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[Shadyglade]

Yes we are all different genetically but we are all governed by the same biological and cellular processes, hence we can have confidence in evidence based treatments if necessary. However as these are based on studies of populations - we cannot say how one individual will be affected or respond - but can look at the likelihood of something working or not. Similarly with the risks of experiencing certain conditions and diseases of ageing, and post-menopause - these are based on population studies so an individual can decide whether to accept the risk (eg of osteoporosis) in the absence of HRT, especially in women reaching menopause at younger than the average age ( I use this as an example) - but we have no idea whether we will be one of those - although genetic factors play a part. We each have to decide whether to do the experiment on ourselves - ie let "nature" take its course but maybe find out many years later that we are one who for whom the outcome is adverse - or else intervene when younger to try to ward off the impending effect!! Everyone needs to have access to up to date and reliable evidence-based information, as well as proper up to date medical advice - in order to be able to make that decision.

Hurdity x

Sorry Hudity, I really can't agree with this.  Unless you have an early menopause there is little evidence that HRT is going to be beneficial for ageing illnesses e.g heart disease, osteoporosis.

https://www.nhs.uk/live-well/healthy-body/menopause-and-your-bone-health/


https://www.menopausematters.co.uk/cvdhrt.php

https://www.bhf.org.uk/heart-health/living-with-a-heart-condition/women-with-a-heart-condition/menopause-and-heart-disease

As for your implication that women are taking 'a risk' by choosing, or not being able to take HRT, I find that more than a little extreme.  I read post after post,on the forum, from women who struggle to find the 'right' HRT, and many seem to give up.  Surely they are the ones who are experimenting.

Each to their own, please

[Otes73]

My mum who's 61 has  taken HRT since age 45 has been diagnosed with oestoporosis and both her sisters age 57 & 59 with Oestopenia also taking HRT.

Makes me worry about my bones!!
X

[Conolly]

Hello Otes73,


Sorry to hear that, and you're absolutely right to be worried but thanks to DEXA scans and new medication available your probable (but not certain) genetic predisposition can be counteracted. Don't forget exercise and diet, it's up to you!
Hugs,
Conolly X

[Mary G]

I agree that there will always be women for whom HRT will not work and it would be interesting to know why.  There will also be women who don't want to take HRT for various reasons but that should be because they don't want to take it and not because they are frightened of it and think it causes cancer.

From my own experience and from reading posts on here, I think the main problem with HRT is that too many women are on the wrong type at the wrong dose and only get minimal symptom relief - I call it being stuck in the HRT halfway house.  There needs to be much more flexibility and I think that dose flexibility of both oestrogen and progesterone is the key to success.  For example, I think too many HRT regimes have too high a dose of progesterone which often overly opposes the oestrogen and drowns out all the good work it does.  That might not be a huge problem if you tolerate progesterone well but if you are progesterone intolerant (or sensitive) like me then it is a complete non starter.  Luckily I only need a very small amount of progesterone but perhaps a lot of women would not have persevered as I have and given up on HRT thinking it doesn't work or isn't worth the hassle.

Far more flexibility and tailor made HRT regimes are needed. 

[CLKD]

As an aside: when I needed anti-depressant medication in the late 1980s it was Trial and Error as side effects were severe.  But my GP persevered and I had to otherwise  .  Fortunately once we found a tablet which didn't make me sick and helped over-all, it worked for 10 years+.  4 me it was a matter of Life or ...........

So maybe HRT is similar?  In that ladies get worn down by a) not being listened to initially, b) having difficulty with what is prescribed, c) worrying about cancer scares which GPs don't bother to reassure them about ..........

[Shadyglade]

MaryG do you think it's because it's a women's issue and therefore not enough experts and research.

[Conolly]

Hello Mary G,


That's interesting regarding tailor made HRT, but how do you think that could be done? Compounded medication is not recommended by NICE, big pharmaceutical companies don't seem interested in producing variable dosage regimens for menopause purpose.
Conolly X

[Mary G]

Shadyglade, yes, I do think it is partly because it's what people think of as a women's issue and a supposedly natural process but I think it is partly due to lack of funding and research.  HRT has been stuck in a rut for years partly due to the deeply flawed and discredited HRT studies that wrongly stopped so many women from taking it.  But I also think that the NHS are too rigid and stick to the guidelines like glue and don't think outside the box.  There seems to be a one size fits all approach and very little help or flexibility for women who, for example, are progesterone intolerant. 

GPs are not up to date with latest guidelines or HRT products either which doesn't help and time and time again we have women on here who have had rubbish advice from their GPs.  I have had to work everything out for myself and seek help privately.  There is no way the NHS would sanction my HRT regime but it works extremely well for me and might for others if they had the chance to try it. 

[Mary G]

Conolly, when using products like Oestrogel, Utrogestan and other types of progesterone that are available separately, it is possible to tailor the dose to suit the individual.  These products have the capacity to provide wide ranging dose flexibility if the will is there to do it.  That is why menopause specialists like Professor Studd and Dr Newson like using these products. 

[Shadyglade]

It seems odd to me that with most other meds etc., they are tailored to suit. You would not have everyone on the same dose/make of blood pressure meds. It does not make sense at all.

[CLKD]

DH and I take the same statins ........... useful when I forget to order my next packet 

I believe that it's because menopause is 'out there' ....... in that it begins so much later than many other problems that affect the human population.  GPs aren't taught about it.  NICE guidelines are sometimes stuck to [thinking of the cannabis medication required by a few people which has been in the Press recently], NICE not funding treatments that would assist patients across the UK because they are in the minority. 

[Conolly]

I agree Shadyglade.


Mary G, let's take Utrogestan for example... a lot of women feel dreadful taking 100 mg. I can't be on a sequential regimen so for me it's 100 mg every night or nothing. It's way too much, I've gone haywire, suicidal thoughts.


Conolly X

[Conolly]

Well, CLKD, you've said on the Body Natural thread that menopause is a natural and old phenomenon. So there should be lots of different dosages of HRT... 


Conolly X

[periwinkle68]

I apologize that I didn't read all 7 pages of this thread before posting, but  I read the article posted in the link and it did resonate with me and I wanted to say something about the anti-anxiety and anti-depressant drugs. 

My experience was that I started perimenopause in 2015 - at least I diagnosed myself as perimenopause since my periods became very erratic on and off, heavy and light, etc. and I was the right age for it.  I didn't have reliable GYNO doc at the time.  I relied on my primary care doctor, who I later discovered knew nothing about menopause.  By December of 2015, my perimenopause symptoms were so out of control, I was a mess (I now believe it was hormonal). Things were happening in my body that scared me, including heart palpitations, feeling sick all the time, and many other symptoms.  I ended up in the emergency room that December because I thought I was having a heart attack!  I wasn't.  My primary care doctor immediately diagnosed me with general anxiety disorder.  At 47 years of age, I had never experienced any anxiety or depression in my life, so I didn't understand how this just came on overnight.  The primary care doc never said it was possibly tied to perimenopause and hormones, but my guess now is that it was the perimenopause phase that triggered the anxiety in my body.  He put me on a very high dose of Xanax, I mean, he started me on 2 mg a day and then upped it to 4 mg a day when I complained that I was feeling sick in between doses.  I knew something wasn't right.  I understood that I might have anxiety, but I shouldn't be feeling so sick in between the doses of Xanax.  Long story short (too late), after I researched Xanax and other benzo drugs, I learned about dependency on the drug.  In 2 short months, my body had become so dependent on the doses of Xanax, that I was going through withdrawals in between doses!  It was crazy!  I ditched that primary care doc and found a new one who better understood and agreed with me that the Xanax had become a big part of my sickness.  It took over 8 months to taper me off that drug.  It was pure hell, the worst thing I've been through. I was literally bedridden and sick so much of the time going through withdrawals from Xanax.  I will never, ever touch that prescription drug again. 

After making it through that drama, my hormones continued to act up.  But still, no doctor would agree that it was tied to hormones and perimenopause.  By now, I knew I was in perimenopause because the periods continued to come and go, on one month, off 2 or 3 months, on 2 months, off 1 month.  I never knew when I would have one.  I still had anxiety, so they put me on Zoloft.  Even though I wasn't depressed, the docs said that studies showed an antidepressant can help many women dealing with menopause.  Literally, the same type of thing happened all over again, my body started to become dependent on that drug and I had to go through another whole withdrawal process from that drug.  It wasn't nearly as bad as the Xanax withdrawals, but it still made me feel sick and was difficult to get off of it. 

By the start of 2017 I was finally officially off all those prescriptions.  It was a complete nightmare.  I know that some people need and handle anti-anxiety and anti-depressants fine, but my body did not like them and they caused me more grief than I can describe in words.  My point is, be careful with these drugs.  They may seem like a quick fix to the problem, but many bodies become very dependent on these medications and it's very, very difficult to come off of them. 

I continued to struggle with the perimenopause, but still, no doctor would agree that my horrible symptoms were related to hormones.  So in 2017, testing for everything and anything that could be wrong with me began, from cancer testing to every autoimmune disease to anything you could think of.  They found nothing.  I'm still technically in perimenopause, but I haven't had a menstrual period since December 2017, so I think I'm on my way to reaching the "official" menopause.  I do believe my body and symptoms have calmed down and I continue to feel better than I have in the last 3 years.  However, even my new OB/GYN doctor still disagrees that my symptoms are related to menopause.  She says that since I haven't had a period since last December that I have no hormonal activity happening in my body anymore so I shouldn't feel sick.  I disagree, but I'm not the medical professional.  I do however know my body and know that something is still "off" in my system.  Based on this forum, and other things I have read, it seems the UK doctors seem to understand menopause better than American doctors where I live.  Pretty much everything I have learned about menopause has been from my own research.  I hope I continue to feel better and that the next phase, post menopause, doesn't bring as much severe sickness as the perimenopause phase. 

[Shadyglade]

I must admit that from what I have read here I am sure I took the right route for me. Life and the menopause were complex enough without adding HRT brands, doses, patches, gels or tablets into the mix.  Plus the trouble lots of the have just getting your prescriptions forefilled.  Peri was very tough at times but I have lived to fight another day.