GP prescibed HRT but had no time for questions- can you help?

[DottyLS]

I'm nearly 51 and have for ages now had very drawn out periods, anxiety, crying, hot flushes...
So finally had phone consultation with gp, quite short, then had to send in blood pressure reading then got the prescription but I have questions I didn't get the chance to ask - could anyone help?

1. both my grandmothers had breast cancer - one in her late fifties, recovered. One in her nineties. No other relatives with breast cancer, but is this a concern?
2. I got prescribed progesterone- says start on day 15 of cycle. missed it this month as didn't keep track at all. For next month - is day 1 the day there is any amount of blood? For me it always starts extremely light, just spotting really, for days - do I count those?

Thanks in advance for your help!

Really you should email the GP and get a follow up chat.

the breast cancer one is tricky as it could be relate to genes and risk? Hard to know. The BRCA gene is linked with women with Jewish backgrounds - is that you? But also if you are slim, healthy, don’t drink alcohol then your risk is reduced.

you might think the risk is tiny and worth it to improve your quality of life. You could try it for six months and see if it helps you?

Thank you! Unfortunately I don't rate my chances of getting more out of the gp.
No Jewish background, not slim but otherwise healthy- don't smoke, barely drink alcohol, exercise regularly
Trying it for a while seems a good idea - but need to work out how!

@DottyLS you shouldn’t have been prescribed hrt without a discussion about breast cancer. It’s something they have to discuss with you before agreeing a prescription.
You need to book a new telephone consult, you could give the topic of breast cancer and hrt

She did ask about family history but I just said grandmothers and she left it at that

If your mum / sisters had it that would flag up more risk than grandmothers

not sure about when to start btw - start of period makes sense but it sort of overrides your natural cycle anyway

And they should have done a thyroid workup too, OP. That's another very common thing that goes wrong around menopause.

Oh 😥- I feel almost like I have no choice but to look into a private appointment! My gp is rubbish!

@DottyLS The 'inherited' risk of breast cancer is if 2 first-degree relatives had it.

That means your mum and your sister.

By 'both' grandmothers, do you mean your mum's mum(your Gran) and your great gran?

It's more of an issue if it's at an early age (so the 90 year old wouldn't count as much.)

Even if there is a strong family history, it's still a very small risk.

I really recommend you listen to Prof Michael Baum on this video where he discusses this. https://thebms.org.uk/publications/bms-tv/

He's halfway down the page on the right hand side.
He's an eminent breast surgeon.

HRT and breast cancer: overall risks and benefits

Prof Michael Baum, Professor Emeritus of Surgery and visiting Professor of Medical Humanities, University College London, answers these FAQs: What percentage of women get breast cancer? I went through the menopause last year and have been troubled with ongoing menopausal symptoms since. Would it be safe for me to take HRT? I have a family history of breast cancer, is it safe for me to take HRT? I have been taking HRT for 5 years and it’s controlling my symptoms well. Could I continue taking it? Should I stop because of the risk of breast cancer with HRT? I went into premature menopause in my 30s and have been on HRT for the last 5 years. Should I stop HRT now because of the risk of breast cancer? I have a family history of genetic cancer and my mother had breast cancer. I carry the (BRCA) gene mutation and went into an early menopause after my ovaries were removed. Is it safe for me to take HRT?

If you listen to that and make your own decision, you probably don' t need another consultation unless you want to be tested for the BRAC gene.

Also, the latest research on HRT and BC shows that for 5 years using Utrogestan, there is no added risk (so it only becomes more of an issue with long term use.)

You start the utrogestan mid cycle (but if your cycles are irregular, start it any time and keep to the same DATE each month- that's easier than counting days.)

That's very helpful- thank you!!