Preparation for gp review of my hrt prescription.

[user1471522343]

I am 60 years old. I would guess my last period was about 6 years ago, and about 5 years ago I started to use Evorel Conti patches. My main symptoms then were hot flushes and vaginal dryness. I did not suffer mood swings or brain fog but I was very concerned about osteoporosis which my mother and grandmother both suffered from.

I’ve now been using patches for 5 years. My previous gp fairly recently told me he would stop prescribing them for me when I reached 60 because of the breast cancer risk. When I said my main concern was about osteoporosis he said - there are ‘other treatments’ for osteoporosis.

I’ve since moved areas so will use a different surgery but I’ve now been called into my new surgery for a review of my HRT and I’m anticipating they want to stop prescribing it.

So how should I approach this review.

My feeling is I don’t really want to stop HRT. My main concern is definitely osteoporosis but I think it helps me in lots of other ways which I can’t quite define, and my understanding is that the breast cancer risk is fairly small?

On the other hand should I be open to alternative treatments which may be as good or even better?

I think I’ll have to give the doctor a fair hearing and should try be open to alternative treatments, but without pre-judging this GP (who I’ve never met) my experience of GPs is that they are pretty clueless on the subject of menopause.

Basically I’d like to be well informed myself prior to the meeting.

Can anyone direct me to information regarding the pluses and minuses of staying on HRT for more that 5 years and the efficacy of the possible alternative treatments.

I’m in Scotland if that’s relevant.

thanks

The bottom line is that you have to be informed of risks and benefits. Then the decision should be reached jointly, or with you having the final say- it's your body, after all.

There is no guidance about stopping at 60.
There is no 5-year rule.
What IS in the guidance is that women can carry on as long as they want to, having been made aware of any risk. You've actually only been on HRT for a short time. (I know someone who's now 70 and in her 16th year on HRT.)

The treatment for osteoporosis is exactly that- treatment.
It's not without side effects and won't be used to prevent osteoporosis unless you are right on the edge of having it (and you'd need a DEXA scan to show that.)

This explains it here. Note that osteo drugs are not recommended for younger women (under 65.)

https://thebms.org.uk/publications/consensus-statements/prevention-and-treatment-of-osteoporosis-in-women/

This one explains how there should be no arbitrary limits on use.
https://thebms.org.uk/publications/consensus-statements/bms-whcs-2020-recommendations-on-hormone-replacement-therapy-in-menopausal-women/

The PP has given you enough information for you to check out before you go for your review - I think you should just be firm and state you wish to continue.

FWIW I'm 70 this year and have been on HRT for around 18 years and all is well.

My gynaecologist and GP are women.

Brilliant. Thanks both.
I’ll read up on all of that. Knowledge is power after all.

Just an update. All good and there was no need for any pleading of my case. Saw GP and as far as she was concerned if HRT suits me, she’s happy for annual reviews until I’m 70. Delighted.

That's good to hear!

I see that your new GP is a woman

Thank you so much for the thread OP! I was told by GP that I would need to stop at 55, so have been desperately trying to sort out finances for an early retirement because I genuinely don’t know if I’ll be able to work without HRT. I feel better armed with information now.