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[celiab]

Hi.
I'm 59 and been period free for about 10 years, but thinking about HRT. Is it too late?
I have been on Vagifem for about 5 years, but it just doesn't seem enough.
Fed up with dryness, burning, bladder issues, dry skin, having no energy, disturbed sleep, irritable mood, joint aches and no sex drive!
Just want to feel like me again. X

[Sheanie]

Yes, it is definitely worth it! And it's not too late. GPs seem reluctant to give HRT out to over 60 year olds, but I know of 80 year olds on it, so..... I'm 57 and started on it a few months ago. My energy levels leapt up dramatically in the first few weeks of taking HRT (Oestrogel and Utrogestan), my mood is lifted, I'm sleeping well because of the Progesterone, and my back ache is pretty much gone. All this affects everything I do and everyone in my life! I think my skin is also better, plumper, too because of the oestrogen, though that could be (partly?) because of the retinol in my new face cream!

I'm still working out how much Utrogestan to take and by what route as it seems I've had a couple of groggy days because of it. But all in all, I wish I'd started on (body identical) HRT ten years ago! BTW as I posted elsewhere, after menopause, we lose 1% BMD per year, so it's worth going on it just to protect your bones IMO.

RE vaginal atrophy, I am using Estring, which delivers a higher dose of estradiol than Vagifem. Apparently, Vagifem used to deliver 25mgm, but it was dropped to 10mcg when research showed that the latter had 'almost' the same effect as the former. Estring delivers 7.5mcg a day, so more or less the equivalent of two of the old Vagifems a week. It might be worth trying. (It's also great as you change it once every 3 months so don't have to remember to use it x times a week, and no pesky blue plastic applicators sent to the plastic mountain!).

I have found Louise Newson's website 'Menopause Doctor' really useful and interesting.

Good luck x

[Katejo]

Hi.
I'm 59 and been period free for about 10 years, but thinking about HRT. Is it too late?
I have been on Vagifem for about 5 years, but it just doesn't seem enough.
Fed up with dryness, burning, bladder issues, dry skin, having no energy, disturbed sleep, irritable mood, joint aches and no sex drive!
Just want to feel like me again. X

Just a quick reply now because I am at work but I have started HRT at 56 (period free for 5 years). Have you seen the recent book on Benefits of oestrogen which argues that the benefits outweigh the risks as long as you start before 60? I will add more later.

I chose to try HRT for the following reasons:

1. I had just read the following book which presents the advantages of starting oestrogen before 60 https://www.amazon.co.uk/Oestrogen-Matters-Hormones-Menopause-Well-Being/dp/0349421773/ref=sr_1_fkmrnull_1?crid=37BIRHND59W81&keywords=oestrogen+matters+book&qid=1556727678&s=gateway&sprefix=oestrogen+matt%2Caps%2C125&sr=8-1-fkmrnull

2. Vagifem was helping a lot but wasn't doing the whole job

3. Ever since peri (around 10 years), I have had aching joints/tense muscles. GP visits got me nowhere. I was just handed a sheet of exercises for arthritis! My practice was rather anti HRT and I suspect still is. I wanted to see if HRT might help

4. My last bone scan showed mild osteopenia and I wanted to stop this getting worse.

I only started Evorel Conti patches 2-3 weeks ago so it is too early to say if it is working. Nothing has happened yet.

[MicheleMaBelle]

Hi Ceci- it's certainly not too late but you may encounter some reluctance from your GP if they're not up to date.
HRT undoubtedly has benefits but it also carries a very very small increased risk of certain cancers etc. I'm sure you are able to put these into context versus the improvement in quality of life that may be gained by going on it.

I'm also sure that by reading numerous posts on here that it's not always easy to find the right regime and it can take time to find something suitable. Indeed, some women just don't get on with it, but if you decide to go for it, don't expect instant results. Some women feel better almost instantly, some feel worse before they get better and for some,they either can't take it or it doesn't suit them. We are all different and what works for one person may not work for another.

I'm on HRT myself so I'm not against it, I suppose I'm just trying to manage your expectations based on my own experience of struggling to find a suitable regime 4 years down the line.

Go see your GP after reading about it on here and good luck. Let us know how you get on x

[Ladybt28]

No never too late Ceci but as MicheleMaBelle says you may encounter some reluctance if your GP hasn't had the right training and you may encounter lack of knowledge on regimes as well but unless you ask you won't know how your GP feels about it and what they knoew.  Anyway there are plenty of us here on the forum to set the GP straight if they are being a bit of a numpty! 
Good luck.  Let us know how you get on.

[celiab]

Hi and thanks for the replies.

I saw my GP yesterday, as had a long standing appointment.
She said if I was sure I wanted to give HRT a go, I could, but said she was slightly concerned that my health anxiety may become worse, due to the cancer risks. She also said most people bleed to begin with and as I have had about 5 episodes of spotting while in menopause this may increase my risk. Is this so?
She has orders a thyroid and Vit D blood test for me.
Not sure what to so now! X

[jillydoll]

Hi Ceci.
A lot of ladies do have bleeding when they first start hrt, any bleeding up to about 6 months of first starting is normal...and should subside.
However, any bleeding should be investigated, did you have any tests done for your bleeds before?
If you feel really rubbish, and are struggling with symptoms, I'd say still go for it. If you don't like it, you can always stop it...although, my hrt isn't perfect, it's made me feel better, and I wouldn't stop it for anything...even though I suffer with prog issues.....good luck, let us know what you decide.......xx

[Hurdity]

Hi Ceci

The recommended time to start HRT according to the BMS and menopause experts, is within 10 years of menopause  and under 60  - not sure how this works if you have a late menopause?! This is for cardiovascular protection and is called the "window of opportunity". However starting outside these times can be tried but a transdermal method is preferred. Do look at the British Menopause Society fact sheet on this which summarises the key points from a detailed paper which updated recommendations on HRT: https://thebms.org.uk/publications/consensus-statements/hormone-replacement-therapy/. Your doc would be well to look at these.

How dare you doc try to project her own ignorance onto you and suggest you are likely to be anxious due to her fears about HRT and cancer!!!

As jillydoll says it is expected that you might bleed when you start continuous combined HRT but this should then settle. Like she asked - I am wondering what the reasons for your post-menopausal spotting has been - if it has occurred 5 times? Maybe you have fibroids or polyps? It is important that you ask what the gynaes have diagnosed as the reason for this spotting and then you will be in a better position to know what is oging to happen., but to emphasis that the spotting when you start conti HRT does not normally need investigation in the first few months.

I'm not sure that the HRT will do anything for your sex drive - it does depend on the type to some extent, and your individual response.

Do challenge your doc on this if you want to give it a try - and let us know how you get on!

Hurdity x

[celiab]

Thanks Jillydoll and Hurdity,

Each of my bleeds were fully investigated and I had hospital checks, scans, biopsies and the camera in uterus, but no cause found except erosion in vagina due to VA. It does appear I bled very easily down that and also bled after a recent smear - which came back normal for cells but positive for HPV (was told this was okay?).
I will read the link, thank you. C

[Sheanie]

Is health anxiety something that has developed or gotten worse with age, as your hormone levels dropped, in peri menopause or post menopause. I think a lot of women get less confident and more anxious in general as their hormone levels decrease. Maybe going on HRT will actually make you less anxious.

(edit: Just read Hurdity's comment on your GP's anxiety and totally agree! Maybe she needs to get better informed on the actual risks and benefits of specific types of HRT to alleviate her own anxiety.  )

I've had no bleeding. I guess some women do, but it's not a given. I'd honestly put up with some though in exchange for the benefits I've derived, mostly the boost to my energy levels. I was on my knees before HRT, exhausted, unable to cope....

I'm taking two pumps of Estrogel a day and continuous Utrogestan (though I'm cutting back a bit on that as I've had a few groggy days), which I chose because they are both body identical and have less risks attached. I really have no concerns about health risks!

I've avoided oestrogen in tablet form as they are associated with a risk of stroke and thrombosis. Patches and gels are not as the oestrogen goes straight into the bloodstream. The cancer risk from taking oestrogen would be endometrial, but so long as you're taking progesterone too, you should be covered. I'm going to have a scan once a year to check that the lining of my womb isn't building up just in case. All bases covered. Nothing to lose sleep about IMO!

Utrogestan is the only progesterone available on the NHS. Everything else, whether it's taken alone or in combination with oestrogen, say in a combi patch, is progestin, which is a synthetic form of progesterone. Research indicates that there is a greater risk of breast cancer when taking oestrogen and (synthetic) progestin than oestrogen and progesterone (i.e., Utrogestan). In either case, the risk of breast cancer is minimal though. https://www.ncbi.nlm.nih.gov/pubmed/17333341 Weighed against the benefits of HRT, especially re protection from osteoporosis and heart attacks, IMO this risk is reasonable and acceptable.

Louise Newson's website (Menopause Doctor) has loads of interesting info on it, and this is her prescribing guide https://pcwhf.co.uk/wp-content/uploads/2019/03/PCWHF-Easy-HRT-prescribing-guide_March19-update.pdf, which I hadn't seen before I went on HRT but supports the choices I made after doing quite a bit of research. It may not suit you. But it's not a bad place to start.

I do hope you decide to try HRT and aren't put off by your GP. It may not work for you, but IMO it's worth trying. I wouldn't want to live another 20, 30, 40 years putting up with the symptoms you describe and not feeling like me!

S xx


 

[celiab]

Thank you so much for the replies. I will look through all the information you have given as I now realise I dont actually know much about HRT! 

[Katejo]

Hi and thanks for the replies.

I saw my GP yesterday, as had a long standing appointment.
She said if I was sure I wanted to give HRT a go, I could, but said she was slightly concerned that my health anxiety may become worse, due to the cancer risks. She also said most people bleed to begin with and as I have had about 5 episodes of spotting while in menopause this may increase my risk. Is this so?
She has orders a thyroid and Vit D blood test for me.
Not sure what to so now! X

I get anxious about health and was previously very apprehensive about trying systemic HRT. However, since reading the book mentioned above, I have decided that the benefits outweigh the risks. I can't answer the question re. previous spotting as I haven't had any. You could perhaps try a 3 month trial just to see if your symptoms improve?