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[CrazyDutchwoman]

Hello there.  I am new to this board. So glad I discovered it.  I began menopause when I was 44 and I had so much trouble coping with the hot flashes and night sweats the doctor put me on hrt. Admittedly I did not  do any research because I was glad it helped.

This male doctor told me I had to try and stop once every year and if I still had hot flashes then I should keep on using it.  He made me believe that one day i would quit the activella and voila I would not have any menopause systems. That being said I tried to quit. Tried cold turkey tried cutting the pills but to no avail because I always had so many side effects.

Last year I changed to his colleague who is female and really listens. She told me that this was not correct and told me that if I kept using it I was in danger of getting a bloot clot and suggested to stop.  I decided to just do it cold turkey.

The nights are horrible because I keep on waking up and it is getting to me now mentally.
I used activella once a day and pill which contains estradol and norethindrone.

Tomorrow I am going to call and make an appointment with here. She also told me some people will always keep symptoms like hot flashes and night sweats and that scares me. Do you have any advice for me? I feel alone in this. There is not much info on women who quit after talking hrt for nearly 20 years.Thank you

[bombsh3ll]

This is inhumane and outdated practice which is not in keeping with current clinical guidelines.

All relevant professional societies now recommend hormone treatment for menopause be continued as long as the benefits exceed the theoretical risks for a particular individual.

There is no age or duration at which treatment should be arbitrarily stopped.

You cannot do anything about the lack of professional education and training of your doctors, however you can educate yourself about your condition and its treatment, and seek out care from a provider with the appropriate knowledge and skills to meet your needs.

[CLKD]

   looks like the rest of the medical World needs to catch up regarding menopause symptoms and appropriate treatments?

She is talking out of ......... yes some women [not people] may continue with flushes and sweats until their oestrogen drops completely. I wonder how many she might B referring to.  I hate it when medics talk about others without addressing my own problems!

Some find that keeping a mood/food/symptom diary of use to chart progress.  It reminds us that there are 'better' days too.

Browse round MM.  Make notes ;-).  Read about the various types of HRT as well as those threads regarding vaginal atrophy - 4warned is 4armed ;-). 

[Konijntje]

This is inhumane and outdated practice which is not in keeping with current clinical guidelines.

All relevant professional societies now recommend hormone treatment for menopause be continued as long as the benefits exceed the theoretical risks for a particular individual.

There is no age or duration at which treatment should be arbitrarily stopped.

You cannot do anything about the lack of professional education and training of your doctors, however you can educate yourself about your condition and its treatment, and seek out care from a provider with the appropriate knowledge and skills to meet your needs.

If CrazyDutchWoman is indeed Dutch, the Dutch guidelines for GP’s unfortunately still say to preferrably use hrt for less than 5 years, because of increasing risks beyond that time. There is a reason that compared to the rest of Europe, there are way more Dutch women suffering true menopause without any treatment at all.
(The guidelines even talk of risks being the same with vaginal estrogen, it’s all very outdated and while it gets updated frequently, they are so far behind the British (and other) guidelines, it’s just ridiculous. I just started Oestrogel myself and max dosage is 2 pumps, while almost all guidelines say 4 pumps, it’s just, well, I’m just going to use ridiculous again).

[CLKD]

MayB dip into the British Menopause Society guidelines as well as what NICE have to say here?  No medical profession should be denying patients treatment in any speciality based on outdated Research!   

[Konijntje]

MayB dip into the British Menopause Society guidelines as well as what NICE have to say here?  No medical profession should be denying patients treatment in any speciality based on outdated Research!   

Yes, I think those guidelines are much better. To be fair, the Dutch Menopause society is much more up to date than the GP guidelines here too, although still not as well as the British Menopause Society and NICE.
I’ve been referred to a specialist myself and those are much more open to prescribe other options than my GP (and she was more than willing to refer me when she didn’t want to prescribe outside the guidelines herself, so not really any complaints there).

[CrazyDutchwoman]

Wow. I am in shock.I did not expect your replies as in that you all think I should have just continued the hrt. Because of her saying I had much more change of a blood clot. I did read this on some other (mostly Dutch) sites as well.  To be honest I would of course love to not need the hormons so I hoped it will get better. I am going to take your advice and read a little bit more about it on this forum and only then will I decide if I keep on going without and hopefully the night sweats especially those stop or I go back on hormons. Thank you so much. Dank je konijntje   

[bombsh3ll]

It is technically true that oral hormone therapy increases the chance of a dvt - by about one extra case per 4000 or 5000 women per year.

This is statistically, but not clinically, significant.

The risk is far greater with overweight or obesity, smoking, an unhealthy diet or a sedentary lifestyle, yet the media isn't terrorising people with any of these stories every half hour.

Transdermal estradiol (patches or gel) has no increased thrombotic risk at all.

However it is a personal decision and perfectly valid to accept the minuscule increase in dvt risk if you are otherwise healthy, for the convenience and effectiveness of oral estradiol.

Additionally it is worth mentioning that in countries with a developed healthcare system, it is exceptionally rare to die from a thrombosis even if you are the unlucky person who gets one (most of whom have never taken hormone therapy) as it is very easily treated if presented early.

[CrazyDutchwoman]

Thank you. bombsh3ll . One more question.Is it also possible that if I keep on not taking it the night sweats and hot flashes will eventually disappear?  So glad I discovered this board. I have been searching for these answers for the last months.

[Mary G]

Just to add, I have several Dutch neighbours in my immediate area (there are a lot of Dutch people who live here part time of full time) and all of them are suffering from untreated menopause symptoms and they all seem unreceptive to any kind of help.  One of their partners approached me because he was so concerned about the behavioural changes (she has completely given up driving which is a massive problem here) and other debilitating symptoms like insomnia, mood swings and night sweats so I gave it to him straight, HRT is the only way to go (it's very easy to get hold of here) and I urged him to persuade her to take it but as far as I know he's not getting anywhere.  He thought the menopause only lasted for a few years and then everything gets back to normal so he was gutted when I told him it's for life unless you replace the lost hormones. They seem to be a some kind of weird denial.

The anti HRT sentiment seems to be hardwired into the culture and yet they all have debilitating symptoms - night sweats are no fun in this climate.  It's a real problem that is not being addressed and I get the impression they can't face it and have a psychological problem with ageing or something, I don't really get it.  They don't know it but they are all younger than me.

I would ignore that culture and immediately restart HRT.  It's complete nonsense to tell women to suffer debilitating menopause symptoms and frankly it's cruel.  The benefits of HRT outweigh the risks and most definitely protects women from future health problems like osteoporosis, heart conditions and there is increasing evidence HRT protects against cognitive decline and dementia.  So it's not just about relieving the immediate suffering like hot flushes and night sweats, it's about protecting your future health.

It sounds like something definitely needs to change with menopause treatment in the Netherlands.

[Konijntje]

I do think things are changing, not because of the GP guidelines obviously, but more because my generation is more used to doing our own research and expressing what we want at the doctors. I’ve said numerous times to my mother in law that she should ask for vaginal estrogen (she has recurring uti’s and a recurring prolapse of her bladder), but she just doesn’t and the doctors don’t offer it, even though I showed my mother in law that it is in the gynaecologists guidelines as a treatment option. It is very frustrating.

The cultural background for it is probably Calvinism and even though I’m from the Catholic South, it’s still very much embedded in Dutch culture.

However, I’m 50 and there are plenty of people my age that are on hrt and even though it still feels a bit like something you are supposed to suffer through (I don’t feel like that myself, more like that should be the general concensus), I do notice that hrt is being talked about more and more. So, I do think things are shifting, just too slow.

[CLKD]

If your relatives won't take the chance of HRT Konijnttje, then gently tell them if they continue to complain that U have given advice which is backed up with Research and personal experiences on these sites, that if they won't take responsibility for their health then U don't want to hear about it in future.  I had to do this with my Mum about a non-related health issue: she would phone over and over and responded to my suggestions with "I can't do that Dear!".  Eventually I contacted her GP directly, which went down like a lead balloon 

She did eventually stop harassing me  .

No patient should suffer!  Especially as in the 1st World there is access to treatments, unlike in War Zones or cultures that are widely spread from Cities. 

[CLKD]

CrazyDutchwoman ......... symptoms may continue for years after the final bleed, it depends a lot on how quickly the hormones drop sufficiently to ease flushes etc..  Why suffer?

MayB keeping a mood/food/symptom diary would be of use?

[Mary G]

Thanks Konijntje, I think we are talking about a form of puritanism here and what is often referred to in the UK as wearing a hair shirt.  None of these people I'm talking about are at all religious but I can see a cultural thread of puritanical behaviour like not having air conditioning for example - not much fun for women suffering with night sweats.

I hope the younger age group can change things there and HRT becomes more readily available.

[CLKD]

Amish mentality?  I wonder how many cultures shun treatments that would enable them to function