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[Mutti60]

I'm 57 and had my last period just over 2 years ago. I'm not on HRT because when I first presented to my doctor he told me it wasn't recommended. More recently when I went to him about another issue I mentioned I was struggling with memory loss and hot flushes and he asked why I wasn't on HRT. I told him because he had told me previously that it wasn't recommended.
Now I'm wondering if I've left it too late to go on HRT and if there would be any benefit now if I asked to start taking it. Specifically will taking it protect me from osteoporosis in the future and help with my current memory problem and these horrible hot flushes.

[Ju Ju]

I started HRT at age 60. It had been offered to me at a younger age, but my sister had died from breast cancer. There is no other history of breast or ovarian cancer in my family, so I had been told that my sister had been a 'blip'. I thought I could cope anyway, but my health deteriorated and CFS was being suggested. With my doctors support and gynaecologist recommendation, I started HRT, in order to try testosterone which was not available on the NHS at the time. Testosterone did not bring any benefits, but oestrogen did. I struggled with progesterone, but have since had to have a hysterectomy due to prolapse. Starting HRT so late is considered more risky, but I decided quality of life was of greater importance to me than quantity. As with many women, I had to find what HRT suited me and it was difficult being sensitive to progesterone.

You have to weigh up what is important for you and do your homework. This website has plenty of information and some members of the forum can give you more knowledgeable advice.

[Joaniepat]

In 1997 I had a hysterectomy and oophorectomy and was given oestrogen (think it might have been Premarin) afterwards. I was 48. When I moved house in 2003 I was denied any more HRT by my new GP, who said it was "government guidelines". This will have been due to faulty research, which was much publicised at the time and led to the HRT scares which are still ongoing. Anyway, I protested as I was only taking oestrogen, but she was adamant and I just had to put up with the return of the hot flushes, etc. I must have been 54 at the time. I  didn't think much more about it until this year.

In December 2016 I got VA and now use a localised oestrogen. In May this year I asked my current GP about having some systemic oestrogen and he said no, because of my age (67). However, I laid it on a bit thick about how I was of slight build, and that my mother had had osteoporosis, and I thought it might have some protective effect. (Mum had also had an unreliable bladder and 2 episodes of bowel cancer, both of which may have been due to oestrogen depletion). To cut a long story short, he said I could have Tibolone, which I now take.

I have an appointment for later this month at the menopause clinic at the Chelsea and Westminster Hospital to discuss the VA treatment, which has responded quite well to Ovestin, and will also ask about taking systemic oestrogen in later life.

I wonder how many older women will now be turning up at their GPs with conditions that could have been prevented if it had not been for those earlier HRT scares. Quite a lot I suspect.

[Mutti60]

To be perfectly honest I don't understand what HRT is and what the options are. There is no family history of breast cancer or osteoporosis. Other than high blood pressure which I take Losartin for I'm relatively healthy but I do worry about the future.
If there is something I should now be taking to alleviate my current symptoms and to protect my future I would like to get it sooner rather than later.
What is the difference in effect between taking oestrogen and taking progesterone.?

[Joaniepat]

If you have a look at the pale green banner at the top of the page (under Menopause and Treatments) it will give you a good overview. Progesterone is needed if you still have a uterus, to stop the uterine lining from building up.

[peri]

I don't think you have left it too late Mutti.  I've learnt from this forum there's no risk taking hrt up to 60.  After 60 I think there's a small risk, but this will vary according to an individual's own health of course.  Blood pressure may be an issue but if you've got yours under control that's good.  Hrt will help with hot flushes and protect heart and bones. Let us know what you decide x

[jaycee]

Many women are still taking HRT into their 70s and 80s, so i dont think you have left it too late,
I have been this morning for an examination by a Gyne Dr,after having a scan for womb ,she said there was no reason i couldnt take it again now,as i still get hot flushes, not as bad as prteviously, and i dont sleep much,plus anxiety
I am 74,just ask, the new NICE guidelines are saying now its good for your heart and bones

[CLKD]

Quality of Life Girls, Quality of Life!

Maybe keep a mood/food/symptom diary so that you have something to talk to your GP/Practice Nurse about?  I don't think it's ever too late as long as the practitioner explains the pros and cons clearly. 

[Hurdity]

Hi Mutti60

 

You are definitely not too late you young thing!  The best time to start HRT is as close to menopause as possible but it is considered OK if started within 10 years of menopause and preferably under 60. You fulfil both of these so if there is no medical reason why you shouldn't take HRT and you are experiencing symptoms that are affecting your well-being and quality of life (that would be my main yardstick for starters - protecting your future health whatever symptoms you are having now, comes close) - then go for it!

Tons of brilliant info on this website as already mentioned. There are tablets, patches or gels. One thing I would say - if you start HRT, even though you are post-menopausal and would be given a continuous combined HRT type (no-bleed) personally I would start on one that does give a bleed so that you could find out whether the progestogen part of HRT suited you. Have a really good read about it all and then come back to us with more questions. I started HRT mid 50's (well just under 54) and have been taking it for over 10 years - still cyclically and have a withdrawal bleed - yes even in my 60's!

The oestrogen is what lifts mood and stops flushes and sweats as well as protecting bones and heart, and the progestogen (as said) protects the womb from the oestrogen.

Hurdity x

[Mutti60]

Thank you for your replies. Ive read through the information on this site and have made an appointment with my doctor to discuss what treatment I should start.
One thing though, there is a family history of DVT. My mum was on Warfarin for many years because of it. Is there a particular therapy I should consider because of this or are they all much the same risk-wise?

[NorthArm]

Hi Mutti60

I think there's not much difference risk wise, but ask your gp about it anyway.

[Hurdity]

Hi there - it depends more on your own risk factors I think ie whether you are overweight (due to fat - muscle is OK), a smoker, have high cholesterol etc and other factors - actually just found them listed here for cardio-vascular disease: https://www.menopausematters.co.uk/cvdrisks.php

I think the route (delivery method) of HRT also has a bearing - so that to reduce stroke risk transdermal ( patches or gel) are preferred - there is some information here: https://www.menopausematters.co.uk/route.php

Also the current view is also that its best to start within 10 years of menopause and preferably under 60 to reduce stroke risk or prevent increased stroke risk - sorry bit tired so not sure if that even makes sense!

So at your age and with your family history patch HRT would be preferred and depends on the other risk factors above. You might want to ask for a referral if possible to a specialist - but sound like your doc may well be on board. Do research the different types and get clued up generally about risks and health aspects (tabs above - pale green banner - heaps of great info!) before you go and if you want to ask about different types then we can help there too .

Good luck with your appt  and keep us posted

Hurdity x

[pamb]

Sorry for hijacking the thread, but can I ask Hurdity - do you find the cyclical HRT better because it gives you a break from the progestogen and also is the bleed much lighter to normal period bleed?   I only ask because I'm going to my GP on Friday to discuss going on HRT and wanted to be as informed as possible.  I'm still having periods so I presume cyclical would be better but I see you haven't switched to continuous.

Many thanks

Pamb x

[Hurdity]

Hi there pamb

I switched to continuous briefly for about 3 months 6 years ago after I had stopped HRT for 3 months and then my symptoms came back. With the help of a woman on this forum we worked out a dose of progesterone (Cyclogest - before utrogestan was widespread) that would work with 25 mcg patches so I took vaginal utrogestan every 3rd night I think. Doc has said try to go on as low a dose as deals with symptoms.

As it turned out the flushes stopped initially but didn't got completely I wasn't prepared to take every night ( vaginally) for obvious reasons if you're in a relationship. By this time utrogestan was being prescribed more readily so I decided to switch to this and to stay with a cycle - partly to avoid the side effects of conti prog, and partly to avoid vag use of Utro every night or nearly so.

On a long cycle I get a much smaller bleed than my natural periods - but then my oestrogen dose is not high (compared to what my own body was producing) - as I am on 62.5 ( a 50 mcg patch + a quarter of one).

Yes if you are having periods cyclical HRT is preferable because theoretically your bleed should be predictable although if your cycle is still powerful then it could break through.

Hurdity x

[pamb]

Thanks for the helpful reply Hurdity.

It's always useful to get as much info as possible before a GP visit.  I haven't seen this one before so hopefully she'll be enlightened with the various methods. 

Thanks again.

Pamb x