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?

Let me know if and when you do and I'll be there!

There's no way a woman has a BSO TH and is 'fine' immediately afterwards and forever. Yet there are so many bonkers claims on MN that they 'had it all out' and were back ploughing fields with a flask of ginger tea the next day.

Edited to add missing word. Mind fog.

I had a TH and BSO at 42, had an implant lasting 3 months, followed by oral, then patches up to the age of 56. This was in the nineties. I think at that time HRT was given for the duration of the menopause, then discontinued, whereas now, it is continued long afterwards and for the rest of life, whether it’s necessary or not.

whereas now, it is continued long afterwards and for the rest of life, whether it’s necessary or not.

Have the posts from women here not been convincing - that posters need HRT and are making sensible judgements?

And that it's quite common to take a 3-month break and then to see if symptoms still persist. I doubt there is a woman out there in her 80s or 90 on HRT who hasn't been advised to 'take a break' and see how she fares without it.

Are you a bit upset that you weren't allowed to carry on with it when perhaps you needed to? @Bignanna and that women now aren't given that incorrect advice?

Tbh that's a bit of a daft statement tbh. Not everyone has a smooth premenopausal life, not everyone has a smooth peri menopausal life and surprising as it may be to you not everyone had a smooth menopausal life.
My periods were manageable, my perimenopausal stage was fine as I had no symptoms bar periods skipping and liss of bone density, menopause was fine given that's literally just the 24 hour period after the 24 months since my last period had past...... Post menopause I became a wreck. Insomnia got worse and worse, joint point and stiffness got so bad I could reach stuff on low shelves and I hurt all every day, my memory was crap to the point I was losing my words mid sentence never mind my thoughts and documents at work, tinnitus, histamine problems. I finally worked out that these things were hormone related, I didn't have a clue and started hrt approx 7 yrs post menopause in my mid 40s. It has changed my life, and I certainly advise the women in my life to research it, I dont push it on them but I wish I had taken it when first offered and saved myself years of misery - although I suppose I wouldnt appreciate it so much then

started hrt approx 7 yrs post menopause in my mid 40s

@MILLYmo0se It sounds like you had a very early menopause. I'm surprised they didn't offer you HRT. That's one piece of advice that's been consistent for many years.

I can not imagine going thru menopause in my 30's🙁

dexa scan - so will GPs not refer us for them? Is it easy to book private ones? I don’t think I’ve ever done private health for anything - is it Nuffield?!

I do have a family history so wonder if that will get me a scan via the nhs

Yes I was diagnosed with POI in my early 30s when periods were irregular after having my first child, last period at 36, 37 maybe. I was offered it but as I said I refused it - because the misinformation raised by the women's health study hadn't been entirely dismissed at that point, my mam had had hormone + breast cancer twice and as it wasn't impacting my life (so I thought at the time) it just seemed too much of an unnecessary risk. It's something I regret, and if I had the information I have now I would have taken it in a heart beat.

@Newgirls You might be eligible for an NHS one based on your family history (eg your mother with severe and or early osteoporosis.)

Where to have one. Just google and it will throw up locations and usually they are private hospitals or, in London, private clinics as well.

You don't usually need a GP referral but if you do, and aren't eligible for an NHS DEXA, your GP ought to write a letter of referral.

Private insurance won't cover this as it's 'ongoing' (ie you need scans every 2-3 years.)

I pay for mine and have had them since my late 40s (no risk factors but threw up severe osteopenia - now greatly improved.)

I didn't really think - or know- that taking a 3 month break from HRT was possible!

So obvioulsy that's what I'll do, when the time comes (I stop working - which hopefully will be well before retirement age of 67).

I'm intending to take it forever, I don't see a good reason not to. I've been on it 11 years, since mid-40s.

@NetZeroZealot This is a very useful guide.
It's a guide written for GPs but it covers a lot of the discussion in your thread - including a 'trial ' to stop, and appreciating the longer term impact of the menopause beyond just flushes.

https://thebms.org.uk/wp-content/uploads/2022/12/09-BMS-TfC-NICE-Menopause-Diagnosis-and-Management-from-Guideline-to-Practice-Guideline-Summary-NOV2022-A.pdf

Me too.. exactly the same.

Please may I respectfully confirm that you've taken absolutely no HRT since and that your weight, bones, heart and energy levels have been fine ever since? And also, how long ago did you stop? I really am just trying to wrap my head around women's different experiences.

@Angrymum22 I'm sorry about your diagnosis, obviously, but some of your ideas are not founded on facts.

Yes, the TV progs by 'slebs' like Davina may give a different view, but the one thing they have done is bring menopause out into the open rather than talking in hushed tones about 'the change' which is what my Mum's generation did.

You are doing pretty ok from what you say BUT that's quite unusual. I know of women on the drugs you're on who don't feel great.

You see, the BMS says 75% of women have symptoms and around 30% are severe. And some women have them for 15 years (so maybe up to 65) and some for life. (I've been told this by a consultant.)

I don't know if anyone really takes notice of TV programmes like the Davina one. Most have the intelligence to understand where she's coming from and do their own research and make choices.

The only up side is that it means women can talk openly about all of this instead of it being a taboo topic. And as only 15% of women use HRT she's not made much impact!

For ever

"HRT may stabilise bone density but even with weight bearing exercise you will only see an improvement of 1-2%."

@Angrymum22 Do you have any evidence for this? I had thought HRT to be more protective than that for our bones.

This is a really informative thread thank you!

@pinkmags I agree that 1% seems very low.

On average, women lose between 3-5% of bone a year for the first few years post menopause then the loss reduces a little annually. So 1% wouldn't even keep up with the loss, let alone build bone.

HRT is considered equivalent at least to other treatments for osteoporosis. But all drugs have pros and cons.

That’s right. I did have medication to prevent bone loss, but that stopped in 2015. My bone density scan was within normal levels in 2015, but haven’t had one since. I do have mild mitral valve regurgitation, but no other heart condition has or as far as I know. Energy levels are very low, but that’s due to other conditions eg Covid, asthma.

Also, when I was on HRT, my breasts did increase significantly, and I had a reduction seven years ago.

@Bignanna Is it not a concern that you have had no follow up for your bones for nearly 10 years?

If you were given medication, that's usually because a problem was diagnosed so you ought to have had follow up.

If you stopped HRT at 56 and that was 'in the 90s' are you now in your 80s?

I had a TH and BSO at 42, had an implant lasting 3 months, followed by oral, then patches up to the age of 56. This was in the nineties.

HRT is considered equivalent at least to other treatments for osteoporosis

That is my understanding as well. But, I think a reality check is needed when it comes to what any of these treatments can do for osteoporosis.

My SIL is 62 and has been on HRT for 25+ years due to early menopause (not cancer related). Overall good health, never smoked, doesn't drink, normal weight. Walking and yoga but no weight bearing exercise. Regular DEXA scans to monitor bones. Last year's scan was excellent. A couple of months ago she sneezed and experienced severe back pain. The sneeze caused two of her vertebrae to basically crumble.

The orthopaedic specialist said that it's important to understand the limits of what a DEXA scan can tell us. While it measures bone mass fairly reliably (though there's considerable operator error and machine variability), it doesn't reveal a lot about bone strength.

So in SIL's case she's retained bone mass but obviously her bone strength is poor despite what would be considered a good DEXA score.

Bone health is complicated. Women taking hrt can (and do) get osteoporosis, as do women not on hrt. DEXA scans are imperfect, but until something better comes along that's what we have to work with.

Edit: Should add that SIL would be quick to tell you that she has benefited immensely from hrt! It's just that it did not prevent osteoporosis in her case.

Late seventies

Never been offered a bone scan!

DEXAs are definitely not the most effective scanning device, once you start being scanned you are basically stuck with that machine because a different one could give a different reading, if you have something like scoliosis there can be an issue with an accurate read, the actual range used to determine whether you fall into normal/osteopenia/osteoporosis isn't great because it doesn't allow for things like someone being of a slighter build afaik, and tbh it seems like the scans aren't always read v accurately by doctors. Quality of bone density is v important, my DEXAs would have showed slight improvement after starting medication but that 'density' is a buildup of dead bone cells because that is how Prolia works (not how it was explained to me when I started it but that's a vent for a different day!) so whether my bones are really any more stable is questionable tbh.
Afaik the REM scans that have been developed are far more reliable but I have no experience of them