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[Katejo]

I'd be interested to know how bad the side effect symptoms of the types of HRT prescribed post menopause are. I haven't tried any of them yet. I am weighing up pros and cons after reading about the benefits of oestrogen.
Did they put you off taking HRT at all because they outweighed the benefits? 

Do patches cause fewer side effects than tablets?

Thanks

[Dancinggirl]

In post menopause you can use sequential hrt which gives a monthly bleed but you can also use a continuous HRT type that usually results in no bleeding at all. Side effects with all types of hrt vary greatly but many find that the continuous HRT types slightly harder to tolerate as using progesterone all the time can sometimes give more side effects.
Some women do really well on almost any HRT with few if any problems. I don't believe there will be any treatment that does not bring some drawbacks but the benefits should outweigh the side effects to make it worth using HRT.
Transdermal HRT can be better for some women particularly in post meno, as it is less likely to upset the digestive system.
Using HRT is a very individual thing and it can be trial and error. Starting HRT when very post meno can bring a few more side effects at first while the body “wakes up” and adjusts to the hormones.
I would suggest a low dose to start with and possibly an Estrodot 25mcg patch ( used all the time) with Utrogestan or Provera as seperate pills to be taken for 12 days each month. If this sequential HRT Regime works well then you could move to the continuous version and possibly increase to 50mcg patch to really get the full oestrogen benefits.
Some women do extemely well on HRT pills (easier to manage overall) and if you want to try pills then why not try the Femoston Ultra low dose to start with and then move to the higher dose after 3 months. Femoston has the Kinder progesterone that suits many women very well.
Fewer flushes, better sleep, more energy together with the benefits for the bones heart skin and joints are just some of the benefits.
Side effects can include tummy cramps, headaches, PMT and sometimes fatigue but often these settle as the body adjusts.
If you don't try, you'll never find out!
DG x

[Dotty]

I was 3 years post meno when I started Oestrogel and Utrogestan. I have had no side effects at all. X

[Katejo]

In post menopause you can use sequential hrt which gives a monthly bleed but you can also use a continuous HRT type that usually results in no bleeding at all. Side effects with all types of hrt vary greatly but many find that the continuous HRT types slightly harder to tolerate as using progesterone all the time can sometimes give more side effects.
Some women do really well on almost any HRT with few if any problems. I don't believe there will be any treatment that does not bring some drawbacks but the benefits should outweigh the side effects to make it worth using HRT.
Transdermal HRT can be better for some women particularly in post meno, as it is less likely to upset the digestive system.
Using HRT is a very individual thing and it can be trial and error. Starting HRT when very post meno can bring a few more side effects at first while the body “wakes up” and adjusts to the hormones.
I would suggest a low dose to start with and possibly an Estrodot 25mcg patch ( used all the time) with Utrogestan or Provera as seperate pills to be taken for 12 days each month. If this sequential HRT Regime works well then you could move to the continuous version and possibly increase to 60 McGlone patch to really get the full oestrogen benefits.
Some women do extemely well on HRT pills (easier to manage overall) and if you want to try pills then why not try the Femoston Ultra low dose to start with and then move to the higher dose after 3 months. Femoston has the Kinder progesterone that suits many women very well.
Fewer flushes, better sleep, more energy together with the benefits for the bones heart skin and joints are just some of the benefits.
Side effects can include tummy cramps, headaches, PMT and sometimes fatigue but often these settle as the body adjusts.
If you don't try, you'll never find out!
DG x

Thanks Dancing Girl    I haven't tried any so far (except the local Vagifem) because I have never had a problem with hot flushes, fatigue  or any of the other well known problems. I am considering it now after reading up on protection from future dementia, healthy bones, healthy heart etc. and also because of possible help with joints/aching feet.   Do side effects include PMT even though periods have long since stopped? I didn't have much trouble with PMT when I did still have periods.

[Dancinggirl]

If you didn't suffer with PMT before then you are less likely to get this with HRT but it can depend on how you react to a particular progesterone.
If you are in your 50s then there could be benefits for you but if you aren't experiencing flushes and night sweats then you may not need HRT as you can still help bones and heart with good diet and lots of exercise.
DG x

[Katejo]

If you didn't suffer with PMT before then you are less likely to get this with HRT but it can depend on how you react to a particular progesterone.
If you are in your 50s then there could be benefits for you but if you aren't experiencing flushes and night sweats then you may not need HRT as you can still help bones and heart with good diet and lots of exercise.
DG x

The book which I am now reading seriously disputes this. It argues that exercise is generally good for you but that once the level of oestrogen starts to drop, you do need to use HRT before you reach 60 and continue with it indefinitely. It discusses many different past studies which support this. Exercise can achieve the same effects pre menopause but not post menopause (according to the book).

[Dancinggirl]

Unless this book is written by a top, well respected gynaecologist (preferably UK based) who has studied all the data from every trial done round the world and is speaking from personal experience of treating women with HRT for the long term, I'm afraid I would question the claims. It is very easy to cherry pick studies to put together a book that will sell well because it sells something people want to hear. It is known that oestrogen helps to maintain bone density but I believe there are not many long term studies of women using HRT well into their 70s and 80s.
Im afraid I found that side effects from hrt became worse as I aged so at 60 I decided to stop as the benefits were outweighing the side effects. I had a premature meno so used HRT from my mid 30s.
Weight baring exercise would still be needed even on HRT but it certainly helps to maintain density without HRT.
If there is a history of osteoporosis and heart disease in your family then 5 years ( or until 60) of hrt in your 50s would certainly be a good idea as I believe it is accepted that this will bring benefits in the long term. Whether you choose to use hrt beyond 60 then, at this stage, that should be discussed with your doctor to assess whether the benefits do then outweigh any the possible risks.
I think one should do your own research, weigh up the pros and cons and perhaps give HRT a try and see how it goes.
If you are concerned about your bones then you could insist on a bone scan. DG x

[Katejo]

Unless this book is written by a top, well respected gynaecologist (preferably UK based) who has studied all the data from every trial done round the world and is speaking from personal experience of treating women with HRT for the long term, I'm afraid I would question the claims. It is very easy to cherry pick studies to put together a book that will sell well because it sells something people want to hear. It is known that oestrogen helps to maintain bone density but I believe there are not many long term studies of women using HRT well into their 70s and 80s.
Im afraid I found that side effects from hrt became worse as I aged so at 60 I decided to stop as the benefits were outweighing the side effects. I had a premature meno so used HRT from my mid 30s.
Weight baring exercise would still be needed even on HRT but it certainly helps to maintain density without HRT.
If there is a history of osteoporosis and heart disease in your family then 5 years ( or until 60) of hrt in your 50s would certainly be a good idea as I believe it is accepted that this will bring benefits in the long term. Whether you choose to use hrt beyond 60 then, at this stage, that should be discussed with your doctor to assess whether the benefits do then outweigh any the possible risks.
I think one should do your own research, weigh up the pros and cons and perhaps give HRT a try and see how it goes.
If you are concerned about your bones then you could insist on a bone scan. DG x

He isn't UK based but is an oncologist with 40 years experience of researching the subject. He is careful to include studies which argue against as well as for and he does cover studies from many different countries. I intend to get a bone density check anyway though I did have one  3 years ago after a wrist fracture. It was ok then.  One of the strongest benefits of taking HRT from 50's onwards appears to be protection against dementia (according to this book).

[Js]

I have been on hrt since 50 I am now 59 and my doctor has recommended me come off it well I have had a few breaks while on it . I am on Everol conti patches which work well for me and better for me as I dont take tablets well and youncan control them better unlike tablets.  So what I am doing is cutting the patch In Half as I come off it slowly as you can't just stop  it . But as my main problem was hot sweats during the night mainly as I do need my sleep and these were keeping me awake so I think if my sweats come back after coming off hrt then I will go back on it and stay on I am aware of the risks of hrt but can't cope with the sweats I must admit that is the only problem I have with the menopause I have migraines but had them before the meno and hrt does not help the migraines so I will see how I get on it would be nice to come off and not have any symptoms anymore of meno but will have to wait and see

Hope others are finding hrt helpful

Js

[Droopeydrawers]

Good post stellajane.im reading the book just now it's a good read so far.D.D

[Katejo]

Katejo I'm looking forward to reading the book you mention. I think its only been written recently if its the one I'm thinking of. I don't think personally it should matter one jot if the gynaecologist is UK based although it can be frustrating to read a book and think yes this is what I want to do, only to be frustrated by the NHS!

It can be controversial but my opinion is that all women should be offered the opportunity to take HRT regardless of whether or not they have symptoms. Its well known to protect against osteoporosis - as for dementia - well all I can say is my poor old mum had debilitating osteoporosis from her mid 60s, vascular dementia from her late 70s - so maybe there's a connection?  Mum only took HRT for a few short months because of the scare stories at the time. I can't help thinking how different her life may have been.

At the end of the day it should be for each of us to make our own individual choice bearing in mind genetic factors, how any symptoms are affecting our lives etc etc. Its never easy. No-one should feel pressurised either way.

Yes it is very recent (Sept 2018). I have almost finished it. Just 1 chapter left which says it will give some arguments to use of doctors disagree with what we ask for. I am wondering whether it would be better to pay to go to a private meno clinic to get longer to discuss options. 10 mins with a GP isn't enough if you first need to convince them that it is worthwhile.

[Dancinggirl]

Katejo - it's always worth trying the GP first.  Go to the appointment really well prepared with all the info you want to put across printed out and also have your symptoms and questions written down. You can start the appointment by saying you know you only have 10 minutes, so you've come prepared to make things easier. Outline what you want to achieve and then present the GP with all the written and printed stuff.
They don't like patients doing this as they are then forced to read your questions and respond to them. If they then argue against what you want, you have the printed evidence to argue your case without actually having to say anything.  This will give you confidence and allow you to be quietly assertive without feeling rushed or getting upset.
Sadly we usually have to manage our doctors or we don't get the outcome we need. 
The beauty of this site is we can usually get all the info we need to get what we need - it will still be trial and error with HRT because we are all different - do keep an open mind. DG x

[Katejo]

Katejo - it's always worth trying the GP first.  Go to the appointment really well prepared with all the info you want to put across printed out and also have your symptoms and questions written down. You can start the appointment by saying you know you only have 10 minutes, so you've come prepared to make things easier. Outline what you want to achieve and then present the GP with all the written and printed stuff.
They don't like patients doing this as they are then forced to read your questions and respond to them. If they then argue against what you want, you have the printed evidence to argue your case without actually having to say anything.  This will give you confidence and allow you to be quietly assertive without feeling rushed or getting upset.
Sadly we usually have to manage our doctors or we don't get the outcome we need. 
The beauty of this site is we can usually get all the info we need to get what we need - it will still be trial and error with HRT because we are all different - do keep an open mind. DG x

Yes that is what I will do first. I had thought of doing it that way but only if I can get a an appt. with  GP whom I like. Advance non urgent appts. are extremely difficult to get.

[Katejo]

You can tell dancinggirl's been there can't you - "quietly assertive" is definitely the way to go in "managing your doctor" - i like it!

From my own experience my GP's been happy to learn that I've done my own research and that I have an "understanding of risk". I think it gives him more confidence to prescribe knowing that I'm not going to kick up a fuss and go blaming him if I should be unfortunate and develop some condition that could be attributed to taking hormones.

I think we have to own our choices. I've already had 10 years feeling in better health overall than I did in the previous 10 so it has been and continues to be totally worth any small risk.

An interesting point which has arisen right at the end of the book says that patches are less effective in maintaining heart/neurological health than the tablet forms of HRT.

One senior GP told me once that patients shouldn't do their own research at all. He ticked me off for doing so even though I was only using quality health website (not just googling). That wasn't to do with HRT.

[Dancinggirl]

Doctors often don't like it when patients know more than they do. This is why one has to be ‘quietly assertive' and recognise that their ego often gets in the way of them giving patients what they need and want. There are also the budgetary constraints that mean they will offer the cheapest option because they have to be seen to go through the least costly route before trying something they actually know is better.
Doctors should never belittle a patient or tell them off for getting clued up on treatment options - doctors are rarely up to speed on things anyway as they simply haven't got the time to keep pace with the latest research.
Look at the battle over the cannabis oil - of course NICE have to be cautious about any drug but cannibis has been around for hundreds of years so surely the scientists must know the risks and benefits - surely those poor parents watching their children experience dreadful fits that could kill them have the right to ask for this simple treatment - nothing else is working for them. DG x