What happens if you don't take HRT?

[Loverofoxbowlakes]

So it appears I am very deep in the throes of peri, with symptoms that I have been mostly putting down to a sudden and awful bereavement last year, work stress, a chronic illness, but should now be easing off, but they're not (plus periods now all over the place).

Hesitant to get GP advice just yet (as they've been not great up to now, but not rejecting it at all) but what happens if you don't take HRT? Does the fog, the sweats, the forgetfulness, the insomnia (ye gods the insomnia) stay forever? Do you just get used to it? My mum and grandmothers never had any drugs to cope but we never spoke of dealing with such things - are my symptoms here to stay indefinitely otherwise?

My Mum was only allowed HRT for 5 years after a hysterectomy at 41. From 46 she was evil. Really really horrible. My teenage and early adult years were a misery and she's not tonnes better now.

In her 70s, she's incontinent having spent years very proud of having a strong pelvic floor. She gets UTIs despite using vaginal oestrogen. She gets wet eye (ironically from an overly dry eye caused by lack of eostrogen), severe joint pain, insomnia, weak snapping nails. She has high blood pressure and IBS. I rather hope not to go down the same way by staying on HRT. Her doc has refused her HRT due to her high blood pressure which is a fallacy as HRT protects against heart disease.

I didn’t have any of the symptoms you describe - apart from hot flushes. I didn’t take HRT. I was just delighted that my periods stopped and I had no pain every month.

My mum and both grandmothers have/had osteoporosis so HRT feels an important part of protecting my bones in peri, along with exercise and diet, and I expect I will keep taking it for a good long time. If it weren't for that I might have tried pushing through my symptoms (insomnia, night sweats, which were a bit joy-sapping but not unbearable.

I am 52 and not on HRT I don't get hot flushes too badly during the day, do get night sweats. Brain fog isn't too bad. As it hasn't been that bad yet, I hadn't thought about HRT. I didn't know it protected against osteoporosis, will look into it more now.

Lots of us don't take HRT, and never have. It's not compulsory. Everyone is different, so you can't judge by other people's experiences, you just have to decide what you think is right for you.

@GOODCAT this may be helpful:

It was a gradual change, the sort where you look back and think oh, I'm not like that anymore, so it's difficult to put a time frame on it. More than 2 years, less than 5.

At one point my brain fog/concentration was so bad my DD had to sit with me for phone calls and explain afterwards because I just didn't understand, it was truly frightening. Now I'm nearly back to my old self, including working out complicated utility bills, going online to sort out tax matters etc.

I take hrt because my bone density is poor and have osteopenia

I would however say that lifestyle factors by far have had the biggest impact on minimising my peri menopausal symptoms and it was only when I implemented these that I felt much healthier and less tired and achy.

The main factor was cutting out all upf and switching to a low sugar and whole food diet which meant I lost all my belly fat without reducing calories. I then had more energy to start strength training 5 days a week which has helped maintain my metabolism despite significant fat loss.

If you are worried about alzheimer's remember that it is now being known as type 3 diabetes and really focus on improving your diet.

Very interesting what @shearwater says about the combined pill.

I'm on Yasmin as birth control (age 40) and when I rang the pharmacy one time to order my tablets the pharmacist referred to it as my HRT! I then looked into it and it's often used to soften peri symptoms.

Maybe something to consider? It's very safe.

Here's an article worth reading on using birth control pills vs HRT

www.earlymenopause.com/information/topics/hrt-vs-birth-control/

Really interesting @INeedAnotherName - thank you

Yes, I wish I'd known about this when I went through the menopause ten years ago.

It was only recently that I went on a higher protein diet and worked on my gut health and started resistance and weight training to get rid of belly fat. I didn't realise that it would also improve my energy levels, sleep and brain fog.

Does the fog, the sweats, the forgetfulness, the insomnia (ye gods the insomnia) stay forever?

I’m nearly 49 and finding that the peri symptoms come and go. For instance, I had terrible brain fog 2-3 years ago, but now it’s gone. I’m still forgetful and I have occasional insomnia, but I take melatonin if it’s bad, which helps. I also get the occasional hot flush.

So my personal experience is that the symptoms ebb and flow. My periods are shorter but still regular, I hope I’m close to the end. 🤞

Not taken hrt as worried about the previous risks associated with it agave managed, the worst being the night sweats but overall been quite lucky. So I think its a very individual thing depending on how many symptoms you have and how much you can tolerate. Having read the list one of the previous posters has put on here I'm now wondering I've had more symptoms attributed to menopause than I realised!

well, if you don't have hot flushes, that indicates that your other symptoms are not related to the menopause. If you would benefit from HRT, then you would have hot flushes. That is not that HRT is given to treat hot flushes, that means that the flushes indicate that you would benefit from HRT. If you don't have them, HRT won't change anything

It doesn't really, only if you have a very early menopause

I had a Mirena coil fitted for 15 yrs so most of the perimenopause passed me by. No erratic heavy periods was amazing, But I was aware of other symptoms so opted for HRT to try and ease them. Apart from the mood swings and mild hot flushes HRT did nothing much. I think I would have had to take much higher doses which in hindsight I am glad I didn’t. After 3 yrs I had to stop because I was one of the unlucky ones who developed breast cancer. If I’d had a higher dose then my prognosis might not have been so good.
I immediately started hormone blockers and although I was expecting a rough time I am fine. The cancer treatment knocked me around but post menopause is actually quite good. No mood swings , there’s no hormones to swing, I have to have bone scans because the hormone blockers can cause osteoporosis but it’s more common in women who already have early signs. Which is interesting because it’s obviously not just lack of estrogen that causes it. I have mild hot flushes again but they are becoming less and less intrusive.
I had a discussion about osteoporosis and dementia with my DSis who despite having two sisters with breast cancer ( not genetic)has decided to take HRT, she was caught up by the whole Davina thing. I had observed that we come from a family where nearly all the women, on both sides , are long lived (80-90) and not one of them broke a hip or suffered with dementia. Dementia is very likely to be genetic but it’s only the last few generations that have lived long enough to make the observations. And probably the same with osteoporosis, bone density is very variable in women, lots of factors involved. But in our family osteoporosis and dementia have not featured. Neither has breast cancer until my generation but none of my female relatives in previous generations took HRT.

This! I mentioned menopause to a nurse at my GPs surgery several years ago, and she told me the majority of women are fine. I don't discuss it with my friends, but I'm pretty sure only one is on HRT.

However, you can't say that on MN, as you so rightly said. If you really need it then take it, but I disagree with this agenda that if you don't take it then you are in for dire consequences.

I wouldn’t be able to function without HRT. The positive effect it has on my mental health are enormous. I had PMDD from my teenage years, so have been a slave to my hormones most of my life, HRT makes me sane, rational, calm and happy.

53 here. Last period over a year ago now so finally officially at menopause! Before that around 8 years of varying symptoms.that changed over time.
Peri symptoms have now mostly resolved This has prob happened over last year or so..
Main remaining issue is total loss of sex drive. Literally zero interest..in anyone. Let alone DH. More forgetful than I used to be and my mood is more fragile generally but other than that feel fine.
Never did HRT

56 not on HRT. I had an endometrial ablation 8 years ago so periods stopped then. At the time the gynecologist said I was 2/3 years away from menopause so I guess I am through it now.

I had a fairly easy time of it. A handful of hot flushes. I notice I 'lose' words more frequently now. Libido is gone.

HRT is probably not for me. I am autoimmune central. Blood clotting, thyroid gone, diabetes. The latest one is vitiligo. I'm one more prescription away from needing one of those boxes for sorting my tablets out.

If you have menopause symptoms that affect your life too much then take HRT and you may benefit in some other ways too but don’t just take it in case you get some of the benefits and you may experience the negatives too. Xx

The thing is you can only take het for so long. What happens when you stop? Do the protective effects last drop off?

Well no. That used to be the case, that you would get HRT for 5 years or whatever and then no more. But that's not the case for many women any more, and some are on patches for decades.

but if you are not likely to start it until 80, and you postpone that until 90, and it doesn't become a problem until 100, and even then you can still get treatment, etc. it isn't really going to be much of an issue in the lives of normal, active women. Not to mention it doesn't give much protection even then