Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Sunnyangel on October 24, 2025, 12:26:20 PM
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Have just posted re estradiol and estriol but wanted to make a separate post for this.
I don't take HRT, I use topical vaginal estradiol tablets instead ( with some estriol cream externally) but, if you read my other post you will know that I am having some difficulties.
I have never requested to HRT because at 60, I assumed I am too old even though my health is good, as far as I know! Is that correct that I would not be prescribed HRT because of my age? Does it help to alleviate bladder issues if used alongside the vaginal estradiol? I believe that a number of women use both but they may be a lot younger than me. It would not be my preferred option but I'm exploring all avenues right now.
Again, many thanks for any advice.
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Systemic oestrogen is not advised if over 60 but that doesn't mean you can't have it, just ask. Its not guaranteed that using both treatments would work better than just the one but again you won't know unless you give it a try.
The only other answer is to increase the dose of topical oestrogen and see how it goes, its all trial and error as we keep saying on here!
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Arbitrary age based cut offs are outdated and against current clinical guidelines.
If you feel you would benefit from systemic hormone therapy then you absolutely deserve a conversation with an appropriately trained clinician about this.
I would see your GP as a first port of call, however if they are unhelpful it may be worth seeing a specialist.
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Thanks Ayesha and Bombsh3ll.
I don't actually want to add anything else like HRT to the mix, I'm just wondering what my best options are if the current treatment isn't sufficient. Also, I wondered if some treatments are better than others for bladder issues. I know that there may be someone here who might have a good insight.
It's all so complicated that it makes my head spin to be honest.
I now seem to have found a decent doctor but there is never enough time for a proper conversation, which is exactly what is required, and although I have seen a consultant privately, it's going to cost me a fortune if I have to keep going back on a trial and error basis when things don't work and I can't afford that, hence posting on here is invaluable.
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First off I would make sure you are using your existing products as often as needed - daily if you need to.
Rationing vaginal estrogen which is a microscopic dose to begin with and not meaningfully absorbed systemically, to two or three times weekly, especially in those with no other estrogen source, often doesn't result in the desired response.
Secondly if frequency of application is addressed and they are still not working, and you have made an informed decision not to use systemic treatment, then you could ask about prasterone (vaginal DHEA).
I don't know about availability of this on the NHS but it might be, and even if not it may be worth paying out of pocket if it helps you.
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Thanks bomb3hell, I will go back to 7x week for now and will bear in mind what you have said and research vaginal DHEA.
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You should be able to control it with enough topical oestrogen if you don't want hrt but you may find your GP imposes a limit of twice a week (mine does). Systemic hrt does help as you have higher levels of oestrogen and it can fully control it without topical oestrogen but it may be at levels higher than the NHS will give you. There is no reason not to use transdermal hrt at 60.
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Thanks all for the responses and advice. For the time being, I shall stick with topical oestrogen and give it a really good try now I have managed to wring a decent prescription from my GP. Fingers crossed that it goes well.