HRT being denied to women over 60. What do you think?

[meyesmyeyes]

I wondered what people make of the fact that a woman who is benefiting greatly from HRT, ie:

Protection from heart disease
Better distribution of healthy fats
Stronger bones
Increased libido
Better mental health
Better sleep patterns
Improved memory
.....to name a few of the many benefits,

has to give up HRT once she reaches the age of 60. She gets to have the 'talk' from her GP, apparently and they do their best to frighten you off taking them.

But a man of the same age, who is transgendering, is not only offered female hormones, but is apparently, allowed to stay on them indefinitely.

Is this fair to Women?

This is not another transgender 'bashing' thread.
I am genuinely interested, from a fairness (and equality) point of view really.

Surely if a woman is not allowed this treatment after a certain age, and has to accept that she will lose a lot of her womanly ways (lack of oestrogen causes a woman's body to start acting more like a man's especially when it comes to where fat is distributed),
then surely it's only fair that a man who is transgendering and is aged over 60' should also have to put up with less female hormones..

(I know about the slight increase of breast cancer, which by the way could do with updating - and is often quoted, which causes unnecessary scaremongering)

Are women getting a raw deal from the medical profession?

I know this is the dailyfail, but it's quite a good article and sums up the hysteria that has surrounded HRT in recent years.

www.dailymail.co.uk/health/article-2147835/A-wasted-decade-How-HRT-scare-caused-thousands-women-10-years-needless-suffering.html

I was informed I couldn't have a diaphragm as they don't do them anymore and the pressure to have a coil fitted was immense

My surgery went through a phase that no matter what you went to them for, they would ask ''do you want a coil fitted''.
They even started phoning me at home about it. Talk about pressure.

'Over 50% of GPs in England are female. Do you feel female GP's do not trust other women to weigh up the pros and cons and come to a decision for themselves? Do you think sexism is endemic in female GPs?'

I think it's more a matter of assuming all patients are stupider than they, and liars. That's been my experience, mostly, with a few exceptions. There's a lot of patronising and simpering and the feeling they aren't listening.

A major reassessment of the research into hormone replacement therapy has concluded that menopausal women were the victims of ‘mass fear’ generated by findings from ten years ago.

Many of the conclusions reached by the 2002 study, including the raised risk of breast cancer, have now been overturned.

British doctors are calling for the rules on prescribing HRT to be rewritten, allowing a new generation to benefit from bone protection and improved quality of life.

At present, women in their 50s are told to use hormone replacement therapy drugs for the shortest period of time that is possible and not for longer than five years.

Some younger doctors have never prescribed HRT because they wrongly believe the risks of the treatment outweigh the benefits, it is claimed.

The new analysis of the evidence by leading experts – including clinicians from the US National Institutes of Health who worked on the original

* A lot don't realise that this is the current (updated) thinking about HRT

Some younger doctors have never prescribed HRT because they wrongly believe the risks of the treatment outweigh the benefits, it is claimed.

This part shocks me.

Someone up thread booed that GPs were reading. I'm a GP (female) and reading. There are risks and benefits as we all know. Personally I am happy for a woman to take an informed decision to continue past the age recommended in the guidelines. However in the last 10 or so years the tolerance of the regulatory authorities for doctors who act out with the guidelines has diminished so much that it is almost impossible to defend in court should something go wrong, whether the patient made an informed choice or not.

I can understand why many GPs will not prescribe it for older women. They are protecting themselves from potentially career damaging and hugely stressful litigation.

NightFalls, can you comment on the assertion made earlier that men don't have such problems with obtaining drugs in similar circumstances, i.e. not life-threatening but quality-of-life enhancing? Viagra was mentioned. Is it a fair comparison, or a fair point?

Owen and Night - that's very interesting about the issue of litigation (a relative of mine, in a different professional field, but also one where a cock-up can lead to deaths, was recently on the receiving end of what I guess you'd call "vexatious litigation" and I know how stressful it was for him defending the action, so I don't blame doctors for being wary).

Owen out of interest you say you'd rather take ADs than a hormonal preparation long term - would this be ADs to treat menopausal symptoms? If so, why would ADs be suitable? (I know there are other drugs which can be used - is it vasosuppressors that can be used to treat flushes?) I just feel like I'd be uncomfortable with ADs with the side effects I've heard friends mention (weight gain, feeling kind of fuzzily cut off from your emotions) when I don't have depression, my hormones are just knackered due to age.

Yops without wanting to get diverted into a discussion of men's health (though it would make for an interesting thread), broadly I think I agree with you. Someone up thread brought up age discrimination, and I think it's a bit too quick an answer to say "GPs would hand out viagra without question." The one I always think of which doesn't get talked about is prostate trouble - not actual cancer, but the enlargement of the prostate which goes with age. I'm hoping things have moved on in the 15 or so years since one relative of mine was treated, but he had an enlarged prostate. Not life threatening, rather a quality of life issue (as with my menopausal symptoms): needing to pee in the night was disrupting his sleep, needing to pee in the day was limiting what he could do because he couldn't be too far from a public toilet. The operation commonly used to treat this causes impotence in 1 out of 3 cases. It did in his case. Now he doesn't think he made the wrong choice, but he and his wife were very sad to be pitched into involuntary celibacy for the last 10 years of their marriage till his wife died. And I get the impression that this is an issue that just isn't talked about. So yes, men's health and sex lives as they get older are minimised, but I'd say 10 to 15 years later than women's health and sex lives start to get minimised.

Someone up thread booed that GPs were reading. I'm a GP (female) and reading. There are risks and benefits as we all know. Personally I am happy for a woman to take an informed decision to continue past the age recommended in the guidelines. However in the last 10 or so years the tolerance of the regulatory authorities for doctors who act out with the guidelines has diminished so much that it is almost impossible to defend in court should something go wrong, whether the patient made an informed choice or not.

I and a lot of other women I'm sure, would be more than happy to sign a consent form, absolving the GP of any blame should something go wrong.

I can understand why many GPs will not prescribe it for older women. They are protecting themselves from potentially career damaging and hugely stressful litigation.

So the few women that are quick to sue the GPS are spoiling it for the many women that would benefit from HRT from age 60 and beyond!
That's a terrible state of affairs (for Doctor and Patient) when you stop to think about it.

Thank you for answering honestly as to why GPs are reluctant to prescribe it.
I suspected that all this 'risk' business had something fishy about it.

GPs not GPS

Meyes - let's say you signed such a form, and then died from a side-effect. You aren't really in much of a position to prevent your family from pursuing a legal claim, are you? You're dead! And do you think they wouldn't be able to find a lawyer who fancied making a few quid suing the NHS? All they have to establish is that you were not in possession of all the facts at the time of signing, or that you weren't in a fit mental state to make a rational decision. You were upset/depressed/in pain/clouded judgement. People in here have already admitted to these symptoms.

OwenMeany, lots of repeat prescriptions carry 'risks' of things going wrong and contra-indications.

LOTS of medication can cause kidney damage and liver damage when taken for too long.
Lots of people take repeat prescriptions for 'life' eg for blood pressure, thyroid meds, statins etc, for the rest of their lives.

Aren't Doctors worried that they could get sued if something goes wrong which is caused by those medications?

I wonder if it's because HRT is mistakenly seen as a 'lifestyle' choice as opposed to necessary?
Thinking aloud here

Yops, what's the answer then?

meyesmyyes, good point about the viagra.

Aren't you also worried that the next man you prescribed Viagra to will drop dead of a heart attack?
Aren't you worried his family might sue you?
(sorry for the constant Viagra references, but it's for comparison)

The point I'm trying to make is - why does it have to be a woman's medication that is targeted and put in jeopardy.

Out of the thousands of drugs out there - that ALL carry risks, why does the negative spotlight have to be on HRT in particular? - one of the few drugs around specifically designed to help women -and is being withheld because of this attitude*

Brilliant posts on this thread about Viagra and HRT.

myeyes youve made some excellent points. Surely Viagra is a lifestyle drug too.

Im 42 on Monday so may have to find out about HRT in the next few years.

Ive never wanted children and was refused sterilisation in my late 20s. "I didnt know my own mind"

In the past ive been on Combined Pill Norplant (early implant which was discontinued) Depo Provera contraceptive injection and the Mini Pill.

Ive also lost a lot of weight (i used to be obese) While on the mini pill i gained a couple of pounds despite sticking to the slimming world plan. Came off it and dropped half a stone.

The Mini Pill made me so bloated it was awful.

"how everything given to trans people is something that has been taken from women"

Sorry, I don't understand this comment from higher up on the thread

Is this a cost issue?

Apparently Pfizer's patent on Viagra expired in 2013. Suddenly the cost of a packet of pills to the NHS dropped by 93 per cent from £21 to less than £2. Co-incidentally, strict restrictions on GP prescriptions were lifted. Is HRT an expensive treatment?

I once asked a GP whether cost had something to do with it and he said that HRT (especially tablet form such as Elleste) aren't that expensive to produce.

I don't think it's cost.

As I said, I think the problem is that HRT isn't seen as 'necessary' in their eyes.
But it IS necessary to a lot of women. Mentally and physically.

Helenadove
myeyes youve made some excellent points. Surely Viagra is a lifestyle drug too.

Exactly.
If the argument is that repeat prescriptions for blood pressure, thyroid and cholesterol are necessary, regardless of the risks, because you could die without them is fair enough.
But if that's the reason, then why prescribe Viagra to men?

It could be argued that Viagra is a lifestyle choice.

After all, not getting a hard-on ever again isn't going to exactly kill you, is it?

If women's needs or wants weren't being met by GPs simply because they are women, and therefore less important, would this apply across all long-term drugs? What about the pill - is that difficult to get as a long-term prescription? It's a woman-only drug, and it's a lifestyle choice.

When I still lived in my home country my go was reluctant to prescribe the pill for me once I was over 25 as I smoked.

At 26 I needed to find a different method of contraception as the risk was just too high

That country has an NHS type medical system