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[pease]

After 20 years on HRT I have decided it is time to wean off it. The last time I came off was 10 years ago. I stopped suddenly and over the following 12 months had severe symptoms again. I am now on tibolone and am very well. It is the increased risk of stroke that worries me. But how do I do this? At the moment I am missing 2 doses a week for a month and just have one or two hot flushes. Next month I intend to miss 3 doses a week for  a month and so on. How have others managed?

I'd also like to know whether there is any published research into how reducing dosage affects risk levels and whether there is a "safe" dose, say 2 tablets a week that might just keep the worse symptoms at bay.
All suggestions gratefully received!

[Taz2]

Have you thought of just changing your type of HRT? Patch or gel HRT is not thought to increase stroke risk.


Taz X

[pease]

Thank you both. I must confess I had not really considered asking for a different type of HRT but now you mention it Taz2 perhaps I should have that conversation with my GP. I had a freaky episode of double vision that lasted less than a minute - this was 3 months ago and I've been fine since. But Dr Google tells me this can be a TIA and they remove your driving licence so I quietly shelved it but then started fretting about Tibolone as it does increase stroke risk. (my blood pressure and cholesterol levels are excellent)
I've had spotting before Stellajane when I accidentally missed some - was investigated, nothing wrong.

[Hurdity]

It depends how old you are pease and whether you have other risk factors for stroke - but if BP and Ch are OK that's a start. What about fitness and body weight or hereditary factors?

I would tend to agree with Taz and especially if you are at or near 60 - perhaps go for a patch at this point?

Hurdity x

[pease]

Hi Hurdity
I'm 67 and happy to say very fit - run regularly, yoga etc - and have no weight issues or hereditary indicators. But other friends (not on HRT) with no health issues, fit etc, have experienced events like embolism so I just got a severe case of the jitters. 
What would you do in my situation? I have no friends on HRT as they all sailed through menopause unlike me. I got the works - hair, nails, flushing every 20 minutes, night sweats, joint aches, terrible anxiety, no libido and HRT was a miracle for me! I came off for a year about 10 years ago and was no better, so went onto Tibolone. It suits me really well but this stroke business is bothering me. 

[Taz2]

I thought that guidelines were for pill HRT to be discontinued at the age of 60 in favour of either gel or patches? I was definitely told at the John Radcliffe Menopause Clinic that Tibolone wouldn't be prescribed after the age of 60 due to the stroke risk.

Taz x

[Taz2]

I've found this info. You need to scroll down to Stroke https://patient.info/doctor/hormone-replacement-therapy-including-benefits-and-risks

Taz x

[pease]

Thanks Taz, I have read similar papers and that's why I have become so aware of the stroke risk. I am doing well at the slow reduction plan and want to control how I come of HRT altogether. There is nothing I can find that helps women withdraw safely and manage any symptoms that emerge. Perhaps that is one for Dr Currie?

[Emma]

See our Stopping HRT page
https://www.menopausematters.co.uk/stopping.php

[pease]

Thank you Emma. This is what I am doing (2.5mg tibolone) but I had to work it out for myself. I am reducing by 2 doses (non-consecutive) each week for a month, then by 3 doses for another month and so on. I am feeling less anxious about it now as so far I have only had one intense bout of anxiety (I don't suffer from this normally, but it became a significant feature of my menopause) and a few hot flushes.

[Droopeydrawers]

Hi please I decided to stop hrt for a number of reasons and i actually tried reducing got flushes back panicked went back on it settled down tried again this time I got fed up faffing around and just stopped I was on estrodot 100 at the time and having horrible problems so one day just didn't replace my patch and stuck it out this time and managed to get past it.its around 20 weeks now I think and apart from the occasional hot surge im doing just fine much better than when I was on it and I tried many of the options.I hope to never have the need to go back on it but I'm realistic enough to say never say never.im using alternative strategies like lifestyle changes diet meditation distraction therapy, (mainly shopping 😂)thats my new name for being naughty it's purely for medicinal purposes I tell him😁.read keep yourself positive by doing stuff you enjoy and believe that there is life without hrt and adjust your life using coping mechanisms that's what I do now and it works for me.ps stay with the v.a treatment if not hormonal use alternatives it never goes away.good luck 😘DD

[Dyan]

My GP wants me to start decreasing my HRT. I am on Sandrena gel 3ml daily.
I started to come down at the end of July. I went through a period of depression & anxiety which I suffer with anyway but when I recovered I felt that I had no feelings of well being.
I went back up to 3ml a few days ago and starting to feel better already.

The reason my GP gave me for decreasing was the risk of breast cancer goes up when you reach 60.
I watched the programme “ The truth about the menopause” the other week and it seems this is not true.
I think it is all down to the budget at the surgery.

Totally unrelated I know, but I had an eye infection that needed specialist eyedrops but the Gp would not give them to me because the ‘ normal drops” were cheaper.
Hence to say, my eye got worse and ended up seeing my private specialist for the proper drops.

[pease]

Hello again! I've now had 3 weeks of missing doses on Tuesdays and Thursdays and I'm fine so far. Same again next week and then I'll miss Saturdays as well. Keep that up for a month, then go down to 3 a week for another month and so on.

[Droopeydrawers]

You keep doing what your doing Pease if it works for you then brill that's all any if us want so if it gets 2 much resume hrt and try stopping again at a later date if you wish to but what I found is if your in the right frame of mind to stop anything you will get there eventually but only if that times right for you so don't feel defeated if you have to have a rethink just plod away till you know the times right for you because you will.
Stellajane thank you for well wishes and I do still get the odd flush but not soaking wet bedclothed stuff like previously and I cope pretty well by just ignoring it as best I can and carrying on regardless.i know it sounds simplistic when I say it but we all know it's not as cut and dried as that it's just that's what's working for me.granny with attitude 😂
My shopping strategy is also simplistic if I'm skint I fill my basket up with what id like then i do the rounds again replacing it and keeping what i can actually buy 😂that does it for me too lol.keep trying stellajane one day it will just click into place and your coping strategy will get stronger each time.good luck ladies DD😘

[pease]

so now I am missing 3 doses a week - this is my second week of that. Yes, I have some spotting (at night) but I was prepared for that. A few flushes a day - nothing too bad. I am feeling quite proud of myself because 20 years is a long time to rely on HRT (I stopped for a year about 12 years ago and the joint aches etc were so awful I went back on).
I do feel ready for this now, but it is still early days. But I will report in at intervals and I'd love anyone else who's completed, going through or contemplating a withdrawal to compare notes!