HRT anxiety, were you worried about starting it?

[Sunshineandrainbow]

After a year of symptoms I went to the GP last week with a list of ? Peri menopausal symptoms. He prescribed me Evorel HRT but I haven't picked up the prescription yet as I am just worrying about the implications after hearing about it possibly contributing to breast cancer while growing up. And I probably could carry on and get through the symptoms of anxiety, no motivation, disturbed sleep, itchy ear, finger locking plus a few others. Anxiety and motivation probably the worst symptoms but I am still managing to go to work but at weekends I don't want to do anything. Feel tearful now writing this down 😞

Has anyone else felt like this and does the worry of taking HRT ease?

The breast cancer scare stories are a good 20 years out of date. Bioidentical hormones do not carry an increased cancer risk. You're just giving your body what it needs to continue functioning. No different to taking thyroxine if you had an under active thyroid gland

You don't get any medals for martyring your way through. HRT has been an absolute game changer for me

I looked into extensively, felt there were more risks not taking it, wanted to address menopause symptoms and I feel sooooo much better on it.

why don’t you try it for six months and see how you feel? It will give you a chance to do further research and also to see whether it is working for you. Your tearfulness and anxiety might be exacerbated by perimenopause

I was desperate to go on it due to anxiety and total lack of sleep, terrible night sweats. There is breast cancer in my family, but I check my breasts and go to my mammograms. I was on birth control for years too so no different really, probably safer!

I did have a break to see if I was in full menopause, I was, but then had to go back on again as the sweats were unbearable. I can take it continuously now until whatever age I feel like stopping!

I wasn't having a lot of symptoms, only brain fog, which was quite bad, so really ummed and ahhed about taking it (Femoston). Much better on it almost straight away, more so after three months.

One thing I did not expect is that I have much more vaginal lubrication now, and my orgasms are amazing! I'd been back on the combined pill to sort out dryness and itching before but hadn't (I thought) had vagina/vulva issues for a few years, but this is another level.

I wasn't at all worried. I'd had a working lifetime of talking about and prescribing HRT (including making sure I could justify doing so when it fell out of favour due to prominent scaremongering) and I don't have any known contra-indications in my personal or family medical history, so I had no hesitation about taking it myself when I had some inconvenient physical symptoms around the menopause.

It's not unusual for women to be anxious about starting HRT, and having anxiety as part of your perimenopausal symptoms won't make it any easier. You've been prescribed a preparation with a very low risk of serious complications and the only way to know whether or not your current symptoms are related to the perimenopause is to give it a try. You'll know within a few months.

Oh yes, the anxiety about starting HRT, added to the peri anxiety you’ve already got, is just wonderful!
I got to the point where I didn’t want to go out, had no interest in anything, and I knew I had to do something. So I wrote a list of my symptoms and agreed with myself to give it a 6 month trial ( writing my symptoms every week or two to see if there was any improvement) and I never came off it. I could see the improvement on the paper and in myself.

I didn’t think twice about taking it.

But you don’t have to force yourself into a treatment just because other people find it helpful. And if you’re that anxious about what you believe are the risks, is it worth taking it? If I thought it was going to give me cancer, I’d not take it. But I don’t, so I do.

None whatsoever.

The stories about the risks that you heard years ago were (a) partly misinterpretation of studies and (b) all based on older types of HRT that hardly anyone takes these days. Newer research on current formulations show the risks are much, much smaller than previously thought. And there are also very significant protective effects against osteoporosis and heart disease - which for most people vastly outweigh the risks.

I wasn't worried at all at first because my consultant gynaecologist was very much in favour of hrt.

The risks of BC are far less than the old research from 25 years ago.
being overweight and drinking more than 2 units of alcohol a day are a higher risk.

There is a possible small link to breast cancer even with micronised progesterone, but the fact is they don't really know. The official advice is that it's safer than synthetic types of progesterone.

There is one very vocal private dr who says there is no BC risk at all- which is untrue. The evidence available is that it's safe for at least 5 years. But there are not many stats beyond that. Most research into HRT has excluded micronised progesterone.

I keep reassessing my HRT after being on it for 18 years. I have ongoing conversations with my consultant and they reassure me that for most women the benefits outweigh the risks.

If I had your symptoms @Sunshineandrainbow I'd not think twice about it and be fine about using it for 5 years at least then reassessing.

Thankyou all for offering different perspectives really grateful.

I lowered my HRT dose recently and went off the rails a bit. It’s like gold to me. Kerps me sane. I think about the protection against dementia and how it supports bone health.

Are you allowed to take it forever? Because what concerns me is that if I will have to put up with all the hotflushes etc eventually and I'm just kicking them down the road, that I'd rather get it over with and get out the other side while I'm still young, so it's easier to cope with.
I know there's an argument you never know how long you've got, so you might as well make things as easy as possible now.

You might not 'get it over with'. My mum's still having hot flushes in her late 70s. [Edit: having never taken HRT]

In theory you can stay on HRT indefinitley, although risks do increase the longer you're in it they are still quite low. In some countries, such as France, it's quite common to stay on it for 20 years or more.

Taking HRT is about individual risks and benefits. Risk can change as we get older - NICE Menopause Guidelines has more information on this.
You don’t mention how old you are but to give risk of breast cancer some context, for a 50-year-old see the attached.

Thank for sharing. I am 50

'Are you allowed to take it forever?'

In theory, yes. There is no definite cut off age. Every woman should be having conversations with her healthcare professional as she ages about her own risk profile Vs the benefits

I'm never coming off it!

Yes, there is no time limit.

As for the breast cancer risk - 'no risk'-

This is not the consensus statement by the BMS (and something I've discussed many times with my own consultant , having been on hrt for a long time it's something that does concern me.)

The only evidence is that is appears safe for 5 years and 'safer/ lower risk' than synthetic progestogen.

There is not much research on it (one French study which looked at women using it for 12 years) but all the meta studies don't include Utrogestan . This is because they are observational studies based on older prescribing.

I know one high profile doctor keeps saying there is no risk but that's disingenuous, because the consensus is it 'appears safer' not 'no risk.'

100%. Don't suffer unnecessarily. Peri can be hard.

I wasn't anxious, just stubborn and in denial that I was old enough to be considering it (I'm 48)! In fairness the info leaflet does spell out several times that HRT increases the risk of xyz cancers, stroke, blood clots etc, but it's from say from 4/1000 to 8/1000 - so doubling the risk, but it's still a very small one. It would make me think twice if I had mild or no symptoms, despite the other benefits, especially if I had side effects. Anyway, first patch applied and we'll see how it goes.

But those stats are based on old stats. (Assume you mean the leaflets in hrt meds?)
And it's only tablet form that increases risks of blood clots.

They do not include Utrogestan which, as far as we know, has a lower risk.

Take it. You’ll never look back.

@JinglingSpringbells I believe you, but it illustrates that it's not just old rumours or received wisdom, it's still being explained as a current health warning. The leaflets should make this clear or be updated. It's not helpful to be presenting apprehensive women with out of date information.

I think the problem is there is a generic leaflet re. risks and it's not been updated for each product. This is a real issue with vaginal estrogen - the leaflet applies to systemic hrt, not vaginal.

The stats on synthetic HRT (that's the synthetic progesterone) still stand.

But there is a difference with tablet form estrogen/ tablets, and micronised progesterone/ synthetic types.

I was worried, but I think that was a sign of how much I needed it. Pre menopause me wouldn't have had any concerns but with menopause I was full of doubts. It took me weeks longer than it should have to start on hrt. It has been a month and so far no regrets.

I didn’t feel anxious about taking it but I know some do.

My mum had breast cancer aged 48, and I also have an auntie who had it (other side of the family). But the GP wasn’t worried about that and was happy to prescribe HRT. I do have yearly mammograms before age 50 but that’s because they consider my bc risk higher than average based on my Mum, not because of HRT.

Incidentally, you have a lot of the same meno symptoms as me- anxiety is the biggie; ‘locking’ finger and itchy ears also! I would say HRT has helped a great deal, but not cured my symptoms.