Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: creativesarahv on July 29, 2014, 03:23:29 PM
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Hi I had a hysterectomy at 39 and was put in evorel patches dose 50 I am now 59 and my new GP has decided to stop the HRT I thought I would be able to be weaned off it
Is it normal to stop abruptly and will I go cold turkey!
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Some of us have done it both ways when trying to stop. I really think it's an individual choice and you won't know till you try.
I am cutting down but at just short of 54 I do have a bit of time yet.
I have also just stopped but flushes were back around 6 weeks. Now I manage on a half patch.
You will find some ladies who will say it makes no difference. The good thing is with patches is you can cut a bit off over the months and see how it goes.
Honeyb
x
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If you have to come off ERT, which I don't think you should unless you want to, then you must insist that you are allowed to come off slowly, first by going down to a 25 patch, and slowly reduce by increments, its the least your doctor can do for you, and to let your body get use to a lower state of estrogen.
Also start to support your body with natural estrogen supplements e.g. phyto estrogens. http://www.patient.co.uk/doctor/Phyto-oestrogens.htm
Hope you have luck with your doctor creativesarhv.
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I stopped cold turkey a few years back, truly awful.
This time I've been gradually reducing it. It certainly hasn't been so horrid this way, but not sure when I will able to stop completely. I'm too scared.
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I have tried both ways - and I had the same results - awful both times!
Have you been told to stop because you are coming up to the not-so-magic age of 60?
Taz x
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hi Creativesarahv
I'm assuming you don't want to stop? if you don't then all the best on the next step you take.
Totally agree with Silverlady at the very least.
But what is it with GP's - this new GP doesn't even know you yet! So how he or she can suddenly make this life changing decision on your behalf is awful.
I too have a gp who is always moaning about trying to get the older ladies (70+) off hrt - why should the GP tamper with their health and wellbeing when they are obviously happy with things as they are is beyond me - and should be beyond a GP's remit!
Just to point out this GP is behind the times - as the British Menopause Society are now saying the following since last year.
"Arbitrary limits should not be placed on the duration of usage of HRT; if symptoms persist, the benefits of hormone therapy usually outweigh the risks."
So if its done you good since you were 39 - then it can do you good till you want it to :)
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Sixty is still sadly the time when GP's think that we should come off HRT but as long as you are told the risks then most will continue to prescribe. I was under the care of the menopause clinic in Oxford who were definitely against prescribing for me after the age of 60 so I returned to my GP who also decided that I should try to come off. My gynae consultant is also against women over 60 being on HRT. The main risk is thought to be stroke not cancer as most people seem to think.
I was taken off last October and have found it really difficult. I did manage to find a box of unused patches in the cupboard in April and stuck them on. The difference that month was amazing. I haven't been allowed any more due to having to have a major op in July but I'm hopeful that the GP will continue to prescribe when I go back to see her in a few weeks time.
This "stopping at 60" is a nightmare for many women now that we have to work until at least 65. I have already been moved to a "less challenging" role in my job - I was fine up till October!
Taz x
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Hi
I feel the same way as you. I just had ovaries removed last week and have been told I can't continue on HRT because a relative had breast cancer. 6 days off it and already in floods off tears not a nice symptom to have on top of the pain I am in. On antidepressants to try and calm things down.
Winnie
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Thank you all for your answers
I have mild cognitive impairment and I am worrying that my memory loss will become worse already a friend has noticed that I am more random than usual!
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How long have you been off it Sarah and what symptoms are you experiencing?
Taz x
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Taz2 i have been off it now for about 3 weeks couple of hot flushes but the main problem is my memory (well lack of it!) and irritability I am not usually an irritable person (well I don't think so ;))
This weekend felt absolute hell
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Sorry to hear things have got so bad in just a couple of weeks.
But as I said earlier if its done you good since you were 39 - then it can do you good till you want it to :)
Hope your getting back to the doctor and back to normal asap. (Don't be fobbed off by the doc - please)
8) :-*
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It could be that as time goes on you will start to feel better sarah but it's always difficult to know. The menopause clinic said that it could take up to six months after stopping HRT before the symptoms ease but I've given it a year now and there is no change. It took around three months without HRT for me to get back to where I was when I first started it at age 53ish. Now, of course, I face another battle with the GP as the first year of using it is where the highest stroke/blood clot risk is and as I've been a year off it (apart from one month's worth in April which I found in the cupboard) it's as if I'm a new user.
Most docs will continue to prescribe if you have given it a try without but they do take some persuading.
Taz x
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Taz low or ultra low dose estrogen only patches don't represent so much of a risk for stroke specially if you take fish oil to keep blood thinner.
Its combined HRT that may be more of a problem.
There are two types of stroke due to blood clots or bleeding, keeping blood vessels healthy is the key and knowing what you might be prone too.
I try to cover both bases with rutin supplement daily and fish oil supplement a couple of times a week.
Keeping an eye of cholesterol and triglycerides helps too, if you show your doctor you are willing to incorporated this into your life he might relent and prescribe estrogen patches.
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Hi Taz/Silverlady
sorry if this has been mentioned before - not trying to contradict anyone here either :)
From what I can see - the stroke risk is associated mainly with the Women's Health Initiative Study when the ladies were targeted for HRT treatment long long after they'd passed into menopause (using conjugated estrogen HRT also). Obviously the use of newer HRT options helps reduce our risks also (patches,gel,bioidentical etc) as has been mentioned before by others here.
But the average age of ladies in that study being "started" on HRT for the first time was 63.2 years. ???
That was a real surprise to me...
More recently the 2012 Danish and MWS studies/reports have apparently shown that the combined HRT started close to menopause showed a reduced heart disease and mortality.
More importantly the studies were showing no increased risk of thrombosis (blood clots).
Sarah, hope you are feeling better as soon as possible.
:-*
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Thank you. I had forgotten that the stroke risk was less. I did find this while searching the other week http://www.npc.nhs.uk/therapeutics/other/hormone/resources/pda_hrt_oestrogen.pdf which is interesting.
I have had the clotting factor blood tests courtesy of my great GP and even those these came back as ok she still doesn't like the idea of women over 60 using HRT. The menopause clinic are also of the same mind as is my consultant gynae - surprisingly - as he was all for it when I was 55!
Taz x
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I was just surprised that it was the menopause clinic who first said I should stop HRT at 60. The GP then seemed to take the same route - although before then was happy to keep prescribing - and I felt sure the gynae consultant would be in favour of it but he wasn't.
Taz x :-\
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I started HRT just before my 60th birthday, low dose. I went to see a private gynaecologist with the support of my GP. My sister died of breast cancer, but as she is the only close member to have had breast cancer this was not considered to be genetic or a bar to my taking HRT. My BP and cholesterol levels are fine.
By the way I have been told I can continue for as long as I want, forever, if there is no health reason to stop.
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I did aim my post more for Taz as I know she has a GP who is not keen on prescribing HRT after sixty.
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I just hope I can SL - it will have to be from the GP as the menopause clinic are really against it so I will pick my GP carefully!! ;D I really don't want to go down the private route if I can help it.
When there are three professionals who are all saying "no" it does shake you confidence a bit. Over the last month the flushes are much better - only a couple an hour - but that's because I am not rushing around I think. Once back at work I'm sure I'll be back to square one.
Taz x
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The thing is they do eventually ease even though you might think they won't, but its the waiting out that's the problem. Its the other things that estrogen helps that the body needs, you can use supplements, diet and exercise to compensate and they do work contrary to what some think. Menopause Matters magazine recommends this even. Its never too late to start supporting your body.
There are just as many women who don't take HRT as do, and I see a lot of very healthy jolly looking much older women and I often think to myself I bet they are not on HRT( they usually don't look the type to even know what hormones are) You have said many times yourself that only women who seek help eg on our forum are the ones who have problems with menopause.
I do hope your GP relents and lets you have estrogen patches as I know you have to work, and I hope you don't have to go down the private route as it can get very expensive.
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You are right about some women not needing HRT SL - my very best friend - soul mate even - and I have gone through the ups and downs of life together although sometimes countries apart and have been the same through most of it. However, she has had no meno symptoms whatsoever. Her periods just stopped at 55 and that was that. She's never had a hot flush, panic attack, sleeplessness etc. and although she is really supportive of me when I have a grumble and a moan she can't understand it. She keeps waiting for it to hit her but she's almost 61 now so maybe she has escaped! The only thing we were different in was pmt - she never suffered that either whereas I did.
Taz x
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Back from Scotland now and catching up on threads - reading this one with interest as always.
Nothing much to add right now except to say creativesarahv - don't stop oestrogen if you don't want to especially as you have had a hysterectomy! Also that I'm 61 and still on combined HRT (as I have a womb), on a long cycle (7-8 weeks meaning I still bleed), with the support of a gynae I had to see last year for investigations, as well as GPs in my local practice (all NHS). Unfortunately there is no standardisation across the board until the NICE guidelines are updated ( next year I think) but the general consensus is that there is no reason to stop and that women should be able to make their own decision, while accepting the risks as published, but recognising their great limitations (ie the studies from which the risks are quoted). Sorry that's a bit rambling!
Hurdity x
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today i am having a phone consultation with the new GP
I am considering changing surgeries as I am not happy with the way our surgery is run since it was bought out by a bigger surgery
I feel as bad as I did after a mini stroke lots of people came up to me over the weekend and asked how I was as I looked so ghastly and seemed so distant
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That does explain why your Doctor is being cautious creativesarahv, not sure what the protocol for HRT is after a mini stroke.
As has been said patches are far less of a risk for stroke, but don't know about if you have already had one, is it possible that the stroke clinic could advise.
Its always best to come off slowly from patches so not surprising you are feeling the effects.
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Hi Silverlady
sorry but Sarah's doc has just cut her off, not even offered tapering.
I agree with you Silverlady - best to come off slowly - but doc isnt even doing this (even if Sarah wanted to come off).
Doc is simply following a flow chart - oops sorry hitting 60 - time to stop HRT thats doing you good :-\
There is no limit to how long you can use HRT as I mentioned earlier.
Being on HRT for 20 years and being happy with it says it all.
People are already seeing a difference in her which must be a sad and scary time for Sarah.
If someone has a mini stroke then that in itself is no reason to stop, wait and resume HRT as often docs do for operations also.
We should keep in mind that mini strokes can be caused by a multitude of things - often due to pretty innocent activities.
But there's no reason that HRT should be withheld as long as illnesses are treated, monitored and controlled.
This includes strokes, high blood pressure and heart attack.
If Sarah has been monitored or discharged by the stroke clinic, then surely its not a good idea to add another arbitrary opinion to an already difficult situation. This might give more confusion and difficulty from someone not specialized in HRT.
It is Sarah's choice to use HRT and feel better for it 8)
Best of luck with your new doc Sarah.
:-*
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peegeetip I really can't see what was wrong with my post and I am sure Sarah can answer for herself.
I was unaware that she had had a mini stroke from her previous posts or even when.
I am sure that this may make many Doctors more cautions, and you can't blame them for this, from what I can gather HRT is not recommended after a TIA.
I hope she is able to find a doctor top prescribe HRT if this is what she wants, I don't believe I said anything to the contrary in my post.
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Hi Silverlady
I didnt say there was anything was wrong with your post. :o
I agreed with you also and pointed out her HRT was cut off.
There seemed to be a lack of caution in the docs course of action from my point of view.
There seemed to be no consideration to the consequence of taking away HRT or to the patients wishes from the posts so far.
Its sad that Sarah is now having to look for a new Doctor but its good she's taking control of her situation.
This seems to be a repeating theme in a lot of the posts sadly.
As for the flowchart comment I've seen the flowchart my own doc uses ;D
I have a slightly different view point to you in regard to the rest in terms of a TIA.
As you say yourself "recommended" - but certainly not a "cannot" or "never".
It's the patients choice (or should be) as in any medicine or operation we need.
A lot seem scared off using HRT on the basis of weak, contradictory, out of date and often wrong information from docs.
I only summarized that if anyone is in a similar position to this post then there are always options.
Especially when things are being treated, monitored and controlled.
Like you I really hope that Sarah and others like her can get better treatment than this.
And hopefully those of us not at the same point can look forward to better treatment; that does not needlessly put us through this mill.
I hope we can agree to disagree on a few things ;) thanks.
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I think you are over reacting a bit a bit, nobody is disagreeing with you at all.
We all have tried to give Sarah support and I am sure she appreciates it.
I have not directed my posts toward you at all only Sarah and Taz and and was hoping to help.
We all have tried to help nothing more, and when you don't know all the facts it can be difficult, perhaps Sarah will be along soon to make things clearer.
ON the TIA subject I have a friend who has had two, she was taken off HRT. I an only go by that experience.
This obviously secondary to Sarahs first post where we have all agreed that she should not have been taken abruptly of HRT, once again I have not disagreed with you at all, also I don't know where I made " "flow chart comment" what ever that is!
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;D - the comment on flowchart - that's just part of my discussion on the forum.
The comment was just to highlights how we are often treated by very simple logic tools like flowcharts.
Hence we have the problems like being stopped at 60 or when ill when they don't need to.
Not saying flowcharts are all bad.
We have a very good flowchart on this site. It certainly helped me understand the options.
http://www.menopausematters.co.uk/tree.php.
Unfortunately most docs have something far more simple to follow.
I wanted to go down the long cycle route with my own gp. However that wasn't on their flow chart :o
Since then I realise the long cycle options were limited too.
On the TIA - again sorry your friend was treated in that way.
As mentioned on the last post - I hope we can agree to disagree on a few things in future ;) thanks.