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?

It was private but definitely not tested every day!

Can I ask where you found this evidence? I'm really trying to educate myself on this but it's actually really hard to find stuff.

I think what @Charliede1182 means is that the research shows that for heart health, there is a lot of evidence that starting HRT within 10 years of a final period reduces the risk of heart disease. That's well known and you can google the question and it will take you to statements by the British Menopause Society. It's called the 'window of opportunity'. Ten years after a last period the benefits are not there as much if HRT is started for example in your 60s.

Not everyone will know what 'hypoestrogenism ' means but it just means low estrogen.

You can't be prescribed HRT for prevention anyway. It's only prescribed for symptoms or for women who have been diagnosed with low bone density where there is a risk of osteoporosis or established osteoporosis.

I've not seen anything anywhere about bone loss taking a nose dive 2 years before menopause (because women are ovulating then maybe not monthly but they are not post menopause.)

What there is evidence on is that bone loss drops sharply but 3-5% in the few years immediately after menopause.

You can find a lot of info here and on the videos.

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

https://thebms.org.uk/publications/consensus-statements/prevention-and-treatment-of-osteoporosis-in-women/

https://thebms.org.uk/publications/consensus-statements/primary-prevention-of-coronary-heart-disease-in-women/

https://thebms.org.uk/publications/bms-tv/

I really recommend Dr Catherine Coward, she used to work for Newson health but set up a private menopause clinic last year https://myviahealth.co.uk/menopause not as expensive as other clinics, and she really knows her stuff.

For me at 43 I went though a period of about 2 months where my period was erratic, I had constant migraines, I stopped sleeping and felt like I was losing my mind. Prior to that I had been experiencing increasing fatigue for years but it had got to the point where I was really struggling to do much of anything, everything felt like an insurmountable task even hanging up washing or making dinner. I just wanted to hide in bed. It was like being depressed but I knew I wasn't actually depressed, I was just lifeless. Within a few days of starting HRT I felt the energy come back into my body and suddenly I was more like my old self.

It can be really confusing knowing when or if to consider HRT because perimenopause can start years before menopause itself. Blood tests alone don’t always give the full picture as hormone levels can fluctuate a lot during this time.

Many women start exploring HRT when symptoms begin to affect daily life or sleep, mood, energy or overall wellbeing. Feeling more tired and experiencing brain fog can sometimes be part of hormonal transition, but they can also be linked to stress, life demands or sleep quality too.

If you’re unsure, it can be helpful to start tracking symptoms and patterns and have an open conversation with your GP or menopause specialist. Everyone’s experience and timing is very individual.

The time to start HRT is a) if you want to try it and b) when you feel your symptoms are overwhelming and affecting your quality of life.

It's not really complicated and don't overthink it..

I had friends and relatives that seem to think they need a blood test to say if they’re in Peri/menopause. I haven’t visited a doctor about it. My periods starting getting gappy post 45 and stopped by 51. I don’t need a blood test to tell me.

I've noticed a decline in sensation during sex, it's not painful, but just less sensitive, almost numbness. Should I speak to a doctor regarding vaginal estrogen. Im 51 this year. I do get brain fog, don't sleep great, I've had no period in a year, only a few days of spotting. Joint pain. I don't feel ready to take hrt yet, but I've definitely noticed the loss of sensation during sex.

No idea.

Oestrogen is the whole of head medicine; progesterone just plays a part.
Anyone on antidepressants is screwed.

what the hell. After poor looking after an under active thyroid you would have thought in this century it better looked after. But should have known better.

For me, it was the sudden sweats (which left me dripping wet, even having to wipe the drips off the end of my nose... not great while I was teaching a class). I also felt brain fog and much more erratic emotionally.
Once I had started, the painful knees when going up and down stairs, also vanished. As, strangely, did the keratosis pilaris bumps on the back of my arms. I hadn't associated either with hormonal changes, but there you go.

Oh my gosh those sweats sound awful. Mine were more a rising heat up my back when watching TV from around 9pm- as though they knew the time. Also hot in bed and kicking covers off a bit sweaty.

Yes get on vaginal oestrogen!