Do younger women really need higher HRT ?

[101trees]

Louise Newson:

Studies have shown that younger women experiencing symptoms of perimenopause or menopause often tend to need higher levels of oestradiol (and therefore usually higher doses of HRT) than older women do.

Interested as I'm 40 and already on a 75mg patch. Recently hot flushes and migraines have returned worse than ever after the 75mg working brilliantly for a few months to resolve these symptoms.

I recognise as my low estrogen symptoms returning, but I feel like I'm already on a high dose at my age.

Studies have shown
Usually where studies are quoted there is a link to the research. Is there a number (usually in blue) beside that phrase linking to research papers?
Or use google and see what that throws up.

but I feel like I'm already on a high dose at my age.

But if you need HRT at 40, you will probably need more than someone aged 75 because you natural levels would be higher , were you not in peri.

The important thing is to use whatever dose you need to control your symptoms, regardless of your age.

Obviously women still using HRT in their 70s, 80s (who still have flushes etc) will probably need less than someone your age but it's very individual.

40 is young to be on HRT and suggests you might be having an early menopause and especially if your periods were to stop before 45 (that's considered an early menopause) and you need a higher dose of estrogen for bone and heart protection, regardless of other symptoms.

If you're not happy with increasing your estrogen are you doing all the lifestyle stuff as well ? Mainly lots of exercise, a good UPF-free diet, low alcohol etc?

Thanks @JinglingSpringbells. There's no source or reference next to the Louise Newson quote and I can't find any actual studies which seem to support this.

My Mum had her last period at 44, and her mum at 42. Neither of them used HRT and my Gran had severe osteoporosis, so what you are saying about bone protection makes absolute sense.

I do usually have a great diet and generally do lots of exercise, but both these things become really hard to maintain when I have a lot of migraines, it's a bit of a cycle where I'm too unwell to do the things which make me feel better. HRT has been the only thing which has ever stabilised them.

I'm not against using more HRT, I just feel this has progressed so quickly. My periods changed and symptoms initially emerged when I was 36. At 39 they became unmanage and I had a blood test which showed slightly low estrogen and slightly high FSH so I was told I was at the start of peri.

I've been on HRT for 6-months, initially the 50mg patch really helped, then I got a resurgence of symptoms and went up to 75mg after 3-months. Again I was back to feeling great and the migraines and flushes vanished. Now suddenly the symptoms are back after another 3-months, all coinciding with this late period - which seems odd as I'm on cyclical utrogestan, so I thought this would trigger the withdrawal bleed in a predictable way. I assume I must have a really strong cycle still for it to be overriding the HRT like that.

I have this constant niggling doubt that I feel I'm so young to be at this stage and I shouldn't be on HRT, but the hot flushes are undeniable. There's so many of them and I think they trigger the migraines; which are out of control. I keep waking up boiling hot, so the lack of sleep feeds into it all.

I think I'm just concerned if I go up to 100mg patch, I've got nowhere left to go after that and it all seems to be progressing so quickly. The idea that younger women need more, and so I'll be able to go down again at a later point seems reassuring.

My prescriber says the ratio of oestrogen and progesterone is also important.

So worth speaking to your prescriber