Anyone decide to just do 5 years?

[PersephoneParlormaid]

When I went on HRT I decided just to do the 5 years, as I’m really concerned about breast cancer, no matter what the studies say. It’s been over 4 years now, and I’ve just found out that my lovely cousin has been diagnosed with breast cancer, and it’s made me think about coming off it. I just wondered if anyone else had come off it and how they felt after?

I’ve been on it 4 years and only just feel the dosage is about right. Still not perfect but much better.

It's a tricky balance isn't it. I'm more concerned about cardiovascular disease and bone health than I am about breast cancer, so I don't plan to come off it. But I'm very vigilant about checking my breasts and attending mammograms.

Agree bone density far more worrying. So many things can affect it and NHS doesnt check until you have problems which are irreversible. Needs much more proactive care in my opinion. 2 friends have osteoarthritis and were asking for help for over a year now cant do hobbies they loved at all because bones would just snap. Extremely sad.

You can still get breast cancer after you have come off HRT; it’s not one or the other.
Depends how you measure your wellness when you come off HRT as your hormones aren’t coming back. Some people are very healthy and have bags of energy and ‘sail through’ the whole menopause and ageing process and are lifting weights and running regularly.
Other people like myself have had a difficult menopause, have chronic health conditions and appreciate the benefits of HRT.
I still check my breasts regularly for lumps as I have done all my adult life, as even if the NHS won’t invite me to mammograms anymore, about 25% of new breast cancer cases are in women over 70.

@Unpaidworkmakestheeconomytick
You can request a mammogram every 3 years from the NHS after the age of 70 - you just need to book an appointment with your local breast screening service.

I will thanks. As I’ve been celibate for decades I’ll presume I don’t have the HPV virus so won’t ask or smear tests.

There's no fixed stop date at 5 years. The NHS page on when to take HRT is blunt: no fixed limit. You keep taking it while the benefits outweigh the risks for you, and you usually get a review once a year under NICE menopause guidance.

Your breast-cancer worry is fair. Combined hormone therapy does nudge the risk up the longer you're on it. The NHS puts it at roughly 5 extra cases per 1,000 women over 5 years of combined treatment. That extra risk falls after you stop, though some of it can hang around for years versus never-users (British National Formulary summary on the NICE site). Absolute numbers stay small for most people. Studies and the feeling can both be true at once.

If you do come off, the NHS usually suggests tapering over 3 to 6 months rather than stopping cold. Symptoms can bounce back. If they're still rough after about 3 months, a GP can talk through a lower dose again or other options. Bone checks (FRAX score, then a DXA scan if needed) can happen before anything snaps.

The NHS puts it at roughly 5 extra cases per 1,000 women over 5 years of combined treatment.

@Perimenostage It's worth acknowledging that those stats are based on the synthetic types of progesterone, not micronised progesterone (there aren't enough stats on that yet, but what there is shows no increase in risk for at least 5 years.)

Likewise, there is no clear, agreed advice on tapering. I know the NHS says some things, but there is also evidence that going cold turkey doesn't necessarily make symptoms come back any quicker or worse.

At the moment, there is no evidence on the dose of estrogen and BC risk. Women on estrogen-only have a lower risk than women not on any HRT.

It is also less of a risk to use sequential HRT, even post menopause, as this has less impact on breasts compared to continuous combined. It is a choice to move to combined continuous.

I've completed my first five years and plan to continue. I am mainly on HRT for bone strength, joint pain and heart health. I am less woried about BC, but do check, and attend mammograms.
I think we each have to make the risk-based choice that works for us.
I can understand that you might be concerned about an increased family risk because of your cousin, so I'd say it's worth speaking to your GP - maybe even getting a blood test to see if you carry one of the known risk markers for BC?