. . I tried several different combinations but they made me feel so tired and made my breasts so heavy I couldn't do any type of fitness. So for me taking HRT when I had no symptoms made my life harder to live rather than easier and I felt so lethargic- however people who really suffer with symptoms say that HRT is a lifesaver and i think if i felt as ill as some people do aching boobs and tiredness woukd be a small price to pay Every day I worry that maybe I should have stayed on it for protection but when you feel so well off it it was really hard to feel ill and not be able to exercise I decided to live for today and not worry about the future. Only time will tell if this was the right decision or not!!

Here's where I am with this today - I've called to make an appointment with the GP again, to ask for a trial of HRT. Won't see her until Monday week though, by which time I expect I may be feeling better again as I'll have had a period and my hormones will probably be on the up. However if not, or if I can be firm with myself and remember how I'm feeling now I'll hopefully keep it and get a prescription.

I've been dealing with a low level constant headache, tiredness and a few random aches and pains for the past couple of days - but my mind is really struggling now. Today it's taken me three hours to decide if I should work from home or go into the office - I don't really want to be alone, don't really want to be with people, can't decide what's for the best, and certainly can't focus on work 😣 I wish I could shut down the overthinking part of my brain and just get on with my day.

I think that's what's finally pushed me to want to try HRT - I can maybe cope myself day to day when symptoms crop up but it's not fair on my family when I'm irritable or flat or not really present. I want to enjoy weekends and days out and be able to make a flipping decision without anguishing over it for hours!

It's so shit that peri can hit just when you're at a time of life when we're juggling everything - everything!! - and need to be top of our game. I don't want to be dragging myself through midlife just trying to get through it - I need to do whatever I can to feel like I've got this, and if that means balancing out my hormones to get my energy back, so be it.

@saffy56 what is really sad about your experience is that you have had bad treatment.

There was no need to change to another type of hrt when your periods stopped.

It's ^advised' as most women prefer a no-bleed sort, but it's not mandatory. I'm still using a sequential type 15 years after my periods stopped. This is with a meno consultant.

Again, you are another example of a GP not really knowing how to manage HRT.

If you have stopped HRT and you aren't going to go back to it, the very least your GP should be doing is arranging a DEXA bone scan for you, to show if your bones are ok at the moment.

It's negligent for them to ignore this in light of your early menopause.

I suggest you go back and ask for this.

Waiting to see if you made the right decision is like Russian roulette- it's not following science.