Has anyone ever come off HRT at 53 and if so what happened

[AInightingale]

I have been on Evorel Sequi for five years and I think went through menopause quite early - symptoms were atrocious at 47/48 and periods had nearly stopped by the time I commenced HRT at 48. Just curious as to what might happen if I cease HRT now. I am a bit wary of being on it for years as my mother had BC at 65 (never used hormone therapy to my knowledge). I've also had a recent mammogram recall (fibrocystic changes) which was scary. The consultant says to make the decision based on my symptoms, but I don't want to take HRT unnecessarily. But on the other hand, I'm also concerned about bones/heart/GU impact. (I could always use topical HRT for the latter.) I have something in my head about HRT being safer when used for the shortest period of time, but I also know that some women remain on it for years! Any thoughts?

The only answer is to come off it and see how you feel.
You're still very young to be on HRT- I started it at your age now.

You should also have a DEXA scan about your bones then you can make a judgement based on that. You may have to pay for one privately - about £200 but they only need doing every 3 years.

Maybe also consider swapping to a different type. Evorel has the old synthetic type of progesterone which is linked possibly to higher risk of breast cancer, whereas micronised progesterone appears safer. You'd use estrogen as a patch or gel and micronised progesterone as a tablet.

Thanks. If I do come off it and my symptoms return with a vengeance, I take it I would go back and move onto a continuous form? Or is ES prescribed to the age of 54/55?

The progesterone element is the bit that worries me - I mentioned the micronised type to my GP ages ago and he said getting a suitable progesterone to oppose oestrogel was a 'bit tricky', whatever that meant. Is it available on the NHS? I am in Northern Ireland so may be different prescribing guidelines.

Or is ES prescribed to the age of 54/55?

It's actually a choice - you can decide what suits you best. I'm still on cyclical after many years, with the agreement of my consultant.
The risk of BC is also supposedly lower with cyclical.

You should be able to get micronised progesterone in N Ireland. It's pretty much the default here and you are in the UK. There isn't anything 'tricky' about it except higher doses of estrogen sometimes mean it has to be used at a higher dose.

There's been a study reported in the last few days which does appear to confirm a slight increase in risk of BC in women under 55 who are taking (synthetic) progestin as part of their HRT treatment. Which is kind of worrying as it's the default prescription for the NHS - as if you have to specifically request the utrogestan, which does appear safer.

I don't have oestrogel anymore (I use sandrena) but with both I have been given utrogestan. Didn't know there was anything "tricky" about it!

I suppose he meant that it needs to be balanced on an individual basis according to the use of oestrogen. Trickier for him and much easier just to prescribe patches with a standardised dose of progesterone to oppose the oestrogen...

That's been known for years now.

I think maybe your GP is behind the times because in England, micronised progesterone has been the default for some years now, although some women do choose to use combined patches because they don't get on with micronised progesterone ( or they don't want to use 2 products separately.)

Not really that hard.

There is a default licensed dose which is 200mgs for 12 or 14 days a month.
Post meno it's 100mg a day.

If women are on higher doses of estrogen (patches 75 or 100mcgs or higher doses of gel) they sometimes need 300mg and 200mgs (if they experience breakthrough bleeding.)

It's not complicated for any dr to manage.

I haven't seen my GP for ages - it's impossible to get an appt (all phone first, no online triage) and there are no menopause clinics in GP practices here. So he's basically just reissued the same prescription and it has really needed review, but that's the NHS for you. It's especially bad in NI. My weight and BP haven't been checked either.

I'm 63 and still on it. I came off once and felt bloody awful. Apparently you are supposed to wean yourself off it slowly.