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Author Topic: Do I have to take HRT ?  (Read 3557 times)

coldethyl

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Do I have to take HRT ?
« on: February 09, 2016, 05:08:12 PM »

Not sure what I'm asking really but I'm curious to know the downsides of not taking HRT if I'm going through the menopausal transition at the usual age. I'm 50 next month and have been having symptoms on and off for three years, increasing since last autumn. Between Xmas and new year the anxiety was unbearable but that seems to have eased and I'm doing CBT and Mindfulness and psychodynamic therapy to help with it, so the main symptoms I'm now experiencing are the flashes and night sweats and erratic cycles. As I suffer from migraine with aura and have endometriosis I'm reluctant even though my latest GP mooted the possibility of HRT, but I do wonder if I'm storing up issues for later as both my gran and mother have osteoporosis. Thoughts? I'd like to muddle on as I am really but all the talk on here of shrivelling lady bits and prolapses etc. freaks me a bit. X
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Joyce

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Re: Do I have to take HRT ?
« Reply #1 on: February 09, 2016, 05:23:09 PM »

It's your choice really. If you feel you can cope without HRT, then that's brilliant. Have you taken a look at alternatives section, that might help. HRT isn't for everyone for various reasons.

I had same worries about shrivelling lady bits, VA, osteoporosis. I was told that I could help for the first two & to take calcium supplements for osteoporosis.  I'm still using HRT, but on a very low dose.
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Lizab

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Re: Do I have to take HRT ?
« Reply #2 on: February 09, 2016, 05:55:09 PM »

Cubagirl, what is to be done for the first two besides hrt? I'm only 39, so I believe I need hrt for other reasons, but honestly, the only physical thing that worries me is the shrivel in and VA potential.
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Joyce

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Re: Do I have to take HRT ?
« Reply #3 on: February 09, 2016, 06:23:34 PM »

GP didn't say but from reading this forum local oestrogen would help things. I'm lucky so far, but sure one of the ladies on here  with more knowledge will keep you right.
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Hurdity

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Re: Do I have to take HRT ?
« Reply #4 on: February 09, 2016, 06:51:12 PM »

Hi coldethyl - no-one has to take HRT but we all balance the pros and cons, risks and benefits, quality of life etc, depending on our own medical history, family history, our jobs, our general health and well being etc.

So - in your case - if there is family history of osteoporosis and you have been peri-menopausal for some years then you may be at increased risk of this.  How long your cycles have been erratic will give you an indication of how long you have been in peri-menopause and how much oestrogen you might have been lacking. If you are worried about this in particular you should be able to ask your doctor for a DEXA bone density scan. I expect you've already looked up about osteo but there is basic info on this site (middle health tab above - which also gives the risk factors http://www.menopausematters.co.uk/osteoporosisrisks.php). There is also the National Osteoporosis Society website. Calcium supplmenets alone won't prevent osteoporosis but are obviously important as well as weight bearing exercise.

For those with early menopause then HRT is advised to help protect against osteoporosis, until the average age of meno of 51/52.

Having migraine with aura is not a contra-indication for HRT - transdermal HRT is recommended instead.

Migraine   
    Migraine is often triggered by hormonal fluctuations and therefore may occur around the time of a period. Such migraine may improve at the time of the menopause. Some women find that migraine may be triggered by the daily hormone fluctuations which can occur with oral (tablet) HRT so the transdermal (patch or gel) route is usually preferred with a history of migraine.

http://www.menopausematters.co.uk/atoz.php#GlossM

If you have endometriosis then this can be problematic but you can still take HRT but you will need a continuous progestogen - and this is what sometimes causes more of the side effects with HRT, This is what it says:

There is a small risk of reactivation of endometriosis with HRT use and any recurrence of symptoms should be reported. If a hysterectomy has been performed for endometriosis, the choice of HRT use thereafter should be influenced by the extent of endometriosis at the time of the operation. Since hysterectomy often causes a premature menopause, it is often advised to take HRT until the average age of the menopause; 51 years. HRT after hysterectomy usually consists of estrogen only. However, in the presence of endometriosis, estrogen may cause stimulation of residual deposits and consideration should be given to using continuous combined (estrogen plus daily progestogen) therapy, or tibolone, though little research has been done on the effect of different types and duration of therapy. Medical treatment of endometriosis often involves ovarian suppression which, along with ovarian removal, may increase the risk of osteoporosis.

http://www.menopausematters.co.uk/atoz.php#GlossE

I would suggest you ask for a dexa scan and take it from there.

Almost all women can take local oestrogen for the "shrivelling lady bits" for an indefinite period so if you are suffering here then also ask your doc for Vagifem or similar!

Hope this helps :)

Hurdity x
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Meeka

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Re: Do I have to take HRT ?
« Reply #5 on: February 09, 2016, 06:52:24 PM »

Not sure what I'm asking really but I'm curious to know the downsides of not taking HRT if I'm going through the menopausal transition at the usual age. I'm 50 next month and have been having symptoms on and off for three years, increasing since last autumn. Between Xmas and new year the anxiety was unbearable but that seems to have eased and I'm doing CBT and Mindfulness and psychodynamic therapy to help with it, so the main symptoms I'm now experiencing are the flashes and night sweats and erratic cycles. As I suffer from migraine with aura and have endometriosis I'm reluctant even though my latest GP mooted the possibility of HRT, but I do wonder if I'm storing up issues for later as both my gran and mother have osteoporosis. Thoughts? I'd like to muddle on as I am really but all the talk on here of shrivelling lady bits and prolapses etc. freaks me a bit. X

If your worried about the osteoporosis you could have a dexa scan which would reveal any problems.  You could then monitor the situation with scans.
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babyjane

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Re: Do I have to take HRT ?
« Reply #6 on: February 09, 2016, 07:23:08 PM »

I have not taken any HRT apart from Vagifem for the discomfort of VA.  I am not too worried about the shrivelling but the Vagifem has dealt with the feelings of cystitis and thrush all the time which were very unpleasant. My mother had a hysterectomy aged 38 and HRT was not offered back in those days. I don't think she found it easy but had no osteoporosis and she lived to 82. I don't think osteoporosis is a given but, of course, some could develop it who take HRT and others don't. My own 3 yearly DEXA scan does not show any osteoporosis.  You cannot take other ladies experiences as a benchmark for your own I don't think.
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coldethyl

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Re: Do I have to take HRT ?
« Reply #7 on: February 10, 2016, 12:32:50 PM »

Thanks ladies, lots of food for thought. Will have chat with my GP when I have follow up appointment in five weeks.
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Dorothy

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Re: Do I have to take HRT ?
« Reply #8 on: February 10, 2016, 04:32:46 PM »

Your body, your health, your choice.  Weigh up the advantages and disadvantages, bearing in mind your own & your family medical history and choose what you think is best for you.  No one 'has' to take HRT - I have a friend with early meno age 39 who is refusing to take anything - I don't agree with her choice but I respect her right to make it!

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coldethyl

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Re: Do I have to take HRT ?
« Reply #9 on: February 10, 2016, 04:41:50 PM »

If I were suffering from an early menopause, I'd certainly be more inclined to take something but as I'm pretty much on the average age for all this nonsense, I'm more inclined to see how it pans out itself. I've noticed tha give been having more symptoms that I recognise as endometriosis stuff recently which suggests I'm experiencing oestrogen highs as well as the lows and makes me reluctant to add anymore into the mix. My GP muttered something about no bleed HRT but that seems risky given I've a womb so I think I'll be sticking to doing nothing at the minute for as long as I can . Thanks x
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Hurdity

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Re: Do I have to take HRT ?
« Reply #10 on: February 10, 2016, 04:45:08 PM »

..but whatever you decide do go along first and get a DEXA scan though re the possible osteoporosis since HRT will slow down and help prevent the accelerated bone loss which occurs at menopause - whatever age that is, since if you live to 90 that's a long time without oestrogen if you are at risk.

Hurdity x
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coldethyl

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Re: Do I have to take HRT ?
« Reply #11 on: February 10, 2016, 04:57:47 PM »

Will chat about that to GP when I go in few weeks as I know my gran ended up immobile for the latter part if her life as her spine crumbled away. X
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