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

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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.

@JinglingSpringbells HRT may not have caused the cancer, but it has fuelled its growth.

The complacency on this thread is interesting. People just don’t want to hear that there might be a downside to HRT.

Transdermal HRT doesn't raise the risk of heart disease or stroke if anything it reduces it.

I think people understand that there are risks but the risks are small, HRT doesn't cause these cancers but as you have said they can promote growth in someone who does develop them. However quality of life is also incredibly important to most people and HRT gives many women their sleep back, their energy and strength back their ability to live a normal life. If people refused to do anything that carried a small risk then nobody would drive, have a child, fly in a plane and so on. Life is all about balancing risk and benefits and for the majority of women who use HRT it will be a net benefit.

@RedRosesPinkLilies , so sorry to hear about your diagnosis. The cancer risk is why I am making a personal voice to avoid hrt . I would rather deal with the menopause, than cancer .

But if the symptoms of meno are really bad for you, so bad you'll have to give up work?
You'll stop working, are you sure? Not like you can claim disability benefits.

The cancer risk is there, sure, but food is still needed, a roof over ones head is still needed.

A slightly different statistical perspective...

The odds of getting cancer in your lifetime I believe is 1 in 3 for women in the UK and increasing as obesity rates increase. Those odds are stacked towards later life. Yes, not all those types of cancer are hormone fuelled. And yes, some women may consider their risk lower, but for those of us at the peri/menopausal stage of life I think we all know several women for whom the cancer diagnosis came as a complete shock. Basically all of them.

There is some anamosity towards GP's who are more hesitant to prescribe. Yes, some GP's are better than others, but I wouldn't necessarily rate them on their enthusiasm to prescribe HRT. Each individual they encounter will have a different health profile. And GP's will see more of that 'low %' of women with a fueled cancer rate... Those cases are tragic, because those women deemed themselves low risk, they quickly face heavy duty cancer treatment/very limited time left to live, so no wonder they make a big impression in certain circles of the medical profession.

I am not bigging up the risk. I am not diminishing the benefits. For me, there is just something about the tone of the debate sometimes.

Also the number of threads on here of women asking how to come off HRT is sort of shocking - so much info on how to start, so little info it appears on how to come off. I wish more of the energy would focus on improving monitoring (this pros and cons of which have been debated and it sounds as if no method is perfect, but perhaps better than nothing) and as much publicity on ways to improve health for those who just should not take HRT - weightbearing exercise for bone density etc.

I don't think anyone is being complacent.

Of course women know there are risks with HRT.

I am reluctant to get into a more detailed personal discussion as you are in a very very difficult situation. I don't want to wade in with comments that may upset you.

All I can say is that the risk of OC and HRT is very small and (having read several research papers) it's not even clear if there is a link. It's not proven.

All I will say is what my consultant says which is there are risks with HRT and there are risks NOT taking HRT.

Each woman has to decide what risks she is willing to take, bearing in mind the other health risks she may experience if she doesn't use HRT.

There is risk in everything. Thousands of people die or are disabled on the roads each year. 1000s of pedestrians are killed as innocent bystanders on footpaths.

Risk has to be put into perspective.

The risk of dying from using HRT is no greater than the risk of not using it (there are no more deaths from BC in women using HRT compared with not using it.)
That may still be too big a risk for some women to take but it is their choice.

I am not 'bigging up ' using HRT just saying that everyone has a choice to make and their own overall health risks (with it without it) are important.

The important thing about threads like this is so women get the facts, because it's clear that many aren't aware of them, or are battling with GPs who are out of date.

Hi Op,
Can you be referred to a menopause clinic. My mums GP was hesitant about prescribing so referred her to a menopause clinic. They were really helpful, kept her open for a while- doing routine blood tests etc.

I think this thread is a perfect microcosm of what happens when women's health is systematically ignored over decades.

We know more about men's erections than we do about the subtle potential links between HRT and some cancers.

We see GPs with a half-day of training on a condition that affects 51% of the population.

We see our sisters from the States living within a completely different set of protocols than women from the UK.

And as @JinglingSpringbells so eloquently put it, we are living in a world where adults are completely ill-equipped to measure and weigh risk.

However you look at it and whatever your stance, that's a bit fucked up.

@JinglingSpringbells - that’s my point. The upside of HRT is pushed too much. From my perspective I don’t think you are acknowledging there might be a downside. I’m supplying the balance here.
Im also saying it would be better if GPs thought about Ovarian Cancer sooner.
My cancer originated in my fallopian tube and there is research that acknowledges being bathed in oestrogen promotes cancer there.

I do think you are pushing back at me a bit too much and downplaying what I am saying.

No one is going to make a decision based on me, but if it creates a little more thought and a bit more awareness before HRT is started, then I am happy..

My cancer is oestrogen sensitive. My ca125 has dropped 1000 units since starting an anti oestrogen tablet - to me it’s obvious that too much oestrogen in my body had an effect. It may not have started the cancer, but maybe I’d have had another ten years before it got to stage 4.

The oncologist said it may not have caused the cancer, but it will have fueled it.
ovarian cancer is in the list of side effects in the BNF for the HRT I was on. The GP touched on that specifically, I thought it s
didn't matter because there’s no family history of gynae cancer of any type.

I’m curious - what comments are you wanting to make that may upset me?

I am actually loathe to reply because I appreciate you are in a very hard situation. You keep coming back to me but I'm not going to get involved in any more lengthy debates.

I usually post the medical stats or suggest posters look at sites where they are available.

Women can make up their own minds based on the stats that they can access online.

I am very sorry about your situation.

Having had a think I presume I’m to be accused of scaremongering
This isn’t true
There are links from oestrogen in HRT to ovarian cancer - particularly where there is a history of endometriosis. My mother had severe adenomyosis, and when I was scanned at the beginning of my investigation I was also told I had the same.
I had bleeding on HRT, and ultrasound scan always picked up that my endometrium was at the upper end of normal. I had the progesterone coil in place, and oestrogen tablets.

When she put me on HRT the GP never asked about endometriosis- or I would have been alerted to a potential problem with taking HRT.

I just don’t think it should be accepted as a fix all without women asking proper questions

At the time I was exhausted from having two children with chronic illness and I couldn’t cope anymore

I don’t appreciate the passive aggressive comment about not engaging with me because of my woeful position. I’m not woeful in the least.

Women need to know there is another side to consider, not just to do what the Dr says. Some Drs are perhaps lone voices against the media, and as stated before most of my Dr friends (and I have many as I used to be one), are not taking HRT.

I can absolutely see the value in HRT, but I think education about it needs to be balanced

My mother is 82 has been on HRT since mid 40s with absolutely no issues. GP made some murmurings about her coming off it but a quick chat to another GP who was the HRT lead in the same practice quickly put that idea to bed. Still on it and still no health problems apart from a cataract

I read it was important to balance progesterone with oestrogen with HRT to reduce cancer risks. There seems to be very few clear answers about what you do if you have endometriosis. I got endometriosis during when I had the copper coil, have had no symptoms while taking synthetic progesterone and oestrogen.

@RedRosesPinkLilies , that is so interesting. As I have said previously I’m concerned about the cancer risk with hrt . I have adenomyosis, so thank you for this information. Again I’m so sorry about your situation.

My GP was like this.
I told her about the free menopause training at the menopause society for medical professionals and she did it.
Maybe tell your dr op?

I'm currently off it myself as it was giving me heart palpitations & making me feel huge. But not ruling it out forever.

www.nhmenopausesociety.org/wp-content/uploads/2022/06/Course-Flyer-1.pdf

How do you know when to come off it, though? I've been on it for 6 years now and am 54. Considering reducing to two pumps to see how I feel. But the symptoms of too much oestrogen are identical to those of too little so how are you meant to know? I'm getting horrendous mood swings. Either very happy or feeling depressed.

And does she seem youthful for 77?
I'm on it, so not knocking it, but I value metabolic health above all else. I heard hrt is v beneficial in your 50s, neutral in your 60s and has risks in your 70s. No idea if that is proven. So I was planning to try coming off it at 60

But that's not true
They are the prescribers of a prescription only medication.
A Dr cannot be forced to prescribe a medication that they do not consider they should prescribe. You can't force them to do that

I'm 48 and haven't had a period for 2 years so I guess I am officially post menopausal. I had very few symptoms and those I did have were during Covid when you could not see a GP for love nor money so I think I missed any window where I might have considered going on HRT.

The reasons I'd go on it now are basically vanity. That it would benefit my skin, hair etc and stop me looking old. I strength train regularly so I'm not massively worried about my bone density. When I hear so many people IRL and on here talking about HRT I do wonder am I missing out on the elixir of life honestly? Do I need to get someone to prescribe it to me and why would they when I have no obvious symptoms?

OTOH my mum first had breast cancer in her 50s and died of it before she got to 70 and HRT was cited as a factor in her cancer at the time so that weighs heavily against me having it

Likely inertia will decide and I'll leave it but there is this fear of being the one wrinkled up prune amongst all the glamorous women on HRT.

@IfYouEscapeTheLionsDenDontGoBackForYourHat she does!

@ThePure It isn't a miracle worker but it does seem to help with hair and skin for many women. Even if you strength train (I do too) hrt will still have additional benefits to your bones. It isn't too late for you to ask for it. It is possible to ask your GP for a trial to see if it help you. This thread is probably a good overview of various risks and benefits and there is other information online. It really is a personal choice for every women I think.