How do you know when you need to start HRT?

[vetprob]

Just that really. I had bloods done a couple of years ago to test my hormones and they predicted my menopause will come at age 52 (in about 5 years time). Obviously peri is probably in full swing - or is it? I'm assuming here.

I'm pretty tired these days, can't seem to stay up very late. And brain fog is definitely a thing (but it has been since DS arrived 13 years ago tbf 😄).

Other than that no real symptoms as such.

Any advice?

Agree that HRT is not expensive in the grand scheme of things. I am just on estrogen patches as I have had a hysterectomy and don;t need progesterone. I buy my patches privately as there have been shortages on the particular brand I use and they cost about £50 for 3 months.

HRT is free where i live thankfully.
I couldnt live without vagifem it is such a game changer.
I was on hrt patches for about 3 years but had to stop when i got sick but they really helped with all my symptons. Id highly recommend it.
Now that i cant use it, i do feel i need to do as much as i can to offset that. I take vit d every day, i dont eat upf, i excercise 4 or 5 times a week. Yoga, swimming, the gym, and weights. All so important in our bone health for older us.
Bone density is a huge factor in how we are older ladies so im doing as much as i can to aid that.
Id go back on hrt in a hearbeat if i could. Im 56.

It;s free where I live too (Scotland) but the NHS is unable to supply Estradot patches and has been unable to for over a year. They keep sending me Estraderm or Evorel which I am allergic to. But even buying the patches online isn't that pricey.

Sounds awful. I recommend magnesium before bed- helps you drift off and stay asleep. It’s like my eyelids get so heavy! I use Nutrition Geeks 3 in 1. Poor sleep can cause all the worst feelings even without menopause. Oh and definitely start vaginal estriol- game changer and the hormones are only localised so not in your wider system. You start every day for two weeks then it’s just twice a week.

It depends on what you want to get out of treatment.

If it is purely for symptom palliation then only you can decide if or when you need treatment based on how you feel.

If it is for the maintenance of bone, cognitive and cardiometabolic health going forward the evidence strongly supports starting early, ideally before you have been exposed to a prolonged period of hypoestrogenism.

In particular bone density starts to nosedive around 2yrs prior to the last period.

greengreyblue

thanks so much, am off magnesium, was having very vivid dreams nightly and waking up like you would from a nap, feeling groggy and sluggish. Tried a few different brands over a few months and was the same. Each time I came off it I’d be back to waking but would wake up better and didn’t have the dreams. I think I’ll live with waking, it just wasn’t worth it!! Will ask the gp for the estriol though, thank you!!

Sorry just seen your question. I was just feeling 'off' - sore, dry, painful sex .. oestrogen cream was recommended here and my GP prescribed it straight away. The difference is incredible - no longer sore or dry, increased libido, and just generally 100% more comfortable down below. It's the best thing ever and I'm so glad I came on Mumsnet and asked questions

I started taking it when the symptoms (many and varied, including a red mist rage that got me pulled over by the police for aggressive driving), became pretty unbearable. If you don't have any symptoms really, well then it's up to you whether you want to take it for protective reasons, but they are compelling - particularly in the case of osteoporosis. Vaginal atrophy and all that that entails is also a really good reason to take vaginal oestrogen, even if you don't take anything else.

Hi, would you recommend the nutrition geeks menopause support bundle?

I knew as all my joints ached particularly in my arms. It was painful to even reach back to put on my seatbelt. I'd read that this could be due to perimenopause. 2 weeks on HRT and it was gone.

I don’t take that so no I can’t recommend. I do use Nutrition Geeks vitD3 and Magnesium 3in 1.

Yep even those on systemic HRT find vaginal cream necessary.

I’d coped with the crazy periods, night sweats, brain fog, ok ish during Covid and wfh. What made me try HRT was palpations that impacted me exercising and tinnitus. Within 3 days I felt a million times better, and things that I hadn’t even realised were symptoms (achy ankles!) had gone.

If your ovaries secreted it in their heydey then yes.

If they didn't then it is likely to be a poor treatment for menopause.

Do you mind sharing how many times your blood was tested? My gynae lead at our GPs said to make blood tests accurate, you would need to test on everyday of the cycle - which generally the NHS doesn’t do.

Hiya, do the aches and pains come and go. Only because, you mentioned your arm hurting, when reaching for the seal belt. I had this recently, just my right arm, but it seems to be OK now. Im 51 this year. I noticed little things, brain fog for one, no periods in a year, just some spotting.

Hesitation about starting HRT for me isn't about any perceived risks, I've been fortunate to live a healthy life so far so no complicating factors that I know of. It's a general habit of not taking medication if I'm managing ok - a fear that it could get worse and then I wouldn't feel the benefit. Plus in my mind it is unshakeably associated with old people and I am not happy being in a relevant bracket (I'm 48)! I just need to get over these really. Like admitting my jeans were too small, buying a size up and being comfortable and properly dressed rather than uncomfortable and awkward.

Muscle strains happen and heal. Do stretching and strength work. I use a set of 5kg dumbbells and have really improved upper body strength and tone.

I do have a loss of libido and dryness - that is the most notable symptom.

@Overrunwithlego you would benefit from vaginal oestrogen. Really, it's amazing stuff. I didn't realise I had vaginal atrophy until I had a check-up with a gynae consultant last summer for something else and she said very matter of factly 'Once you're done with these tests you need to go on vaginal oetrogen, because you have vaginal atrophy and it will really help'. I was stunned, as I had no idea. I had vulval itching at night and loss of libido, but I hadn't realised that those are signs. She said that most women have it when they are menopausal/post and I'm guessing that, like me, they just don't realise and how easy it is to fix.

I've been on Estriol cream since the autumn and it's great. Everything down there has sensation and tone again. I couldn't really do Kegels any more before I started it, but almost immediately I could, plus itching gone and libido back! Honestly, it's amazing and for your symptoms it will turn things around and if you're in a relationship it's great - my DH is certainly very happy!

@zurigo do you take that as well as patches?

Yes - it’s taken alongside either patches or gel.

Yes they were intermittent at first but then more constant. I definitely had brain fog. Found myself searching for words. Was concerned I had dementia at one point. Also felt teary at unexpected moments when under stress, sadly this remains despite HRT but big improvement in the other symptoms. Always worth having a chat with your GP. Mine said to give it a go and see if it made a difference.

I think alot of women jump on the HRT when there symptoms start affecting their life adversely.
My main symptoms were brain fog, hot flashes, joint pain and insomnia. One day I was so sleep deprived I had to call in sick to work, that was when I knew I needed to do something.

I love this description as it’s exactly how I feel!

I use gel, not patches, but yes.