Print

Please login or register.
1 Hour 1 Day 1 Week 1 Month Forever
Login with username, password and session length

[Dandelion]

Hello ladies.


Speaking personally as a post meno woman I would love to be okay without HRT.

I know several women who have never used it and they are fine, they don't have osteoporosis or CVD and they look well. 
Why that should be I don't know but they seem to have weathered the storm of the menopause and are now settled on a low but stable level of oestrogen.

Personally it is stability that I am hoping for as I take a break from HRT. I do have some VA  symptoms but they are mild. Perhaps they will worsen, perhaps not,   I will certainly consider topical HRT if necessary but for now I need a break from systemic HRT to see where I am naturally.

Perhaps this whole hormone thing is more nuanced than we know. Perhaps Oestradiol in HRT is too strong or inappropriate for some of us, perhaps the weaker Estrone that we continue to have in post menopause is a  better fit? Who knows? We can only experiment on ourselves and hope for the best.

The great thing about this site is that all opinions are represented and that is of value to us all.

Wishing you well ladies and take care.

K.

I didn't want to be reliant on a pharmacy for the rest of my life, which is why I didn't want HRT.
I also looked to the other ladies who appeared to be doing fine, some are super-fit, but dig a little deeper and some don't sleep enough, go to the loo more often, have things like dry eyes, mouth etc, muscular skeletal issues, high blood pressure, diabetes type 2, perhaps go off sex as it's a bit sore down there, none of us knew enough to put these down to menopause.
Also, heart attacks present different in women to men.

I now know that the seemingly symptom free women are still at risk as menopause is just doing it deadly deed silently.

Oestradiol is the oestrogen we lose in menopause, and as there are oestrogen receptors on every cell in our body, and lack of oestrogen is itself, inflammatory, we can now understand why the manifestations of lack of oestradiol is so pervasive, albeit silent in some ladies, at first.
The weaker Estrone is made by our bodies in the absence of oestrogen. This is made in the fat cells, so many of us accquire cuddliness around our middle, - I have that.

So, while I did make the choice to come off HRT last year, it wasn't an informed choice, so I did the opposite and went back to the Dr, and it turns out I need double to what I had.

I found the comment regarding fat cells around the middle interesting. A few years ago I was told my cholesterol was too high (6.9) and I had to take statins which I refused. Instead I lost weight and exercised more losing 2 stone, my cholesterol went down to  non risk. However I felt my health went down too, my VA got worse, I suffered for months with recurring thrush and bladder problems, I had palpatations and anxiety (had Talking therapy) and I'd wake up in the night with my chest and neck wet through.
I went through menopause with mild symptoms, the odd hot flush and palpatation but never needed HRT.

Five years post menopause and I was diagnosed with severe GSM and prolapse and eventually managed to get under control with local estrogens. That was 10 years ago, I'm 69 now. The weight I lost a couple of years ago has gradually crept back, not all, I definately have a cuddly belly, but I feel well. I feel better than when I was thinner. I'm not saying everyone should get fat but maybe we get the middle age spread for a reason.
I've always been naturally thin all my life  until peri menopause when I gradually gained weight and have stayed that way.
I use vagifem and estriol cream nightly so maybe some of that goes systemic and helps, who knows.

Hello
I learned about the cuddliness around the middle from Dr Louise Newson, she explained about the body producing estrone in the absence of the oestradiol our bodies stopped producing.
Sorry you had those symptoms, they are due to low oestradiol, which is a risk to future health.
Vagifem is not synthetic and will not protect you but oestradiol will and progesterone if you have a womb and perhaps consider adding in testosterone.

[Dandelion]

Thanks Pippa, Dandelion and bomb for your kind words.  I'm trying to persuade my sister to consult a private menopause specialist (which she can afford) but it's not easy because she seems to be convinced by what this so called specialist said which is s actually contrary to what the NHS says about HRT and osteoporosis.  I'm thinking the Newson clinic or Professor Panay would be a good place to start.

Pippa, I had to go back to Oestrogel because I needed a higher dose of oestrogen for symptom control.  It's a pity because I found Lenzetto so easy to use.

You're welcome.
I hope your sister gets sorted.
Nick Panay is Dr Louise Newson's menopause doctor as her own GP would not give her hrt 😐

[Dierdre]

I wonder, does Estrone protect us? I always wonder also how some women manage without HRT and are OK and others have an awful time without it. Is it because they aren't producing Estrone or enough of it post meno to compensate the loss of estrogen?
Can we take Estrone or has that not been manufactured yet? Just googled it and there is a cream for vaginal use.

[buffy26]

buffy26 - really interested to hear of your experience of being on Lenzetto as that is what I am being swapped onto because of the shortages.  A lot lower dose to start with though - 2 sprays for a week then going up to 3.  I am seriously hoping it works for me as I am running out of options .  I am on a 50 Estradot patch at the moment.  xx

Hi Pippa, its working for me so far, but so did Oestrogel for a time! I do find it very convenient but as I am on 6 pumps a day to enable me to reach the target level on NHS guidelines, it runs out very quickly. I spoke to my doc on the phone the other day, to discuss the testosterone and she said I should change where I apply the spray as it is reputed to be more affective on the inner thigh - but I find it is more difficult to get a decent spray at that angle. It sounds as though you may do well on it, as Lenzetto is not as strong as the other forms, perhaps the eventual 3 sprays will serve you well. A lot of ladies who do not absorb well seem to have success on it. I am keeping my fingers crossed! Just to forewarn you, I have experienced delays in getting my prescriptions due to difficulties in supply. I hope it doesnt continue! Good luck

[buffy26]

Dandelion, yes absorption seems to vary greatly & as Sheila suggests perhaps changes over time. 

It's not so much that I feel I need lower dose oestrogen in my early-mid 60s to control symptoms than I did previously, more that side effects with higher blood levels seem to have worsened to the extent they outweigh the beneficial effects I formerly felt, meaning I've had to reduce my dose.  I remain symptomatic to some extent & have worried somewhat about reduced bone protection given osteopenia, but I'm becoming resigned to the situation.  I reason that some oestrogen replacement will be better than none & with other systemic conditions in the mix my priority has to be achieving the best overall balance I can.  My latest E2 result was ~170 on 30mcg Estradot (just below top of postmenopausal range) so a lot higher than the unmeasurably low result I had before starting HRT 10 years ago.

The great thing about this site is that all opinions are represented and that is of value to us all.

Kathleen, I agree but would add that I also find it helpful when longstanding members continue to post their experiences so that we can see how situations change, or not, over a period of some years & that may throw light on our own circumstances.  As I age, I'm very interested in the experiences & opinions of women older than me, in their mid-late 60's & 70s, whether on HRT or not, as I think the wisdom that comes with life experience can be invaluable, helping us develop new perspectives on issues we may only just be beginning to experience ourselves.

W x

Hi Wrensong, just wondered if you were re-checked for any improvement in bone density after the Osteopenia diagnosis? I am not sure if it is standard practice. I am so scared of falling over and fracturing, as I had fractures in my 30's and I still shudder rememberng the pain

[bombsh3ll]

Estrone is considered less favourable metabolically than estradiol, and there is some suggestion it is more inflammatory and possibly less good for breast health.

Louise Newson talks about this however I don't personally share some of her views about transdermal estradiol being better than oral as there is theoretically less conversion to estrone

Whilst estrone from fat cells is better than nothing in an untreated postmenopausal woman this situation is far from optimal.

My nana was obese and never broke a bone, but she had other problems due to lack of estrogen, whereas my mum is slim and has multiple osteoporotic fractures.

I am not going to accept either of those fates for myself.

[Dierdre]

The problem is getting GP's to prescribe HRT when there's no menopausal symptoms post menopause, just for prevention of osteoporosis. Even if you're diagnosed with this, HRT is not the first option if you have no other menopause symptoms.
My only symptom is GSM and this is managed quite well with local estrogens but if I did start having more post menopausal symptoms I think I would struggle to get HRT at my age now (69) from the GP without a gynae to intervene. I had to get the gynae to up my vagifem years ago and add Estriol cream as the GP wouldn't without their approval. Both are on repeat now but I still dread the yearly review as in the past I've had to battle with the resident incompetent pharmacist doing the review, who wanted to reduce my dosage "as it causes blood clots". Sadly this is what some of us are still up against. Thankfully he's gone.

[bombsh3ll]

Estrogen is actually licensed for osteoporosis prevention in the UK, however this is often not disclosed to patients in favour of less effective drugs such as bisphosphonates, with significant toxicity.

The BMS website actually states:
Oestrogen remains the treatment of choice for osteoporosis prevention in menopausal women,

I don't know whether I will ever experience any stereotypical symptoms of menopause - my mum didn't, and I had none when shut down with buserelin for IVF - but I sure as hell will be claiming raging hot flushes if that's what it takes when the time comes!

[Joaniepat]

Estrogen is actually licensed for osteoporosis prevention in the UK, however this is often not disclosed to patients in favour of less effective drugs such as bisphosphonates, with significant toxicity.

The BMS website actually states:
Oestrogen remains the treatment of choice for osteoporosis prevention in menopausal women,

That's true, osteopaenia was one of the reasons I was "allowed" to get my oestrogen supplementation back in my late sixties. My Premarin was confiscated in 2003 (at age 54) as a result of the hysteria surrounding the WHI study. My osteopaenia has remained stable since, which I regard as a win of sorts as my mother had severe osteoporosis of the spine.

JP x

[Wrensong]

Hi Buffy, I think you may need to ask your GP to refer you for another DEXA if it's some time since you had your last, unless you are fortunate to be with a menopause clinic that might do this for you.  My endocrinologist has a special interest in osteoporosis & it was he who last requested my GP arrange a repeat scan.  I think I've only had 3 over about 20 years.  There is no automatic recall, at least in this area.  My last was 5 years ago & my oestrogen levels have been up & down rather erratically since then with huge variation, so I have no idea what my bones are like now.  It's been on my list of medical matters to sort, but lower down than others each time I've had an endocrine review & though I have flagged it up once or twice it's never made it into the clinic letter.  I will have to flag it up with my GP & ask if she can arrange another, but I think it's at their discretion & may depend on risk factors & degree of lower than average density (mine was only minor).  I think I was only permitted to have a DEXA on the NHS at first because I'm underweight & chronically hypothyroid & thyroxine use was at one time considered a possible risk factor.

I'm sorry you had painful fractures at such a young age & can understand your concerns.  I'd check with your GP/MS to see what the situation is.
W x

[SarahJane1234]

Thanks Pippa, Dandelion and bomb for your kind words.  I'm trying to persuade my sister to consult a private menopause specialist (which she can afford) but it's not easy because she seems to be convinced by what this so called specialist said which is s actually contrary to what the NHS says about HRT and osteoporosis.  I'm thinking the Newson clinic or Professor Panay would be a good place to start.

Pippa, I had to go back to Oestrogel because I needed a higher dose of oestrogen for symptom control.  It's a pity because I found Lenzetto so easy to use.

You're welcome.
I hope your sister gets sorted.
Nick Panay is Dr Louise Newson's menopause doctor as her own GP would not give her hrt 😐

I've had a telephone consultation with Nick Panay via the NHS menopause clinic at Queen Charlotte's and he was very helpful for me regarding testosterone

[Pippa52]

SarahJane1234 so pleased for you that Nick Panay was so helpful. 

[Dierdre]

Estrogen is actually licensed for osteoporosis prevention in the UK, however this is often not disclosed to patients in favour of less effective drugs such as bisphosphonates, with significant toxicity.

The BMS website actually states:
Oestrogen remains the treatment of choice for osteoporosis prevention in menopausal women,

I don't know whether I will ever experience any stereotypical symptoms of menopause - my mum didn't, and I had none when shut down with buserelin for IVF - but I sure as hell will be claiming raging hot flushes if that's what it takes when the time comes!

That's good to know it's licenced for prevention and we can go armed with that information if needed. It might not be an option for me though, I did try systemic HRT oral and transdermal at age 62 for 6 months to try to improve my GSM but the side effects and heavy bleeding became too much so I gave up.
Local  estrogens were then increased and luckily have worked since.

[bombsh3ll]

There's also tibolone which is indicated for osteoporosis prevention and suits some who haven't got in with conventional HRT.

Tibolone is generally bleed free and has a LOWER risk of breast cancer than continuous combined HRT.

It also doesn't increase the risk of blood clots - this is stated in GPnotebook.

There is a marginal (0.3%) increase in absolute stroke risk.

[buffy26]

Hi Wrensong,

Thank you for sharing your journey. I have no faith in the endocrinologist in my local hospital, he declared, "you have undetectable estrogen and testosterone, but thats completely normal for a woman your age" Switching the focus to testing for diabetes insipidus as I had night time frequency going 5 times a night. Completely unaware this is text book due to estrogen deficiency and I urgently needed vaginal estrogen! As soon as a saw a meno speciaiist she prescribed Vagifem, my loo trips are once a night now! I still cannot believe it. I may ask at my next review about the Dexa, but like you my estrogen levels have been like a yoyo. Hoping Lenzetto will be the saviour  and then I can get the testosterone sorted, at last.