What are the benefits of NOT taking HRT?

[AlpacaThePicnic]

We obviously are wall to wall with the benefits of taking HRT

I just wondered if there are any benefits of not taking it as I weigh it up in my mind whether I wish to continue with it

Your private clinic will say the right hrt for you is utrogestan and oestrogel. If you don't thinknits working they'll say whack the oestrogel up. They might also dangle the carrot of testosterone in front of you as its unavailable on the NHS. That'll be 300 quid please plus blood tests

I just asked my nhs gp for utrogestan and oestrogel and paid the 19 yearly sub.

Once you get vaginal atrophy, are you stuck with it forever? Or does it go away if you start HRT?

Well Im not going private to obtain it, I cant afford that, Im going private so that I can have an hour, whole hour with someone who can talk through my symptoms, history, worries, expectations etc, then blood tests which my GP wont do, already asked, plus I may choose to have a bone density test, depends how I feel.

From there I will then be able to ask for what I need with my GP

So yes they will make money out of me, the consultation and bloods are very expensive, the bone test not so much, but not as an ongoing patient

I'm 62. Periods stopped around
45 and I've never taken HRT.
I had a couple of difficult years in my late 40s, mostly with night sweats, but never felt the need for chemical intervention

As soon as I read the words Vaginal Atrophy I start clenching. What can those not on HRT do to minimise chances of this??

Much better with the cream
Ovestin I think it's called , works great for me

I’m genetically at high risk for osteoporosis and will definitely discuss this with my doctor, but I’m hoping that HRT isn’t the only way to slow the onset.

Obviously if my menopausal symptoms become unbearable, I’ll consider it, but I’d prefer not to, tbh.

They can use local estrogen in the vagina. It's not classed as HRT. It's not absorbed into the body.

There is no way to prevent atrophy.

1:4 women on full HRT also use vaginal estrogen.

@JinglingSpringbells could I ask .. can something like vagifem or whatever it's called, be used in Peru menopause? Or can it only be used if you're post menopausal?

@midgemadgemodge I hope you won't mind if I come back to clarify a few points you made.

Private clinics are one way of getting HRT but not all menopause consultants work from a 'clinic'. They have a base often in a private hospital (s) where they work as gynaecologists.

Vested interest? These are professionals working within a strict code of medical ethics. They aren't flogging double glazing! (Unlike NHS GPs who are sometimes given financial incentives to prescribe certain drugs.)
And yes, they do read all the research.

They don't make money from suppliers (Of HRT?)

With a private prescription, it's dispensed from a 'normal' pharmacy where the woman takes it. They are the ones who set the cost. It's usually 1.5 times the cost of the drug (RRP) and that includes a dispensing fee for the pharmacy. For example, a bottle of gel at cost price to the pharmacy might be £5 and they will sell it at £8 (these are not actual figures but close to.)

Some women have one appt with a private consultant and then their HRT prescriptions are managed by their GP.

You can use it when needed at any age- some women are prescribed it during long-term breast feeding as that lowers estrogen levels. So it can be used at any age even up to 95 :)

You're stuck with it unless you treat it. You don't need HRT just vaginal estrogen. (It's not HRT.)

There are some scary horror stories (all true) of very old women whose vaginas fuse shut. The walls are so thin and fragile they stick together and can't be opened at all. And it causes pain and also bleeding sometimes.

Surely you can whip up a bit more paranoia @JinglingSpringbells? Good to know that “all” the horror stories are true(!)…

The benefits of not taking HRT are that you avoid triggering bleeding/ bloating/ further hormonal upset.

You don't have to worry about products being out of stock/unfulfilled etc.

You don't have to worry about getting the balance right or experimenting with endless Hrt products.

I never took it as I moved overseas at 50 and it doesn't seem to be used here. Now 55, I still run, get 10000 steps minimum, have a full time job, and I'm completing a doctorate. I feel pretty good and if I'm tired it will be because I'm up by 5.30 daily. I don't know what HRT could bring to the party.

self help info here for VA:

pah, I had a link...

The benefits for me of NOT taking it would be:

Not having to endlessly do repeat prescriptions for tiny tubes of ovestin and changing patch prescriptions.

I'd get some vaginal moisture back. Since HRT it's all disappeared.

I wouldn't have a never ending mental dialogue about which progesterone I will settle with.

I did put on weight at the start, mainly bloating, some because I just ate crap because it was quite draining dealing with the fallout of progesterone depression. I've since lost half a stone in 3 weeks calorie counting just like I have always been able to do.

Benefits OF taking it:

No night time wees. I thought this was normal until I didn't need to go all the time.

I sleep all night. Every night. Not done this since pre children in my early 30s and I'm now 45.

My vagina feels firmer if more dry. And hopefully my prolapses won't get so much worse as fast as they might have done.

My skin is amazing.

My breasts are perky again. I hadn't noticed how droopy they were until I started taking HRT!

I'm really happy about my life again. I don't cry all the time.

I don't need a daytime sleep like I have every day for years and years. So much energy.

So on balance it's positive for me 🤷🏼‍♀️

If you can manage without it, or don't feel the benefit of taking it, or would rather use vitamins and whatever then that's all FINE. That's the right decision for you.

But there are other women out there - like me - who found the menopause hit them like a ton of bricks. Repeated UTIs because of vaginal dryness, anxiety and depression like nothing I'd experienced before, not being able to sleep and waking at 5am with the feeling of doom in the pit of your stomach, brain fog. I seriously thought I had dementia, I was so miserable, and so hard to live with.

A 75 mcg patch of estrogen makes me feel like ME again. I don't take progesterone as I've had a hysterectomy, and fully intend to keep slapping on the estrogen patches forever. I have been taking 2 tablets every morning for my thyroid so slapping a patch on my arse every 4 days is no biggie. And you know what? I don't care if it's made me put on a bit of weight. I'd rather be fat than dead. And the menopause affected my mental health so badly that I was planning my funeral and thinking about the least difficult way to kill myself.

There seems to be this idea that menopause is a short period where you hormones go a but haywire, and then come back to pre-menopause levels. That;s just not true. Once your ovaries pack up and stop making estrogen, they won't start again. And yes, there's an increased risk of osteoporosis and other conditions.

@GillyGilipollas did you mental health symptoms only crop up with peri. (I have them now but also them previously so not sure tbh if just down to menopause.)
I'm on ADs and I know they're not advised for women with anxiety / depression for the first time in menopause - but I was already on them.

I never had mental health issues before I had my hysterectomy when I was 44. Certainly nothing I felt was bad enough to see the GP about, never had post natal depression, coped OK with life's ups and downs.

Unfortunately my GPs were pretty shite and didn't join the dots in realising that I wasn't needing prozac or citalopram, I needed HRT.

I'd advise seeking out a GP who knows what they're doing with menopause which isn't as easy as it sounds.

How can that be when the most well informed HRT doctors are usually private and have a passion about this whereas your average GP is usually sub par on this topic.

Ovestin IS oestrogen so it is HRT.

Although I’m lucky to have an informed and supportive NHS GP, it’s hardly surprising many women go private when learning about menopause is not even a mandatory module in GP training.

Apologies if it's already been mentioned - I've looked & can't see it - but The Menopause Manifesto by Dr Jen Gunter includes lots of excellent & balanced information on what HRT does & doesn't do which I thought was very helpful.
The author is clear that she does take it herself, and explains her reasons why - but definitely doesn't suggest that it is appropriate for all women.

FWIW so far I use topical oestrogen cream, but not HRT, because I feel like that's the right choice for me. I have few symptoms, and those I do have aren't shown in studies to be improved by HRT, no family history of osteoporosis, and I do an outdoors manual job which again will contribute to bone health. I also have a family history of gynaecological cancers.

The advantages to me of not taking it are in not using a medicine that I don't think would provide me with benefits that outweigh the (admittedly small) risks. If I develop more symptoms, or my lifestyle changes, I will reconsider.