Hi
I was wondering if anyone can shed some light on this apparent contradiction I seem to be coming across in my 'research' into menopause and HRT.
On the one hand, a lack of oestrogen in peri/menopause causes symptoms like hot flushes, cold shivers, palpitations, vaginal dryness etc,
On the other hand, even the lowest dose like Elleste Duet 1mg sequential causes/contributes to endometrial thickening, hyperplasia, polyp etc. - all signs of too much oestrogen, unopposed by adequate progestin.
My early menopause came suddenly at 44, no surgery, no chemotherapy, no illness of any kind, perimenopause was very brief - a couple of missed periods, and that's it, ovaries shut shop. The advice usually is to start HRT as soon as possible to protect the heart and bone strength (there is a window of about 2 years when without HRT there would be a sudden deterioration in bone strength, then the decline slows down).
Despite my low dose Elleste Duet, after a few months of heaven, the bleeds started, all those invasive procedures to investigate post menopausal bleeding etc, and the traditional doctors recommend to stop HRT because the oestrogen is 'causing or contributing' to all these endometrial changes, which could turn them cancerous. The fairy tale is over, and I am still only 47.
If I go off HRT, life will be unbearable again, my bones will start deteriorating very quickly, thermostat remains broken (hypothalamus will make me sweat every few minutes, then freeze, and again) and the palpitations will probably give me a heart attack as it's not normal to have a resting heart rate over 100 bpm when resting (on HRT my resting HR is 60-70). Also sleep deprivation will cause all sorts of other problems... but hey, I'll have a low risk of oestrogen related problems, and I can take a lovely thin endometrium with me to my early grave (from lack of sleep/heart attack/hip fracture/going nuts - take your pick).
If I stay on HRT, I'll continue to feel great, look young, sleep well, stay calm, have no flushes, live my life and think clearly, have no joint pain, but the oestrogen will continue thickening the endometrial lining, growing polyps, trying to turn them cancerous...
So I'm screwed if I do, and screwed if I don't...
Too much oestrogen is bad, too little is no good either. Seriously, which one is it? I get that after a certain age - like past 70 for example, the body is not meant to have levels of oestrogen like the HRT provides, but in the 40s? 50s?
If the progestogen is meant to be balancing the oestrogen, (in my case it failed) then what is the point of sequential HRT? If I remember correctly, approx 50% of women on sequential HRT will develop these problems.
I am aware that patches contain a lower dose, but they are better absorbed, so the total circulating oestrogen is the same as the 1mg tablet.
P.S. Never smoked, never drank alcohol, never been obese or overweight (until the 2 years of sleep deprivation before HRT made me put on a stone, but still normal weight).
We can send a man to the moon, so can scientists now please please please come up with something? I know al the ladies here know what I mean when I say that until you experience how hot flushes, cold shivers, palpitations and lack of sleep can slowly be killing us, it is hard to understand. But sleep deprivation has been used as a method of torture all over the world for centuries. Why? Because it breaks even the highly trained soldiers in the end. Yet, half of the population is expected to somehow just simply get on with life... Grrrrr! Rant over, I'm going to weed the garden now - brilliant anger management by the way.
AndieKC xx