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[pepperminty]

There is no age limit as you say pepperminty, but of course always good to re-evaluate now and again ( not that I do!!! I used to say I would revisit when I got to 70 but now I'm there - not prepared to go through what might happen when I stop and yes I am aware of the risks, especially potentially of progesterone - even bio-identical - or rather there is insufficient research for long term use in women of my age I don't think.

The recommendations as to what is "best" vary according to age and circumstance, as well as health.  Since there is a whole host of preparations on the market this gives women a great variety to choose from.

Hurdity x

Yes I agree - I think it is sensible to re evaluate.  I can't remember if there is a study on the increase in risk ratio for prog' but I do know it is lower with Dygesterone.  That is why it makes my blood boil that we can't get it as a separate tablet. There is risk to everything, some greater than others. 

PMxx

[pepperminty]

Not a very impressive article in my opinion. 

Not all women need HRT

How does the author know?  By the time you find out, it could be too late to reverse the damage.

Ideally address any diet and lifestyle issues which may be contributing to symptoms and which can affect later health; easier said than done but important to try

All the healthy diets and lifestyles in the world would not prevent my migraines.  I need good, hard, medication.  Nothing else works.

HRT is rarely needed forever; consider when to stop

I wouldn't bet on that.  If I stopped using HRT, I would be plagued with migraines.  I suppose I might have some success if I was drugged up to the eyeballs on ADs but why would I decide to do that?

Not sure why the American spelling of oestrogen was used because they then went on to use progestogen rather than progestin.

The person who wrote the article is obviously an HRT sceptic and sounds about 20 years out of date.

I agree it does seem out of date , but it popped up on this site's email news.

PMXX

[Sage 🍃]

The article seems to be in line with recent articles by the current chair of the BMS Dr. Paula Briggs. I don't have the links now but I can post them if anyone is interested. 

[joziel]

The BMS are notoriously conservative about just about everything. They would still be trotting out the WHI ball-cocks info if it weren't for people like Louise Newson piling on.....

[pepperminty]

The BMS are notoriously conservative about just about everything. They would still be trotting out the WHI ball-cocks info if it weren't for people like Louise Newson piling on.....

I agree,

it should be about shared decison making and patient choice. It is hormones - there are far more dangerous drugs that are prescribed without all the scare mongering that has surrounded HRT.  Doctors are not God. Infact I dare to say that some ladies on here have a more thorough knowledge of HRT than many a Medical professional.  Women have more chance of dying from Dementia , heart desease,stroke , The flu, lung desease and lung cancer rather than breast cancer.
There is a risk to everything we do . We know HRT  protects against so many things such as osteoporosis .Falls are a serious threat to older women's health, wellbeing and independence, causing pain, distress and loss of confidence. Despite having serious consequences, falls in later life are often dismissed as an inevitable part of growing older, when the reality is many of them are preventable. HRT helps keep bones healthy .

And is it a coincidence that after the HRT scare when women stopped taking HRT that the incidence of dementia increased significantly. Then there is the   appalling lack of effective treatment for UTI's, and the significant increase in them  for women in recent years is probably also partly due to the reduced use of HRT, as estrogen supports the bladder.
Estrogen can be for life , menopause is a permanant condition. Not long ago women were lucky if the lived past 60 years . 

PMxx

[Joaniepat]

Great post pepperminty 👏.
JP x

[Mary G]

The BMS are notoriously conservative about just about everything. They would still be trotting out the WHI ball-cocks info if it weren't for people like Louise Newson piling on.....

Spot on.  They are extremely conservative and I'm pretty sure the late, great Professor Studd came under pressure from them with his 7 day 100mg Utrogestan regime.  I and many other women used that regime successfully and safely (backed up with TVS scans of course) for years and it was a real life saver for many but the BMS were not having any of it.  A more flexible organisation would have sanctioned the regime with a caveat ie it must be monitored with annual TVS scans rather than a blanket NO that meant many women gave up on HRT altogether.  Perhaps they should have been honest and said the NHS can't offer routine scans and only offer scans if someone has a problem.

This same organisation seem incapable of getting Utrogestan licenced for vaginal use in the UK and seem to be all over the place on how it should be used.

As for those wretched, poorly conducted and deeply flawed studies, yes, the BMS were very quick to act on their findings but extremely slow to act when it turned out to be BS.  I wonder how many lives were ruined as a result of that?  It's a warning as to what can happen if you are overly wedded to studies and take the results of all studies as gospel immediately.  Very often another study will come along and contradict the previous one anyway. 

Louise Newson is doing some very good work but the whole menopause/HRT thing needs a good shake up.

[pepperminty]

Great post pepperminty 👏.
JP x

Thanks Joaniepat,


PMxx

[pepperminty]

The BMS are notoriously conservative about just about everything. They would still be trotting out the WHI ball-cocks info if it weren't for people like Louise Newson piling on.....

Spot on.  They are extremely conservative and I'm pretty sure the late, great Professor Studd came under pressure from them with his 7 day 100mg Utrogestan regime.  I and many other women used that regime successfully and safely (backed up with TVS scans of course) for years and it was a real life saver for many but the BMS were not having any of it.  A more flexible organisation would have sanctioned the regime with a caveat ie it must be monitored with annual TVS scans rather than a blanket NO that meant many women gave up on HRT altogether.  Perhaps they should have been honest and said the NHS can't offer routine scans and only offer scans if someone has a problem.

This same organisation seem incapable of getting Utrogestan licenced for vaginal use in the UK and seem to be all over the place on how it should be used.

As for those wretched, poorly conducted and deeply flawed studies, yes, the BMS were very quick to act on their findings but extremely slow to act when it turned out to be BS.  I wonder how many lives were ruined as a result of that?  It's a warning as to what can happen if you are overly wedded to studies and take the results of all studies as gospel immediately.  Very often another study will come along and contradict the previous one anyway. 

Louise Newson is doing some very good work but the whole menopause/HRT thing needs a good shake up.

I agree,

I wish all the high profile HRT specialists like Nicky Panay and Newson and all, would get together and try to persuade via relentless media coverage and constant letter writing to the goverment and drug companies about getting Dygesterone back and creating a one stop shop for menopause health. Instead of saying that there is " no commercial interest" . I wont say the well known specialists name who said that. I did reply - " how about creating some commercial interest ?"
My Gynaae said that thier life would be made easier with bringing back Dygesterone.
The BMS is far to conservative.

PMXX

[Mary G]

pepperminty, I think you can buy Duphaston (which is dydrogesterone) from online pharmacies outside the UK and they will post it to you.

You have made some very good points and I would add that most menopausal women have to work need HRT in order to be able to function properly.  Too many women are having to give up work because of intolerable menopause symptoms and/or an intolerable HRT regime that could easily be customised to suit them if only they could get the support they need.

[pepperminty]

pepperminty, I think you can buy Duphaston (which is dydrogesterone) from online pharmacies outside the UK and they will post it to you.

You have made some very good points and I would add that most menopausal women have to work need HRT in order to be able to function properly.  Too many women are having to give up work because of intolerable menopause symptoms and/or an intolerable HRT regime that could easily be customised to suit them if only they could get the support they need.

Exactly right,

it is no coincidence that not that long ago the majority of women just stayed at home once they were in peri/ meno and rarley worked beyond .  It was a rarity that women worked beyond , and most that did probably  took HRT, but did not tell anyone thier secret! It wasn't talked about then. Also these women did not really know as much about HRT as we do now, they just took it and it helped.
Now most women have to work to live. HRT does not work for everyone and it is not a cure. Add HRT with proper nutrition and gut health  and you most likely stand a better chance of a healthy old age.
 
Thanks I know that Duphaston is available abroad , but I would worry trying to get it. The one thing that interests me with Duphaston is that it has the lowest risk for breast cancer.  Not sure if there are any studies comparing it with Utro' ?

So if the BMS is so worried about side effects / breasts/duration etc , why don't they campaign for Duphaston to be brought back to the UK?  If it were men's testicles at risk ( and not breasts) then be sure that the powers that be would reinstate it pronto!


PMxx

[Mary G]

pepperminty, have you ever tried dydrogesterone?

if you want to trial dydrogesterone why not get hold of some Femoston and top up the oestrogen with gel or a patch if necessary? That's what I did with Angeliq and it worked well although the patch was too weak.

[pepperminty]

pepperminty, have you ever tried dydrogesterone?

if you want to trial dydrogesterone why not get hold of some Femoston and top up the oestrogen with gel or a patch if necessary? That's what I did with Angeliq and it worked well although the patch was too weak.

Hi Mary G

Yes I am on 1/10 femosten but really would like the opportunity to try transdermal . I top up with Zumenon - but wuld rather try another estrogen.

PMxx

[Mary G]

pepperminty, if you want a transdermal form of oestrogen alongside dydrogesterone, you are almost there if you take Femoston 1/10 and top up with Oestrogel as opposed to Zumenon.  It's probably easier than battling with buying it online from somewhere outside the UK.

It's interesting that both 1mg and 2mg Femoston contain 10mg dydrogesterone.

[pepperminty]

Thanks Mary G ,

I have an appointment with my NHS menopause clinic soon, I will mention this to them. Although my GP practice prescribes, so it is difficult getting any adjustment as my main GP is still under the illusion that in your mid fifties you hould be reducing to come off HRT. I had to explain to him what the progesterone was in my HRT and why I needed it, and the difference between sequential and continuous HRT.

PMXX