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Menopause

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What are the benefits of NOT taking HRT?

232 replies

AlpacaThePicnic · 21/05/2023 20:28

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

OP posts:
Damnspot · 23/05/2023 08:10

Most women on hrt don't need a specialist clinic? If you are 50+ and your periods are stopping then you should get HRT from normal gp if you want it.

JinglingSpringbells · 23/05/2023 08:22

Damnspot · 23/05/2023 06:57

How can vaginal cream be localised but you can also use utrogestan tablets vaginally??

@DustyLee123 They are completely different products. And different strengths. It's a bit like asking why does gin make you drunk but tea doesn' t.

As the PP has said, menopause consultants have been advising the manufacturers of Ovestin etc for a long time, to get the leaflets changed. They are not appropriate as they are the same leaflet as in systemic HRT.

There is information about this online such as the Youtube videos with Prof Nick Panay (gynaecologist and menopause researcher) .

A few of us here are sharing knowledge from our own research or many conversations with experts, trying to help!

Greenlight1 · 23/05/2023 08:24

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GillyGilipollas · 23/05/2023 08:26

Damnspot · 23/05/2023 08:10

Most women on hrt don't need a specialist clinic? If you are 50+ and your periods are stopping then you should get HRT from normal gp if you want it.

Completely agree.

But getting HRT is an enormous struggle for many women. Often it takes repeated visits/appointments, where if there was a clinic with a clued up GP, it could all be wrapped up in one/two appointments.

And women struggling with menopause who have other medical conditions or a strong family history of certain cancers may require referral to a menopause specialist at hospital..

JinglingSpringbells · 23/05/2023 08:28

@Greenlight The figures I gave were from a graph on the ONS. It's easy to find but the URL was so long that it didn't paste- you can have a go if you like!

The figure I gave was correct as it was shown on the graph as life expectancy for that year of birth. There were also two other ages given- median and modal.

As a professional health writer, I've also spoken to menopause experts, as well as reading the journal of the International Menopause Society who covered this topic in depth, all of which say that women are now living longer post menopause than ever before.

Greenlight1 · 23/05/2023 08:35

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JinglingSpringbells · 23/05/2023 08:53

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I'm not. Most women born in 1940 did not die in infancy in enough numbers to skew the LE figure. I think you are misunderstanding as you are with your theory of why menopause occurs - so older women help look after the tribe - only a theory. It's not supported by many experts.

JinglingSpringbells · 23/05/2023 09:01

Getting back to the original question !!!!

If you want some scientific reporting rather than misinformation and opinions this article is worth reading.

International Menopause Society

[[https://www.imsociety.org/wp-content/uploads/2020/07/wmd-2014-white-pages-english.pdf

This is the first paragraph which is relevant to your question @AlpacaThePicnic

ABSTRACT

Women may expect to spend more than a third of their lives after menopause. Beginning in the sixth decade, many chronic diseases will begin to emerge, which will affect both the quality and quantity of a woman’s life. Thus, the onset of menopause heralds an opportunity for prevention strategies to improve the quality of life and enhance longevity. Obesity, metabolic syndrome and diabetes, cardiovascular disease, osteoporosis and osteoarthritis, cognitive decline, dementia and depression, and cancer are the major diseases of concern. Prevention strategies at menopause have to begin with screening and careful assessment for risk factors, which should also include molecular and genetic diagnostics, as these become available. Identification of certain risks will then allow directed therapy. Evidence-based prevention for the diseases noted above include lifestyle management, cessation of smoking, curtailing excessive alcohol consumption, a healthy diet and moderate exercise, as well as mentally stimulating activities. Although the most recent publications from the follow-up studies of the Women’s Health Initiative do not recommend menopause hormonal therapy as a prevention strategy, these conclusions may not be fully valid for midlife women, on the basis of the existing data. For healthy women aged 50–59 years, estrogen therapy decreases coronary heart disease and all-cause mortality; this interpretation is entirely consistent with results from other randomized, controlled trials and observational studies.

Thus. as part of a comprehensive strategy to prevent chronic disease after menopause, menopausal hormone therapy, particularly estrogen therapy may be considered as part of the armamentarium

INTRODUCTION
As the world population increases, along with an increase in life expectancy, many millions of women will be spending a third or more of their lives after menopause. Several of the topics for World Menopause Day in the past have focused on treatment. This year, our focus is on Prevention. Indeed, from a medical economics perspective, although still debated, it is our view that preventing disease is much preferred over waiting to treat a condition once it manifests. Here we seek to outline the major chronic diseases that occur after menopause and suggest strategies that could be put in place to prevent these occurrences. Some of these conditions (cardiovascular disease) accelerate in women after menopause, and others (cancer) increase as a function of age in both men and women. Nevertheless, in the final analysis, our goal is to suggest strategies to combat all diseases after menopause with the aim of improving not only the quantity, but the quality of life for postmenopausal women world-wide. Women presenting to their medical providers during the menopausal transition provide a unique opportunity for risk assessment, counseling and the institution of various prevention measures. Our perspective of happier and healthier women around the world is a lofty goal. We are cognizant that the prevalences of various diseases are different in various regions of the world, and therefore the emphasis for specific strategies will vary. Further, it is anticipated that, in the near future, we will have different tools for risk assessment, which will be personalized. Molecular tools and pharmacogenomics will enable us to determine individual risks and the appropriateness of various preventative therapies; some of these concepts will be explored later

https://www.imsociety.org/wp-content/uploads/2020/07/wmd-2014-white-pages-english.pdf

Bookist · 23/05/2023 09:22

DustyLee123 · 23/05/2023 06:54

It’s interest that the localised vaginal oestrogen is said to not travel around the body, yet if you read the blurb it can cause side effects which are not local, ie high blood pressure and stomach pain, and the warnings include previous breast cancer, blood clots and liver disease. Yet it’s localised 🤔

Unfortunately, the same generic leaflet is put in both HRT and Ovestin packets. I belong to a menopause advocacy group and there are plans afoot to get the leaflet changed because it's so misleading.

Bookist · 23/05/2023 09:31

rattymol · 22/05/2023 22:29

Why not?

If this is your response to my question 'Why would NHS consultants, who also see private patients, give different advice & medication to their patients?' I'll answer with this. It's because they have a code of conduct to adhere to, their medical ethics to adhere to, because they, and their prescribing methods, are regularly evaluated both internally within the NHS and externally by bodies such as the CQC.

TellySavalashairbrush · 23/05/2023 10:15

I watched my mum struggle in her later years with osteoporosis. She had her menopause in the 1970s and was offered no HRT. I have a history of eating disorders so I was terrified of the increased risk of osteo. It took a bit of trial and error to find the HRT that suits me, but now I have (Gel and Utrogestan) I feel just much more like the 'pre-menopause me'. At £20 a year for the prescriptions, it is a small price to pay.

Jewel1968 · 23/05/2023 10:24

I forgot that I also have Osteopenia and a family history of osteoporosis. That was the other reason I decided to take it. I must admit I had also hoped it would improve my mood but to be fair I don't think my mood is hormone related.

I do think it's a personal choice and I do think some women will benefit more from hrt. My osteoarthritis on my hands definitely improved but in other parts of body didn't.

I often wonder why for some women the menopause has such a big impact and for others less so.

ILoveMyBedTooMuch · 23/05/2023 10:26

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That is one of the many theories debated about the reason for menopause. There are several. No one really knows.

ILoveMyBedTooMuch · 23/05/2023 10:33

bellac11 · 23/05/2023 08:07

Yes, theres no 'well woman' clinic at my GP or anything tailored for menopause etc.

I asked specifically for the doctor responsible for menopause at my practice but there wasn't one. The Gov has said it is not necessary and nor is specific training in menopause needed by GPs.

Bookist · 23/05/2023 10:35

ILoveMyBedTooMuch · 23/05/2023 10:26

That is one of the many theories debated about the reason for menopause. There are several. No one really knows.

I very much doubt that prehistoric grandmothers were that healthy and strong, considering that low estrogen causes heart disease, osteoporosis and joint pain.

ILoveMyBedTooMuch · 23/05/2023 10:57

Bookist · 23/05/2023 10:35

I very much doubt that prehistoric grandmothers were that healthy and strong, considering that low estrogen causes heart disease, osteoporosis and joint pain.

I agree - my G Grandmother was run down after having 11 children and living in a small fishing village hand to mouth in the 1890s- 1900s.

aussiegonewrong · 23/05/2023 14:25

DustyLee123 · 23/05/2023 06:54

It’s interest that the localised vaginal oestrogen is said to not travel around the body, yet if you read the blurb it can cause side effects which are not local, ie high blood pressure and stomach pain, and the warnings include previous breast cancer, blood clots and liver disease. Yet it’s localised 🤔

The blurb is scary and I did not want to use it but the dryness got so bad and I was reassured by oncologist and GP that it is ok and the information is going to be updated

WeRateSquirrels · 23/05/2023 14:53

Damnspot · 23/05/2023 08:10

Most women on hrt don't need a specialist clinic? If you are 50+ and your periods are stopping then you should get HRT from normal gp if you want it.

Almost impossible to see a GP round here. Don't even know who mine is any more. Excellent private clinic in the next village which I can afford. I'm not going to do battle with the NHS when I don't have to.

rattymol · 23/05/2023 20:50

Lots of us can still see our GP fine. There seems to be an assumption that nobody can. I can get a same day appointment most times when I ring. And I can book a later appointment online.

rattymol · 23/05/2023 20:51

My grandmother born in 1912 lived till 98 years of age. She was incredibly healthy.

Damnspot · 23/05/2023 20:56

Yeah no issue seeing my gp. Tbh I just text them through the system they have. Can't imagine not at least trying to save money. How much is it to see a gp privately for menopause? £300?

unfor · 23/05/2023 21:03

I suffer from bad menstrual migraines and am eager to get through menopause and see if they stop (as they do for many women).

Bookist · 23/05/2023 21:16

rattymol · 23/05/2023 20:51

My grandmother born in 1912 lived till 98 years of age. She was incredibly healthy.

I'm sure she was. However, she would have been very much an outlier.

PerryMenno · 24/05/2023 03:11

unfor · 23/05/2023 21:03

I suffer from bad menstrual migraines and am eager to get through menopause and see if they stop (as they do for many women).

My periods are winding down (3 in the last year) and this has been a game changer. One of the reasons I'm not keen on HRT. I'll never say never but for now the peri symptoms are manageable.

(If anyone's tempted to jump down my throat and tell me HRT doesn't cause migraines... save your breath, I don't believe it, or most of the other half truths posted on these threads.)

CrunchyCarrot · 24/05/2023 08:42

Bookist · 23/05/2023 10:35

I very much doubt that prehistoric grandmothers were that healthy and strong, considering that low estrogen causes heart disease, osteoporosis and joint pain.

I very much doubt prehistoric grandmothers even existed, or if they did, were as rare as hen's teeth. Back then, no antibiotics, no surgery, no medicine apart from whatever they did with herbs, maybe. So if you got wounded, infected, injured you would have a tough time surviving. Would have been a very hostile environment.