How long do you plan to stay on HRT for?

[NetZeroZealot]

I've been on it since I was 52 and am 60 now.

It's been a genuine life changer. I can't imagine ever stopping! But think I must at some point, probably when I retire - I still have quite a demanding job.

Interested in others experiences, especially people older than me who are still taking it.

How do you know when you should quit?

@bruce31

I've had private mammograms (mainly as I've been on HRT for a long time and the NHS doesn't do them often enough IMO) and the info on breast density is given. There are 4 different 'grades' of density from mainly fatty up to very dense.

It' s an important factor as @CulturalNomad says and any woman with dense breasts might benefit from more frequent screening.

If it worries you, there are lots of options for private mammograms and the cost is around £200-£300 depending on where you live. Most consultants suggest one every 18 months - couple of years unless someone has a higher risk factor.

Transdermal estradiol is considered ideal, but not everyone can use the patches. I am allergic to them (I think it's the adhesive) and have to take a tablet. In any case, the progesterone is a pill, so unless you don't have a uterus, you will be taking at least one pill.
One of the earlier posters said her mum couldn't take it because of breast cancer. That's is not always the case and in any case the vaginal estrogen cream is not contraindicated for women who have had breast cancer.

Those who are having difficulty getting it prescribed by their GP should print out the NICE guidelines regarding Menopause and HRT. There is also lots of science and information on the North American Menopause Society's website

I have it on my medical records that I am never to be asked if I want to stop taking mine. After mental health problems most of my adult life and finally getting stable since being on a consistent dose of oestrogen, never will I stop taking it.

I'm 69 and have been taking HRT for around 18 years. My female gynaecologist said many women stop around retirement (she didn't mention what percentage) but that I can just stay on for as long as I want, so I will!

Very interesting thread & good question OP!

I'm 50 this year and literally started HRT yesterday. Oestrogen patches & prog tabs. Am hoping I'll feel like a new woman by next week. 😅

Talked about it with my aunt who's an OBGYN and she also said there's no general reason to stop taking it until you die. Unless they're other complicating factors. I don't know what these are though.... early days for me.

@ItsFuckingBoringFeedingEveryoneUntilYouDie this morning I am totally relating to your user name 😅

(sorry, off topic!)

One GP tried to get me to stop it and I said this is not the time ( Dad had had stroke) and talked him into giving me another six months. He said you have been on it for five years so it’s time to stop. I knew that was wrong but took the six months. Rang back and got different GP and said I didn’t want to stop yet- not a problem she said here’s another year. I don’t intend to stop it, history of both brain and cardiac problems in my family and no history of Breast cancer. Get regular boob squeezes.
I will force the issue if I have too with nice guidelines as that is how I got hrt in first place

This thread is very reassuring as I began hrt at 45 and am now 49 and have no wish to stop yet as it helps me so much. Terrified the drs will make me stop soon when it's been 5 yrs 😱

🤣🤣🤣👍

I started it three years ago (at 51) and combined it with 50 mg sertraline not long after (mental health took a real battering). I feel better than I have ever done, in spite of having had more adverse life events in the last five years (and obviously being older) than the previous 20. I don’t intend to come off it, but I am now going to look into getting a private mammogram to establish breast density, and will get extra screening if it’s indicated.

The 5 years was never there for any real reason and it's been dismissed YEARS ago.

There is newer guidance online (by 'new' I mean several years old) which says there is no time limit.

Love this chat.

im not sure I’m on the right hrt. What are women who are post their periods taking?

This is from the BMS 4 years ago. I've picked out the most relevant parts.

https://thebms.org.uk/publications/consensus-statements/bms-whcs-2020-recommendations-on-hormone-replacement-therapy-in-menopausal-women/

There should be a holistic and individualised approach in assessing menopausal women, with particular reference to lifestyle advice, diet modification as well as discussion of the role of HRT.

The decision whether to take HRT, the dose of HRT used and the duration of its use should be made on an individualised basis after discussing the benefits and risks with each patient. This should be considered in the context of the overall benefits obtained from using HRT including symptom control and improving quality of life as well as considering the bone and cardiovascular benefits associated with HRT use.

The HRT dosage, regimen and duration should be individualised, with annual evaluation of advantages and disadvantages.

Arbitrary limits should not be placed on the duration of usage of HRT; if symptoms persist, the benefits of hormone therapy usually outweigh the risks.

HRT prescribed before the age of 60 has a favourable benefit/risk profile.

HRT initiated before the age of 60 or within 10 years of the menopause is likely to be associated with a reduction in coronary heart disease and cardiovascular mortality.

I'm allergic to sticky things, but use Oestrogel which is transdermal

Both my gynae consultant and the pharmacist at my GP practice told me the mirena is only effective as HRT for 4 years as the hormone levels drop too low after that time. The levels are still high enough for contraception up to 5 years. So you should get a new coil fitted after 4 years for HRT. So I would agree with your GP there.

However she is dead wrong about needing to stop HRT because of your age. Latest guidelines say you can take it for your whole life unless you get certain conditions. Definitely push back on that!

Taking progesterone by tablet is normal but the oestrogen is better taken as gel or patches as it eliminates the small clotting risk of oestrogen tablets. Sounds like you are on the right regime.

I started taking it at 41 and plan to continue indefinitely as I have poor bone density unless any new medical evidence emerges. I am much more concerned about protection from osteoporosis than cancer risk which I understand that obesity is a much greater risk than HRT for.

Women aren’t told their breast density in the U.K, even after mammograms - and the radiographer will know. Across the world now, countries are changing their guidance on this and there are many campaigns. I’m one who had dense breasts - now gone - and got breast cancer, and, worse, had the large cancer missed on mammogram because - wait for it - I have dense breasts. I feel very incensed about all of this. Anything you can do to find out about your breast density, do so.

Can i ask what is meant by dense breasts? Is it related to the size of your breasts?

Sorry, just seen that my question was answered above in the thread!

I was made to stop at 60 - told the guidelines did not allow continuation. Hell, do I wish I had stayed on it! Not likely to be prescribed now as I have developed a heart arrythmia and on anticoagulant.

I have another question, though:
I have endometriosis, so I've been told I need to protect against endometrial/uterine cancer by having a mirena coil (even though I'm 51 and likely past menopause) alongside my oestrogen patches and Utrogestan tabs.
Anyone in a similar position been given any advice on how long is 'safe' to continue with this form of HRT?

British Menopause Society say it is ok to use a Mirena for HRT up to 5 years.

"Intrauterine progestogen administration through 52 mg levonorgestrel releasing intrauterine system provides adequate endometrial protection in women receiving estrogen therapy. Only one product containing levonorgestrel 52 mg (the Mirena IUS) is licensed for progestogenic opposition of estrogen within HRT and has a four-year license in the UK. Studies have shown it to be effective and to offer sufficient endometrial protection up to five years within HRT regimens. As a result, it is common and safe practice to use the 52 mg levonorgestrel intrauterine system for five years within HRT regimens (out with its manufacturer’s license)."

When I had my Mirena fitted a couple of months ago, the gynaecologist told me it would be fine for the progesterone part of HRT for five years.

He also told me that a useful sign that it might need replacing earlier would be breakthrough bleeding, and of course if that happens (I'm postmenopausal) I'll be getting referred back to him straight away.

I’ve been on it for nearly a year, and apart from a blip with gel and oral utrogestan and then. switch to patches, you’d have to pry it out of my cold dead hands 😉

Mine has been a game changer for the insane joint pain I was having, and the Drs were playing a game of ‘could be RA, could be fibromyalgia 🤷🏻‍♀️’ turns out it was neither. My mood swings are less and more manageable

We do have cancer, including breast cancer, right through my maternal family line, but I don’t carry the BRCA gene, I have dense breast tissue and have yearly private mammograms and did some research. I have basically cut out booze and upped my exercise which were also contributing cancer factors (aside from genetics obvs)