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?

Gp not go obviously

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.

Yoni, the oral contraceptive pill is under fire at the moment as well.
So many women are being pushed bullied into having a mirena coil fitted.

The pill will be next. I wouldn't be surprised.

What, a tory government is cutting back on the NHS?

They'd have the pennies out of a dead man's eyes, as my gran used to say. I never voted for these bastards. I hope those that did are satisfied.

Myeyes IMO the Viagra comparison isn't right. Comparing something like KY jelly and Viagra is more accurate and then comparing TRT and HRT. if my understanding is correct, HRT does much more than just enable sex. Same with TRT, it will increase libido but it will help with a range of other things to.

Saying all that I'm not sure how readily prescribed it would be, especially to older men.

Mide one of the things HRT does is bring the female libido back to its normal level.

I think the comparison is completely fair as TRT is much more rarely used than Viagra is.

I'm 46 and although I have no symptoms I know the menopause isn't far away. Thankfully I have a new female GP who is the same age as me and is pro-HRT (she even joked we could go through the menopause together and compare notes). As relieved as I am to now have her as my GP, it shouldn't be luck that decides my fate for the next 20-30 years. I know my own mind, I saw my mother suffer for 15 bloody years and I don't want to go through that if there's something that can help me. I will accept any risks HRT brings for my quality of life.

I understand that Helena but it's one of the thing is does not the only thing. Same with TRT.

Whereas Viagra its sole purpose is sex related, same with a lube

My experience so far is that HRT simply returns libido to its normal level (rather than being switched off totally - which was my experience with peri - not all women find this by any means, some women go through menopause with their libido unaffected, others find it actually increases, which may be partly psychological due to being liberated from the threat of unwanted pregnancy).

As for cost, I think my current prescription is something like £2.15 per month to the NHS (my GP looked it up last time I was in to get the dosage changed), i.e. I actually pay more in prescription charges than it actually costs (NB I have no objection to that - that's the whole point of the NHS, to spread the costs and risks).

I am lucky with my GP - he takes me seriously and listens to me. How he will feel about me continuing to use it past my mid 50s, though, I'm not sure. (He may well be retired by then )

HRT would lead to an increased number of stroke victims in the population

What about the women who watch their diet carefully, and have their blood pressure checked regularly and find that it is always normal and therefore are not at high risk? Surely in these instances HRT can be taken for longer.

It shouldn't be a 'One Size Fits All'. It shouldn't be a case of,
'Some women over 60 are at risk of stroke - so therefore lets stop HRT for ALL women over that age'
Also, people age at different rates. Some 60 year olds can have the health and physicality of a 40 or 50 year old and vice versa. You can be an extremely young and fit 60 year old.
So you can't go lumping people into one huge at-risk age group.

^I would prefer to try an AD for menopausal symptoms.
they have very few side effects once they are established on them. Long term there are no known risks of cancer, stroke or heart problems.^

Long term use of AD's can (just like HRT can ) cause problems with the liver and kidney function. So by handing out AD's instead of HRT, you care cutting the risk for strokes, but increasing the risk of long term kidney and liver damage.

Also, HRT is known to 'protect' against heart disease - so you can take heart attacks out of the equation.

It also includes ibuprofen which was well publisised a few years back

I'm glad you mentioned ibuprofen.

A close friend of mine, who is 63, has the fitness and strength of a 30 year old. (in fact I would say he's fitter than most 30 year olds I know)
He runs the London Marathon every year and is the picture of health.

He had a very mild injury not so long ago and he found it laughable that the Doctor (because of Government woo woo Guidelines) wouldn't prescribe him Ibuprofen because he was OVER 60!

Once again, the British 'One Size Fits All' way of doing things is laughable. And wrong.
There is too much emphasis on trying to place people in set age 'categories'.

'They appear at present to be very very safe medications for the majority.'
'I don't think we fully understand how they work.'

And you really believe it's wise to prescribe such drugs long-term for what they were not originally created?

Wow. Just wow.

'A prescription for an AD is not just to try and help someone cope with menopausal symptoms, it can actually improve them.'

So a woman who presents with menopausal symptoms can stand a little 'improvement' with these drugs that are designed for . . . depression and to act on . . . the neurotransmitters in her brain.

Hot flashes? Night sweats? Be improved, ladies! You are probably a crabbit old coo, too.

'I think it's a shame if it seen as a failure to choose this treatment rather than HRT on the part of the patient or doctor.'

That's right, ladies: you don't know what is best for you. It's AD's, not HRT.

I have no idea what the nhs is like for men. I do know that nearly every interaction I have had with it has been patronising, belittling, dismissive- and where it has concerned anything involving any specifically female parts of me, all that with bells on

I am 40, and HRT looms imminently for me

How about a Mirena coil, chibi, it really works for everyone ! And have some ADs, too. Now go away, it's all in your head.

yes chibi, you can have a mirena coil and stuff yourself with AD's when you reach the menopause. But make sure you stay away from Ibuprofen once you hit your 60th birthday.
But HRT and (Ibuprofen) is the work of the devil. It's D A N G E R O U S!

I think you've articulated my thoughts on the matter precisely, Expat. Menopausal symptoms are caused by a drop off in the body's normal hormone balance. Surprise, surprise, the symptoms go away when you put the hormones back in. Of course, there are some risks - because these hormones are associated with increased risks of breast and ovarian cancer and strokes. But to say "hey, let's use ADs instead" when (as you point out, ADs act on neurotransmitters in the brain) smacks rather of that age-old tendency of the medical profession to assume that any physical issue women present with has in fact got some sort of psychological component.

I know that sometimes drugs turn out to have unexpected uses in other areas (and this can cause problems for medical practitioners because as soon as you're using a drug to treat a condition that the drug company didn't run clinical trials on, you're opening yourself to a whole heap of litigation possibilities - funny that you don't mention that in connection with using ADs to treat HRT, Owen, when you're so anxious to stress that doctors don't want to prescribe menopausal after 55 because of the threat of litigation - I'd have thought that if litigation was a genuine worry it would apply in both cases). So it's not beyond the bounds of possibility... but you do have to remember that the medical profession has a really, really bad history of dismissing women's concerns as psychological (from Hypocrates and his wandering wombs through 19th century diagnoses of hysteria to pushing valium as "mother's little helper" in the 60s and 70s). So I, like Expat, am deeply suspicious that there's a subtext of "menopausal symptoms - all in the mind, silly little women" - going on here.

hooray can't wait

Why did you take my comment personally?

My experiences with the nhs thus far have involved being told to to complaining about pain, I couldn't possibly be in any as I wasn't in labour, that I couldn't have any pain relief during labour as the doctor needed to see how much pain I was in, that my recurrent severe anaemia did not require any investigating- 'you're tired? Welcome to being a mum!'...

I have had other positive experiences but far fewer. I think my assessment of my experiences is fair. If you don't patronise or belittle your patients by refusing to take them seriously or bother investigating their symptoms, then good for you.

I wish the gps at my surgery were the same

Sorry Owen, I guess it's just that ADs are a particularly sore point for me as several friends and family members have been mis-prescribed them, and I'm old enough to have seen what my mother and her friends went through in the 70s with many doctors' attitudes to women - it sometimes felt (wild over exagerration for comic effect alert) that you could go to the doctor for an ingrowing toenail, and if you were female you'd come out with a prescription for valium (which I know is not an anti D but was used to treat not just depression but just about any sort of expression of dissatisfaction with one's lot in life back then). So I guess I'm pretty jumpy about ADs. And even friends who've been on them for depression and found them very effective treatments have said they do strange things to you. One friend who was on much needed SSRI treatment suffered a bereavement and said she felt almost as though she was watching her grief through glass rather than experiencing it, and this to her felt unhealthy because in these circumstances grief was what she felt was a healthy reaction (very sensibly she didn't come off the SSRIs because she knew she needed them for other reasons). But it would make me very wary of accepting a prescription for them rather than a prescription for HRT.

And it is undeniable that there is a difficult history regarding the medical profession when it comes to paternalism and dismissing women's issues, and sadly, individual doctors have to remember that history is there and will have affected how some of their patients view health care professionals even if the particular doctor they're facing right now doesn't have those attitudes themselves.

I've been thinking about this a bit more.

I mentioned upthread that I'd had hyperthyroid at one point. Now, listed in the symptoms for this just about anywhere you check is "anxiety" (obviously there are a whole lot of obviously more physical symptoms - palpitations, shortness of breath, hot sweats, visual disturbances). When I was suffering from it, it always struck me that "anxiety" wasn't the right word. It had some superficial similarities - that whizzy, engine over-revving while in neutral feeling of your thoughts going too fast, but without the affect - the thoughts just cascaded over you, not in any particularly upsetting or worrying way, as would be characteristic of depression.

I wonder if it's the same with the mental symptoms some women get with menopause. I think I used the phrase "attack of can't be arsed-itis" to describe one of the effects I suffer when I don't have enough oestrogen. Now of course, depression can lead to this too - but in my case the underlying cause isn't depression (in the sense of some sort of neurochemical imbalance), it's hormonal. So I wonder if it's the superficial similarity to one aspect of depression that makes it seem appropriate to treat it with ADs? But to my mind it seems much more sensible to treat the underlying endocrine imbalance.

(I know menopause is a "natural" part of the ageing process rather than an illness, but just because something is part of the ageing process doesn't mean it's not something you might want to mitigate if you possibly can. I read one evolutionary biologist put it this way: there are lots of evolutionary adaptations which are beneficial to the young organism at the cost of being detrimental to the old organism, because if you think of the risk of death by accident as being reasonably constant throughout an organism's life, this alone will mean you always have more organisms in the younger age groupings than you do in the older ones - so if you want to pass on your genes efficiently, being a healthy youngster is much, much more important than being a healthy octagenarian. So just because something happens to us "naturally" as we get older doesn't necessarily mean it's a good thing, it could be one of these trade-offs).