Menopause Matters Forum
Menopause Discussion => Alternative Therapies => Topic started by: Eliza H on January 31, 2018, 08:14:14 AM
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I am one of three sisters, all now in our sixties. My two sisters went down the HRT route and are now struggling to stop using them. One recently did the cutting down/ weaning off route over a long period, but without success as symptoms came back so severely that she had to give up.
I managed with herbal remedies, taking soya products from my mid forties, and supplementing them with different extras like sage, red clover etc as I went along. As soon as one extra seemed to be losing its effect I swapped. All I get now is too warm at night/ poor sleeping, but at least I'm not now facing a struggle to wean myself off a drug that I no longer want to take. As far as I can see HRT is offered as a quick fix without all the future problems it brings being properly spelled out to people. Who wants to deal with all the menopause symptoms late in life?
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Eliza H, I am going to take HRT for life, it is a decision I made a long time ago. There is no longer a time limit for using HRT as there was years ago because it moved on and the newer bio identical brands like transdermal Oestrogel are much safer than the older versions used 20 odd years ago. All HRT risk is in the progesterone component and again, things have moved on a many of us on here use localised vaginal micronised progesterone which has minimal risks and doesn't damage your breasts. So there is no longer any need to look upon HRT as a short term solution with a view to weaning yourself off after a few years.
The NICE guidelines changed a couple of years ago but the new information is taking a long time to filter through the system. The good news is that the deeply flawed HRT studies carried years ago have been discredited and more or less consigned to the garbage bin of history. The outdated oral HRT forms used in those studies were heavily laden with synthetic progesterone and women don't use that type of HRT now.
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I think what Eliza is saying is that she is now mostly sympton free so would not need HRT. Where as her sisters have bad effects when they try to stop. Sounds like a dependance problem and I can see her point. I also used alterative treatments and 5 years post meno am symptoms free (though sometimes hot at night). No matter how good HRT might be I would not like to be trapped into taking it for life. That, for me, would have been to high a price to pay.
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It is really time we permanently laid to rest some of the more common misconceptions about HRT.
Firstly you do not go through menopause twice (if you go through menopause during the normal age range) so taking HRT does not delay the menopause.
Menopause occurs when the ovaries pack up and is preceded by the peri-menopausal transition characterised by wildly fluctuating hormones levels, mood swings often with irregular and erratic periods over several years. Some women suffer debilitating hot flushes and sweats as well as other symptoms and HRT is prescribed to enable them to achieve a better quality of life and ease them through this time until hormones stabilise. In many women this is essential to function and not simply a quick fix in the same way that taking an aspirin for a headache might be if you don't know the underlying cause of the headache. There is no virtue in powering on through and suffering.
So even if you only take it for a few years and you stop when you estimate you will be post-menopause, your hormones will have stopped surging and your ovaries will have packed up so you do not have years of symptoms due to this. Looking at the most obvious symptoms of flushes and sweats that drives most women to seek help - research is increasingly showing that some women (those who have not taken HRT) continue to experience hot flushes for many years after menopause – which can be up to 14 years. You cannot predict in advance if you are going to fall into this category, and nor can you predict the course and severity of your menopausal symptoms from that of your relatives eg sisters, although there is a correlation between age of menopause and age of your mother's menopause.
Still keeping to the flush issue – those who have gone through menopause and whose flushes have subsided – have been lucky – but you don't know in advance whether, if you start HRT you will be one who would have stopped. In terms of coming off HRT – some research suggests that tapering off HRT slowly might prevent the worst of the rebound effect – ie sudden recurrence of flushes – but not everyone will experience a resumption, and of those women some may experience them for perhaps 9 months or so and then they stop. This is much less time than the years of flushes they might have had, if they had not taken HRT.
Added to that you cannot take away the years of benefit you will have had while on HRT - the quality of life and your health, and the additional years of bone protection to give an obvious example, as well as protecting the cardiovascular system. Post menopause and associated oestrogen deficiency is for ever – so it is not just about symptoms like flushes and sweats. The long term benefits of taking replacement oestrogen are becoming increasingly recognised as we live longer than ever before, perhaps up to 40 years post-menopause.
The current view is that up to the age of 60 the benefits of HRT exceed the risks, from 60-70 there are approximately the same and only beyond the age of 70 do possible risks potentially begin to outweigh the benefits. I say potentially because there has not been sufficient research into long term HRT use in over 70 and particularly of the bio-identical type ie estradiol and progesterone – which are the same as our own body's hormones.
Other factors put women more at risk from things like breast cancer or stroke than taking HRT – for example being overweight, smoking, drinking alcohol over recommended limits, taking insufficient exercise, eating a poor diet – all put us at risk of various cancers. If you aim to keep yourself as healthy as you can post 50 especially, but continue to take HRT – you are minimising these other risks – and of course improving your overall health and quality of life.
Phyto-oestrogen supplements and in the diet may have a weak effect and help some women's symptoms a little at some point during menopause (perhaps very early and post-menopause?) although evidence is not conclusive – but they are no substitute for replacing oestrogen.
Some women who have had breast cancer are unfortunately unable to take HRT and there are other prescribed medications available to relieve symptoms.
“As far as I can see HRT is offered as a quick fix without all the future problems it brings being properly spelled out to people.â€
Many of us would like to see the future problems and possible health consequences of NOT taking HRT– (cardiovascular problems, osteoporosis, vaginal atrophy and more) properly spelled out to women.
Those who continue to take it into their 60's (like me) know what they are doing and choose to continue to maintain oestrogen levels as long as they can, health permitting - and especially to try to stave off osteoporosis which besets many elderly women. Personally I may decide at some point to stop - but not yet - and I certainly don't feel trapped! :)
Well I got that out of my system!! ::)
Hurdity x
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Wow. Okay.
Glad you are happy Hurdity.
Each to their own. :)
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Bravo Hurdity, well said! Thank you for taking the time to write this excellent and comprehensive post, these things need saying.
:thankyou:
JP x
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At work I sit next to a 33 year old woman who said one day “ I don't know why you faff about with hrt, you're only delaying the inevitableâ€
I asked how on earth can you DELAY the menopause? When Your eggs are gone, they're gone! And if I could delay it I'll tell you now that I'd delay it permanently ! She soon shut up
Some suffer, some don't, some can't take hrt. I'm one that intends to stay on it for life, health permitting !
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Well I hope this thread hasn't frightened Eliza off. This forum is about sharing experience and that is all she did. I know many women are helped by HRT. Some try it and don't get on with it and some like Eliza and I chose a different route. That does not me we suffer less !! (who has the right to judge others experience). There is nothing wrong with different opinions but there should be healthy debate without it getting adversarial.
Well I'm off to Suffolk now. I hope you are still with us Eliza. ;)
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It's wonderful that some people are able to get through this time without HRT but that doesn't mean that it is a 'quick fix' for those who can't, or that they are necessarily going to end up with worse problems in future. You only have to read the many threads on this forum to see that some women have fought for years to be given HRT, so it's hardly a 'quick fix' for them! Also, most women on this forum are well-educated about the benefits and risks of HRT so have made their decision with that in mind.
OP, It would be really helpful if you could discuss which alternatives you tried and which you found most helpful. After all, this is a section for discussing alternatives, not for knocking HRT! Many women either can't take HRT or don't wish to, and it's helpful to know other people's experience of various alternatives.
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As with many health conditions, one size doesn't fit all.
I won't go over what has been said about menopause which 'translates' as the end of menstruation. My periods waxed and waned for several years: I would miss months and months then have periods regularly for months and months: then they stopped. I didn't stop carrying protection for 5 years though :D.
It's how ladies are treated by their GPs/Practice Nurse which may make the situation hard work. Some ladies find that keeping a mood/food/symptom diary useful to chart daily feelings. Gentle exercise can help. Some require HRT, some need anti-depressant and/or anti-anxiety medication, some require both.
There R no hard and fast rules but it can be Trial and Error until we find something that works to relieve any hormonal symptoms. That was the same 4 me trying to find an anti-depressant medication in the 1980s, it took MONTHS!
:welcomemm: Eliza H - browse round. Make notes ;-)
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So, from what I am understanding now from this thread and from other threads, future "problems not made clear" don't necessarily exist. Thank you Hurdity for unravelling the myths and sharing your experience to date and future HRT plans. I am 45 in peri for probably 3 yrs, but only now understanding it, trying phytoestrogens (4 mths) and testosterone (2wks). I am feeling better now, but making plans for the future (i.e., I will take HRT when I feel I need it). These discussions/debates are very helpful. Thank you all for your input.
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Menopause is the cessation of monthly periods. End of.
What we don't get told are that some symptoms can cause problems. But HRT doesn't delay problems - it is after all, 'replacement'. Some ladies require it, others don't.
Testosterone of course is the male hormone of which some may be low enough to have symptoms, my GP won't prescribe it. Fortunately my libedo came back up on it's own >phew<!
Keeping a diary can be really useful 'cos it's easy to forget how we are on our better days ::)
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Hi! I think that hrt is a necessity for premature and early menopause. I'm 42 and on hrt.
I think that estrogen is vital for my health and the quality of life. I don't want to suffer and I cannot see meno as a natural event at a such a young age.
I agree with you Mary G, I hope I can take hrt the longer I can. I take synthetic progesterone but I'll change it soon.
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Using hrt does not mean you will have a bad time when you stop using it. Hurdity, as always, has explained things very well. HRT is not for everyone but to assume HRT is not beneficial for many women is a narrow viewpoint.
ELIZA - It's not that we want to frighten you off - you are very entitled to your opinion. I can understand why you believe that HRT has perhaps made things worse for your sisters now - I do wonder why they have stopped using hrt? Have they been pressured by their GP? Unless there are health reasons or they simply decided they wished to stop, then they could continue if they feel good on HRT, provided they understand that there are very, very small risks.
We all experience the menopause differently - my 2 sisters had few problems. You may have been lucky and not had meno symptoms as severely as your sisters and the withdrawal symptoms, may well have been what they would have had during the years they were using hrt - they would not have had quality of life through that time. The average time for most meno symptoms to last is between 2-8 years but many suffer for 20 or more years!!! BUT the negative effects of oestrogen deficiency goes on giving problems for the rest of our lives. Life is short and if we need to work, then we do everything we can to keep working.
How much have you spent on alternative remedies over the years and how much have you had to adjust your life to cope with flushes, lack of sleep and generally feeling unwell?
As Hurdity has pointed out, HRT will offer protection for the bones and heart in the long term - so your sisters have a reduced risk of developing bone and heart problems. HRT will also help to prevent urogenital atrophy. I also believe there is research that shows HRT gives a reduced risk of bowel cancer! HRT us not just symptom relief.
If you are getting any urinary issues or vaginal dryness, I would strongly suggest you ask your GP for some local
Oestrogen - this can be used for life ( virtually no risks or side effects as it is not absorbed systemically) and will help to keep your whole urogenital area healthy for the long term.
I'm afraid many of us are fed up with people highlighting the negatives of HRT and not emphasising the positives.
DG x
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This is an interesting topic. I notice there are lots of threads and posts regarding starting HRT and problems etc., but not much input about coming off. I know I am not HRT literate but I would have thought coming off would have some sort of effect on symptoms, perhaps negative and positive, so ladies with personal experience could give valuable information.
The Choice not to take HRT was clear cut for me but for others such information would help in their choice. Especially as GPs seem to know so little the personal experience of others is even more important. That is what makes this forum so important. It would be good if ladies such as Eliza's sisters could come on the forum and discuss their experience.
The more information the better.
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Come in Eliza H >wave<
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Shadyglade that is an excellent point. For me one of the main reasons I have always been reluctant to go the HRT route is what would happen when I come off. The first gynaecologist I went to said that I would have all the same symptoms as menopause is basically your body trying to adapt to the reduction of hormones which is exactly what would happen when you stop the HRT. Some stories from ladies who have actually been through this process would , I agree, be very helpful. Being quite old now for starting HRT (57) my body got a huge shock when trying the full dose of the Oestrogel and testosterone and I felt dreadful. My Oestrogen was so low it was undetectable in the testing and I feel it was too much to start straight away on three pumps. This seemed to show me that my body was already part way through the process and that I would be back to square one if I did get my body to adjust to the high levels of HRT and then withdraw again at a later date. I know for many that HRT has been amazing and therefore the decision to continue is an easy one. I have tried four kinds of various types and not been so lucky.
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I suspect for some women it's getting through the body's adaption period, which then creates a new balance once you're there, and for others their oestrogen levels balance out too low so they feel they need to add more to top up to be at the same level as the first group.
The pill or HRT (if your hormones aren't too volatile) can also sustain you better through the early adaption phase. Many women have reported that stopping their HRT later means that their hormones will immediately fall rather than surge about for a few more years, as it may take another 10 years or more after periods stop for the oestrogen to settle.
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This is an interesting discussion. As the menopause affects everyone differently, each of us has to find what helps for us. However, for me, HRT isn't about getting through a few years of hot flushes and mood swings. The problems caused by lack of oestrogen are permanent. I'm 49 with a family and a full-time job, a lifetime of keeping fit and eating healthily. I am not ready to accept joint pain, vaginal atrophy, brain fog, cystitis, loss of libido, exhaustion, brittle bones, and depression for the rest of my life, and I will fight every step of the way to have a decent quality of life for as long as I can. For me, that means HRT.
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Wilks - you have summed it up perfectly. HRT isn't right for everyone but for so many it does give quality of life. As, when or if one stops HRT, like so many things, how one feels will vary - some crash, some have a bit of trouble for a while and for others (like me, after 25 years of HRT) the benefits of HRT were being outweighed by the side effects.
Most treatments have side effects and consequences - I have developed awful digestive problems as a result of PPI drugs and these are dished out routinely by GPs and can even be bought over the counter - nobody tells you the awful problems one gets when trying to come off these PPIs!!??
WE have choices but we need to be informed so we make the right choices. I want to be treated with respect and understanding by my doctors and have full information. DG x
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I took hrt for a couple of years after surgery.i tried two years without initially then two years with as sweats at 43 were unbearable,I then tried again without for 5 years,my health deteriorated terribly,all the usual symptoms of meno and some I never knew you could get with meno,I made the best descision I've ever made going back on it,stuff future problems,after a severe injury I've learned the hard way to live for today and In the present and if need be I'll deal with the future - in the future.
none of us can predict what's in store for us so I guess the secret is think positive and live in the present as best you can,I'm just grateful to be here even with my unpredictable issues lol.
Bless you if you can cope without hrt but some of us just can't.life deserves to be lived.xx
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Quality of Life Girls, Quality of Life - after all that bus might be along B4 any of us get ill from HRT!
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Stellajane - all you say is soooo true. I tried a very low dose Amitriptyline to help with back pain and the first 2 weeks were OK but by week 3 the side effects were horrid so I stopped taking it - it took about 4 weeks to get over the withdrawal - the GP didn't warn me about the side effects or the withdrawal problems!
The lobby against HRT, for all kinds of very spurious reasons, is still so strong and GPs very often tell patients that HRT will just delay the inevitable which is simply not true. What is inevitable is that without oestrogen the body does suffer and, as you rightly point out Stellajane, clearly some women's bodies can compensate for oestrogen deficiency better than others. DG xxx
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Be careful not to generalise DG. Women who don't take HRT do so for all sorts of reasons, and are not spurious but genuine and authentic. I personally wanted my help my body find it's own way through the meno, using more natural and holistic methods. I did suffer, but from what I read here on a daily basis, so do many women who are on HRT. We all choose are own path.
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If you read what I have said carefully, I am not generalising at all - there is still a very strong lobby against HRT. I was not referring to women who don't wish to take HRT - of course it is a choice and we all have to find our own way. I was referring to the press and many in the medical profession who deem HRT dangerous and unnecessary for the wrong reasons. Too many women are sent away from a GP appointment having been told to ‘ride the storm' or given a very scary talk about how dangerous HRT is.
I believe HRT is simply one of the many strategies we need to deploy to get us through this challenging time. I am 62 now and not on systemic HRT any more (had premature meno so had to have HRT for nearly 25 years and was so often told I was taking something ‘dangerous') so I have made the choice to go forward without HRT - although I would not be without the Vagifem which is a good preventative against the horrors of urogenital atrophy. I cope with the poor sleep, flushes and awful fatigue by tailoring my life around all these symptoms - I have given up full time work because I simply couldn't do it any more due to these meno symptoms but I was also struggling with the progesterone of HRT as I aged - so, for me, the natural way is certainly not easy.
It is, however, very tough to be judged as being ‘weak' for using HRT or, as a practise nurse commented, “using HRT to stay young looking†!!
Women have fought and still have to fight really hard to get help with menopause problems, so when someone tells us HRT is merely delaying the inevitable or will be dangerous for our health this is very wrong.
We are all different and those women who are lucky enough not to suffer badly with menopause symptoms can 'sometimes' sound very dismissive and sanctimonious and those of us who suffer have to smile sweetly and turn green (or should I say bright red) with envy that we are not like them. DG x
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Hello,
I have returned to the forum after many years..I am in such a bad way (very little sleep, sweats/chills, exhaustion and memory really bad) that could not work out how to post a message but found this thread which is relevant. Thank you for the comments on here.
I went on hrt when 47 (am now nearly 59) so,following advice of GP and nurse, have made several attempts to come off over the last few years as told I had been on long time and that the benefits could now be outweighed by risks. I have been taking reduced dose since last August, gradually getting the dose down to about 3 days out of 7 up until Christmas, and nothing since, as thought doing okish (sleep has been poor for years anyway, even without hot flushes and being on the hrt) and had some hot weeks where assumed had a bug.
However over the last month have got increasingly worse, so back with the sweats - at least 10 heavy ones a day and through the night. Plus have had shingles, more hair loss again, eyes too dry for my contact lenses, painful knees, ...the list goes on, but probably the worst is the short term memory loss - finding it hard to read a book, forgetting the names of my own team members at work, forgetting conversations I have had, making mistakes, being complained about now to the point that may have to give up work. It feels like more than just bad nights causing this and am finding it scary. I think it is mostly post menopause symptoms again (especially as had a smear test from hell. Never having one again (and wont be called for one now am 59) -not been painful before. I could hardly walk home. Then two days later had period like cramps that lasted a week.
All that said two positives -no migraines, and upset stomachs (sort of IBS) have reduced.
I have finally relented and called GP surgery. I asked for nurse (as she was sympathetic about me going down the hrt route as she had also done so reluctantly). However she would not prescribe hrt again but is sending me for blood tests (not sure what for - had a load a few months back due to swollen ankle/foot and tiredness).
I dont think the blood results will show anything but am worried that if I can't get through this (am I just at the peak of it and will get better soon?!) I don't know what I will do. I have a holiday booked in June (my first abroad for a long time) that I am considering cancelling and just losing the £.1500 (insurance does not cover menopause!). When I get really hot I vomit, so don't want to be doing that when away, it is bad enough at home (and work).
Any advice welcome. I feel like an idiot and that I am making a fuss and should just get on with it. I expect my boss (who is 20 years younger) thinks the same.
Janouska
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Hi Shadyglade - you chose "to suffer"
Now that is a bit naught Stellajane. That is not what I said at all. Yes I did have times when I suffered BUT many more times when I managed pretty well. The same also seems to be true for the HRT ladies.
This idea that if you chose not to take HRT you are stupid has to be challenged. I would not dream of saying the reverse to HRT users. :o
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Thanks Stellajane
I agree there is no absolute ideal solution, I had side effects with the hrt -just taking the pill each day I always got a big sweat in the morning, and did not solve the early waking etc. but on balance what I am suffering now is far far worse.
I was going to ask GP whether patch route may be better (if I get to see my GP as surgery in a bit of crisis at moment, which was another reason for asking for nurse as they offer phone consultations). I have no partner so am not concerned about the vaginal atrophy aspect - it was just evidence of the impact of reduced hrt. as if I needed any proof!
I would like to add that I agree - going on hrt or coming off it is really not an easy choice. None of us know when we hit menopause how long the adjustment will take -months, years.. Just as I don't know now if or when I will ever get over the post menopausal symptoms. I just have to balance the pros and cons. I really only came off because of my age, and because my mother died following a series of strokes and narrowed arteries (undiagnosed -only found that out at autopsy) so part of me has a fear of that. But fear of losing my mental capacity greater and losing my job outweighs all of those fears in the end. I want to enjoy my life now.
Good luck to all struggling with these choices. x
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To go back to the theme of this thread, ‘future problems from HRT that are not made clear' - this implies that it is HRT that 'is responsible' or causes the symptoms that we experience when we come off HRT and this is simply not the case. It's the withdrawal of hormones, more specifically oestrogen, that causes the symptoms - so using HRT has nothing to do with how we feel when we come off it. HRT can maintain a balance which gives a good quality of life for many through years before retirement that can be tough. How long the symptoms will last nobody can tell us but the consequences of oestrogen deficiency goes on regardless. This is not to say we should all be using HRT BUT there does need to be a better approach by the medical profession that allows women to make an informed decision about whether they should use HRT or not and for how long. IF they want us to work till 66 or longer then, for many, HRT is their only option - and HRT it still far from ideal. DG x
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Precisely Stellajane. "this is probably down to oestrogen loss but we'll run some tests to rule out any other cause then you can make a decision about which route you may wish to consider".
A good common sense approach. DG x
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I've just read all of this thread and it's fascinating.
I'm 59, went through the menopause at 50. Spent the last 8 years with hot flushes night and day, drenching,embarrassing. Depression..but nobody (GP included) related it to the menopause, loss of confidence, extreme anxiety ..trying to hold down a full time job as a single mum with a learning disability child, I thought I was in hell. It got to the point where unfortunately a little ‘bullying' at work from a younger female caused a total breakdown.
I fought back, still working the same place but aware that will always be in the back of people's minds....'she couldn't cope'.
It's not as if I'm not used to ‘Menopause symptoms'. I went through 3 lots of IVF which effectively replicated an artificial menopause each time, so had the mood swings, hot flushes prior. I do wonder if that has led to such an extreme ‘natural' menopause?
I tried every single natural remedy I could think of...nothing worked ( amazing for those of you that have found an alternative) but it was my GP in the end who asked me to to try HRT.
So I am trying and it's not been easy, (see newbie post) don't think I have achieved the right combination yet but there are improvements...'hot flushes be gone'....and I need to keep working to support my son for as long as I can.
So thank you for all your informative posts, they have helped me SO much.
And good luck to everyone going through this challenging phase...whatever your preference is ;) :bighug:
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I had been on Hrt (Elleste solo 1mg) for nearly 25 years following a total hysterectomy ( I am now 68 years old) - immediately after the op I had HRT implants - so have never actually 'suffered' from any of the usual menopausal symptoms as such . Over the last 2-3 years I have been 'taken-off' HRT on Dr's orders - due to the numerous negative reports on it's long term use and suffered terrible hot flushes and night sweats each time then going back to the Dr to 'beg' to go back on and then being told that there were new studies and reports out by then saying the opposite of the original reports! My most recent 'mandatory' withdrawal of HRT - following yet another 'scare' report was around November 2017 and at the time I was only taking 1 tablet every other day so really thought I would be ok this time and wasn't too bothered - I stopped taking them immediately. How wrong was I ! Hot flushes and night sweats back with a vengence, plus insomnia, aching joints, and much more. After 4 months or so of suffering and going to and fro the surgery with various ailments I casually asked the Dr if there was any reason I could not go back on, reducing the dose down again as before. Surprisingly my Dr said OK ! as long as I understood 'the risks' and it was my choice - so I started taking Elleste Solo just 9 days ago and today I would say is the first day I have not actually had a flush at all - yet, anyway. BUT, I really don't know if it is due to starting the HRT again after the 4 month break, but I must admit I do feel quite nauseous throughout the day and have done for the last few days. Having been on and off a few times - though this was the longest period off - I cannot recall feeling like this before - maybe it's just me, maybe it's anxiety, Just don't know. I'm going to make an appointment with the Dr just to discuss this - if I don't feel any better over the next week - but right now I feel very confused as to whether I should be taking HRT again at my age - maybe I should have just put up with the flushes and other problems and maybe they would have gradully disappeared ! I do however feel that I really have been 'messed about' by the medical profession with all the negativity - not a happy bunny right now!
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Hi CINDYGIRL
Stellajane has done an excellent post.
You are using a low dose and every other day is a hood idea. Unfortunately when ie takes a break the oestrogen can drop quite dramatically and when iestegn is reintroduced the body has to adjust again.
I totally agree with Stellajane that you should consider switching to transdermal oestrogen - Oestrogel would probably be ideal - as you often need a lesser dose because it absorbs into you system better than pills and is less likely to give nausea.
Unfortunately digestive problems like nausea do get more problematic as we age anyway.
I know a lady who was on HRT well into her 80s and she is amazing. DG x