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[BarbieAnn58]

Hi Ladies,  I wonder if any of you could offer some advice, I am 61 years of age and had a 5 year relatively trouble free time on tibolone 2.5mgs, after wrongly being prescribed sertraline in my mid 50's. However I had a sudden one off bleed, that lasted intermittently 10 days whilst on a holiday to Aus; I stopped my tibolone whilst on my holiday and after following the 2 week path way with an USS and hysteroscopy and biopsy my endometrial lining was found to be 6.5mm but no abnormal cells or further bleeding. No advice other than ?stay off HRT due to risk of stroke or heart attack. Well since then I feel like I am on an emotional rollercoaster, I can't stop crying, I can feel like I am in a rage one minute and so upset the next, I keep forgetting things and my concentration is lapsing as well as sweats returning and the usual dryness, but I have no idea whether I can restart HRT. Does any one know if I can approach my GP? Was even looking at private clinics near too. Any advice or help would be greatly appreciated, I am an active fit, still working 61 year old, with just mild osteoarthritis. Many thanks Babs 

[Dotty]

Hi and welcome to the forum.

There’s no reason why you can’t go back on hrt. The risks of stroke and heart attack are minimal and quality of life is important.

I hope you get a knowledgeable GP.

[sheila99]

Tibolone is for ladies up to 60 as the risk of stroke increases after this age but you can still use transdermal hrt. They like the lining to be 4mm, some say 5, but 6.5 is above what the want so a change might be a good move anyway

[BarbieAnn58]

Thanks for your replies ladies, much appreciated, I think I will be back at the GP and ask to try the transdermal HRT.

[bombsh3ll]

Just to say any treatment should be based on individual risks vs benefits and that hard age based cut offs go against clinical guidelines.

There is a very small risk of stroke with tibolone which was shown in women over 60, many of whom had pre-existing risk factors in that study.

However for most healthy women the benefits far outweigh the risk, and individuals should be afforded the autonomy to make an informed decision

Birth control pills also increase the risk of stroke by a greater (but still tiny) percent, but nobody suggests healthy women should forego birth control.

Also the reason you were being given for being denied further treatment has nothing to do with the reason you initially halted it which was a vaginal bleed with benign investigations.

[sheila99]

The difference is that those on birth control are all younger women who have a low risk of stroke. Over 55 your risk doubles every 10 years and over 65 they aren't uncommon. Obviously there are lifestyle factors too but I don't think you'll find many gps willing to prescribe something with a known risk when there are alternatives that don't carry that risk.

[BarbieAnn58]

Thanks for your responses, I am really having difficulty with flushes, tiredness,insomnia, weepy, low mood VA and generally not feeling myself. Can I request to recommence low dose transdermal patch & progesterone with the 6.5mm hyperplasia?  Would my GP prescribe it? Do you need regular USS with this level of thickness to uterine lining? I didn't ask any of this when I had my hystersocopy; couldn't get out fast enough and gynae Dr's just said to stop HRT if possible.
Would I be better going to a specialised clinic?
There seem to be quite a lot of benefits to HRT  & I didn't expect to feel so wretched, but that was the reason I started it, don't know why I should be so surprised.
Just worried about this hyperplasia, was only told to get in touch with GP if further bleeding, end of.
Any advice will be much appreciated.