Hi Debina
from me too.
Please read this link from the British Menopause Society if you haven't done so already:
https://thebms.org.uk/wp-content/uploads/2022/12/09-BMS-TfC-NICE-Menopause-Diagnosis-and-Management-from-Guideline-to-Practice-Guideline-Summary-NOV2022-A.pdfIn particular this point:
"
Starting and stopping HRT
HRT can be commenced for vasomotor symptoms or low mood
or anxiety that is menopause related. Since we cannot predict how
long symptoms will last, there should be no arbitrary limits for
duration of use of HRT and previously held views that HRT should
be stopped after 2 to 5 years or at the age of 60 are not backed up.
When women do decide to have a trial cessation of HRT to see if
it is still required for symptom control, either stopping suddenly
or gradually makes no difference to whether or not symptoms
will return. "
Ideally print it off to take to the most senior person in your practice who is a menopause specialist.
Please also see this from the main MM website:
"Hypertension
Blood pressure should be measured and, if high, should be controlled prior to starting HRT. Blood pressure measurement should be repeated 3 months after starting HRT and is then usually checked at annual review. There is a very small risk of conjugated equine estrogens causing a rise in blood pressure which resolves on cessation of treatment. In the presence of controlled hypertension, HRT is unlikely to worsen control; some recommend using transdermal (patch or gel) HRT.
Sage should be used with caution if hypertensive and St.John's Wort should be used with caution if taking antihypertensive therapy. "
https://www.menopausematters.co.uk/atoz.php#GlossHAs per sheila - transdermal may be recommended, especially as you have hypertension, but also depends whether you have other risk factors eg if you are overweight, smoke, drink more than the recommended amounts of alcohol. poor diet (lots of refined foods, carbs and fats and few fresh foods) etc, insufficient exercise. If everything else on that list is OK then maybe you can continue with oral, say, until you're 60?
Evorel conti - transdermal patch (medium dose) - has the same ingredients as Elleste conti, though your body may take a while to adjust to the change in delivery - how the oestrogen gets into the body - and your resultant oestrogen levels may be slightly lower - as Elleste Duet conti is classed as higher dose.
Hope this helps
Hurdity x
