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[Dediva Ann]

Thanks very much Freckles    Very helpful and I will do some more research.  My next HRT review is not until end of October but might see if I can bring it forward.  Have been wondering for a while if the oral route is not for me and this post has precipitated that thinking.

Your informed wisdom above has also been very helpful reading. 

[Petra]

Dang! I have an appointment with my GP tomorrow for a 6-month script renewal. I'm in NZ...every time I go, I get the disapproving look and the suggestion that I quit. Not a gun-rights nut, but I repeat the NRA bumper sticker to myself with a substitution: "I'll give you my HRT when you pry it from my cold dead hands". We don't have the same drugs...here, I'm taking, daily two pills: (1) Progynova (estradiol valerate) 1 mg and (2) Provera (medroxyprogesterone acetate) 2.5 mg. I would welcome any insights people have into this regimen re the latest study...or any observations really. This is funded here, and I imagine if I wanted to branch out and try something else, I'd have to pay the full cost. But I can't say I have much understanding of the different combinations etc. Meanwhile, I'll be looking out for more detailed reviews of the study. I feel like HRT saved my life...

[hotstff]

Unfortunately, I think those of us who wish to continue, because the benefits outweigh the risks, will have to go private and get prescriptions off gynecologists, who seem much more clued about HRT than your ordinary GP, who are prone to falling hook line and sinker for scare stories.

Lets all stop eating eggs while we're at it, after all, they're extremely dangerous.  There was a study and all, it's been in the newspapers, It must be true!
Oh wait , that was a load of bull**** 
Just like this is, I suspect.

[hotstff]

I'm joking on the outside, but inside I feel like crying at this latest news.
Seriously. 
Why is society so anti-HRT?  Are they anti -older women?   (because it feels that way) 
I'm fed up with constantly having to fight for something that improves my quality of life.

[Freckles]

You are welcome DeDiva Ann.  I found the whole issue of HRT is really confusing at first, but once  you read some informed posts, things do become clearer. Personally I'm not a fan of oral (tablet) HRT and transdermal (gels or patches) are consistently shown in clinical research papers as being a far safer and more effective treatment option.  Why GP still prescribe HRT oestrogen tablets is beyond me, other than they are a bit (but not much) cheaper than Oestrogel and often a lazy option to prescribe.
I was so frustrated with Femoston doing nothing for me, I ended up seeing Professor John Studd privately, as my GP just wanted to give me antidepressants instead.  Even if you don't see him, his web site has some really useful articles and information on HRT you can read. Quick Google will show his web site.
Do read up on the posts though and any links - knowledge is power!
Good luck and keep us updated?
 

[Mary G]

First class post Freckles, brilliant!

I've just watched BBC News at Ten and they made it quite clear, the risks of using oestrogen only HRT are the same as for women who do not take HRT.

They know where the risks lie so they now need to deal with them and change the progesterone doses and delivery method. 

[sweettooth]

Hi ladies, don't often post these days but felt I wanted to post on this topic as I know it's such a important one.

I was diagnosed with bc 2014 by routine mambo, I was on hrt for 13yrs -7 of these on estrogen only as had hyster.  I will always wonder if hrt played a part but it was the right thing for me all those years as I had horrendous symptoms.  It is easy for people to judge against hrt but for some it is a life line.  If anything estrogen probably makes cells develop more rapidly but not actually cause it.

Thankfully mine was caught early but I do still struggle with memo symptoms and have had to give up work.  I would say it's a decision made according to ones symptoms and their quality of life and remember it is not JUST women on hrt who get breast cancer...I miss it😘

[Freckles]

Thank you DG and Mary G! Much appreciated.
They *should* improve treatment options regarding progesterone but they (both pharma companies and the NHS) won't as:
a) they don't care;
b) it will cost money;
c) women with HRT aren't a particularly lucrative group for drug research and we don't overtly cause future problems for the NHS re costs for health problems (but of course we potentially do, re heart, osteoporosis, psychological problems, etc., if incorrectly treated)
d) they don't care- oh, already mentioned that ....

[Freckles]

Hi Petra,
The HRT drugs mentioned on here are fully available in NZ- it's just the trade names that vary.

As you will gather, I am a huge fan of the Oestrogel and Utrogestan regime, rather than oral (tablet) HRT. I found it life changing compared to the oral HRT I was on.
I have briefly  lived in NZ and can't quite remember how the health system works although I remember it was a mixture of public and private health care .
Private prescriptions for the Oestrogel and Utrogestan regime vary here in the UK according to the pharmacy but I paid £70 for three months supply, including a small amount of Testim (testosterone) gel after I first saw Prof. Studd.  Have a look online for NZ to see what the charges are?
I'd suggest reading as many posts as you can on the forum so at least you can make an informed decision about treatment options.
And as many on here will testify, don't be fobbed off by a GP who is intellectually, clinically or often emotionally, challenged about HRT and the best treatment regime to offer.
It's your body, your life and your choices about the quality of life you want.

[Dediva Ann]

Thanks Freckles.  I've often wished I could see Prof Studd but sadly can't afford it.  My GP does her best within the constraints of the NHS and I'm really hoping she'll be happy to switch me to gel or patch. I think she's also going through the menopause as been very interested when I've shown her posts from here before.  I did ask my (male) GP if testerorone was available for women on the NHS as I am desperate to get my libido back (very long story but as a full time carer to Mum from 5 -46 my sex life didn't really begin until three years ago and I feel hard done by!) and he said "some old fashioned gynaecologists might still prescribe it but it was far too risky and caused a) b) c) etc." I can't bear the thought of being condemned to a life without desire.  Will report back.  Thanks so much for yours and everybody's input, experience and advice.

[Dana]

Dang! I have an appointment with my GP tomorrow for a 6-month script renewal. I'm in NZ...every time I go, I get the disapproving look and the suggestion that I quit. Not a gun-rights nut, but I repeat the NRA bumper sticker to myself with a substitution: "I'll give you my HRT when you pry it from my cold dead hands". We don't have the same drugs...here, I'm taking, daily two pills: (1) Progynova (estradiol valerate) 1 mg and (2) Provera (medroxyprogesterone acetate) 2.5 mg. I would welcome any insights people have into this regimen re the latest study...or any observations really. This is funded here, and I imagine if I wanted to branch out and try something else, I'd have to pay the full cost. But I can't say I have much understanding of the different combinations etc. Meanwhile, I'll be looking out for more detailed reviews of the study. I feel like HRT saved my life...

Hi Petra

I'm in Australia, so we probably have similar HRTs. You might find the Australasian Menopause Society website helpful as the information is more relevant to us in regards to the different types available. They specifically show the types available in NZ.

http://www.menopause.org.au/for-women/information-sheets/426-ams-guide-to-equivalent-hrt-doses

I agree with Sunnydays that there is no real consistency with the amount of progestogens needed for a particular dose of estrogen. However, it depends very much on the individual woman, so it is very difficult to have a set dosage rule. It really comes down to trial and error, and this is one of the reasons why I prefer Provera to Utrogestan which is very inflexible with doses.

I use a 50mcg patch which is a medium dose, and I take a 5mg Provera tablet for 12 days every two months. That works really well at keeping the lining at bay. Sometimes I even wonder if I took 2.5mg for 12 days if that would be enough as well. I also toy with the idea of trying a continuous method, where I would take 2.5mg Provera every day, but I'm nervous about how taking it every day will effect me.

The other option I may try next year is to take 5mg x 21 days a month, giving myself a break for the rest of the month, to see what effect that has. It might be enough to keep the lining thin enough so I don't get a period, or it may make no difference at all.

[Dr. Heather Currie]

While this study reported today is good for an observational study, it is still an observational study and hence has biases. The overall information does not tell us anything new and nothing that was not included in the NICE guideline.
Some important points to consider:
1. The associated risk returned back to baseline within 1 to 2 years after stopping HRT, confirming the view that HRT does not CAUSE breast cancer, but that it may promote the growth of cancer cells which are already present in some women--it can act as a promoter, not an initiator. This is a really important message since many women fear that HRT causes breast cancer.
2. The NICE guideline did in fact take into account the fact that previous observational studies may have underestimated the risk so NICE recommendations are still very relevant.
3. There is evidence that different progestogens may be associated with a different risk, types increasingly used today were not the main types used in this study.
4. While trebling of risk sounds very alarming, the actual figures are still very small and for many women, the benefits will continue to outweigh the risks.
5. Statement from British Menopause Society and Royal College of Obstetricians and Gynaecologists will be placed in our news section later today.*
I hope this is helpful.
In summary, no major changes in advice or recommendations.
Best wishes
Heather

--
*update: the statement is on the news page here:
http://www.menopausematters.co.uk/newsitem.php?recordID=174/RCOG-BMS-response-to-Breast-Cancer-Now-Generations-Study-on-HRT-use-and-breast-cancer-risk

[Freckles]

Hello again DeDiva Ann

If you GP is interested, do go to John Studd's website as his clinical research articles and his more "reader friendly"  for the lay person are on there and you can print them off to give to your GP.
Do read them re gels versus oral HRt and testorterone
Your male GP is taking rubbish re testosterone!!
All women need testosterone and in fact young women in their 20s naturally have more than most young men.
The Testim (testosterone) patches were taken off the UK market for commercial reasons, not clinical ones.
I am prescribed a daily very tiny bead of Testim by my GP via Prof. Studd on the NHS. So it is prescribed and it's not "old fashioned".  It helps not just with libido, but also depression and loss of energy and works with oestrogen to improve mood. It's not "risky" (there's not any evidence clinically for that all, at a very low dose that I and others here on MM are on)
There was a recent article in the Sunday Times "Style" magazine by a woman in her early 50s who had lost her libido and went to see Studd and is now all singing and dancing in that area due to Testim!
Studd currently costs £300 to see him initially and I got my hormone blood tests  done on the NHS to save costs at his clinic.
I couldn't afford it either but as my GP is a mentally challenged 12 year old and wanted to put me on anti-depressants, which I didn't want, I had no option.
I am so, so pleased I did,  as his regime I have found to be life changing and worth every penny.
He wrote to my GP and I get it prescribed all on the NHS
If your GP isn't helpful, beg, borrow from family/friends or use your credit card to see him.
Life is too tough and too short to feel so crap for the last third of your life.
Good luck- do some reading and research and let us know how you get on?

[Petra]

Thanks @Dana and @Freckles. Obviously I need to do a lot more reading around what to do re the Provera/progesterone side of things. I will check out the Oz site for sure. Thanks for the really useful feedback to my post.

[Dediva Ann]

That is all incredibly encouraging Freckles.  Thank you soooo much. Am going to speak to my GP and if not my credit card may just have to come out.  I had pretty much written myself off but am daring to have a little hope now