Thanks Sammi and Hurdity 
This is not for me - I am on combined so you haven't registered wrongly 
- I was talking to someone is in this situation and was wondering if I had my facts straight. Unfortunately some health professionals do seem to embroider things and go round the houses and you start to lose sight of the facts.
I understood that transdermal oestrogen only was pretty safe as long as you are healthy and did not necessarily contribute to a raised risk of breast cancer, unlike combined. I will read Hurdity's links.
Sammi - you are right about the age 51 as she is being asked to consider coming off it as she is at the normal menopause age. She has always been well on it but had considerable difficulties before the surgery - most things are relative.
With the hair, it might be best to use a patch so that you get the most even dose of hormone over the day. I know that some patches reduce their dose towards the end of their life and when you are experienced with it you can tell when this happens and it needs changing. I have always found that keeping things as even as possible is good with hormones. There are some hair threads on here with lots of ideas to help keep it at its best when you have problems.
Another question was is there a point where your body 'goes into menopause' in a way that is independent of your ovaries? So that you 'know' it is time to come off.
The only thing I could think of was your oestrogen receptors stop responding if you have not had oestrogen in your body for a long time, but otherwise the concept made no sense.
Glad I've not been completely absent while reading our posts. Now I come to think of it you're on Femoston I believe?
Anyway re the links - I know you're scientifically minded so if your friend wants more accurate in depth info - then the BMS website eg their position statements on HRT will probably be more instructive. Also their 2016 HRT recommendations ( paper with Women's Health Concern - Hamoda, Panay et al I think) is very good. Gives summaries of the studies to that point.
https://journals.sagepub.com/doi/full/10.1177/2053369116680501Re your comment about what happens when you reach the age of what would have been your natural menopause - well for at least the first two years following the last ovulation oestrogen levels fall quite dramatically but according to the STRAW paper ( I think we've discussed this before? - paper - Stages of Reproductive Ageing Workshop?)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3340903/ some ovarian activity continues for several years:
"
Early post-menopause: Stage +1c [starts 2 years following last ovulation] represents the period of stabilization of high FSH levels and low estradiol values that is estimated to last 3 to 6 years; therefore, the entire early postmenopause lasts approximately 5 to 8 years. Further specification of this stage will require additional studies of trajectories of change in FSH and estradiol from the FMP through the late postmenopause
Late postmenopause (Stage +2)
Stage +2 represents the period in which further changes in reproductive endocrine function are more limited and processes of somatic aging become of paramount concern. Symptoms of vaginal dryness and urogenital atrophy become increasingly prevalent at this time.7,70–72 However, many years after menopause, it has been observed that there may be a further decline in levels of FSH in very old persons73,74; future studies will be needed to determine whether an additional stage is warranted near the end of life."There have also been studies demonstrating that the post-menopausal ovary continues to secrete androgens (can't remember which now - maybe DHEA or a precursor) which are then converted elsewhere to testosterone.
This is despite the fact that in most women (not sure if on HRT?) the ovaries appear to atrophy - and are not found easily on scans. They don't disappear or dissolve as someone I think mentioned here - they are still there but tiny and hidden behind other organs (they can't see mine on scans) so it is interesting that they are still functional organs (at least for the androgens) for many years - but I don't know whether this has been quantified in much older women long past menopause?
This is why women who have their ovaries removed sometimes have a lot of trouble getting HRT stabilised - because it is trying to balance this!
Our adrenal glands also produce androgens in addition to the ovaries so women in surgical menopause rely entirely on this supply.
re conversion of extra oestrogen to testosterone - I wasn't aware of this? Do you have a ref please? The general synthetic pathway is the other way round - testosterone is a precursor to oestrogen - which is not to say that it does convert because there will be limiting factors in different tissues....
Interesting idea about the receptors and in fact I did read that in the absence of oestrogen the endometrium does indeed atrophy. I do remember reading that it was thought that perhaps the oestrogen receptors no longer responded to oestrogen, otherwise the lining would continue to grow in the presence of the oestrogen we continue to produce at low levels throughout our lives - and more women would get endometrial cancer - which is actually quite uncommon. I would have thought that receptors must still be active in other parts of the body - otherwise oestorgen production would be redundant, although past reproductive age - who knows?!!
It's all very complex and a delicate balancing act - so I hope you are able to inform your friend!! I would say no reason for her to stop taking HRT but eg when she gets to 65 or 70 (or whatever suitable age) if she has been taking it for a long time - maybe try cutting down the dose gradually to a minimum maintenance dose to keep symptoms at bay?
Gosh I didn't mean to ramble quite so much but you did raise some interesting points!
Hurdity x
Author
Topic: surgical menopause and oestrogen only hrt (Read 1620 times)