Menopause Matters Forum
General Discussion => New Members => Topic started by: Mintea on January 07, 2020, 12:34:22 PM
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I have just registered on this forum and so would like to say hello to everyone. I have been thinking for sometime about taking hrt and have researched it quite well, I've read the 'estrogen window' and 'estrogen matters' as well as lots of other information. I have been diagnosed with vaginal atrophy and been using vagifem and ovestin for about 2 years which has helped a bit but I also have joint aches, constant tiredness, never want to go out and have anxiety. I've become quite reclusive. My last period was when I was nearly 55 so I know I fit into the 'within 10 years of menopause' for being suitable for hrt but some sources say it's best if you are below 60 when first starting so it's a bit confusing. My GP said she wanted to look at my blood pressure readings and read the email advice Id got from Heather Currie before making a deision. She also said they would normally be taking women off hrt at my age! I also have a family history of osteoporosis (although I dont have it) but wouldnt like to get it in the future. I am feeling nervous about going to see her this Friday and am just wondering if anyone else is in my situation at a similar age. From what Ive read it does seem that the benefits of hrt outweigh the risks if taken within 10 years of menopause but then other sources (dr Newson is one I think) say under 60. Any help would be appreciated.
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I think Hurdity is the best person to advise you on this. She is very knowledgeable and on HRT herself. I think she is 66.
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Thanks, are we able to message people directly, I'm not sure if we are?
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Hello Mintea, welcome to the forum.
You should be able to use HRT for the rest of your life, that is very old fashioned thinking about stopping when you are 60. You need it forever to stay healthy. However, it's good that you are still within the 10 year window. I'm sure if you have got all your facts together you will be able to argue your case, but if the GP gives you any trouble you could ask to be referred to a menopause clinic.
You will be able to send private messages when you have done ten posts. However, I am sure Hurdity will see your message and respond.
Obviously you will be needing progesterone, so as a 70 year old oestrogen-only user (TAH/BSO years ago) I'm not competent to give advice on a suitable regime. However, I'm sure you already know that the transdermal route is considered best for oestrogen.
Good luck with your appointment on Friday, let us know how you get on.
JP x
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Thankyou for your reply and welcome, JP. I'll let you know how my appointment goes.
I have to have a pelvic exam as well which I'm not looking forward to!
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My sister in laws friend is 72 and still on it.x
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Hi Mintea
:welcomemm:
Yes as I understand it the advice is to start HRT within 10 years of menopause ( ideally 5 years) and under 60 - for cardio-vascular health,. If starting over 60 then low dose transdermal HRT ( ie patch or gel) is recommended - and also for those with blood pressure issues. There is now no age or time limit for stopping and depends on a mutual decision betweemn you and your doctor and looking at all health issues.
Here are the BMS recommendations:
https://thebms.org.uk/publications/consensus-statements/hormone-replacement-therapy/
"HRT prescribed before the age of 60 or within 10 years of the menopause has a favourable benefit /risk profile and is likely to be associated with a reduction in coronary heart disease and cardiovascular mortality.
If HRT is used in women over 60 years of age, low doses should be started, preferably with a transdermal estradiol preparation."
However have you had other blood tests to determine whether your symptoms could be due to something else? Joint aches and tiredness can have multiple issues and I would be looking at thyroid function, and levels eg of vitamin D, iron etc.
However if you have severe VA that has not responded to increased doses of local oestrogen (how often do you use them?) then systemic HRT maybe diagnosed. If you look at Maryjane's posts (Jane Lewis) - she has written a book "Me and MY Menopausal Vagina" and is very knowledgeable about the whole issue - having done lots of publicity so also I suggest starting a new thread in the main menopause board "All Things Menopause" with vaginal issues etc in the subject title maybe?
Also there is an Estring which delivers higher doses of local oestrogen which is also a possibility if you haven't come across it?
The main problem with any HRT is the progestogen component which can provide challenging for some women! I am indeed 66 and taking HRT - but I started in late peri so the window of opportunity does not really apply as I hadn't got there yet!
Good luck and hope all goes well at your docs appt - do keep us informed..
Hurdity x
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Hi Hurdity
Just a short message to say thanks for all the information and links you posted - really helpful.
Recent blood tests are all normal.
I suppose I'm hoping systemic hrt may help more but realise it may be problematic with the progesterone and from reading the experiences of others.
In my e consultation, Dr Currie suggested I take utrogestan and oestrogel or patch at low level to start with.
Thanks again for your help. I'll let you know how I get on at the doctors tomorrow.
Mintea x
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Feedback re GPs visit
Saw my GP this morning and she prescribed exactly what Dr Currie had advised so Im really pleased. However, she did say I would only be able to have it up until I was 10 years post menopause which I was a bit surprised about having read it can be prescribed for life. I didnt want to argue with her at this stage as only just prescribed but wondering if that is what GPs are told to save money as presumably the longer women take hrt, the higher the cost. She did seem quite firm when she said this as if it was an unbreakable rule. Anyway I shall see how I get on. She wants to see me again in just over a month. I am starting with a low dose of oestrogel and also utrogestan. I am hoping I dont get bad side effects.
Mintea x
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Feedback re GPs visit
Saw my GP this morning and she prescribed exactly what Dr Currie had advised so Im really pleased. However, she did say I would only be able to have it up until I was 10 years post menopause which I was a bit surprised about having read it can be prescribed for life. I didnt want to argue with her at this stage as only just prescribed but wondering if that is what GPs are told to save money as presumably the longer women take hrt, the higher the cost. She did seem quite firm when she said this as if it was an unbreakable rule. Anyway I shall see how I get on. She wants to see me again in just over a month. I am starting with a low dose of oestrogel and also utrogestan. I am hoping I dont get bad side effects.
Mintea x
But women who continue HRT beyond the 10 years may avoid other health problems such as osteoporosis (fewer hip fractures) VA , heart problems , possibly dementia etc.
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Yes I agree with you so it wouldnt make sense for GPs to be putting a limit on use purely on financial grounds as the amount spent on dealing with osteoporosis, heart problems etc must be enormous. I think the jury's still out on the benefit of hrt as attitudes and research on it keep changing so much.
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Yes I agree with you so it wouldnt make sense for GPs to be putting a limit on use purely on financial grounds as the amount spent on dealing with osteoporosis, heart problems etc must be enormous. I think the jury's still out on the benefit of hrt as attitudes and research on it keep changing so much.
It is definitely helping my VA and that won't stop at 60.
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Good luck Mintea. Good result for you at doctors.
Keep us informed...
:welcomemm:
Jd xx
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Thankyou x
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Mintea...you are fortunate. I am 68 so well past 'acceptable age and my GP absolutely REFUSED! She said that no doctor would prescribe HRT to anyone of my age UNLESS they had been on HRT for some years and even then it is questionable.
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oh whatsupwith this.. sorry to hear you got that reaction...she's wrong that no GP would prescribe and it is not an unbreakable rule even if she made it sound as if it was but some do have some very set out dated ideas especially that those already on hrt have to stop. It used to be like that but the thinking has changed and so I believe have the guidelines but it takes a while for our so called medical professionals to catch up. I am 58 and there is now way I am giving up at 60. In fact I will fight tooth and nail to never give it up!
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oh whatsupwith this.. sorry to hear you got that reaction...she's wrong that no GP would prescribe and it is not an unbreakable rule even if she made it sound as if it was but some do have some very set out dated ideas especially that those already on hrt have to stop. It used to be like that but the thinking has changed and so I believe have the guidelines but it takes a while for our so called medical professionals to catch up. I am 58 and there is now way I am giving up at 60. In fact I will fight tooth and nail to never give it up!
I agree. I am 56 and didn't start until 2019. I don't intend to give it up.
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Thx ladybt28...I have severe VA and my GP says it can be well managed with Vagifem. Apparently because I am past the hot flushes et al, HRT would be dangerous and impractical. So far I am managing on vagifem daily and estrogen cream but I wonder what happens when ladies have mobility issues and can no longer insert vaginally. Let's hope that the research pharma's find a much better solution to menopause in the near future.
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Whatsupwiththis.....
have read posts from a woman in another forum who started hrt when she was 70. She had to really pester her GP for it but got it in the end and is doing really well on it.
I think it helped my case that I had a consult with Heather Currie prior to my appointment and took the email in with me.
Have you thought about doing that so you could find out from a specialist what they would advise?
All the best
Mintea x
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I live in Canada. We do have a good health care system but not nearly as inclusive as UK. I wish (sigh).
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You may still be able to use the e consult on MM , might be worth checking.
Mintea x
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Mintea hi and welcome
Glad you got your request, don't rock the boat just yet about how long you can have hrt but nearer to the time when it will be questioned Make sure you are prepared and ready for battle if they refuse. Gather info and fight your case. Many of us here have had to battle with gps to get what we want/need, me included x
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Feedback re GPs visit
Saw my GP this morning and she prescribed exactly what Dr Currie had advised so Im really pleased. However, she did say I would only be able to have it up until I was 10 years post menopause which I was a bit surprised about having read it can be prescribed for life. I didnt want to argue with her at this stage as only just prescribed but wondering if that is what GPs are told to save money as presumably the longer women take hrt, the higher the cost. She did seem quite firm when she said this as if it was an unbreakable rule. Anyway I shall see how I get on. She wants to see me again in just over a month. I am starting with a low dose of oestrogel and also utrogestan. I am hoping I dont get bad side effects.
Mintea x
Great news Mintea that your doc was able and willing to prescribe HRT to you for the first time at age 61, and also that she took note of Dr Currie's response ( if you needed to show it). Also the good news is that she is wrong about the time limit. The 10 year window (although I gather preferably 5) is for women to START HRT - once started then you can continue for ever. I think once you reach 70 the risks tend to outweigh the benefits on average - if you have past history of stroke etc but then the various risks are individual to you and will depend on genetics as well as your lifestyle and general health.
https://www.menopausematters.co.uk/balance.php
The good news also is that you have plenty of time to read up about it and as Anni10710 says no need to worry just yet - when you go for your review each time if she brings the subject up you can drip feed her the up to date info!
But we're getting ahead of ourselves here - frist you need to try it out for 3 mnonths and see how it deals with your symptoms - hopefully everything will improve.
Incidentally I hope your prescrption for vaginal oestrogen was continued as well?
All the best and keep us updated! :)
Hurdity x
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I started Evoril Conti patches at 52 and i am coming up to 62, i have decided to keep on them after much deliberation although i have cut back to one patch a week instead of two.
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Feedback re GPs visit
Saw my GP this morning and she prescribed exactly what Dr Currie had advised so Im really pleased. However, she did say I would only be able to have it up until I was 10 years post menopause which I was a bit surprised about having read it can be prescribed for life. I didnt want to argue with her at this stage as only just prescribed but wondering if that is what GPs are told to save money as presumably the longer women take hrt, the higher the cost. She did seem quite firm when she said this as if it was an unbreakable rule. Anyway I shall see how I get on. She wants to see me again in just over a month. I am starting with a low dose of oestrogel and also utrogestan. I am hoping I dont get bad side effects.
Mintea x
Great news Mintea that your doc was able and willing to prescribe HRT to you for the first time at age 61, and also that she took note of Dr Currie's response ( if you needed to show it). Also the good news is that she is wrong about the time limit. The 10 year window (although I gather preferably 5) is for women to START HRT - once started then you can continue for ever. I think once you reach 70 the risks tend to outweigh the benefits on average - if you have past history of stroke etc but then the various risks are individual to you and will depend on genetics as well as your lifestyle and general health.
https://www.menopausematters.co.uk/balance.php
The good news also is that you have plenty of time to read up about it and as Anni10710 says no need to worry just yet - when you go for your review each time if she brings the subject up you can drip feed her the up to date info!
But we're getting ahead of ourselves here - frist you need to try it out for 3 mnonths and see how it deals with your symptoms - hopefully everything will improve.
Incidentally I hope your prescrption for vaginal oestrogen was continued as well?
All the best and keep us updated! :)
Hurdity x
Hi Hurdity
I am keeping up with the vagifem and ovestin and assume my repeat prescription is still the same but must check as it hadn't occurred to me this would stop.
Just wondering if the oestrogel and utrogestan should be taken at the same time? I used the gel this morning and the utrogestan vaginally tonight as I've read on here that is OK. It says on the box to take it orally on an empty stomach but as I ate quite late and so my stomach wouldnt be empty, I thought it would be better vaginally.
Thankyou for all your help so far x