Started HRT at 59 - have I made a mistake?

[Bobbisocks]

I posted last week about whether it was too late to go on HRT as I’m 59 and my last period was six years ago. Since then I have managed to see a female GP who is positively evangelistic about it and put me on combined patches. She allayed my fears and made it sound very appealing (she’s on it herself).
My reasons for starting were that I have had sleep issues (mainly due to still getting night sweats), low energy and brain fog for years now, and I wanted to try HRT as a solution before it got too late for me. I was also worried about the osteoporosis issue as my mother had that. Having said that, most of my other menopause symptoms had almost completely disappeared, so I feel like I’d already come through the worst.

I’m now three days on the patches and the side effects are really kicking in. Slight nausea but hungry all the time, odd low achy abdominal pressure, mood becoming low, and the last couple of nights I’ve had awful sleep (an actual increase in sweats) with bad dreams. And feeling ‘tired but wired’. DH thinks I should just stop because I was better before I started (I actually was) and I’m wondering why I’m putting myself through this. I’m also quite disconcerted about the small but not completely insignificant risk of breast cancer and other issues listed on the pack leaflet, especially starting so late and having a family history. I feel like I’ve just caused myself more stress.

Not sure whether to just take the patch off now or give it to the three month review as I know side effects may be only temporary. Could my dose be too high? Is it ok to just stop once I’m on it? What happens if I’m on it for a couple of years and then want to come off - do I go through another menopause?

I’m worried I’ve made a big mistake and should have just left well alone!

I personally would give it at least 2 months. Any hormone changes can make you feel unsettled for a while. Or you could try half a patch?

I would give it a bit longer. My situation is almost identical but I started last November. The hot flushes have gone, and I actually sleep a whole night through. Honestly, sleep is incredible and I’d no idea how much I was missing it!

I also feel much more like me. I can’t put my finger on it, and it might just be the better sleep, but it’s noticeable.

I had a few initial side effects but they settled down.

I have had some complications, but that’s due to my GP not addressing the progesterone levels properly. I’m coming out the other side of the issues and am still glad I’m on HRT.

I would see if you can get a DEXA scan to give you an idea of how your bone density is holding up. If your bones are good and your symptoms are worse with HRT than without, it may not be right for you. But without that information you don't know how your risks stack up.

I’m like you - I did leave it a few months but for me, the side effects of being on HRT were worse than the menopause. I never felt happy, I was a huge bloated balloon and I wouldn’t know how I was going to feel from one moment to the next - the anxiety flares in particular were really destabilising. I still continued to get hot flushes on it too so in the end I just stopped, put up with the tiredness and flushes and had a calmer mind.

the pill made me feel the same as well when I was younger.

Three days is absolutely no time. You’ve got to give it a couple of months before you make a decision.

I would stop like your husband suggested.
You were coping before.
You have family history of breast cancer.

What's your cardiac health like? HRT is proven to reduce the risk of heart disease. Consider that as well as your fracture risk.

Please also read this about the breast cancer risk. It's not for body identical oestrogen! https://www.drlouisenewson.co.uk/knowledge/family-history-of-breast-cancer-should-i-take-hrt-and-testosterone

I went on it at 60 after years on medication for osteoporosis which didn't work! Since then a dexa scan has confirmed an improvement in my bone density. I have just reduced my dose as after three years the side effects were coming back and am now on the lowest strength patches. Fingers crossed seems to have settled as the next level of osteoporosis drugs have horrid side effects and I want to avoid them for as long as possible.

I’m on Evorel Conti which is not body identical, apparently. If I decide to stay on it, might see if I can swap.

But I’ve read conflicting info regarding breast cancer, including from the package information leaflet, which lists breast cancer, heart problems and stroke as some of the potential risks.
I’m still undecided. Had another horrible night, increased flushes and now keep feeling anxious.

How are you feeling today OP

Another peri menopausal woman here wondering whether to ask for HRT at 48 due to all the night sweats and hot flashes and other myriad of stuff like achy joints.....however, last period was 7 months ago and I am hoping they do not come back , the last period lasted a month just awful ! I did have a fibroid diagnosis in 2025....

I would suggest speaking to your gp op.

perhaps she can reduce the dose but still continue for 3 months.

I wouldn’t make any decisions without speaking to your gp first.

I started hrt one month ago and am feeling really good. My gp put me on a really low dose, so maybe that would benefit you?

weirdly I didn’t get hot flushes before hrt, but I do now!!

but anxiety and overwhelm and mood crashes completely gone!

@Bobbisocks I could post LOADS about how you're feeling and your GP but will try to keep it brief!

The first thing is your GP doesn't seem that clued up despite being on HRT herself.

1 If you are worried about the BC risk you should be using micronised progesterone, not synthetic progestogen. Your GP really ought to know this. The British Menopause Society has a statement saying that for 5 years at least micronised progesterone does not increase BC risk.

2 You should start on a very low dose of estrogen not just the medium dose of a 50mgs patch. This is why you are having side effects. Too much too soon.

For context, I started HRT more than 15 years ago with an excellent gynaecologist (privately) and was advised to start on half the absolute minimum dose.

That was half a pump of gel ( so that would be the same as a quarter of a 50mcg patch.) I used that for around 3 weeks then moved up to 1 pump- which would be a 25mcg patch.

3 The risks on the leaflet are not always up to date OR tailored to each type of hrt.

Strokes are only a tiny risk with tablet form estrogen. BC risks are based on old data and do not include micronised progesterone.

HRT protects against heart disease.

I don't know if you can afford it but I'd suggest you see a private menopause specialist- or at least read the links left by other posters and ask your GP for a change in your HRT.

Start on gel, on the lowest dose ( 1 pump) for a few weeks.

Use micronised progesterone.

If you want to get the estrogen dose right you can try sequential HRT for a few months . This means you can experiment with the dose and increase it gradually.

There are LOTS of options and more privately, which I won't go into here but just to say your GP has dived in with the bog standard patch and it's clearly not suiting you.

@Dsfdf The risk of BC is not with estrogen. women who use only estrogen have less BC than women not on hrt. It's the progesterone (and the synthetic types) that appear to increase risk.

I onli managed 6 weeks. I feel like my fibromyalgia was worse. Was not prepared to feel crap.

Thank you. that’s useful info. I think I will contact my GP next week and see if I can go on the lowest dose, and on the micronised rather than synthetic.

The anxiety is easing up (touch wood) but the sleeping is still awful and I’m getting increased flushes, so really not seeing any benefit so far! I know it’s early days though. I’ll give it a while longer, but my worry is that if I decide to come off I’ll get rebound effects, which I’m not looking forward to.

The guidance is to try it for 3 months.

I've come off HRT twice to see how I felt. My consultant said give it 3 months. (I didn't last that long!) However, the point is that each time I stopped it took 3-4 weeks before my symptoms came back. So...you aren't going to get results in a few days. It takes weeks to build up your estrogen (and yours will have fallen a long way at 59.)

There is a bit of a psychological side to this- if you think it's not going to work, and you're a bit unsure, that is likely to be the outcome (it's the opposite of the placebo effect, called the no-cebo effect) Wise words from my consultant.