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[Hurdity]

Glad they worked for you Milliemoo. However personally I would never touch any of those ADs for symptom relief - I wouldn't want to take medication - and of course they don't replace oestrogen lack of which causes the more worrying symptoms and potential health conditions as you get older.

How appalling about your ignorant GP. If a young newly qualified GP goes round telling women that then there is not much hope for the future...

Taz - I understand re the duty of care - when I said I wanted to continue it was quite like a formal statement ie she said you are aware of the risks but it is your right to decide to continue knowing these risks. I explained I minimised all other risk factors ie re weight, diet, exercise, smoking, alcohol. It has probably been put on my records as such too ie that they explained the risks.

Thefact is we really don't know because that study used equine oestrogens and synthetic progestogen taken orally and the design of the study was flawed anyway - unfortunately it's the only major study there is so until there's another big one we are stuck with it. The small increase in breast cancer risk was with combined HRT (oestrogen and progestogen) so my view is to keep the prog to a minimum and stay on a cycle - but this has increased  risk of endometrial cancer!

So I suppose none of it is without risk and we have to weigh it all up and decide for ourselves.

Hurdity x

[skkb]

I had a full bloods check and all came back 'normal' so I'M guessing the flushes are due to my estrogen levels dropping again!! Think I will slightly increase the hrt to eliminate the flushes as day to day life is miserable. So far my GP hadn't mentioned stopping hrt (thank goodness). Feel bad moaning about it when others have so much worse to cope with!!

[ellie66]

May be its me but I find appalling that GP's want to take women off HRT. So long we understand the risks the decision should surely be ours to make? 

[Taz2]

It is important to understand the risks and then make our own decision. My doc was very fair in that I  must admit. She said that she didn't want to be sat opposite me sometime in the future, with me facing terminal breast cancer, and not feel that she had spelled it out plain and clear the risks to women taking HRT when over 60. We also discussed the risk from drinking wine - she is of the opinion that any woman on HRT should give up alcohol - as she has - just to lower the risk. We then talked about the stroke risk for women over 60 - it wasn't a cheery conversation obviously! She is a good GP but sometimes a bit forthright in her manner!

Taz x

[skkb]

But Taz we could scare ourselves to death with something we "shouldn't" be doing/eating/drinking etc every day.........some women who have never been on hrt will develope breast cancer, some people who have never smoked a cigarette will get lung cancer, someone who has always had plenty of fibre & a healthy diet with regular bowels will get bowel cancer.....it's endless, you cant live like that, you have to have a life. One day something will end your life, for some it's far to soon but instead of worrying about the next glass of wine just enjoy it and look forward to the next one and so on. You die of old age, illness or accident and thankfully we don't know which or when and wouldn't want to know.......but who wants to live to be 100 if the last 20 or 30 years of that life have been utterly miserable because we didn't accept medical or other help as we were always worrying "but what if" before we popped a pill!! Just my thoughts

[Rowan]

You might find this interesting

http://www.medscape.com/viewarticle/727863 

I think its important also to know that there are two types of strokes  Ischaemic and Haemorrhagic, estrogen is supposed to make blood vessels more elastic so for one kind of stroke (Haemorrhagic) it could be protective.

[Hurdity]

That's great silverlady publicising that BMJ study from 2010 with evidence demonstrating that lower dose transdermal oestrogen is associated with lower risk than oral oestrogen. Have you got any more info about the different types of stroke and oestrogen - that sounds interesting - or did I miss that in the paper as I only glanced at the summary?!

This is a summary about the research to date re stroke in the recent paper giving recommendations on HRT by the British Menopause Society and Women's Health Concern:
http://min.sagepub.com/content/19/2/59

Stroke
Observational studies on the use of HRT and stroke have yielded conflicting results.

The WHI study revealed an overall increased incidence of stoke in women using estrogen and  progestogen therapy or estrogen alone. Re-analysis of the combined data from the estrogen and progesterone study and that of the estrogen alone study revealed a smaller increase in incidence of stroke in women who commenced HRT between the ages of 50 and 59.

The HERS study (the Heart and Estrogen progestogen Replacement Study) found no increased incidence of stroke with HRT.

On current evidence, HRT cannot be recommended for the primary or secondary prevention of stroke.

Caution should be exercised when prescribing HRT in women over the age of 60 particularly when they
have a risk factor for stroke or thromboembolism. In these groups, current evidence would suggest that the transdermal route may be advantageous.

The effects of HRT may be dose related and the lowest effective dose should be prescribed in women
with significant risk factors.

Interestingly at the end of the article you linked to silverlady it says this:

These are intriguing findings. Keep in mind, though, that this is an observational study -- it's not a randomized clinical trial. It is possible that there were other factors explaining the differences. It could be that there are confounding factors contributing to the better results of transdermal vs oral estrogen. But I think these findings should encourage and stimulate additional research on the benefits and risks of transdermal estrogen. In the meantime, they inform clinical decision making by suggesting that transdermal estrogen may be a very good alternative for many women.

So as well as reducing other risk factors eg alcohol when we reach 60  women should think of changing to patches or gel if we haven't already done so.

I agree Taz - it is their duty to tell us the risks as they understand them and then we can make an informed choice.

Hurdity x

PS I meant to say as long as they (the docs) are up to date with the latest evidence and recommendations!

[gilaray]

SKKB, I agree.
What we develop or not is mostly within our genetic make up.
Lifestyle is important but not to a draconian degree
My mum was slim, ate healthily, loved walking, didnt drink or smoke but she still died at 66 from cancer
My husband who is also slim and stress free had a heart attack at the age of 53
Its all in the luck of the draw

[skkb]

ABSOLUTELY - don't live life fearing what you might get

[Rowan]

Hurdity I don't know if this applies to our own endogenous balanced hormones or man made added hormones.

Estrogen is known to be an antioxidant  http://www.sciencedaily.com/releases/2005/08/050827120540.htm

No matter what I read I have found conflicting findings where hormones are concerned whether it is scientific papers and findings, or mainstream.
 
I think you can drive yourself mad searching for evidence that you are doing the right thing for your health and wellbeing including taking hormones.

In the end you can only do what feels right for you and cross your fingers. I try to do this but I have the research gene and have to know the ins and outs It drives me nuts sometimes.

[Hurdity]

.... but I have the research gene and have to know the ins and outs It drives me nuts sometimes.

Haha - so do I!!!
Thanks for that link - very interesting - really going into the cellular mechanism for how it works - it's one thing to have all the studies showing an association (between treatment and effect) - or possible cause in terms of conditions/side effects/illness etc, but how this is caused is quite another.

What we develop or not is mostly within our genetic make up.
Lifestyle is important but not to a draconian degree
Its all in the luck of the draw

Hi gilaray -  sorry to hear about your mum, but I do disagree with your statement above - yes we have a predisposition to certain things in our genetic make-up but whether or not this is expressed or not in many cases can be affected by external factors ie diet, exercise, lifestyle. I know there is evidence for this but haven't got anything to hand. If we took a fatalistic view of ourselves and our health there would be little point in doing anything - I meanwe could loll about eating fatty foods, no fruit and veg, smoke, drink, never take exercise etc!!! No thanks - I want to maximise my chances of good health despite my genetic make-up.

Also cancer is a complicated disease and we can never know whether for example if some environmental factor earlier in our lives could lead to our developing it later. Even if you have a genetic pre-disposition to a cancer eg breast cancer, then living a healthy lifestyle could make a huge difference to survival or life-span even if you are unfortunate enough to develop the disease. I am sure there will be information on this.

Hurdity x