GP keeps telling me I'll have to stop HRT and how its only delaying the inevitable

[spaceagemat]

I am in my mid 40's and have been on HRT for a few years now and it has been a god send. However I have been getting some hot flashes creeping back in and I asked my GP to increase my dose. They agreed but made a big song and dance about how I'll have to stop taking it eventually and that the more HRT I use the worse my symptoms will be when I have to come off HRT and I'll have to go through all the effects of the menopause eventually. She said the same thing when I started HRT.

I just said yes that I did understand that but I have zero intention of ever coming off HRT unless it is a medical necessity i.e. some kind of hormone driven cancer. Its just so frustrating that my GP who is a women in her 40's herself has such a backwards view of HRT. She is a few years older than me and perhaps thinks that because she is fine or powers through that those of us that use it are just looking for an easy option.

One of the nurses is very positive about HRT so I will ask her next time which GP is the best to see about HRT in future but like I said I do not plan to stop using it ever and will change my doctors or go private in future if I need to.

Yeah sorry that is all debunked research from the WHI study, especially with new forms of body identical hormones. Women in the US are being done a massive disservice by their doctors. If anything HRT reduces the risk of Heart attack and it can also help reduce blood pressure therefore stroke risk as well. Only oral HRT carries a small risk of stroke within the first year of use and most women in the UK will be using transdermal HRT these days, this removes the stroke risk completely as it is no longer processed through the liver.

Any risk of cancer with HRT is tiny and there is research that shows women who develop a hormone receptor cancer who were on HRT actually have better outcomes than women who develop the same cancer than those who were not on HRT. Then there is the protection from bowel cancer it provides and possible protects from other cancers and even diabetes. HRT is also associated with a lower risk of dementia. Now the big one is that HRT protects your bones and can help prevent osteoporosis and the hip fractures that come along with it, hip fractures have a worse survival rate for women than many cancers.

It is oestrogen that provides all these benefits, otc progesterone creams and evening primrose oil are doing nothing to protect your or any women's long term health, they help you manage vasomotor symptoms of the menopause at best. It's a crying shame so many women like yourself are misinformed and missing out on being able to make an informed choice about HRT use.

This isn’t true. The study I think was related to the old fashioned HRT tablets from years gone by which were much higher doses. Modern HRT is a much lower doses and much of it is bio-identical.
HRT can protect women from heart disease and reduces the risk of death from it by 30% according to a study released this year.

@JinglingSpringbells Thank you for that information, I will certainly look into that if I run into issues with my GP.

Good for you, however the rest of us that need to keep working to eat, we need HRT. We dont take it for shits and giggles.

I was on the cusp of quitting work and eating fresh air until I got HRT. It saved me.

I have seen two top Harley St Gynae/Meno consultants who have advised me to stay on it as long as o wish. I'm 57 and been taking it 12 years. They told me it's good for my heart, bones and brain. I have an annual mammogram. The problem with GP's is in the first word.. General.

She’s not following nice guidelines. Shocking response. Change GP’s — honestly this makes me so angry

That is not the case here in the UK. HRT is the best solution for women who experience medium to severe menopausal symptoms. I am 76 years old and evening primrose oil did nothing for me at all. Meanwhile my bone health is proven to be protected by being on HRT Long term. Hope that helps helps.

So much misunderstanding and misinformation around menopause. I had a total hysterectomy last year. My surgeon told me as I didn't have a womb I didn't need progesterone. Got a second opinion and wrong! Progesterone has far reaching benefits other than womb thinning including benefiting the brain and a positive impact on mood and sleep, amongst other things.

Thanks for this, do you have any links to share? I actually feel quite well on my utrogestan so I do think it helps.

Spaceagemat

My consultant had books with latest evidence backing it up, I stupidly didn't make a note of them. Utrogestan is also a sedative and helps get me to sleep.

You need to be aware that the risks of breast cancer are increased by using estrogen and progesterone.

Estrogen alone has a lower risk of BC across the population, when compared with women NOT using HRT.

Progesterone (micronised) may be less risky but there aren't enough very long term trials to be sure.

@JinglingSpringbells Yeah I do know this thanks as far as I know there isn't enough data to say if micronized Progesterone is a risk at all but even if it is it appears to be small.

@ohthejoys21 Luckily as long as I have my estrogen patches and my flushes are under control I seem to sleep well but yes I have heard people say it is great for sleep.

@spaceagemat I’m not sure that everyone that was on HRT and has a hormone fuelled cancer has that good prognosis
I fit the criteria- but have been told I have a year to live. That’s two years since diagnosis. I don’t class that as a good prognosis

There’s too much complacency about HRT in my view

Here was me gearing up to make an appointment with my GP to ask for HRT. Certain posts on this thread have scares the bejeesus out of me now!

@RedRosesPinkLilies Not every patient no but statistically they have a better outcome. I am very sorry to hear about your diagnosis.

@WorriedMama12 It’s more about being properly aware, rather than thinking of it as a magic pill. In population terms it will improve women’s health, in individuals there will be adverse outcomes
I will say that a lot of my friends are Drs, and only one is on it. It helps her get a nights sleep whilst she’s still working. When she retires she says she’s stopping it.

I agree. My plan is also to consider phasing it out gradually after retirement. I’m not fully sure about this though. My job is high pressure stressful so being able to sleep without hot flushes and anxiety is a no brainer for now.

I’m planning to have DEXA scans every 5 years going forward. It’s interesting that this isn’t offered unless a fracture has occurred. It might save the NHS money in the long run.

Heart disease is a major health issue in the US due the obesity epidemic. This means many women by the time they are of age for peri symptoms are in too poor cardiovascular health to take HRT safely as many more US women have too high a risk of stroke or heart failure compared to average U.K. woman.

We may go the same way as our obesity epidemic is not far behind theirs. The advice to keep fit is good advice not just to manage symptoms if lucky but to be healthy enough to take HRT if you do need it.

I have been on HRT since 41 as my bone density is poor and I have premature ovarian insufficiency. Spoke to a rhumatology consultant about my bones and was surprised to hear she said I would need to come off hrt at 51 as she said I should only be on it for 10 years . I thought by now consultants would be better informed

HRT protects women who are in good cardiovascular health from developing heart disease if they start it before age 60. It’s not as strong a protection as say statins and you do need to still have a decent amount of exercise and a good diet to reap the full benefits.

@RedRosesPinkLilies
So sorry to hear you have terminal cancer. It’s important to hear from you. Personally I think that anyone taking any medication or treatment that increases cancer risk should then be automatically screened at least twice a year for the relevant cancer types.

From the BMS website:

Estrogen may have a protective role in CHD prevention especially if initiated in women below age 60 years or within 10 years of onset of menopause.

So for someone who was post menopausal at 53, 10 years hence would be 63 as the 'window of opportunity.'

The risk of leaving it too late is that estrogen may help to dilate already hardened arteries with the risk that plaque may disperse and cause clots.

We can't compare statins and HRT as they have different criteria for prescribing.

HRT isn't prescribed to prevent CVD. It's a bonus which some women may feel is appropriate because of family history (that's me as generations on my maternal side had CVD , although some was lifestyle-related.)

Statins are prescribed for people identified at risk of CVD either because of identified lipid levels, medical events, or possibly family history.

That is such poor advice!

Mammograms cannot be more than once a year, as a routine screening, even privately. This is because of the risks of radiation. But also because of the risks of over diagnosis.

There is a huge controversy over screening. Some breast specialists don't accept screening as a prevention, because statistically more women are over-diagnosed and have unnecessary treatment (with many dying prematurely from the effects of radiation treatment near the heart) than dying from breast cancer . The say that the number of women's lives saved by screening at a population level is no different from not screening.

It's obviously controversial.

It's different for ultrasounds, to look at the ovaries, uterus etc.