Breast cancer in family and Peri menopausal

[Derbybound2022]

I saw my GP about my symptoms of peri-menopause and she just referred me yo a site recommending a range of alternative supplements for me to go and research. We have breast cancer prevalent in my family so I can't take HRT.

Anyone else in my position? Is there a specialist who advises in this area?

I'm not quite there yet, but will be shortly.
I did save this article, it is about a new medication that has been licensed in America and should be available in the UK by Nov/Dec this year. The drug is Fezolinetant and is a treatment for hot flushes.

www.theguardian.com/society/2023/may/20/drug-hot-flushes-transform-menopause-treatment-doctors-fezolinetant

@Derbybound2022 There is a very good video on the British Menopause Society website with Prof Michael Baum, breast specialist, where he talks about HRT and family risk. If you were interested I can help you find it?

In a nutshell, he says any woman with a large risk (which means a mum and sister having BC at a young age) they ought to be tested for the BRACa gene.

If that is not the family history, and it's more diverse, he says women should not be afraid to take HRT.

Hello

Thank You for this information.

We have a gene variation of unknown significance. Not brca. I really cannot take hrt. I need to see a specialist who can advise. Is it a breast specialist then?

Anyone else in the same boat?

. I need to see a specialist who can advise. Is it a breast specialist then?

You should see a gynaecologist who specialises in menopause and treatment for women who can't take HRT.

What you will be offered are other types of medication for your symptoms. These sometimes include anti-Ds, or blood pressure meds for hot flushes.

No idea where you live, but there are specialists like this in London but also other cities in the UK.

You could start by looking at the website of the British Menopause Society and their link to SPECIALISTS but then you will need to do some research into who is best in your area unless you want to travel to London.

I have the brca2 gene and have had breast cancer. Even though I'm ten years post diagnosis (was diagnosed at 36) no one will prescribe HRT.
I take an SSRI for hot flushes. Recently my GP has also agreed to prescribe a topical oestrogen for vaginal atrophy, which is a good development!
I'm in Edinburgh and was referred to the menopause clinic there.
Good luck!

TBH @Derbybound2022 the drs telling you that you can't use HRT (the ones who did the genetic testing, presumably) are also responsible for finding /directing you to other professional care, not just pointing you to supplements, on a trial and error basis (many don't work.)

I'm not trying to push HRT at all, but there has been a big shift in the opinions on HRT in the last few years, because there are women who have had BC using it (some are on this forum now and then) .

It's not as black and white as you may have been told previously because there are many different types of HRT now and one sort especially appears to be much safer.

Obviously you need expert advice.
I'll leave the video here that I mentioned.https://thebms.org.uk/publications/bms-tv/ Left hand column towards the bottom. Michael Baum.

I don't think Michael Baum is working with patients any more however his daughter Katie Taylor is very involved in menopause treatment and runs a Facebook group called The Latte Lounge.https://www.lattelounge.co.uk/about-us/katies-story/ Worth looking at for suggestions of drs.

Thank you so much for the advice. I'm able to travel to central London, no problem. I will start researching all this! So much more helpful than my Gp!

Does anyone know who are the leading menopause doctors in London ?

I'm high risk for breast cancer due to my family history but can't be tested for the gene as both my mother and my aunt died from breast cancer a long time ago pre-gene testing.

I'm in peri and my symptoms have been debilitating (on top of long Covid and other related health issues). I pushed hard for HRT as I was unable to work and I'm the only source of income so need to be working! I've been under the care of the breast cancer team at Barts for many years and my oncologist said I mustn't take HRT (and was I mad basically?!). I saw a menopause GP privately who disagreed and eventually I got Barts to agree that if my quality of life was so badly compromised, I should try the HRT if I was willing to accept the increased risk (approx 4% in my case). It wasn't an easy decision but I started on HRT (Oestrogel and Utrogestan) last Nov. So far so good. I'm also under the menopause clinic at Barts.

I'm 53 and 2 years older than my mother when she died from breast cancer (she had it 3 times). I always thought I'd go the same way so technically I'm 2 years up already. It's scary but the HRT has made a big difference as I'm able to work again (in a stressful role in Financial Services). Maybe I'm a ticking time bomb but I felt had no other viable option as I'd exhausted everything else.

I will PM you but there are some names/faces on the BMS video link I left for you.

This is an old thread (started by me) but might be helpful for you @Derbybound2022

https://www.mumsnet.com/talk/menopause/4378478-Nick-Panay-HRT

@weebarra Can I ask which topical oestrogen your GP prescribed you? I want to ask my GP for something but unsure what to ask for. Did you have a hard time getting the prescription?

I was prescribed vagifem but a friend who is a GO recently got the go ahead from oncology to prescribe the estring - estradiol vaginal ring, for a post menopausal cancer survivor, which I found really interesting.
I didn't have a fight but he did quite a lot of research and I don't use it continuously.

That is really helpful, thank you. I was going to ask for Vagirux or Vagifem.

I saw that the ring can be prescribed for cancer survivors but only for max of 2 years (apparently).

I have yearly private mammograms and consultations with a breast specialist due to family history. He was helpful in discussing genetic testing and in helping me to make a balanced assessment of whether to take HRT, based on my risk and needs. Testing negative for BRCA was a great relief of course, but it sounds as if your situation might be more complex due to other genetic factors. I take HRT, although my GP was initially reluctant. She listened to my breast specialist and was reassured, so you might still be surprised when you consult a specialist.

Were you offered a follow up consultation after the genetic testing to discuss the implications of the results? I guess the next step would be to see a specialist around non-hormonal menopause management, if it’s a definite no to HRT.

My workplace hosted a menopause Q and A with this GP - who also runs a private menopause service.

She was very nice and seemed extremely knowledgeable - people were asking the most detailed and specific questions about medications etc and nothing phased her at all!

She had lots of suggestions for people who couldn't take HRT.

https://www.nuffieldhealth.com/consultants/dr-beth-thomas