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[Italianlover]

I was taking HRT patches for about 10 years without problems and was very happy on a low dose patch, I had a hysterectomy in 2017. About 18months ago my GP recommended that I should try stopping HRT and partly because obtaining my patches was becoming an enormous faff, I agreed. The first year was ok but recently I’ve got extreme overheating and sweating, poor sleep, aching joints and fatigue, feel so much less well than I used to. My general health is very good otherwise, slim, active, blood pressure ok.
I really want to restart but I’m now 62, can I go back to HRT having had a break?

[Dotty]

Yes you can 😊.

[sheila99]

Yes. The NICE guidelines used to have an age limit of 60 but now they don't so you can take it forever.

[bombsh3ll]

Absolutely!

It isn't appropriate for a clinician to decide unilaterally and arbitrarily that somebody should have to come off an effective treatment without a medical reason.

Unfortunately however depending on the skill and knowledge level of the person you see, you may have to really advocate for yourself, so don't give up!

This may involve showing them the NICE guidelines, asking for a referral to an NHS menopause clinic, or paying to see a specialist and having them write a letter to your GP.

[Italianlover]

I don’t expect much help from my GP so I will probably have to find a private meno clinic I imagine but I might be pleasantly surprised! Good to know that it’s possible to restart even at my age, wish I’d never agreed to stop to be honest!

[Jillyboo]

Unfortunately I think it's probably wise to decline any suggestion to stop unless there's a good medical reason!  If you want to try stopping you can do it in your own time and should you decide to remain HRT free you can inform your surgery once you are sure.

[Italianlover]

Update: had a GP appointment and was refused HRT because I’m over 60 and I have had 10 years on it. Guidelines etc! ☹️

[Ayesha]

Seems like the GP's own personal view but there are research papers stating that its not good to continue after 60, then you have the research that say its fine to continue, or start HRT after 60.
I would now think about a Menopause clinic or change GP.

New NICE guidelines are being published 7th November which will hopefully clarify all this nonsense of one woman can and another can't.

[sheila99]

They are out of date. Print off a copy if the NICE guidelines and take it with you. And complain to the practice manager, the doctor need to remain up to date. The age limit and not over 60 was from older types of hrt, transdermal doesn't carry the same risk.

[bombsh3ll]

I agree with the other replies, age or duration based cut offs are not supported by current guidelines.

An individual assessment of the very small theoretical risks vs the benefits is recommended by all relevant professional bodies such as BMS and NICE.

I think sending in a letter to the practice with the relevant guidelines highlighted is probably the best thing to do, it is easier to think about what you want to say and get your point across without feeling hurried or intimidated, and there's also a written record of what you have said rather than them simply documenting their side of the discussion.

Ultimately though if it comes to a choice between paying for it and going without, health is one of those things that's worth prioritising if at all possible. I have to pay for my combined pill as it isn't funded on the NHS in Scotland.

[Ayesha]

They are out of date. Print off a copy if the NICE guidelines and take it with you. And complain to the practice manager, the doctor need to remain up to date. The age limit and not over 60 was from older types of hrt, transdermal doesn't carry the same risk.

The NICE guidelines are pages long. Do you or anyone else, have a link to the specific page about the age limit?
There still seems a lot of confusion regarding taking HRT after 60 with so much online about the risks incurred, that's all I am finding!

[bombsh3ll]

You may find the references below helpful;

https://cks.nice.org.uk/topics/menopause/management/management-of-menopause-perimenopause-or-premature-ovarian-insufficiency/

Support the woman to make an individual decision on when and how to stop HRT. Advise that:
HRT should be continued for as long as benefits of symptom control and improved quality of life outweigh any risks, and there is no arbitrary limit for duration of HRT use.


https://thebms.org.uk/wp-content/uploads/2023/10/02-BMS-ConsensusStatement-BMS-WHC-2020-Recommendations-on-HRT-in-menopausal-women-SEPT2023-A.pdf

• The decision whether to take HRT, the dose of HRT used and the duration of its use should be made on an individualised basis after discussing the benefits and risks with each patient.

• 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.

[Ayesha]

Many thanks for that, Bombsh3ll. Not as simple to print out and plonk reams of paper in front of a GP and say read this, its a study!!

There really should be no excuse from a GP if a woman wants to start or resume HRT at age 60+ and any refusal must be coming from a personal point of view.