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[KK75]

Hi all,

I am 50 y/o and had no bleed for 3+ months.
I have been on HRT in tablet form for 2 years, then patches which were short lived with horrible side effects then onto gel with progesterone tablets about two months ago.  I didn't get a chance to feel full benefits as I had to come back off again in prep for surgery, however, it zapped the night sweats and hot flushes which were literally on a loop.  My mental health was also taking a nose dive, which improved too.

Now post op, I am free to go back on, however, the flushes and sweats have not returned.  Generally, I feel OK(ish).  Despite not bleeding, I am definitely still experiencing symptoms, like the wee angry woman in a permarage.  Still got brain fog.  Libido isn't low, it needs dug up from the cemetery!  Having said that, none of the HRTs I have been on have helped with libido.

Bloods done a couple of months ago did show that despite being on HRT, my oestrogen was still low and testosterone was on the low side of normal, although I still can't get a prescription for it on the NHS.

I am conflicted about whether I should go back on HRT or just leave things as they are and would welcome your views.

[sheila99]

I think this is one where only you can make the decision. Personally they'll be prising it out of my cold, dead hand but I have symptoms that make my life hardly worth living ( and hell for those who live with me). I think you need to consider the long term risks of not taking too, particularly osteoporosis though if course it may be that you won't get it anyway ( level of at least 250 needed for bone protection). If you levels are low it might be that they're insufficient to help with libido though some people need testosterone as well. You could ask for a referral to an NHS meno clinic for it, by the time you get an appointment your levels may have fallen enough to get it, or if you can afford it try Newson.

[bombsh3ll]

If you can afford to I would see a private specialist because it doesn't sound like you have had very good care this far.

A couple ot things - why did you switch from oral to patches? Oral estradiol is convenient and reliable, and due to the era it came on to the market (pre-WHI) the doses in oral treatment are typically more generous.

Blood tests - if taken on gel, blood tests for estradiol are clinically meaningless due to the pharmacokinetics - it leaves the bloodstream very rapidly.

Surgery - if you were on transdermal this doesn't need to be stopped. Premenopausal women aren't put into chemical menopause if they are having an operation. You were given ill-informed advice. (Oral HRT can be temporarily switched to transdermal to mitigate perioperative thrombotic risk)

Finally, hormone therapy isn't (or shouldn't be) just to palliate vasomotor symptoms. Your brain, heart, bones mental health and libido etc all matter as well, and what you need is a clinician who thinks so too, AND has the skills to achieve this.