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Author Topic: Q for post meno ladies - are you supposed to reduce your HRT?  (Read 1149 times)

Gilla999

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Q for post meno ladies - are you supposed to reduce your HRT?
« on: December 30, 2022, 06:14:57 PM »

Sorry another question from me but a different topic so a separate post!

When you reach the stage when you stop ovulating, are you supposed to think about reducing your HRT? My understanding was that younger women often need higher levels of HRT and Estrogen but I think (??) that post meno you eventually need less, and I'm just wondering what prompts that... have any of you started experiencing symptoms of high E and therefore naturally ended up wanting to reduce? Or is it just something you're supposed to just try at some point? Or do many of you take no less a dose of HRT now than you did when your periods were erratic / you were still ovulating?

Keen to hear how it's panned out for ladies in the transition to post meno. Thanks all  :)
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discogirl

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Re: Q for post meno ladies - are you supposed to reduce your HRT?
« Reply #1 on: December 30, 2022, 06:59:19 PM »

hi gilla999

thats an interesting one and i would like to follow this thread.

im 4 yrs post meno and i seemingly skipped through peri however feb of this yr my hormones fell off the proverbial cliff.

i developed tinnitus chronic insomnia and bad anxiety. i started hrt in august. im currently on 4 pumps gel a day.

i always said id do the meno naturally but how wrong i was.

i dont endorse taking hrt for taking its sake and no i dont think everything is down to the meno and hrt isnt a magic pill. however if i need it i need it xxx
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Dotty

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Re: Q for post meno ladies - are you supposed to reduce your HRT?
« Reply #2 on: December 30, 2022, 07:02:29 PM »

Hi everyone is different and so there is no easy answer to your question. x
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Petra

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Re: Q for post meno ladies - are you supposed to reduce your HRT?
« Reply #3 on: December 31, 2022, 03:23:04 AM »

I'm at least 12 years past my last period, and didn't start HRT until after my last period (does that count as post-meno? I clearly certainly am now!). I had peri symptoms in my 40s but didn't click as to what was going on. Dang it! A big regret.

I've slowly reduced my HRT (see my profile below for current regimen) and my GP is always trying to get me to quit (says it's because of govt. health guidance, I'm in New Zealand), but she's generally always been very unhelpful and unsympathetic.

Recently tried quitting, but am now back on after a return of the worst symptoms, and I fully intend to stay on my low-dose regimen "forever", aka till I snuff it ... if they'll "let me". :-)
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Gilla999

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Re: Q for post meno ladies - are you supposed to reduce your HRT?
« Reply #4 on: December 31, 2022, 10:28:51 AM »

Thanks for the reply Petra, that is really helpful to know. I know Louise Newsom is very vocal about it being ok to be on HRT forever, I just wondered if your dose needs generally change over that time, especially in the bridge from when you're still ovulating to when you stop.

Side note: I lived in New Zealand for a few years and it's the best country in the world  ;D

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sheila99

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Re: Q for post meno ladies - are you supposed to reduce your HRT?
« Reply #5 on: December 31, 2022, 11:02:09 AM »

I'm interested in this too. Every time I try to reduce my symptoms return though perhaps this will change in the future. I wonder if it's based on flawed data - either from GPs prescribing less or none regardless of symptoms or from women who had some years without oestrogen.
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Gilla999

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Re: Q for post meno ladies - are you supposed to reduce your HRT?
« Reply #6 on: December 31, 2022, 11:47:02 AM »

I agree Sheila, it's hard to know isn't it and as Dotty says I guess everyone's experience is different. I think my questions stem from my nervousness at reaching this next "stage" of Peri where I'm having erratic and anovulatory cycles. After 1.5 years of gradually falling estrogen but still ovulating, I finally felt like I got to a place of stability with my HRT and now this next stage starts to happen. Which it was always going to, it just makes me nervous as I'm not used to how to deal with the horrendous ups and downs that accompany erratic ovulation that I realise the majority of women here are going or have been through! I'm not sure whether moving to the stage where I'm not ovulating means I might need to increase my dose, or the opposite... etc etc!
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Mary G

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Re: Q for post meno ladies - are you supposed to reduce your HRT?
« Reply #7 on: December 31, 2022, 12:39:48 PM »

I'm 61 and 15 years post menopause and ended up reducing my HRT dose by accident really.   I had to stop everything because I needed to establish baseline hormone blood levels and was surprised at the lack of symptoms (mostly sweating and feeling tinny) but they slowly crept back.

I have no intention of ever stopping HRT but it was an interesting experiment and when I restarted HRT I found one pump of Oestrogel was enough and giving me a good blood level of 77 pg/mL (about 280 pmol). 

I think it depends on symptom control but apparently 300 pmol is the number to aim for post menopause - in other words, it's a post menopause maintenance dose.

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Cassie

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Re: Q for post meno ladies - are you supposed to reduce your HRT?
« Reply #8 on: December 31, 2022, 01:05:53 PM »

Im also very much post meno and am doing great on 1 pump of the gel I have no intention of relinquishing it if I can get away with it  :-X
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Gilla999

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Re: Q for post meno ladies - are you supposed to reduce your HRT?
« Reply #9 on: December 31, 2022, 02:44:58 PM »

Thank you Mary G and Cassie, that's all very helpful to know and hear about. Interesting on the 300, that's really useful info to know too as I hadn't heard that!

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CLKD

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Re: Q for post meno ladies - are you supposed to reduce your HRT?
« Reply #10 on: December 31, 2022, 03:02:57 PM »

If U feel fine ......... if it were me, I wouldn't even think about stopping.  Same with my Anti-depressant medication, it's enabled me to get a Life.  I never want to feel as ill or frightened again!

HRT protects heart and bone health.  Must be worth something. 
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CLKD

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Re: Q for post meno ladies - are you supposed to reduce your HRT?
« Reply #11 on: December 31, 2022, 07:30:56 PM »

poppytoast - mayB ring the clinic to see if a referral has actually been sent and received?  R U able to accept a cancellation at short notice which might get you to an appt. sooner?
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CLKD

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Re: Q for post meno ladies - are you supposed to reduce your HRT?
« Reply #12 on: January 01, 2023, 06:42:32 PM »

MayB put 'tibolone' into the search box to see the threads on this medication?  Why do I think of 'toberlerone' when I read it  ;D
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sheila99

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Re: Q for post meno ladies - are you supposed to reduce your HRT?
« Reply #13 on: January 01, 2023, 09:02:42 PM »

Poppytoast your gp really should be capable of prescribing a different hrt. She really shouldn't be pushing you on to a menopause clinic just because she can't be bothered to educate herself. Is there anyone else you can see? Our gp 'meno expert' would only prescribe evorel too (I think it's the cheapest one), I only got gel and utro because I saw a completely clueless male gp when the 'expert' was off. I knew more than he did so he gave me what I asked for. Whatever you try next it might be useful to start on a sequi regime as it's usually the progestogen that causes the problems and this will show if you're OK on oestrogen only. Do you have a womb? If so you will need progesterone.
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CLKD

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Re: Q for post meno ladies - are you supposed to reduce your HRT?
« Reply #14 on: January 02, 2023, 03:55:08 PM »

Many GPs are leaving due to low morale as well as it being cheaper to begin using their Pension than to continue paying into it, as well as other insurance policies that they have to pay out for every 12 months >:(

Could you source support from where you get your Methadone or is this from your Surgery?  Do ask for an appt to a menopause clinic, mayB you could self refer to one locally?  Most surgeries now have GPs that see everyone, rarely is there a practice where 1 gets to see a Doctor on a regular basis, ours we have to wait a few weeks if I want to continue with the GP who knows my history.
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