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[Avalon85]

I’d really like to help a neighbour who I feel would benefit from transdermal HRT. I’m a Menopause Yoga teacher and a Wellness Coach so after a session I recommended she ask her GP. She was on a combined tablet version 20 years ago but stopped as it gave her breakthrough bleeding. I suggested she asked for Oestrogel and Utrogestan and she went away feeling hopeful, and relieved there was finally light at the end of the tunnel. She asked her GP but was told she is too old to start it again. They said there would be a stroke risk and heart risk which I completely disagree with and think this is the wrong advice.  She has severe muscle and joint aches as well as other classic symptoms. Wondered if anyone has some practical advice as I’d love to help her. She really wants to try HRT again.

[Suziemc]

No advice on the HRT, sorry, but I find Collagen really good for my joints and muscles. It's not cheap at £28 per month, but it helps me.

I didn't notice a huge difference at first, it takes about 3mths to have any effect and then it's not a flash bang wallop. But 6mths in I went on holiday for 3weeks and didn't take any, just 10 days in I noticed my knees hurting going upstairs and general aches when getting up out of bed. So it def works for me and I'd recommend it to anyone who can afford it.

Suzie

[CLKD]

Morning.  Her GP should have referred your neighbour to a dedicated menopause clinic; there are waiting lists, both NHS and Private.  Quality of Life is important.  70 is no age these days!!!

I suggest that your neighbour rings round her menopause clinics: not gynaecologists: too see whether she can self refer and what the waiting lists might be.  GPs seem to dismiss symptoms without any joined up knowledge!

[sheila99]

If she can afford to go private I'm sure she'd find someone willing to prescribe. I've heard this theory too but but don't know if there's evidence using transdermal hrt to support it. The NICE guidelines say
'does not increase cardiovascular disease risk when started in women aged under 60 years'
 Which kind of implies but doesn't say there may be an increased risk over 60.
The BMS says
'If HRT is to be used in women over 60 years of age, lower doses should be started, preferably with a transdermal route of estradiol administration. Evidence from the Cochrane data-analysis as well as that from the long-term follow-up data of the WHI showed no increase in cardiovascular events, cardiovascular mortality or all-cause mortality in women who initiated HRT more than 10 years after the menopause'

[orrla]

Well, they gave me a lower dose, at 63, and now I have a whole list of irreversible issues, including collapsing spine, that's how good these guidance are!

70 now is that cohort that stayed away from HRT because that famous breast cancer scare. Now they have no women to research on, so are just being cautious,  that's all!

[bombsh3ll]

Unfortunately it will be difficult for your friend to get it on the NHS. 

Arbitrary age based cut offs in any area of medicine are not good practice in my opinion, they often take the place of an individual assessment and good clinical decision making, however that is the situation when the clinician is allotted 8 minutes per patient and has no training on menopause care.

If she has the resources to go private, she would be best to do that and can then at least be receiving treatment whilst pursuing referral to an NHS menopause clinic if she wishes.

If she is in good nick - slim, active, non smoker youthful outlook etc - it may be worth her arguing the case for them to consider her biological age rather than her chronological age.

That works for me when I get a clinician unfamiliar with UKMEC who has a problem with me taking the pill at 44.