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Author Topic: Going to see HRT nurse tomorrow  (Read 3382 times)

Pennyfarthing

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Going to see HRT nurse tomorrow
« on: March 14, 2016, 10:12:23 PM »

She changed my HRT a few months ago and I'm not feeling as well as I did and have been feeling very hot in the evenings and in bed, despite it being cold weather.

I think I was on Climesse and a higher dose now I'm on Kliovance but only 1 mg  which is Estradiol/norethisterone acetate.

I mentioned it to the doctor about a month ago when I was there for blood tests and she said I had to use it for several months. So I've  done that and I want my other stuff back now!
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Pennyfarthing

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Re: Going to see HRT nurse tomorrow
« Reply #1 on: March 15, 2016, 10:59:00 AM »

She has rather reluctantly put me back on the previous HRT. She says I must understand that at 62 I am at higher risk of heart attacks and strokes on this.
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Mary G

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Re: Going to see HRT nurse tomorrow
« Reply #2 on: March 15, 2016, 12:56:44 PM »

Yet more out of date information.  The chances of you having any health problems while taking HRT are very remote.  If you are happy with the Climesse and it works for you, continue taking it and don't worry about it.  If it ain't broke, don't fix it!

Next time your doctor tries to frighten you off HRT, you can tell her/him that the benefits of taking HRT far outweight the risks and that oestrogen depreviation causes far more health problems than HRT.  Many women (myself included) have raised cholesterol when their oestrogen is low and my mother developed high blood pressure as a result of low oestrogen.  That is what causes strokes, not HRT and you could tell your doctor that you also know about the risks of NOT taking oestrogen. 

I'm pleased you have managed to get back to your old regime, make sure you stick with it!

« Last Edit: March 15, 2016, 05:15:16 PM by Mary G »
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Pennyfarthing

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Re: Going to see HRT nurse tomorrow
« Reply #3 on: March 15, 2016, 04:08:01 PM »

Yet more out of date information.  The chances of you having any health problems while taking HRT are very remote.  If you are happy with the Climesse and it works for you, continue taking it and don't worry about it.  If it ain't broke, don't fix it!

Next time your doctor tries to frighten you off HRT, you can tell her/him that the benefits of taking HRT far outweight the risks and that oestrogen depreviation causes far more health problems than HRT.  Many women (myself included) have raised cholestorel when their oestrogen is low and my mother developed high blood pressure as a result of low oestrogen.  That is what causes strokes, not HRT and you could tell your doctor that you also know about the risks of NOT taking oestrogen. 

I'm pleased you have managed to get back to your old regime, make sure you stick with it!

Oh thank you Mary. Are you in the medical profession? 
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Hurdity

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Re: Going to see HRT nurse tomorrow
« Reply #4 on: March 15, 2016, 04:34:02 PM »

Actually Pennyfarthing, your nurse is partly right - but it is the route of HRT that is the crucial point here rather than age. The NICE Guidelines state that oral HRT is associated with higher risk of stroke than transdermal, especially if you are overweight.

Please read the relevant section of the Guidelines starting at section 1.5

https://www.nice.org.uk/guidance/ng23/chapter/Recommendations#information-and-advice

I've reproduced it below:

Venous thromboembolism

1.5.1 Explain to women that:

the risk of venous thromboembolism (VTE) is increased by oral HRT compared with baseline population risk

the risk of VTE associated with HRT is greater for oral than transdermal preparations

the risk associated with transdermal HRT given at standard therapeutic doses is no greater than baseline population risk.

1.5.2 Consider transdermal rather than oral HRT for menopausal women who are at increased risk of VTE, including those with a BMI over 30 kg/m2.

1.5.3 Consider referring menopausal women at high risk of VTE (for example, those with a strong family history of VTE or a hereditary thrombophilia) to a haematologist for assessment before considering HRT.

Cardiovascular disease

1.5.4 Ensure that menopausal women and healthcare professionals involved in their care understand that HRT:

does not increase cardiovascular disease risk when started in women aged under 60 years

does not affect the risk of dying from cardiovascular disease.

1.5.5 Be aware that the presence of cardiovascular risk factors is not a contraindication to HRT as long as they are optimally managed.

1.5.6 Using tables 1 and 2, explain to women that:

the baseline risk of coronary heart disease and stroke for women around menopausal age varies from one woman to another according to the presence of cardiovascular risk factors

HRT with oestrogen alone is associated with no, or reduced, risk of coronary heart disease

HRT with oestrogen and progestogen is associated with little or no increase in the risk of coronary heart disease.

1.5.7 Explain to women that taking oral (but not transdermal) oestrogen is associated with a small increase in the risk of stroke. Also explain that the baseline population risk of stroke in women aged under 60 years is very low (see table 2).


Personally in your position - if you do want to stay on HRT long term into your 60's (you are the same age as me), then I would look to changing to transdermal HRT. Evorel conti is a medium dose patch that contains the same progestogen as you are taking at the moment and seem to be able to tolerate.

Hope this helps :)

Hurdity x
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Mary G

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Re: Going to see HRT nurse tomorrow
« Reply #5 on: March 15, 2016, 04:43:41 PM »

Pennyfarthing, no, I am not in the medical profession but years of having no joy from doctors regarding the menopause and HRT has forced me to learn and research this fairly unchallenging part of medicine.  If I can learn about the menopause and HRT and keep myself up to date with it, the medical profession should find it a cake walk.

I'm sorry you have been messed about for no reason and do hope that you can now recover from it and get back to where you were. 

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Mary G

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Re: Going to see HRT nurse tomorrow
« Reply #6 on: March 15, 2016, 07:17:48 PM »

Pennyfarthing, to tag on to what Hurdity has said, the oral HRT route does carry higher risks (albeit very small risks) and if you were either (a) unhappy with your current regime/progesterone intolerant or (b) starting from stratch, I would definitely suggest Oestrogel and Utrogestan which are bio identical and vitually risk free.  However, because you were happy with your old regime and presumably you have been taking it for years, I would hesitate to suggest you change particularly as you have been messed about.

I also hesitate to mention the deeply flawed HRT studies that are responsible for ruining millions of women's lives for fear of giving them any credibility but one thing that did come out was that women should not start taking combined oral HRT if they are over 10 years post menopause and have never taken HRT before.  We now know it is important for women to start on oestrogen therapy as soon as their levels start to drop and in your case, I assume you have been taking Climesse for years so this does not apply to you. 

I did read somewhere (can't remember where) that because women's arteries start to clog up when they are oestrogen deficient, the introduction of oral HRT a long way past menopause (but not transdermal HRT for some reason) can cause a kind of descaling effect that can cause problems but again, that does not apply to you. 

The HRT nurse said she was changing your regime because of risk but she didn't change your prescription to the bio identical transdermal route, she just put you on another synthetic oral form of HRT on a lower dose (bound to cause problems) so it doesn't make much sense.  I'm not entirely sure what she was trying to achieve because Kliovance is no less risky than Climesse - not that there is much risk. 



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CLKD

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Re: Going to see HRT nurse tomorrow
« Reply #7 on: March 15, 2016, 07:30:56 PM »

Lack of education maybe? or what the Surgery will pay for?  Maybe have a chat with a Pharmacist?

It's that proverbial bus again - it might be along far earlier than any ill effects from HRT!


Let us know how you get on!
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