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?

[Overweight ] Which approx 40% of us have! And occasionally hrt increases breast density which might be a consideration for some women.

@CulturalNomad HRT doesn't automatically cause dense breasts.
It can depend on the type of HRT. I think that the research shows that micronised progesterone has less effect.

The stats on weight v HRT show that there are 28 more cases of breast cancer in 4 years per 1000 women who obese, compared to 4 more cases for women who use HRT.

Never heard of this and it doesn't sound right or logical. @irishmurdoch
The Mirena only works in situ.

And endo is found right through your body potentially.
So the Mirena won't have any effects there.

Was this a menopause consultant advising you?

There is some helpful advice on reducing breast density here
https://mammalivefoundation.org/decrease-breast-density-reduce-breast-cancer-risk/
Menstrual and Reproductive Factors that Decrease Breast Density and Cancer Risk

• have a child before age 24[37]
• have three or more children[38] [39] [40]
• breastfeed your children for 6 months or longer

Dietary Recommendations that May Decrease Breast Density: What to Decrease or Avoid in Your Diet:

• Decrease or eliminate red meat, transition towards a plant-based diet
• Decrease saturated fat (meat, butter, ice cream, fatty cheese)
• Decrease sugar, refined carbohydrates and high glycemic carbohydrates
• Avoid alcohol or limit to less than 3 alcoholic beverages per week
• Eliminate caffeine
• Decrease caloric intake[41]

Consume Daily:

• increase fiber to 45 mg/day[42] – use chia, flax, legumes, psyllium, rice bran, wheat bran if tolerated
• use 2 or more Tbsp freshly ground flaxseed[43]
• eat 1-2 cups of legumes[44] daily (bean soup, bean dip, bean and grain casserole)
• eat 6 servings of vegetables daily (2 cups salad, 2 cups steamed vegetables)
• eat vegetables containing carotenoids[45] (carrots, squash, sweet potato)
• eat 2 Tbsp or 3000 mg of linolenic acid from flax and/or fish oil[46] [47]. Pour flaxseed oil over rice, pasta, baked potato; add to salad dressing, use in smoothies. Never heat it. Keep refrigerated.
• use 1 Tbsp olive oil[48] [49]daily in salad dressing
• use ½ cup organic tofu or 1 glass soymilk[50] daily, or both. Avoid if allergic.
• drink green tea[51] or take a green tea supplement
• use rosemary as an herb and as tea

Nutritional Factors that May Decrease Breast Density

• vitamin D >1750 IU/day[52] [53] – recommend 3000 IU or more
• calcium >700 mg/day[54] – recommend it be taken with magnesium glycinate

Other Nutritional Supplements that May Help to Reduce Breast Cancer Risk

• inositol and alpha lipoic acid[55]
• curcumin[56]
• rosemary[57] [58] [59]
• N-acetyl cysteine[60]
• Coenzyme Q10[61]
• Green tea extract
• Grape seed extract[62] [63] [64]
• B complex[65]
• magnesium[66]
• kelp[67]
• indole-3-carbinol
• tocotrienols[68] [69]

Lifestyle Factors that May Help to Reduce Breast Cancer Risk:

• Exercise 40 minutes a day
• Spend more lifetime hours in the sun[lxx]
• Avoid weight gain during adulthood and after menopause
• Avoid the birth control pill and hormone replacement therapy
• Avoid plastics containing bisphenol-A and phthalates, especially during pregnancy
• Use organically grown food as often as possible[lxxi]

@SongSungBlues ok didn't know that, though given how long it is likely to take to get someone to replace the coil I have, if I start to chase it at the four year mark I might just get it done by five years!

@Thegreatgiginthesky I'm very skeptical about those diet and supplement recommendations that supposedly reduce breast density. None of the major breast cancer organizations endorse that as there's no evidence to support it.

A quick perusal of the "mammalive" website reveals that their advisory board is staffed by Naturopaths which are not MDs.

It's great that this issue has been raised although it will only be helpful if women have private screening where they can ask for and be given their density.

The list of how to reduce density- well, it's not a medical site and none of those suggestions about food and diet are universally accepted. Many are small trials with animals and most of the papers there come with the caveat 'may help'.

For older women, fat usually replaces fibrous (dense) breast tissue post menopause but I agree there is a drive to help women know their density with a view to more regular mammograms than the NHS every 3rd year.

My mums still on it, she’s 72 and has no intention of stopping.

We do have cancer, including breast cancer, right through my maternal family line, but I don’t carry the BRCA gene

@LittleMy77 There are a number of genes associated with increased BC risk besides BRCA. I'm not sure if you'd have to pay for that privately though. Just something to consider if you're concerned about family history.

agree there is a drive to help women know their density with a view to more regular mammograms than the NHS every 3rd year

And for the percentage of women who have very dense breasts mammograms are often supplemented with ultrasound (or even MRI if you are deemed to be at High Risk).

At the very least a woman with very dense breasts should be advised that a mammogram can miss approx 40% of tumors due to the visibility issue.

Not in the U.K. Even if you have had breast cancer and it is known your breasts are dense, you are unlikely to get an ultrasound or MRI for screening. People campaign and petition about it, but the answer is usually no. And the chance of a mammogram spotting cancer in dense breasts is only 11%, especially if you have lobular breast cancer.

Not in the U.K. Even if you have had breast cancer and it is known your breasts are dense, you are unlikely to get an ultrasound or MRI for screening. People campaign and petition about it, but the answer is usually no

Unfortunately it's not much better in the US.

By law you must be notified of your breast density after you've had a mammogram (so that's good!). BUT insurance coverage for additional screening (if the doctor recommends it) varies widely and is usually dependent on whether or not you fall into the High Risk category.

I'm 52, three years in, and never coming off either. It's been life changing. I'm on gel and prog tablets, but am I right in thinking the prog tablets can stop once your periods have finally ended?

Could some kind soul inform me how I start a post on here. I've tried to lookup and see if there is any information about the problem, can't find anything

You need to take progesterone if you still have your uterus.

Thanks for clarifying. Was hoping that wasn't the case! I take prog in a 12-day cycle and it gives me horrible PMT vibes.

Go right to the top of this thread and you should see a blue box on the right with the words "Start New Thread". Click on that and bob's your uncle.

@JinglingSpringbells You got me worried when l read that women over 60 are not given oral hrt. l'm 70 and have been on oral hrt for 16 years. I'm on oral Femostan conti and have never had any problems with it. About 9 years ago l asked my GP if l could try patches and uterogestan but unfortunately the uterogestan did not agree with me and gave me terrible stomach pains.
I had a scan and nothing untoward was found so it was concluded l was intolerant of that progesterone as the pains eventually disappeared when l stopped it. I enquired about patches but my GP wouldn't prescribe the Everol conti combined patch due to it containing Norithisterone which increases your cholesterol levels significantly. The only other patch was Femseven which has a different progesterone, but was then out of stock. The gel was also not suggested as at that time there were no other progesterones to use alongside apart from the two l've mentioned, though l'm not sure about now. So l am still on my pill hrt and so far it's been great for me and l really don't want to stop it. I've had regular mammograms, my blood pressure is good, l've never broken a bone and l'm not overweight.
Should l be worried?

It's standard advice by menopause doctors and you can find it here on Page 9.

https://thebms.org.uk/wp-content/uploads/2022/07/BMS-Menopause-Practice-Standards-JULY2022-01D.pdf

Advise women who continue HRT intake over the age of 60 to have estradiol administered transdermally.

The risk of blood clots with oral estrogen is the issue. Although it's small, it's there.

Never heard of high cholesterol with Norethisterone. Have you done your own research on this and looked at medical papers online?

You also have the off-label option of using Utrogestan vaginally, which is common in Europe and becoming far more acceptable here, and would avoid tummy trouble.

No intention of stopping. I’m 70.

Really interesting responses.

Forever, would be my answer. Been on it 7 years, am almost 60. Like some others I'm battling at every review as the 28 yo nurse says, 'Would you like to come off HRT now?' and I say, 'Absolutely not'.

@JinglingSpringbells Thank you, l did try to find alternatives but my GP wasn't very clued up. The main aim 5 years or so ago was to try to get you off hrt at a certain age but then fortunately NICE guideline changd.
At the time l mentioned transdermal and my GP looked up the info re patches and ruled out Norithisterone.
I have just done a quick search contra indications and apparently it adversely affects the lipoprotein risk factors for coronary heart disease. I have borderline high cholesterol levels that l work at to keep in check so that's probably part of her reasoning.
I had read about of the vaginal route for Uterogestan but if its off label l'm pretty sure my GP wouldn't agree as she's a stickler for rules. l wonder if l should try the Femseven and see if l cope with the Levonorgestrel prog? Not sure what to do, I'm nervous to bring it up in case my GP decides l should stop the Femostan and l want to protect my bones plus all the other benefits as long as l can. Sorry about the essay, I will have a think!

Thanks. Yeah, I did ponder it. I think statistically I know I'm more at risk so more aware and do checks etc and get my yearly mammograms.

At this point, I've decided not to find out, as I'd constantly just be worrying. My mum died last year, and she outlived her sisters so we can't go back further than me and siblings.

There's also environmental factors at play - they were brought up in an industrial city centre in the 40s / 50s, were the first gen users of birth control, all smoked like chimneys and exercise etc wasn't a thing

My mum is 90 this year and has been on HRT since she was 45. She's still very healthy and has no intention of coming off it although she's cut down recently to half a pill daily. I've been on it since I was 50. I'm 65 now and have no intention of ever stopping. I have recently changed from kliovance pills to patches on the advice of my gp. He says they are fine until my mid 70s when I might need to look at an alternative progesterone. It is all so much easier now than it was a few years ago when every request for a repeat prescription was a battle.

Crikey! Good on your mum for getting prescribed that!