Menopause Discussion > All things menopause
HRT--good or bad?
newstart:
I'm on a roll now .....
Follow up study on women doctors' HRT use:
Link:
http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=16096171&ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstractPlus
UK women doctors' use of hormone replacement therapy: 10-year follow up.Isaacs AJ, Drew SV, McPherson K.
Department of Health and Social Sciences, Middlesex University, London, UK.
OBJECTIVES: To determine changes in the prevalence and duration of use of hormone replacement therapy (HRT) by women doctors over 10 years. METHODS: Questionnaire survey of 1234 UK women doctors (randomized, stratified sample), compared with a similar survey in 1993. RESULTS: In women aged 50-64 years, the age-standardized prevalence of ever-use of HRT had increased from 53.4% in 1993 to 66.2% in 2003 (p<0.001). There was a marked reduction in uptake by women under 50 years, while the age-standardized prevalence of current use in women aged 50-64 years was unchanged at 38.1%. The discontinuation rate in this age group had increased from 27.8% to 42.4% (p<0.001). Over 20% of women aged 65-74 years were still using HRT. The median duration of HRT use was 8.1 years by current users and 5 years by past users. The major indications were symptom relief and osteoporosis prevention. Current users of HRT tended to have more definite views about the potential risks and benefits of long-term use than past or never-users. CONCLUSIONS: The proportion of women doctors starting HRT increased after 1993, but uptake and continuation rates have now both declined, consistent with prescription data, probably reflecting the changing nature of the evidence base. However, many women doctors still intended to continue long-term HRT.
PMID: 16096171 [PubMed - indexed for MEDLINE]
flutterby:
Hi Patricia
Very interesting, good link too. Mind you statistics have never been my strong point.
Flutterby
SevenOfNine:
I wonder how many women doctors have tried to come off it (unsuccessfully)?
I think to HRT or not to HRT is a VERY personal and individual choice. Some suffer many symptoms (my own 3 years of hot flushes/night sweats is driving me MENTAL :'(), in the end some are desperate for relief and who can blame them. In most cases HRT will bring back a quality of daily existence which went down the plughole on day 1 of the meno hitting us.
Every day I think "just take the stuff and be cool for a change", but I'm 3 years into this - surely there's an end in sight........!
My problem is the lack of knowledge of some who are on it. No idea that you do not 'bypass' the menopause symptoms. When you come off HRT you will catapult right back to square 1, you don't suddenly start making your own hormones when the artificial ones are withdrawn. The best you can hope for is to minimise the return of symptoms with a controlled and lengthy withdrawal from HRT as opposed to the 'natural' peaks and troughs the rest of us must tolerate.
Many have not researched the difference between bio-identical HRT and conjugated horse pee ones. In UK no natural progesterone is available to combine the oestrogen with, so we are left with only a synthetic choice. Many do not choose which one they would like to try, merely taking the first prescription given. Make no mistake, a GP in UK is driven by PRICE, Elleste Duet is very popular here - it's also the cheapest. Coincidence??
When I visited my GP 3 years ago he gave me a prescription for HRT and delivered his "on it for maximum 5 years or until I was 55" rule (same thing for me). He had no answer when I asked "but what then"? He had absolutely no alternative he was willing to give me at that time and I was sent on my way. I chose not to take it (make no mistake, it is HARD).
The medical profession cannot seem to agree from 1 year to the next whether or not HRT is 'safe', so we are left to weigh it up ourselves. Personally, I don't believe it 'causes' breast cancer, but I do believe it may make those women predisposed to BC move along more rapidly towards it. Many BC tumours have hormone receptor cells, sufferers are frequently given Tamoxifen to 'knock out' their oestrogen after a BC diagnosis and suitable treatment. Do I want to put and artificial version of oestrogen and progesterone into my body after it has reached a time of life when it has decided it is no longer needed? Lets face it, the human body is an incredibly sophisticated machine, does it know what's best do you think?
Enough waffle from me. At the end of the day no woman should feel she has to justify taking HRT nor justify not taking it. We are responsible for our own bodies and must guage quality of daily living and make our own choice. Thankfully we now have the internet, a godsend for info and advice. Good luck to all of us, whatever we decide. :foryou:
flutterby:
Hi SevenofNine
Couldn't imagine the Borg having meno symptoms does the whole collective suffer - sorry, quite a Star Trek fan myself too.
Seriously though It definitely wasn't waffle what you said - it was very interesting
I don't know whether I subscribe completely to this 'just delaying the inevitable'.How many menopausal symptoms are due to the wildy fluctuating levels of hormones, rather than lack of them. If while you are on HRT, your own hormones are kept in check but are diminishing,surely there is a chance when you come of it the symptoms will not be as bad. This may be a different time scale for different women.
I appreciate your body is not going to replace the oestrogen when you come of it and it makes sense that some symptoms would start again or even new ones. But I know several women that had virtually symptom free menopause so what is going on there.
There are so many variables, my brain just starts to boggle.
Wouldn't it be great if the menopause was taken a more seriously and a lot more research done.
I am hoping I will be like my husband's step mother - Really bad meno symptoms in late 40's, on HRT for 7-8 years came off it - no problems.
Flutterby
Hot2Trot:
You say you are three years in SevenofNine. From the experience of women on the forums, you may be only in the early days. I was well over two years post menopausal having had a peri-menopause of nearly five years. I was not symptom free at that point and in view of the fact that, as you rightly say, we never produce again the natural oestrogen of the past, I cannot see how we can actually ever be symptom free again. My mum and my MIL and in fact every older lady I know, still suffer from sweats and heat intolerance. Poor sleeping is often mentioned and I have to wonder how much of that is actually down to menopause symptoms and not age. I know my mum has complained for a number of years about poor sleeping and yet on the face of it, there is no real reason why she should not sleep at least reasonably well.
I do have issues with the use of horse urine products, but that is an ethical choice. I am lucky that I have not been prescribed that and because I was started on HRT by my gynae who I see privately, I have also not had to settle for the cheapest. Fortunately my GP has agreed to take on responsibility for my HRT and has put it on repeat prescription, to be reviewed in May (or sooner if necessary).
I was one of the most anti-HRT women you could have found. Having started on it though I realise I was selling myself and other women short. At 46 years of age, the benefits outweigh the negatives. I have a number of years of working life ahead of me, not to mention a desire to have an active and fulfilling retirement. None of this is possible when a lack of sleep at night drives me to bed in the afternoon. Quality of life has to be a consideration and it is this that will make me fight to remain on HRT until I choose otherwise, not because my doctor has a fixation about length of time on it.
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