The Menopause conundrum - who do we believe?

[Stridingthroughtheglade]

There seems to be a thicket of information out there, at the same time a dearth of actual rl advice and help! Need some advice negotiating my way through the problem please.

I am in my late fifties. Had a full hysterectomy with ovary removal nearly five years ago.

Went on HRT immediately for six to eight months but I wasn’t given any info about it and it didn’t seem to do anything in particular so I stopped taking it.

Only now, when it’s a few years later, I find myself not sad but just flat, no energy, no motivation, physically sluggish, don’t care about anything. My hair is receding and falling out. I have loads of bristles appearing on my chin and dark hairs on my upper lip. My limbs ache. My back hurts. I’ve gained weight. Any minor task that previously I would sail through, seems to be an enormous burden and I need to psyche myself up to do it, for hours and days in advance. Afterwards, I am exhausted. I’m existing, not living.

I have been offered anti-depressants but I am not sad and I don’t have anything to be depressed about. Good long marriage, lovely adult dc, ok job, ok home, supportive family, great friends, interesting hobbies. My life is a breeze compared to most people’s.

So where do I go now?

I see Dr Claire Newsome (is that her name?) all over sm. She talks about HRT as if it is a necessary, preventative treatment for most women. I understand the risks of HRT have largely been disproved but who do we believe? She seems very sincere and obviously I don’t begrudge her a living, but how much do we trust in what she says?

I’m a keen gardener and trust that nature knows best in most things and we get in to trouble when we meddle with it.

So the options are:

** ADs

** HRT

** diet and exercise

Sorry for long op, but what exactly should my next step be please?

How does everyone negotiate this issue?

Just working my way down all of the posts and I haven’t thanked you for your link to the you tube film Sorrynotathome apologies!

And interesting that you say “The protective effect of HRT on bone density has been overstated - particularly by Dr Newson who has misinterpreted some old research.”

Eeeek! I am so grateful for the breadth of views here but it continues to be confusing for the lay person!

How did you get on at the doctors ApolloandDaphne?

The menopause doesn’t just stop. It continues for the rest of your life as your hormones depleteIt’s how you deal with it that’s the question. As someone else said earlier we don’t stop taking blood thinning tablets when we get to 65. So why would I stop taking HRT which enables my hands to not ache on a daily basis, and makes me feel 100% better all of the same.

I think this is also a very valid viewpoint. If I wasn’t feeling so crap this would be my strategy!

Hrt is just topping up your oestrogen, I'm assuming you won't need progesterone if you no longer have a uterus (progesterone in hrt is to protect your womb lining from over thickening). Lack of oestrogen has an effect on so many parts of our bodies, and mood - I'd definitely try it first.

(Still working my way back down thread)

Jingling I think you have hit the nail on the head when you say that perhaps it’s not about who we trust but what!

I am going to look at the EU equivalent of NICE, as presumably there will be the collective wisdom of 27 EU countries in there!

I never knew that HRT was made from yams either!

It is surprising how little we know about the basics!

And I don’t mind admitting that I am also confused about menopause being a transition state or an ever-more state!

Modern HRT is made from yams, and is called 'body identical'. The molecular structure is exactly the same as your own. You're topping up your own levels. It's not the same as Pill or the HRT that was used 20 years ago.

Not to dispute your evident wealth of knowledge on this subject Jingling but couldn’t that be said of most drugs, that they are derived from plants I mean?

Amen! It's just a supplement, no more unnatural than the vitamins and mineral supplements we might take.

I need a vitamin d supplement because I can't get enough from my diet and there's no bloody sunshine and the deficit has an impact on my body! I take an oestrogen supplement (hrt) because my body makes less now and that has very painful and life disrupting effects.

I resisted hrt for years because I thought it was a big pharmacy conspiracy, or incompatible with my feminism, or some damn thing! Now I've experienced the difference a bit of oestrogen makes, you'll never stop me.

I am going to look at the EU equivalent of NICE, as presumably there will be the collective wisdom of 27 EU countries in there!

@Stridingthroughtheglade I don't think that is necessarily a good move because not all HRT is licensed in all countries. eg for women in Ireland, there are options we don't have here . Just one tiny example is they can get dydrogesterone ( a type of progestogen similar to Utrogestan, and as safe) as a separate tablet to use with estrogen. In the UK it's not available.

What you might want to do is to explore the International Menopause Society (IMS) which is a group of countries working internationally, like the BMS. https://www.imsociety.org/

One of the main UK menopause specialists is on the team - the President is - Nick Panay. He's highly involved in research as well as having his own practice and NHS work.

The Climacteric is their journal if you want to read articles.

However, I'm a bit stumped now about what you want as 'wisdom'.

The bottom line is you either take the plunge and try HRT for 3 months or you sit on the edge of the pool and keep debating it. 🙂

@Stridingthroughtheglade I think you're being very thoughtful and considered about this, which is very unusual as many people seem to leap to a conclusion and then shout about how right they are! Ultimately you will decide what is best for you as an individual. The brilliant thing about living in 2023 is that you have lots of options! I remember when HRT first came out and it was a revolution and a revelation for many women. But not all women want to take it and there are lots of ways to address symptoms that may work just as well as HRT. You can try HRT and then change your mind and do something else!

Someone mentioned rising rates of breast cancer - most likely due to our modern lifestyles. Proven risk factors (apart from gene) are being overweight/obese (now 2 out of 3 adult women), alcohol, smoking, early menarche, having children later, not breastfeeding or only breastfeeding for less than a year in total, late menopause. If you look at all those things the only one in decline is smoking.