Starting HRT aged 41 - what to expect?

[TakeABreath2023]

Hi,
I’ve been actively screened for early menopause given pre-existing other autoimmune conditions and I’ve seen FSH and oestradiol blood tests which mean I know I’m going to be diagnosed as confirmed menopausal at my next appt (even though still regular cycles and not really noticed obvious symptoms). I have a history of eating disorders and I’m quite anxious about what to expect around HRT - my endocrinologist had already said that he’d start me on some low dose of oestrogen (patch??). I used to get migraines on combined pill so any comments on that would be really helpful. What is the typical regime, and how do you start, and how bad are the side effects?

Thanks in advance…..

You will need oestrogen and a progestogen. The best type is called body identical which means it's identical to what your own body produces. The pill isn't body identical. All the transdermal oestrogen is body identical but the only body identical progestogen is micronised progesterone which comes in little capsules. You can take them orally or vaginally so if you dont get on with oral you have another option. For oestrogen you can get patches, gels or a spray.

I just felt a lot better when I started patches. I don't get on well with progesterone so I take a non body identical form. I lost weight initially as I had so much more energy. Gained from progesterone but that is unusual, and it was because it makes me really tired. If you gain weight is usually because the balance between the two of them is wrong.

Gel means you don't have a sticky patch on your body but you have to apply it daily, which is fine at a low dose but a pain if you're using a higher amount.

I forgot I had breast pain with both but evening primrose oil sorted that out.

Thanks for all this. I suffered horrendously with cyclical breast pain in my late twenties and took starflower oil then. I do have a lot of concerns about not managing the hormones very well as I’ve had so many issues with the migraines, breast pain, while I have no adrenal or thyroid hormones anyway….so worried about it all. Does everyone have to take the progesterone?

I am just a few years older than you and also had concerns about starting on HRT as I had reacted really badly to the pill when I was younger. However, my fears have been completely unfounded and it really has been life changing for me. I was convinced that I would have negative side effects but there literally hasn’t been any!

Also- I was extremely nervous about taking progesterone as had heard others say it caused anxiety but it definitely hasn’t had that effect on me. If anything I feel more mellow than before!

Similar to @Blueberry40 I was worried I would have tonnes of side effects. I am allergic to pretty much all oral medication. I have the mirena coil and oestrogen gel and it has been life changing. I am 44.

I have estrogen and progesterone, you have to take the progesterone if you still have a uterus, it protects you from developing uterine cancer. I have always been progesterone intolerant, I’m a nightmare, I can’t take it continuously, the mood changes are like PMT. The best solution for me is an HRT called Tridestra, it’s an estrogen tablet that’s taken for 3 months followed by progesterone, which is medroxyprogesterone (a lesser androgenic progesterone)then you have a short withdrawal bleed. This I’ve found is the best regime for me due to my issues with the progesterone.

Hope everything goes well for you, I saw a menopause specialist to help me, she suggested this regime, the G.Ps just weren’t that clued up on the choices. There will be a regime that suits you, it may take a little time to sort it out, but it is well worth it. I’m never giving my HRT up, my life is so much better with it and there’s no age limit, my neighbour is 71 and she swears by it. To be honest she looks amazing, so I’m definitely signed up for life. I also take testosterone in the mix, it’s given me my energy back, and my libido is very healthy 🤣

Thanks so much for all this info Snippit. Did your weight change?

To be honest totally paranoid about the weight….I have a history of eating disorders. I exercise a lot (need to start doing weights). I hope that will help…..scared when I read of the increased hunger.

@TakeABreath2023 I was worried about that too but if anything my appetite has decreased a bit and I’ve maintained the same weight. The first few days on progesterone can cause a little bit of bloating but it’s not weight gain.

If you start hrt and you don't like it you can try different doses and types, and if nothing works for you you can just stop taking it. There's no law that says you have to be on it!