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Menopause

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Age 61 and no more HRT

82 replies

Wowarentyoutall · 30/07/2025 15:42

Been on Femoston Conti for 5 years with no problems at all (patches before that but I didn't like them ) now been told that age over 60 the cons outweigh the pro's of HRT as theirs an high riskof breast cancer so doctor has taken me off them.
Stopped taking them 6 weeks ago and the hot flushes/mood swings/insomnia have returned with avengeance.
Was recommended Black Cohosh and Sage neither of which seem to be doing anything at all, can anyone recommend anything that has helped them.

OP posts:
EmeraldJeanie · 30/07/2025 16:01

Lordy me. I am 59 and on Femoston conti having recently been on Femoston 1/10.
Unless real health reason ( apart from age) I would be seeking a second opinion. I am now on Femoston conti ultra low but am hoping to continue hrt (in some form) over 60 as well.

BadActingParsley · 30/07/2025 16:07

https://www.nhs.uk/medicines/hormone-replacement-therapy-hrt/when-to-take-hormone-replacement-therapy-hrt/

Benefits and risks if you're older
As you get older, and particularly after the age of 60, the risks of HRT may start to outweigh the benefits.
This is because you'll usually find that menopause symptoms improve as you get older, so you're less likely to need HRT to help with symptoms. Meanwhile the risk of breast cancer increases the longer you take combined HRT.
If you want to keep taking HRT or start taking it over the age of 60, a GP may recommend taking a low dose, and using patches or gel rather than tablets, to reduce the risk.
Read more about the benefits and risks of HRT

Hiya

I stopped at 55 as they were finding it hard to read mammograms because of the HRT hormones. The breast clinic suggested I try stopping and seeing how I went with the symptoms (I'd been on it for about 10 years) and then weighing up the risks against the symptoms (with GP help if needed) . I stopped the HRT and the symptoms were manageable, which they hadn't been before when I was younger.

It sounds like your symptoms aren't so I'd ask for a second opininion to weight up the risks for you.

nhs.uk

When to take hormone replacement therapy (HRT)

Hormone replacement therapy (HRT) helps with symptoms during perimenopause and after the menopause. It's best to only take it for as long as the benefits outweigh the risks.

https://www.nhs.uk/medicines/hormone-replacement-therapy-hrt/when-to-take-hormone-replacement-therapy-hrt

JinglingSpringbells · 30/07/2025 16:17

@Wowarentyoutall what you've been told is incorrect. By a long way!
The guidance on HRT is that there is no age to stop.
It's an individual choice.

The risks at 60 - 70 are the same as benefits.
The risks over 70 are mainly to due with blood clots and this is reduced if you move onto transdermal HRT.

The risks with breast cancer are not related to age in any way, other than ALL women are at increased with age, regardless of HRT or not.
Your GP is misinformed,

There are slightly higher risks with length of time on HRT but 5 years is no time at all. I've a friend in her 70s coming up to 20 years on HRT. I've also a friend who's just started on HRT at 63 (through NHS GP.)

I suggest you see another GP who's more up to date.

The '5 year rule' was ditched years ago.

https://thebms.org.uk/publications/consensus-statements/bms-whcs-2020-recommendations-on-hormone-replacement-therapy-in-menopausal-women/

Key points

All women should be able to access advice on how they can optimise their menopause transition and the years beyond.

There should be a holistic and individualised approach in assessing menopausal women, with particular reference to lifestyle advice, diet modification as well as discussion of the role of HRT.

The decision whether to take HRT, the dose of HRT used and the duration of its use should be made on an individualised basis after discussing the benefits and risks with each patient. This should be considered in the context of the overall benefits obtained from using HRT including symptom control and improving quality of life as well as considering the bone and cardiovascular benefits associated with HRT use.

The HRT dosage, regimen and duration should be individualised, with annual evaluation of advantages and disadvantages.

Transdermal administration of estradiol is unlikely to increase the risk of venous thrombosis or stroke above that in non-users and is associated with a lower risk compared with oral administration of estradiol. The transdermal route should therefore be considered as the first choice route of estradiol administration in women with risk factors.

Evidence from large observational studies and case-controlled studies suggests that micronised progesterone and dydrogesterone are unlikely to increase the risk of venous thrombosis and are associated with a lower risk of breast cancer compared to that noted with oral progestogens.

The potential benefits of bioidentical hormone therapy can be achieved using conventionally licensed products, without having to resort to unregulated compounded varieties from specialist pharmacies.

Arbitrary limits should not be placed on the duration of usage of HRT; if symptoms persist, the benefits of hormone therapy usually outweigh the risks.
HRT prescribed before the age of 60 has a favourable benefit/risk profile.

HRT initiated before the age of 60 or within 10 years of the menopause is likely to be associated with a reduction in coronary heart disease and cardiovascular mortality.

If HRT is to be used in women over 60 years of age, lower doses should be started, preferably with a transdermal route of estradiol administration.

Evidence from the Cochrane data-analysis as well as that from the long-term follow-up data of the WHI showed no increase in cardiovascular events, cardiovascular mortality or all-cause mortality in women who initiated HRT more than 10 years after the menopause.

BMS & WHC’s 2020 recommendations on hormone replacement therapy in menopausal women

https://thebms.org.uk/publications/consensus-statements/bms-whcs-2020-recommendations-on-hormone-replacement-therapy-in-menopausal-women/

SequinsandSoleros · 30/07/2025 16:27

Hi all
Sorry to hijack.
I am 54 and have now finally had no periods for a year so, after two clock resets, think I am through to the other side (2 periods in 3 years).
I have had no HRT at all.
I did not want to bleed again and was unsure whether this would happen and I was fearful of side effects, as I suffer from depression in any case.
So I have battled through the brain fog, insomnia and hot flushes because I didn't want other side effects.
I am not in great health - tendonitis, depression, taat, dentistry. There is cancer in the family (bowel) not breast. I am panicking a little about bone weakness later and having missed out on any protective effects.
Any advice for me?

GoldDuster · 30/07/2025 16:30

This drives me absolutley bonkers, it's so dependent on the individual GP and their personal whims and it should not be. Arm yourself with information, and go back. See a different GP if you need to until you get someone who knows what they're talking about.

NICE guidelines recommend that there is no set time limit for taking HRT, and it should be continued as long as the benefits for symptom control and quality of life outweigh any risks

Hdpr · 30/07/2025 16:32

Agree that the Nice guidelines don’t set an age limit for HRT. Read them and see a different GP. Some medics just have their own opinions

sualipa · 30/07/2025 16:36

There’s no history of serious health issues in my family. I don’t smoke or drink, exercise regularly, and maintain a healthy weight. I’m 62 and keep up with my yearly HRT check-ups. I’ve been on Femoston Conti 1/5 for five years now, and it really makes me feel great.

When I tried to stop it a few months ago, the hot flushes were absolutely horrendous—I ended up taking cold showers and sleeping in wet clothes! Definitely not doing that again anytime soon. Plus, the HRT has a positive effect on my bone density, and it definitely helps keep me from wanting to kill my husband!

elastamum · 30/07/2025 16:39

I'm 61 and wouldn't dream of giving up my HRT. I have read the nice review and for me I think the benefits outweigh the risks. Suggest you see another GP.

Mancity08 · 30/07/2025 16:46

That’s a very old fashioned statement there from your GP, and they’re not upto date with their knowledge!!

id go back see another doc, or ask to go menopause clinic
if you can afford to see a private menopause dr
and then get your prescription through gp service 👍

Limonades · 30/07/2025 16:59

sualipa · 30/07/2025 16:36

There’s no history of serious health issues in my family. I don’t smoke or drink, exercise regularly, and maintain a healthy weight. I’m 62 and keep up with my yearly HRT check-ups. I’ve been on Femoston Conti 1/5 for five years now, and it really makes me feel great.

When I tried to stop it a few months ago, the hot flushes were absolutely horrendous—I ended up taking cold showers and sleeping in wet clothes! Definitely not doing that again anytime soon. Plus, the HRT has a positive effect on my bone density, and it definitely helps keep me from wanting to kill my husband!

I’d be interested to know what your yearly HRT checkups consist of? Blood tests? Bone density?

LBFseBrom · 30/07/2025 17:03

I would have thought being on HRT for five years was enough if you are 60 and well past the perimenopause state.

I've known five women who were on HRT and had breast cancer. It's not worth the risk imo and you should be fine now anyway as long as you look after yourself nutritionally.

I was on it for just over two years and that was many years ago.

sualipa · 30/07/2025 17:03

Limonades · 30/07/2025 16:59

I’d be interested to know what your yearly HRT checkups consist of? Blood tests? Bone density?

When you see a nurse at the GP, they check your weight, height, and blood pressure. They also ask lifestyle questions about your exercise, diet, and habits. If everything looks good, they explain the risks which are minimal at the momentas well as the benefits. No blood tests though.

sualipa · 30/07/2025 17:06

I put my post above through ChatGPT this is what it said ;

Absolutely! I can provide approximate statistical risks based on current medical research related to your profile. Keep in mind these are general estimates and individual risk can vary—your GP or specialist is the best source for personalized advice.

  1. Risk of cardiovascular disease (heart attack, stroke)
  • Non-smoker, active, healthy weight, no family history = low baseline risk.
  • For women aged 60-65 without major risk factors, the 10-year risk of a major cardiovascular event is often below 5-7%.
  • HRT risks: Oral combined HRT (like Femoston Conti) may increase the risk of venous thromboembolism (VTE, blood clots) about 1.3 to 3 times higher than baseline, but absolute risk remains low in healthy women.
  • Absolute VTE risk for healthy women on HRT is roughly 1 to 3 cases per 1,000 women per year.
  • Risk of stroke may increase slightly (by about 1.2 to 1.4 times), equating to an absolute risk increase of about 2 to 4 extra cases per 1,000 women per year.
  1. Risk of breast cancer
  • Baseline risk for a 60-year-old woman with no family history is about 3-4% lifetime risk over 10 years.
  • Combined HRT slightly increases this risk; studies suggest an additional 0.3% to 0.5% absolute risk increase over 5 years of use.
  • After stopping HRT, risk returns to baseline within 5 years.
  1. Bone health (osteoporosis and fractures)
  • HRT significantly reduces the risk of fractures by about 30-50%.
  • For women aged 60+, fracture risk without HRT could be around 5-10% over 5 years, so HRT provides a substantial protective benefit.
What this means for you:
  • Your risk of blood clots and stroke is still quite low but slightly elevated due to HRT.
  • Your breast cancer risk is marginally increased but remains relatively low.
  • You gain significant benefits in quality of life and bone health, which is important at your age.
Would you like me to help you interpret these in the context of your lifestyle or suggest questions for your doctor to discuss these risks in more detail?
JinglingSpringbells · 30/07/2025 17:15

@LBFseBrom Many women have symptoms affecting quality of life well beyond 60. It doesn't always compute that being older means symptoms disappear.
My dr has told me of women aged 80+ still on HRT.

JinglingSpringbells · 30/07/2025 17:18

@sualipa ChatGPT can be great but isn't right with a lot of that!

The CVD and stroke risks do not apply to transdermal HRT. Using transdermal doesn't increase risks above your own baseline risk. I guess it's using the old data from the WHI which was based on the old types of tablet HRT (mainly.)

EmeraldJeanie · 30/07/2025 17:22

However, op (and me!) Femoston users at present so useful to see oral tablet risk is still low. I am reassured by the dygesterone in Femoston as well.
At 60, I will have a review and if deemed safer for me, try transdermal then. I will see how I go on my ultra low Femoston conti until then...

EmeraldJeanie · 30/07/2025 17:24

I do like a glass of wine so increasing my risk there...
Trying to be moderate in my consumption....

sualipa · 30/07/2025 17:39

JinglingSpringbells · 30/07/2025 17:18

@sualipa ChatGPT can be great but isn't right with a lot of that!

The CVD and stroke risks do not apply to transdermal HRT. Using transdermal doesn't increase risks above your own baseline risk. I guess it's using the old data from the WHI which was based on the old types of tablet HRT (mainly.)

Thanks. Should I be pushing for the transdermal now then ?

EmeraldJeanie · 30/07/2025 17:46

There is a step lower on your Femoston conti....
I will discuss transdermal at 60. It depends on how my risk seems to what I do. For example, whether my blood pressure still OK etc...

EmeraldJeanie · 30/07/2025 17:46

I have very hot baths which may compromise patches...

EmeraldJeanie · 30/07/2025 17:50

Femoston not an old type of tablet I don't think and dygesterone a good feature I understand...
My GP mentioned transdermal this review but when looking at my recent health check said happy to go with my decision. I trust him though and he sounds very different to your gp op...

thenightsky · 30/07/2025 17:54

Place marking as I was taking HRT until mid May when my GP stopped them because I'm 66. I'm having horrendous symptoms and feel murderous. Going to take notes from this thread so I have them to hand.

JinglingSpringbells · 30/07/2025 17:54

sualipa · 30/07/2025 17:39

Thanks. Should I be pushing for the transdermal now then ?

Your GP should have pushed you!
Oral HRT is not used for women over 60.
The reason is that tablets are metabolised via the liver.
The affects lipids and can increase your risk of blood clots.

@EmeraldJeanie It's more or less mandatory to change over 60 to transdermal estrogen and either micronised progesterone (as the progesterone) or the Mirena coil, or a combined patch with both hormones. It's in the BMS HRT guidance.

CatAsstrophe · 30/07/2025 17:57

I'm a year older than you @Wowarentyoutall and my GP, who's clued up about HRT, hasn't told me I have to come off it.

I take Femoston 1/5 (I can't tolerate any other progestin apart than dydrogesterone), Sandrena gel and Testosterone gel.

I don't drink any alcohol, my BMI is in the mid normal range, my BP is always on the low side of normal and a recent ECG was completely normal. I have blood tests every year, including Testosterone.

Ideally, I'd like to take dydrogesterone and Sandrena, but dydrogesterone isn't available as a 'stand alone' so Femoston is the next best thing for me.

EmeraldJeanie · 30/07/2025 18:06

I wonder if the dydrogesterone situation might change in the future. Seems a shame can't get separately.
Are risks with oral tablets lowered if you are on a low dose?
Femoston ultra low seems as low as you can go with oral hrt.