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[Dancinggirl]

Brightlight - I think your last post is pretty accurate. As I intimated to you before, menopause in the mid 40s is not necessarily premature meno but is an early menopause so for you HRT is not essential. There is now strong evidence that 5 years of HRT, beyond our natural menopause and before the age of 60, will give a protective element for the long term health of our bones and heart.  I believe that oestrogen has a positive effect on the way we process fat which means our arteries don't fur up so much.  Once we are post menopause we need to be particularly careful about fat and cholesterol whilst still getting enough calcium for our bones. This is why I am slightly baffled when a women's blood pressure goes up a bit and they immediately told they should come off HRT.  Many enlightened GPs will simply give blood pressure drugs alongside HRT.
There is also evidence of a reduced risk of bowel cancer if HRT has been used for a few years - I have recently encountered 2 ladies in their 60s who have been diagnosed with bowel cancer - neither used HRT.  Many women report that digestive problems like Crohns, IBS etc will often improve when on HRT (although this is mostly hearsay from women on this site).
Sadly the press have loved all the scary elements of risk with HRT, which under the age of 60 doesn't really apply and in fact the many benefits are underplayed. This is not to say all women should take HRT or will need it but I hope we will see a day when HRT will be routinely offered as a preventative as it could save the NHS a great deal of money in the long run and give us all a better quality of life in our later years.
It is now routine to give a flu jab to everyone over the age of 60  - I'm sure we will see a great many more things introduced as preventatives - whether we choose to take these things will still be a personal choice.
I would also like to point out that when I mentioned about problematic vaginal atrophy and urinary problems in a previous post I was not implying that you would get these things (many women don't get any problems in this way).  However, it does seem that those, like me, who have suffered oestrogen deficiency too early are perhaps more prone.  I took a break from HRT from 49-53 years of age and my VA problems really escalated during this time and unfortunately I doubt I can reverse this damage but merely manage it with ongoing oestrogen treatment.
I discovered this site about 18 months ago and it has been a wonderful source of information and support - I feel so much more empowered to do what is right for me - I hope you are beginning to feel the same.   DG x

[peegeetip]

Hi DG,

a very good post.

However one thing to take from your comments.

"I'm sure we will see a great many more things introduced as preventatives"

Two things in relation to this.

Peoples general attitude to peri/meno being just one of those things (rather than a true condition/illness to treat) means that we have some way to go before people truly realize the preventative benefits you mention.
Its a bit like the way we now treat late onset type two diabetes.
Type 2 will not kill you but it lowers your quality of life.
Until recently that was also pretty much ignored and not treated.
I have no recall of anyone even mentioning type 2 till recent years.

To fix a problem often we have to agree that we have a problem in the first place

There are also risks that products will diminish as some companies realize the cost and distribution is not worthwhile.

We have already seen this in the UK with testosterone patches "for ladies".
These were removed from the market for commercial reasons.
Basically very few gp's prescribed it to ladies with Hysterectomy or Peri/Meno issues that might benefit from a boost in testosterone.
Use it or loss it in effect.

I hope we see things going the way you describe soon too and hopefully NICE will help with that too soon.

 

[Dancinggirl]

Good points peegeetips.  Dg x

[BrightLight]

I really agree that hormone therapy will become commonplace in the future - for all sorts of reasons. It is becoming clear that the balance of our bodies - including blood sugar levels etc are run by systems that need fine tuning and ultimately will prevent major disease in the long run.   

I don't agree than menopause is an illness - I do think that it has become a problematic time for many reasons and those must have something to do with longer life span, the way we live our lives, the stresses from environmental and food factors. 

On the plus side, hormone therapy and the understanding of it's role is amazing, the reasons we need it in our modern world are also interesting to me - we can balance things out with medicine, which is fantastic, though there must be other factors in our evolution that mean these balances in our bodies are becoming problematic.............?

It's all very fascinating.

[Dancinggirl]

To be very controversial - one could argue that because it is no longer a matter of survival of the fittest our gene pool is weakening so certain genetic traits will be more prevalent. My grandmother and mother both had premature menopause - I got those genes but my sisters didn't. 
External factors naturally play a part e.g. it is thought that because teenage girls produce so much more oestrogen than in the past and the use of the contraceptive pill is encouraged, our water is now quite oestrogenised and this is thought to be reducing fertility.  Our desire to keep everything hygienically clean is giving rise to more allergies.  My brother-in-law is a leading gastroenterologist and he actually encouraged his young twin sons to play with mud to trigger their immune systems.
We are complex beings and I think it is inevitable that more health and physical problems will emerge. We all have to die of something but while we live we just want a good quality of health. DG x

[purplenanny]

.  Our desire to keep everything hygienically clean is giving rise to more allergies.  My brother-in-law is a leading gastroenterologist and he actually encouraged his young twin sons to play with mud to trigger their immune systems.

My son has just built a mud kitchen out of palletts in the garden for his twin sons. I will have to let him know how good it is for them DG.
 PN x x

[Hurdity]

Quick reply to yours Dancing girl ( although there have been lots of posts since yesterday so need to go back over them all too!) - it's not at all controversial - it's a fact. Medicine clearly and desirably saves people's lives who have conditions/diseases etc that they would previously have died from or would not have been able to reproduce, so many "less favourable" ( in terms of health) genes will survive and be passed on.

Hurdity x

[Hurdity]

I started the patch as a precautionary. Since then I have read all I can about bone health and its known that it takes lot less estrogen (only one of the protectors, and even then that has been challenged) for bone health, hence Menostar.

Regarding this specific point - the bone protective effect of oestrogen on bone mineral density is dose dependent so while it is true that a small amount of oestrogen will confer some protection - ie better than nothing, it will be far far less than a larger dose, and as I think peegeetip said earlier, only doses of 50 mcg patch are licensed to protect against osteoporosis. This will be based on clinical trials and percentages of women protected - and this won't be 100 % either, so even with 50 mcg patch you can't categorically say you won't get osteoporosis.

Hurdity x

[Hurdity]

There is even controversy as to whether HRT does protect you from heart disease.
 

Just a quick point about this ( in a hurry now!). The paper published for World menopause Day which I keep referring to says this:

For healthy women aged 50-59 years, estrogen therapy decreases coronary heart disease and all cause mortality; this interpretation is entirely consistent with results from other randomized, controlled trials and observational studies.

Sorry don't have time to elaborate but I would say that speaks for itself!

http://www.imsociety.org/downloads/world_menopause_day_2014/white_paper/wmd_white_paper_english.pdf

Would be interested to know where this is disputed?

Hurdity x

[scriv]

Just a slight deviation here for a moment - when I was resisting HRT after menopause at 39, my doctor at the time (a male) kept me in the surgery for about 30 minutes to try to persuade me to try it!

I was argueing that I wanted to do it naturally and he was getting extremely exasperated and burst out that I was misguided about my loyalty to nature and did I not realise that I was 'on nature's scrapheap' now that I had outgrown my biological function of having my children and did I really want to end up in a wheelchair in my 50s!

Well, I thought!!! I was amazed at the strength of his conviction.

Incidentally, I did then agree to use it. I had tried HRT whilst in peri menopause and it was very hard to get it right and I felt awful on it. When I used it post menopausal, it seemed easier to get the right dose/method. I settled on a patch for the oestrogen and 14 days of a progesterone which I tolerated well. This was all over 20 years ago!

[Dancinggirl]

Wow scriv - a doctor who really had your best interests at heart.  Most doctors wouldn't bother to give such strong advice.  I was 37 when my GP sent me for the DEXA scan and then simply said "If I was her daughter she would insist I take HRT". I was in quite a bad state mentally at the time as I had recently been told my son had a language disorder that put I'm within the Autistic spectrum and I was having counselling to help me cope.  I was lucky to have a GP who was experienced, mature and that I could trust. I did as I was told and started HRT but like you I struggled to find the right HRT preparation for me for some time.  Oh Boy am I glad I followed the advice and persevered.  DGx

[honorsmum]

Blimey, Scriv, what a nice way he had of putting it! 
Still, the truth can be brutal and it obviously had the desired effect.

[Dandelion]

I started perimeno at 42 but did not use HRT till age 47 because I did not know I was menopausal and mistook the symptoms for other things.

No doctor has ever told me my heart and bones may be compromised.

Hi there - I just wanted to clarify that it's possible I have early menopause, which is classified as stopping periods before the age of 45 and some women stop even earlier in their 20's and 30's - in these situations the loss of estrogen hormones so young can increase your risk of bone strength and heart disease.  So you don't need to worry as it sounds like you are experiencing a natural menopause at the usual age

Hi, I think I had early perimenoause, cos even though my periods were still there, i was flushing etc My current hrt has really helped the flushes although some still come.
I am a bit concerned about the 5 years I was not on hrt.

[honorsmum]

I started perimeno at 42 but did not use HRT till age 47 because I did not know I was menopausal and mistook the symptoms for other things.

No doctor has ever told me my heart and bones may be compromised.

Hi there - I just wanted to clarify that it's possible I have early menopause, which is classified as stopping periods before the age of 45 and some women stop even earlier in their 20's and 30's - in these situations the loss of estrogen hormones so young can increase your risk of bone strength and heart disease.  So you don't need to worry as it sounds like you are experiencing a natural menopause at the usual age

Hi, I think I had early perimenoause, cos even though my periods were still there, i was flushing etc My current hrt has really helped the flushes although some still come.
I am a bit concerned about the 5 years I was not on hrt.

I don't think the age you go through perimenopause matters, does it?
Since it can last 5 to 10 years, and menopause over 45 is not seen as early, a woman could well start peri at 35 and it not be "early".
I'm 45, still having periods but they are fluctuating in frequency and length, and I'm getting other peri symptoms which I'm hoping HRT might help.

[Hurdity]

Hi janm

So glad to hear you are healthy and well!

Sorry to hear you have experienced lecturing about a life of misery without HRT, and that you also feel that somwehere ( where?) there is an evangelical crusade to get women onto HRT!

In fact from reading on here I feel many women's experience is quite the opposite - that doctors are often more ready to prescribe anti-depressants than HRT for menopausal symptoms, rather than crusading for its use, and urge women to remain on it for the shortest possilbe time!

As I said maybe on this thread or another - an individual woman's experience is interesting, but cannot inform us about risks and benefits, short or long term, which is where the science comes in - not a matter simply of opinion but evidence based, through studies & data.

I like to think that those of us posting on here are giving a balanced view by linking to the most up to date information as it comes to our attention mostly through this site or by general reading - from the expert gynaecologists and researchers. The fact is that yes it is a questions of statistics and trials which can help women make up their own mind as to what they are prepared to risk in terms of future health. As you say - it is your decision but must be based on what is currently known.

I don't remember reading anywhere that women are condemned to life in a wheelchair without it, but scriv's experience was quite extreme although had the desired effect! As I've said several times before recently - do you want to do the experiment on yourselves - because once done it can't be undone eg go through an early menopause, try without HRT for 20-25 years and see what happens? Of course many women will be fine - but what if you were going to be one of those who weren't?

I am sorry that you tried several HRT types which gave you worse symptoms than without it - and I think womenin your position will have more difficulty in deciding to stay on it, - ie those who have an early menopause, do not have bad menopausal symptoms, and experience worse symptoms on HRT than offit - I can imagine it would be difficult to be persuaded to continue! Often this can be remedied with a different type and it's a pity that some doctors aren't sufficiently knowledgeable about this!

I hope you continue to experience good health! 

Hurdity x