Thinking about HRT but scared

[Nad21]

Hello everyone!

im 40 and think im going through perimenopause as have most symptoms, it started with major anxiety and super hot flushes which would trigger the anxiety feelings, they came on suddenly I was put on sertraline at the time because I had no clue it was peri and the doctor didn’t say anything about it! Any way the anxiety side has calmed down and so have the not flushes but they are still present, I’m also now getting palpitations but whether that’s sertraime or peri I’m not sure! I also feel the cognitive side of it, I feel like I’m dumb if that makes sense? Trying to work things out is hard and frustrating! I also find it hard to explain things or find it hard to find the right words it’s so scary! My sleep used to be disrupted but not as bad anymore. I’m thinking of going on HRT but I’m scared of the risks it comes with although it’s low it still terrifies me. Is it worth going on it or should I leave it and avoid the risks? What do u guys think please? Sorry this is so long!

I also have fatigue and low energy like 👍🏼 can’t be bothered to do anything

Didn't want to read and run. Read the NICE guidelines for HRT and educate yourself on your options. www.nice.org.uk/guidance/NG23 It certainly sounds like menopause buy only you can make the decision. Personally, they will have to prise my HRT out of my cold dead hands but other people have other opinions,

Been on HRT last 4 years. Love it, feel so well physically and clear and happy mentally. Lots of energy and like the previous poster I’m staying on it till I pop off! I’d rather have good quality years than feel miserable and live till 90. You can always start it and at low dose patches the risks are minute. Can come off it too if u decide not worth the risk or doesn’t help.

Been on HRT 4 years and wouldn't be without it. Stopped the hot flushes, brain fog and anxiety.

The only thing is my doctors say you can only stay on it 5 years then have to take a break. I don't know how I will cope without it.

Recently started it. I am a new person. Fatigue gone, hungry gone, insomnia gone, energy back, no longer irritated by everything. Please consider it

Before looking at HRT maybe look at supplements. I thought all my symptoms were peri but HRT had no affect apart from reducing the grumpiness and hot flushes, which were not really a problem. After some research I realised that one of the meds I was on was causing problems with absorption of Magnesium and B12 and after 6mnths of supplements I felt much better. I don’t take them continuously but until the symptoms improve.
I also take vit D during the winter.
I took HRT for 4 yrs until I was diagnosed with hormone sensitive breast cancer. Unfortunately I was one of the statistics, learnt that although risk is low every one of those statistics is a real person. There are rumblings coming from breast surgeons suggesting that with the massive increase in the use of HRT there has been a rise in breast cancer diagnosis. I’m sure that over the next few years further study will be able to confirm whether this is the case or not.
HRT helped me through the worst of menopause and would have taken that route still, but I’m not sure how safe HRT is in perimenopause. No long term studies have been carried out. Most of the data ( longterm) is from studies on post menopausal women since historically you had to be post menopausal to be prescribed HRT. Longterm to me means 20yrs not 4 or 5 that some of the current advocates use.
Davina McCalls recent news is interesting, her recent diagnosis of a benign brain tumour/cyst suggests it has been there for years and the symptoms she would have had may have been a cross over with perimenopause. She claimed that HRT only partly solved her problems but no one explored this. Had she not had HRT she may have been diagnosed earlier.
My sister had a similar experience, she had daily headaches that were initially diagnosed as peri migraines. But a family history of a rare brain tumour prompted her GP to test and they found a pituitary tumour which was subsequently operated on.
At 40 I would be asking for further tests to rule out other conditions. Peri symptoms are vague and common for a number of endocrine problems. It’s easy to dismiss them as “hormones”,
Our family are lucky to have a medical background, even so, we recently lost my youngest sister to pancreatic cancer, notoriously difficult to diagnose. She was stage 4 before it was even found because she had very few symptoms until a few weeks before she died. She was still running with her running club this summer.
If you don’t feel “right” push for a more thorough diagnosis.
Im not trying to put you off but it is very easy to assume.

The problem I have found is that there isn't much exploration done. I've been feeling rerrible for years and after doing full blood tests the doctors ruled that there is nothing wrong with me, that was the end of the story. So the sort of scanning Davina received is not available to most. I am now trying HRT after years of suffering as nobody has offered any other help

I umm and ahhed for 2 years (I'm now 48). I've been on it for 3 months and wish I'd done it 2 years ago and not spent the entire time miserable, fatigued, cross and feeling ill. I feel like I did in my early 30s now.

That's pretty out of date advice. There's usually no need to stop taking it after only 5 years.

Taking HRT in your 40s, particularly early 40s, has a pretty good risk profile - it may increase some risks a small amount (less than either being overweight or drinking 2 units a day) but also reduces your risk of osteoporosis which can lead to fatal fractures. But it's important to rule out other causes and weigh up risks in the light of your family history.

Thanks everyone! I really do appreciate your prompt responses and opinions on this matter! This world could do with more people like you all to help others! ❤️

@DanceTheDevilBackIntoHisHole

I know this now. Only as someone on another thread pointed it out. I'll see what if anything happens 😊

I have recently went into surgical menopause due to ovarian tumor. I’m on gabapentin but it’s not doing anything for the hot sweats. I’m reluctant to try HRT, due to what Iv been through. The doctor says it’s safe for me. I’m seriously considering going on it. Hot sweats, aches and pains, itch vagina, insomnia. I have went straight into the menopause overnight

Your gp be reluctant to prescribe it before 45 but you can ask. You could try this for 6 months and see how you feel - cut out alcohol, focus on sleep, do strength training for your bones, take iron, magnesium and vit d. If you still feel rough then insist on the hrt

Me too with breast cancer and no family history of such, thank you for raising this. HRT was a game changer for me but I wasn’t reviewed regularly and given the information I needed that would have prompted me to stop sooner / change meds.

There is research now linking brain changes and formation of amyloid plaques in peri menopause to alzhiemers. I personally feel the risks associated with not taking hrt are greater than those associated with taking it. Reduce your risk of breast cancer by reducing your weight - oestrogen produced by fat cells is a greater risk than the one in a patch.

Thanks for the research - that’s rather a limited idea of risk reduction for bc as there are many factors. In my case, non smoking, very low alcohol, vegetarian, low upf diet, appropriate bmi (slim), exercising regularly, bc was a shock.

You are right to point out the risks. It’s a question of balance and being advised appropriately for personal needs by our medics.

This overview from the Women's Health Concern is quite helpful in setting out the risks acrobat.adobe.com/id/urn:aaid:sc:EU:6f462c19-8c30-49d9-be09-d828dd567fcf

I was diagnosed with a pituitary tumour in my early 20s that seemed to have put me in a premature menopause. Fortunately my on the ball GP did ( an expensive) blood test and I received the right treatment. One thing my consultant commented on was that the condition may be more common than they thought because if it happened in your 40d it would be diagnosed as menopause. Eventually the actual menopause causes the tumour to burn out and testing would show no problem. The tumours are often micro tumours that wouldn’t show up on a scan, and menopause symptoms are rarely investigated with scans.

Certainly my symptoms at 21 matched menopause completely, but my age was the red flag.

There are a number of conditions that can mimic menopause, but GPs are not likely to look for them if you are of a certain age. Davina McCall is a prime example. Her brain cyst symptoms were clouded by her menopausal symptoms.

Technology is advancing rapidly, somewhere in the future we will have a move towards diagnostic GP centres where scans are carried out on site rather than our rather archaic system we have. As a dentist, I am also a trained radiologist ( all dentists are), we carry out radiographs and 3D cat scans to allow accurate diagnosis before referring to specialists. We need to move towards better diagnostics particularly in the digital age where radiologists can be centralised and remote from where the tests are carried out. There is no need to have a multi tiered system that moves at snails pace. In addition if you are referred to one discipline they can’t refer on if incidental findings arise. You are sent back to your GP to start all over. This never used to happen.

Surgical menopause is a tough road, believe me. I'm 10 years post surgery. Please seriously - SERIOUSLY - consider starting HRT if you have no contraindications.

SebastianFlytesTrousers
yes thank you, it’s been no picnic the past 10 weeks. The aches and pains and hot flushes are the worst. I’m seriously considering HRT. I have the doctor in a few weeks.

If you're looking for medical information on risks, this is a source written by a consultant.

It covers how HRT has different risks at different ages.

Also, it's worth mentioning that the stats here on risks are based on the older types of HRT (not micronised progesterone) a point that has been picked up by the British Menopause Society in response to the newest NICE guidelines that came out last week. No women on micronised porgesterone are included in this data here.

https://www.menopausematters.co.uk/risks.php

Obviously you need to consider the severity of your symptoms, family history and risk factors across your lifestyle as well.

Hi OP, i feel for you. I went on HRT due to heart palpitations, complete loss of interest in life, barely able to function at work. It took some time to get the right dose and right type. For me i needed low dose of oestrogen, too much actually made my MH worse, and to use the progesterone vaginally, as taking it orally was bloating me uncomfortably. I also take a little bit of testosterone daily for mood and mental clarity. It took some trial and error, but one year later i am in a much better place. i have just landed a promotion at work, I have no concerns about being able to perform, and my enthusiasm is coming back - i am currently planning a Xmas party out of choice. I think it's worth a try, and trial and error to find what works for you