Can I ask how you would resolve this dilemma? Did any of you older ladies think that this whole business should be over soon and be tempted to stick it out, and if you believed HRT was still necessary how did you arrive at that decision?
Kathleen I know exactly how you feel - well almost! The dilemma part anyway. The difference between you and me apart from a few years in age (I am 63) is that the same dose of oestrogen stopped all my flushes and sweats from very soon after I started HRT (in late peri-menopause at age just under 54) - and they have stayed away. Also last time I had my oestrogen levels measured they were 200 and something pmol/l - so this explains the difference - even though we all have different optimal levels to banish symptoms and to feel good.
The other difference of course - which we have discussed before is that you are not only on continuous combined HRT but also taking a synthetic progestogen - which although it is not known to impact on actual oestrogen levels - may well attenuate oestrogen's beneficial effects to some extent - notably flushes and sweats (although your sub-optimal oestrogen levels speak for themselves).
Women talk about being through the menopause and symptoms working themselves out - but it is a truism that oestrogen deficiency lasts forever as we have discussed many times. The vaso-motor symptoms (of flushes and sweats) may or may not diminish at some point after withdrawal from HRT, but any long term health consequences of oestrogen deficiency may become more apparent and have an effect on your health. However you cannot take away the beneficial years you have had while on HRT so - it could be that you have already delayed any negative effects until much further down the line!
The dilemma is really only a problem for those of us who still have a womb (discounting other specific factors which might affect why women might choose to stop HRT) - because we have to decide - in your case whether to go on taking cotninuous combined HRT long term - and that is with the progestogen, or in mine and several others of us in our 60's - how long we are prepared to continue having a withdrawal bleed though cyclical HRT.
If you've had a hysterectomy - the decision is pretty straightforward provided you are generally healthy and don't have any other risk factors.
I am wondering exactly the same - when do I stop? When do I start to reduce? What will I feel like? How will I cope? How long before I feel anything like normal again? In my case I introduced testosterone into the mix - due to incredible tiredness, and muscle aches and pains after exercise - and I don't want to be condemned to a life of pains and exhaustion or a diagnosis of CFS or similar - as Ju Ju was threatened with - if these symptoms return. I don't want to lie on a sofa not exercising and mopping my brow!
I don't see why you should not try a slight increase in HRT - or at least perhaps try a cycle. I know you tried a different type for a while (estrogel? - but didn't get on with it?) - but I would strongly recommend changing to Estradot 50 mcg - the same dose as Evorel and perhaps Utrogestan. Could you bear to go back to a cycle - perhaps a longer cycle - and have a bleed? It's really not that bad and worth it not to have to take progesterone all the time. I actually slightly increased mine recently - only because I didn't want to become testosterone dominant (androgenic side effects) so I've added 12.5 mcg to my dose (by judicious snipping of patch!).
It also depends on your work situation - as you won't be at retirement age for a while? I still work part-time and there is no way I could countenance the lying about brow mopping lark!!! I need to use lots of energy in my work when I am out so have to be on top form.
You are still young (in my eyes) so changing or increasing slightly cannot do you any harm if you are otherwise healthy, fit, good shape and don't have other health problems - well at least the risks are lower than other lifestyle factors - being overweight, smoking, drinking too much alcohol, poor diet etc.
I haven't decided yet what/when to reduce and how to do this along with the testosterone - (without becoming too hairy
).
linz57 - I can't remember how old you are (?57) but if you've only recently started HRT and it hasn't stopped the symptoms then definitely increase the dose - I mean there is no point taking it if you are still suffering. The idea is to improve quality of life. 50 mcg is not a high dose anyway - it is the standard medium dose for post-menopausal women (as you can see from the conti patch doses) - especially I imagine those who went through menopause at or beyond the average menopausal age.
Just a few thoughts and a bit of a ramble but hope some of it is helpful. I don't really have any answers - but I do think it is important to feel well now - rather than worry too much about the future. It's not as if you are on 3 or 4 pumps of gel with oestrogen levels at 500 pmol/l or more. This would be difficult both to maintain and to reduce from I imagine, if you still have a uterus.
Hurdity x
