Menopause Matters Forum

Menopause Discussion => All things menopause => Topic started by: skkb on June 11, 2022, 12:21:24 PM

Title: 20 years on HRT ….now doctor does a review
Post by: skkb on June 11, 2022, 12:21:24 PM
Amazing, after 20 years on HRT I suddenly receive an email from my GP surgery asking me to fill in a form for an HRT review. I had to smile since I have largely managed my HRT meds myself for the last ten years and never once has it been questioned. A telephone call was booked and a very nice lady GP asked about my Sandrena etc etc, she asked if I still had a uterus…..yes, I said, followed by….I know what you’re going to say, that I should be having progesterone to protect my womb. I know that but at 72 and for the last 10 years plus I didn’t want to have a bleed and was told I would have to. I now only use the Sandrena on 3 days each week and have an annual scan to check my ovaries and uterus. Oh she said, but I can put you on a continuous low dose progesterone (utrogestan 100mg) to take one each day and no bleed. Why wasn’t I given this information 10 plus years ago 🤷‍♀️. Do I really need to start a daily dose of progesterone at 72, or will it just upset the applecart??
Title: Re: 20 years on HRT ….now doctor does a review
Post by: CLKD on June 11, 2022, 03:17:04 PM
I wouldn't risk upsetting the apple cart.  Would you require a scan to check the lining?  Otherwise, stick with what works ;-). Did she sound as though she was pushing for you to stop?
Title: Re: 20 years on HRT ….now doctor does a review
Post by: McPeri on June 11, 2022, 03:29:54 PM
I agree with CLKD. Just keep having the scan annually to check. You are taking a very low dose so risk is not so high.
Title: Re: 20 years on HRT ….now doctor does a review
Post by: CLKD on June 11, 2022, 05:35:04 PM
Why two threads  :-\
Title: Re: 20 years on HRT ….now doctor does a review
Post by: skkb on June 12, 2022, 07:19:00 AM
Thanks both, sorry about 2 threads I couldn’t get back into the original for some reason. I tend to agree, my Sandrena is 0.5mg three times a week (Monday Wednesday Friday) so I’m really reluctant to put 100mg of progesterone daily into my body. I’m actually hoping that by the time in 75 I can stop the Sandrena completely but my body doesn’t take kindly to zero estrogen!! I can book a scan now that the Covid situation is better, so that’s my way forward …… I’ve no idea if I would have any reaction to progesterone anyway and after 20 years of trial and error on this menopause journey I really can’t face upsetting the applecart again. Thanks again, I never thought at 52 this would still be an issue for me 20 years on !!
Title: Re: 20 years on HRT ….now doctor does a review
Post by: CLKD on June 12, 2022, 07:58:04 AM
Locked out of your thread   ?   🪡. whoops  ::)

Women should if a regime suits, be able to continue with what works?  Let us know how you get on.
Title: Re: 20 years on HRT ….now doctor does a review
Post by: skkb on June 12, 2022, 08:56:47 AM
I’ve just booked my ultrasound scan for this coming Thursday…..womb lining, ovaries checked and they also do the blood test for the ovarian cancer marker which I had last time. They will send a report directly to your doctor if requested. It’s not cheap but worth it for peace of mind  ;)
Title: Re: 20 years on HRT ….now doctor does a review
Post by: Hurdity on June 12, 2022, 09:01:24 AM
Hi skkb - long time no "see"! I thought you didn't take prog because of side effects rather than because you didn't want a bleed? I know we have discussed in the past! I would wait to see the results of your scan before agreeing to anything. It may well be that you are one whose uterus lining does not thicken on low dose oestrogen which woud be amazing! How long is it since you stopped taking progesterone and how many annual scans have you had since? Is this the whole 10 years? What have the scans shown re thickness and have they been TVS or U/S because the results can differ ( they did with me)?

I must say i woudn't want to take progesterone daily though there are many women happy with it, but I agree about upsetting the apple cart at your age! Wait and see, If it turns out you do need to take it then it might be a small price to pay to be ablet to stay on HRT with a womb, well into your 70's? Alternatively if it has thickened it might be possible eg to do one course (per annum) eg of 14 days x 200 mg utrogestan vaginally to shed the lining and then carry on without the prog? There are several possibilities....

I agree that bleeding at this age is not great - I am still on cyclical HRT at late 60's!

Hurdity x
Title: Re: 20 years on HRT ….now doctor does a review
Post by: skkb on June 12, 2022, 09:36:43 AM
Hi Hurdity, yes it’s been a while, this meno thing goes on and on doesn’t it. Reading from my last scan in November 2020 ( unfortunately I am overdue due to the pandemic) :-

CA125 marker was 20 …..normal range 0 - 35

Scan comment on report:-
Normal post menopausal retroflexed uterus noted.
The endometrium is thin and uniform measuring 3.1 mm
Both ovaries appear normal where seen
No free fluid, cysts or adnexal masses

Previously my scans were May 2016 (endometrium 4.5 mm) July 2017 (endometrium 3.5mm)  July 2018 (endometrium 3mm)….. in all cases reported as normal.

It’ll be interesting to see if there’s any significant change when I go next week. I’ll let you know x
Title: Re: 20 years on HRT ….now doctor does a review
Post by: skkb on June 14, 2022, 08:46:06 AM
Scan on Thursday, will see if any of the above has changed. Decided against taking the Utrogestan !!
Title: Re: 20 years on HRT ….now doctor does a review
Post by: CLKD on June 14, 2022, 11:50:10 AM
Let us know how you get on?  If U have questions, take a list ;-)
Title: Re: 20 years on HRT ….now doctor does a review
Post by: florriepeck on June 14, 2022, 01:07:50 PM
Starting utrogestan continuously shouldn’t mean that you bleed, but that’s by no means certain.
Title: Re: 20 years on HRT ….now doctor does a review
Post by: skkb on June 15, 2022, 07:07:33 AM
That’s exactly my concern. I’m 72 and use Sandrena 0.5mg three times a week (Monday Wednesday Friday) so 1.5mg per week which keeps my symptoms controlled and manageable. The GP who rang me who has never seen me or knows my history wanted me to take 100mg of Utrogestan daily continuously (700mg per week)…….no idea if I would have side effects or bleed (although she said I shouldn’t). She was very pleasant but I suspect ticking boxes as “ I have a uterus so must have progesterone “.  Hopefully tomorrows scan will still show my womb lining well under 5mm , which it has always been in my previous scans…..and I’ve been told under 5mm is fine. I’m presently not experiencing any problems hence why I’m reluctant to pump another drug into my body. Obviously if things change I will look at it all again. Still hope that at 75 surely I won’t need Sandrena or progesterone!!
Title: Re: 20 years on HRT ….now doctor does a review
Post by: florriepeck on June 15, 2022, 07:27:29 AM
It’s tempting to think “ if it ain’t broke, don’t fix it”, isn’t it?
Especially as you’re having regular checks on thickness of womb lining.
Title: Re: 20 years on HRT ….now doctor does a review
Post by: florriepeck on June 15, 2022, 07:30:56 AM
It’s so difficult to get the right balance of HRT, but you seem to have cracked it.
Until this GP came along and put doubts in your mind.
Title: Re: 20 years on HRT ….now doctor does a review
Post by: skkb on June 15, 2022, 08:47:29 AM
My thoughts exactly…….I’d been happily going along for years, tweaking my own regime if required, GP didn’t really want to know most of the time. During the pandemic I had a bleed (because I had slightly altered my regime) within two weeks I was whisked in for a hysteroscopy, small polyp removed, all good, sent home, so you can see my reluctance to upset the applecart again. Let’s see what tomorrow brings
Title: Re: 20 years on HRT ….now doctor does a review
Post by: Hurdity on June 16, 2022, 07:50:46 PM
Do let us know skkb - I hope it went well....

Hurdity x