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[Radoy]

Hi everyone: I have osteoporosis and have been on HRT patches for 5 years. I've done so well on them, and my DEXA scans have been much better. I also have no menopause symptoms and feel great.

I've just turned 60 and my GP wants to review my HRT patches. My reading online has lots of positive results from remaining on HRT and as I am doing so well I'd like to keep going. I understand the increased risks, which are minimal (in my opinion) compared to declining due to my Osteoporosis. If I am comfortable with the risks as published and think if I'm doing so well, why would I want to ruin that.

Does anyone have any thoughts on this, or can you point me to any resource which you think is valuable arguing for or against. I really like my GP, but to be honest, she's not an expert in menopause, HRT or Osteoporosis. Many thanks! :-)

[CLKD]

Some GPs want us off HRT at 50    .  However, 1 has to consider quality of life; if a regime is working that we should continue with it; also how HRT protects bone health and heart!  Don't wait until your prescription runs out but have that conversation in good time.

Let us know how you get on.  Several ladies have started HRT after 65, also it is known that we can take HRT for Life as long as the possible risks have been explained.

[Radoy]

Thanks so much for the encouragement! :-)

[CLKD]

Hopefully some ladies over 60 will be along in the next few days >wave<

[sheila99]

Take the  NICE guidelines with you. They used to say you should stop at 60 but now there is no age limit. He may not know they have changed.

[Hurdity]

Here is someone over 60 still on but I am not a lady! 

I would suggest you read digest and produce the British Menopause Society's latest recommendstions on HRT in a joint consensus statement with Women's Health Concern:
https://thebms.org.uk/publications/consensus-statements/bms-whcs-2020-recommendations-on-hormone-replacement-therapy-in-menopausal-women/

Here are the relevant extracts:

"The potential benefits of bioidentical hormone therapy can be achieved using conventionally licensed products, without having to resort to unregulated compounded varieties from specialist pharmacies.

Arbitrary limits should not be placed on the duration of usage of HRT; if symptoms persist, the benefits of hormone therapy usually outweigh the risks.

HRT prescribed before the age of 60 has a favourable benefit/risk profile.

HRT initiated before the age of 60 or within 10 years of the menopause is likely to be associated with a reduction in coronary heart disease and cardiovascular mortality.

If HRT is to be used in women over 60 years of age, lower doses should be started, preferably with a transdermal route of estradiol administration. Evidence from the Cochrane data-analysis as well as that from the long-term follow-up data of the WHI showed no increase in cardiovascular events, cardiovascular mortality or all-cause mortality in women who initiated HRT more than 10 years after the menopause."

That should be all you need. Fine to review it but continuation shold be a joint decision with you the patient. Patches are the ideal way to continue HRT at 60 and beyond.

I am late 60's and have been on HRT patches since age 53/54 - I sometime wonder when I should think about stopping especially as I take it cyclically but every time I think about it, I decide hmm not yet. Luckily I have a very supportive gynae specialist GP who despite being the same age fortunately still works part-time at the local practice.

I hope you  are successful - and do let us know. Btw what patches are you using?

Hurdity x

[Radoy]

Thank you so much, Hurdity. This is just what I needed. You're lovely. :-) xx

[vickypk]

Hi Radoy
I'm on HRT patches and I'm nearly 65.  I've been  on them for five years  I'm just starting testosterone , see how I get on with that.
Wishing you all the best   
Vickypk

[Suza]

Hi Radoy
My advice to you would be, don't let your GP persuade you to come off the patches if you're feeling so well on them
I'm nearly 64 now, but age 62 I was told, not advised to come off my hrt which was evorel contii patches
I wasn't really given any choice in the matter, but told it was because of my age.
Fast forward to present day, and after a year of many phone calls and insisting I was referred to a menopause clinic I'm now back on hrt, this time lenzetto spray.
It's also thanks to joining this forum during that time that gave me the strength to fight my case
Good luck
Susan

[Sheila65]

Hi I'm 65 I came off HRT at 60 didn't want to but was told it wasn't advised,I'm back on patches again due to VA which has helped a lot also vagifem and estriol cream! Don't intend coming off so fight your corner and take the nice guidelines..Good luck!

[Radoy]

Hi everyone: Just to give an update that I met with my GP to stay on the Evorel Conti 50 microgram patches and she's pushed back to say I should cut the patches in half as a trial for a year. I've explained the main reason for using the Evorel is my osteoporosis and the efficacy of Evorel 25 for the prevention of osteoporosis has not been demonstrated.  https://www.medicines.org.uk/emc/product/10931/smpc#gref I broke my back a few years ago slipping in my kitchen (grace personified) and I still struggle with the pain, and my mother was diagnosed with osteoporosis when she was 48 so there's a strong family history. I want to avoid the heavy pharmaceutical route she went down (Prolia, Forteo, Fosamax).

Thanks to Hurdity for the BMS data, which I also sent her.

I have teenagers and a business to run so need to keep myself strong, and I'm hoping she agrees. If not, I will need to find a doctor privately to prescribe, costly but probably inevitable. It's such a war for us ladies over 60, especially when the evidence is there and I feel so well. The question for me is why? I'm perfectly capable of researching this and coming to a conclusion that I take responsibility for, that is best for me, and it feels like you have to constantly swim up waterfalls. Thanks everyone for your help and support. Will let you know how I get on.

[Kathleen]

Hello Radoy and thanks for the update.

I thought I would mention the experience of a friend of mine. She is sixty, small in stature with thin bones but healthy. Five years ago she broke her wrist and was diagnosed with Oesteoporisis and prescribed the relevant meds, she was not taking  HRT at the time and it was not offered. Fast forward to today and she recently had another scan and has discovered that her bones are in worse condition than they were five years ago! She has now started HRT and is frantically doing weight bearing exercises.

Dr Newson at Newson Health believes that the best treatment for osteoporosis is HRT and my friend's experience seems to bear that out.

Wishing you well and take care.

K.

[Floradora]

All the guidance now states that there is no arbitrary stopping age for HRT as long as a discussion has been had re benefits v risks. I would have thought that in your case the benefits clearly outweigh the obvious risks of future fractures. There are a huge number of studies demonstrating the efficacy of HRT in preventing loss of/maintaining bone density. It might be worth getting a copy of the book ‘Estrogen Matters’ and quoting a few of the studies re bone health to your GP. I have recently had a second fracture and while my bone scan shows I’m not quite at the osteoporosis level yet , I’m at high risk of future fractures and I have no intention of stopping HRT when I get to 60. Perhaps try to speak to another GP in your practice if that’s possible?