Are some women just against HRT full stop?

[Ladywing]

I can totally understand a healthy dose of scepticism around HRT it isn't going to keep you from aging and while newer forms are safer no treatment is totally risk free. I can also understand anyone choosing not to take it as it is a personal choice of course but there does seem to be an attitude in some women that HRT just isn't needed, that diet, exercise and supplements are all that is needed and that women who use HRT are some how weak and looking for easy answers.

Why is it so difficult for some people to accept that menopause doesn't effect all women in the same way and that for some women HRT is life changing and necessary?

@Ladywing Did you start his thread because someone else had started a thread about her friend saying she was 'cheating' the menopause by using HRT?

It's an eye-opening thread (that one.)
Quite worrying to see a lot of misinformation there about the menopause.

We shouldn't be left by the nhs to just work it out for ourselves or rely on private suppliers who have vested interests in selling it.

Is there a misunderstanding that going to see a private menopause specialist always means they give you HRT ?

The best menopause consultants don't just give HRT. They may suggest other things, especially if you don't want HRT, (and help you work through all the alternatives) but would prescribe HRT if you asked for it and had no contraindications.

This in spades! I've encountered an almost evangelical zeal about hrt on here at times, with a proverbial pile on of why you should be taking hrt when you've said you're quite happy without it. Added to that a dozen posts asking if you've had a dexa scan, which quite frankly is nobody else's business.
I don't care if an individual takes hrt or doesn't, but people need to stop making an issue over somebody else's choices either way.

This is good point. I don't take HRT and never have because too me it sounded too much like taking the pill which I didn't get on with. There are other options to HRT.

I take 5mg of DHEA every day instead. It's a supplement widely used in menopause in mainland Europe and the US but you can't buy it in the UK. You make DHEA as a mother hormone and it peaks in your 20's but drops off as you age, more so after menopause.

I buy mine from a company called Eurohealth who are in Sweden I think but you can also buy it from the states. Lots of research has shown it increases oestrogen and goes some way to supporting bone health.

Never had a hot flush, brain fog etc and it gets rid of my achy joints (my only symptom at 54). I started taking it for joint pain as I read that can be cause by low oestrogen and I really notice it in my joints if I stop taking it for a few days.

It doesn't seem to be widely known about in the UK for some reason. There is a link to an old article about it but I'll post that in a separate reply as I don't want to get this deleted as someone might find it useful 🙂

This is it. It's an old article, but interesting. You can see how engaged people are about the alternative to HRT by all the replies 😅www.independent.co.uk/life-style/health-and-families/health-news/staying-forever-young-565335.html

@JinglingSpringbells if I want testosterone I have to buy it from somewhere like Superdrug (unless I see an expensive private doctor/menopause specialist). With the best will in the world, Superdrug don't know me like my GP does snd is reliant on the information I give them, whereas my GP has my whole medical history at their disposal. And how would I really know if I'm seeing the best private menopause specialists? They make a living from selling HRT and supplements to women - a GP doesn't. And most women only really have access to NHS services anyway.

The sachets are licensed for men, not women, so I'd have to guess at dosing, since each sachet is sold to be used in one go (for a man). Can't remember if it's this thread or another, but women are talking about the best way to deliver the dose and there's confusion about frequency. My GP has completely washed his hands of giving me any advice at all until my appointment with the specialist comes through.

I am popping in to confirm @JinglingSpringbells facts. I can say this as a nursing student and from lived experience. I had a hysterectomy at 34. (Haemorrhage during high-risk twin c-section.) I pottered around very smugly not missing my periods at all. Suddenly I began feeling OLD. Very old. I was in my early 40’s. Blood tests showed hyper parathyroid jam and scans showed osteopenia. (Pre-osteoporosis). I stabilized in the osteopenia range with mega doses of vitamin D. It wasn’t until I was 46 that I started using oestrogen gel and all of a sudden, my bone scans showed rapid improvement back into the “normal” range. The other improvements included mental health and well-being, and my skin came back to life. They’re going to have to pry that stuff from my cold, dead hands.

Do people actually have an opinion about it though?

I use/don’t use HRT and have no thoughts at all on what other women do. I don’t think I get beyond “they’ll make the right choice for them”.

I have never had a conversation where I thought someone else was over invested in other peoples’ HRT status.

Well, I wasn't aware that Superdrug sold testosterone for women. I am happy for you to tell me more, but I thought that anyone using any HRT had to have a consultation with a dr via Superdrug before they could be prescribed it.

They make a living from selling HRT and supplements to women - a GP doesn't.
Gp practices get funding for targets they reach.

You are wrong, sorry, to say private consultants make a living by 'selling' HRT. Most consultant gynaecologists see a wide range of women, from puberty to old age. This includes period problems, endo, infertility, PCOS, prolapse and menopause.

How do you know you are seeing the best? How do you know you are seeing the 'best' GP?

Research. Most have websites, you can study their CVs, see reviews, see if they do research or have written papers etc.

I give them, whereas my GP has my whole medical history at their disposal

But you've just said they can't or won't prescribe testosterone as they don't have the expertise.

This is good point. I don't take HRT and never have because too me it sounded too much like taking the pill which I didn't get on with.

But you know now that HRT is not like the Pill at all?

It's natural hormones, molecularly identical to your own, unlike the Pill that is a much higher dose of synthetic hormones that don't exist in nature, except in a lab.

I'm actually fed up seeing hrt being hailed as a miracle drug. Many women cannot tolerate hrt, for some of us the side effects are worse than Meno symptoms. Progesterone makes me, and many other women suicidal. Not against it all, I've tried to take it in many forms over the years. Great if it works for you OP but that is not the case for all of us.

@JinglingSpringbells my GP says he's not allowed to prescribe without me seeing a specialist first, but the wait for the specialist is long and the GP won't even talk about it with me as an option - just says he doesn't advise buying it privately but can't stop me. I wouldn't be able to talk to him about doses or side effects if I needed to.

Yes, Superdrug does want you to have a consultation before selling but an online consultation doesn't feel as safe to me as going through my GP.

There's a whole industry which seems to have grown up around selling stuff to menopausal women. Every time I go on instagram or fb someone is trying to sell some supplement they claim helps - I just want to go to my normal dr surgery and get advice/prescriptions from someone who hasn't built their business around selling specific products. And I think normal GPs should be properly trained to assess need and given the authority to prescribe testosterone if needed. My dr was reluctant to even do a blood test to check testosterone levels.

Hello thank you for your advice. I feel ok but as you say there could be stuff going on i cant see. Was thinking of GP visit for the dryness so i will do that and ask about bone density.

I too suffer from bladder pain and do sometimes pee myself a bit if i cant get to loo quick enough. I also had recurring UTI. Bladder exam showed all normal. The GP though did say could be vsginal atrophy, i do suffer dryness also. Another trip to GP in order i think

@JinglingSpringbells Women have been completely let down by the medical community when it comes to bone health. We can start losing density as early as our 30's and many, many women head into menopause already suffering from osteoporosis.

It's really scandalous that young women/girls aren't given guidance on how to build and maintain strong bones.

I am 56, a few days from 57 and have only just stopped having periods. (3 months).
I have a few flushes now and again.
I am tired but work fulltime so I expect that.
I don't take anything as I don't need it. If I had to seek medical advice and needed HRT then I would probably go with it.

I sailed through the menopause with hardly a sign. My bone health (monitored for other reasons) is apparently better than average. I felt no need for hrt so don't take it. For several friends it has been a godsend, and I fully agree they should take it. We are all different and should support each other, not snipe.

I didn't clock that the article referred to DHEA as a natural treatment but I don't see that using the word natural deflects from how useful it could be to some women wanting an alternative to standard HRT. DHEA is a relatively cheap, not patented supplement.

Yes DHEA is a hormone precursor but so what? Vitamin D is a hormone, thyroxine taken for hypothyroidism is a hormone, insulin is a hormone. Taking anyone of them is a form of HRT. Yes, taking DHEA is a form of HRT, I understand that and didn't claim I was avoiding HRT, merely that standard prescription HRT is very like the pill which I didn't get on with so I tried DHEA instead. DHEA works for me and lots of other women.

As for the Dr mentioned in the article, I don't understand the relevance of you hearing/seeing bad things about them. Were these bad things 10 years ago when they were referenced in the article or since? As far as I know they aren't the only one recommending DHEA to women and the article was from 2004. Would you be critical if the same Dr was recommending taking vitamin D in winter just because it's that particular doctor?

I only posted the link to give a bit more back ground information about DHEA and in reference to my first post because from what I read on MN there are quite a few women it could benefit.

@AvidMerrian Do you genuinely not know that people have opinions on whether others should or shouldn't take HRT? You seem to think that because you don't, and you've never personally had such a conversation, those people don't exist.

People frequently don't make the right choice for them. Follow any menopause discussions for a while and you'll meet women who deeply regret either taking or not taking HRT. Many of them made their decision based on inadequate or false information and bad advice. Some have had to give up work, lost relationships, give up hobbies etc as a result. Some suffer permanent damage to their health as a result of those decisions which they now know were the wrong choice for them.

And of course people aren't allowed to freely choose for themselves whether or not to take HRT in the first place, because the medical profession controls access to medications. Some women can't get HRT, or the HRT they want/need, because the medical profession won't give it to them, and not everyone can or will persist until they get help.

@LadyBird1973 That sounds dreadful that your GP can't offer basic menopause care. There are numerous training courses all year round for GPs as well as online 'courses' so there is no excuse. 51% of their patients are women!

I find it hard to believe he is not allowed to prescribe HRT- that really does sound like nonsense.
Is this the stance of your GP practice? Menopause clinics are for special, complex cases.

I am not using testosterone but know women who do.
I know it's only given once estrogen/progesterone is established as HRT, and not on its own.

Is this helpful?

You mentioned not wanting an online consultation - but many GPs are doing this now and have been since lockdown. It's become quite normal.

If you don't want to wait for the menopause clinic, there are private GP services and online GPs where you could have a consultation.

Googled DHEA as wasnt aware of it. People who use instead of HRT do you find it effective ? Which do you use and what dosage ? I read 30 to 50mg thanks

@Pollyputhekettleon So we are not allowed to be non-judgemental now in case it makes people being judgemental feel that they are being judged? There is a difference in offering evidence-based information/suggestions that can help and making others feel bad about their decisions which is what this thread is about.

HRT and Brexit seem to be the only two areas where it is acceptable to claim that other' decisions are made from a position of ignorance or misinformation. Add that to the willful manipulation of evidence by some experts/media outlets which is ongoing at present (for example recent stories about HRT preventing Alzheimer's from some quarters while soundly rubbishing studies suggesting it increased risk based on very similar observational studies when the true story is that there simply isn't enough evidence to say definitively yet) and we have a toxic and confusing situation.

I think many GP practices now have geared up their menopause provision and now have at least one prescriber who has completed the Confidence in Menopause course championed by Louise Newson. I know in my area most have, although they still have to have consultant involvement for testosterone as is @LadyBird1973's experience.

"There is a difference in offering evidence-based information/suggestions that can help and making others feel bad about their decisions which is what this thread is about." That's an utterly false dichotomy and no, the latter is not what the thread is about.

No HRT and Brexit are not the only two areas where that is acceptable. Another false dichotomy. How about Covid policy, vaccines, the contraceptive pill, voting for Tories, natural childbirth, Trump, opposition to abortion. I could go on. More to the point, it's acceptable always and everywhere to claim that others' decisions are made as a result of ignorance and misinformation if that claim is true. And human beings being what we are, it's frequently true.

You literally demonstrate why the situation is toxic and confusing, yet you object to anyone claiming that people are making decisions based on the consequences of that confusion. That makes no sense.

I don't know what point you're trying to make about GPs. Their incompetence and arrogance is widespread. There's no data to say anything beyond that and nor will there ever be. Even statistics for having attended a course in menopause wouldn't prove that they learned anything from it. Some of them were online shopping while logged in to the course in another window.

@JinglingSpringbells he has given me normal HRT but not testosterone. Sorry, maybe I wasn't clear. He won't discuss testosterone at all until I've seen a specialist

I do think I'm going to end up going to an online consultation for testosterone. I just would have preferred to just see my normal dr.

I took it for 10years and felt great then I wean3d myself off and all my joints started playing up. Wish I was still on it.