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[buffy26]

I am 62, I have been on HRT for 3.5 years. I started to bleed last week which was painful and lasted 5 days. I was sent for an urgent investigation, internal and external scan plus a full internal inspection by a Consultant Gynae. All was fine so it was deemed to be down to HRT, and not absorbing it very well. I am on 4 pumps yet have a continued decline of Estrogen down to 185. The doctor said " you know at your age its not really the best thing for you now, the protection to the heart is not as valuable at this age, and it could even be detrimental to your heart" I was very shocked at this. What about bones? What about the all the other menopause symptoms we get? Surely we need the missing estrogen in our bodies?! Then I was advised to go onto a spray estrogen which kind of confused me given what had been just said. Is this something well known and has anyone else had this said to them due being the senior post menopausal age. Really am flummoxed!

[dangermouse]

This is potentially based on the fact that the research into heart protection was carried out on younger women, under 40 I think, who had low oestrogen. The older you get the less the research supports this. It may be the same with the bones research but not sure on that one.

If you are only taking it for protection then it may be worth reflecting on. If you get other benefits, perhaps not.

[buffy26]

This is potentially based on the fact that the research into heart protection was carried out on younger women, under 40 I think, who had low oestrogen. The older you get the less the research supports this. It may be the same with the bones research but not sure on that one.

If you are only taking it for protection then it may be worth reflecting on. If you get other benefits, perhaps not.

Thank you dangermouse, thats helpful. I was advised to go onto HRT at 58 as I had so many horrible symptoms including Osteopenia. I will dig a bit deeper!

[che]

I am 62, I have been on HRT for 3.5 years. I started to bleed last week which was painful and lasted 5 days. I was sent for an urgent investigation, internal and external scan plus a full internal inspection by a Consultant Gynae. All was fine so it was deemed to be down to HRT, and not absorbing it very well. I am on 4 pumps yet have a continued decline of Estrogen down to 185. The doctor said " you know at your age its not really the best thing for you now, the protection to the heart is not as valuable at this age, and it could even be detrimental to your heart" I was very shocked at this. What about bones? What about the all the other menopause symptoms we get? Surely we need the missing estrogen in our bodies?! Then I was advised to go onto a spray estrogen which kind of confused me given what had been just said. Is this something well known and has anyone else had this said to them due being the senior post menopausal age. Really am flummoxed!

I an nearly 54 and been told by 2 gps different information on this, one said no benifit to staying on it, the other said it is a good idea for bone, brain and heart. I wonder if it is more about money tbh

[CLKD]

Lack of knowledge probably.

How is 'detrimental' defined?  I think more discussion about this aspect is required buffy26.

[bombsh3ll]

I wonder when this "specialist" last read a peer reviewed journal or undertook any education on menopause or hormone therapy.

Also where was any mention of your quality of life or autonomy in the conversation?

I think some of them within the NHS just see hormone therapy (and those using it) as a nuisance because it can lead to bleeding which they have to investigate. Women's quality of life has always been really undervalued as an outcome, and there is a high cultural tolerance for women's suffering within healthcare that wouldn't be seen as acceptable for male patients.

Estrogen has indisputable benefits for quality of life, bones, joints, skin, muscle, pelvic, urogenital, metabolic, sleep and mental health that persist as long as it is used.

There is less evidence specifically that it continues to provide as much cardiovascular protection in older women as it does to younger women, however there is certainly no evidence that currently used MHT products have any negative effect on heart health at any age.

The best thing you can do is educate yourself on the topic, there are plenty of good quality, scientifically accurate resources online that are freely available, then you will be able to make informed decisions regarding treatment yourself without relying on the opinions of those with less knowledge.

In particular the NICE guidelines discourage arbitrary withdrawal of beneficial treatment based on age, and hormone therapy can be continued as long as it is of net benefit to the individual concerned.

I will be on it for life, as there is no age at which my quality of life ceases to matter, or at which I am willing to accept osteoporosis.

[buffy26]

bombsh3ll I couldn’t agree more with you.
Also when I mentioned about Testosterone levels being at <0.7 , outside the normal reference range for women she poo pooed it saying women are not men and they don’t have the same requirements as men for that! For a Gynae to be saying that my mouth dropped open. I really wanted to challenge her and get into a debate over that one as I have done a LOT of reading up on it. I read the Nice guidelines briefly last night on Estrogen, as her insistence that 4 pumps was a hell of a lot of product  despite me saying it was not regarded as that and some have up to six pumps, and we’re all different. Her face said it all and I couldn’t wait to get away as I could feel myself getting really cross. There is a long way to go to get a unified view across women’s health. It reminds me of the days when health visitors / midwives and GPS all gave conflicting views and advice on breast feeding 30 years ago😤

[CLKD]

"Breast is Best" 

[bombsh3ll]

As with everything in life there is never one single universal "best" option for everyone as we are all different.

That's why it's important to know what is available, the pros and cons of each, and also yourself - lifestyle, priorities, medical/family history specific to you, and what outcomes you are hoping to achieve.

[Dandelion]

Hello
Whoever told you was miseducated.
The evidence is now that you can have it for life.