Meg - you are absolutely not too old to start - just!
Recently the British Menopause Society reviewed all the information and came to the conclusion that there was a "window of opportunity" for women under 60 or within 10 years of the menopause to start HRT, and if done so at this time then the benefits should generally exceed the risks (or be equal to them once you reach 60).
Read what it says on this site about the risks and benefits at different ages:
http://www.menopausematters.co.uk/balance.phpHere is a brief summary - on this site:
http://www.menopausematters.co.uk/newsitem.php?recordID=145/BMS-Council-Consensus-Statement-on-HRT (2013)
Summary practice points
The decision whether to use HRT should be made by each woman having been given sufficient information by her health professional to make a fully informed choice.
The HRT dosage, regimen and duration should be individualised, with annual evaluation of pros and cons.
Arbitrary limits should not be placed on the duration of usage of HRT; if symptoms persist, the benefits of hormone therapy usually outweigh the risks.
HRT prescribed before the age of 60 has a favourable benefit / risk profile.
It is imperative that women with premature ovarian insufficiency are encouraged to use HRT at least until the average age of the menopause.
If HRT is to be used in women over 60 years of age, lower doses should be started, preferably with a transdermal route of administration.
It is imperative that in our ageing population research and development of increasingly sophisticated hormonal preparations should continue to maximise benefits and minimise side effects and risks.
This will optimise quality of life and facilitate the primary prevention of long term conditions which create a personal, social and economic burden.
This is the consensus statement on HRT May 2012:
http://www.menopausematters.co.uk/newsitem.php?recordID=136/New-Consensus-Statement-on-use-of-HRTAnd this from the International Menopause Society:
http://www.imsociety.org/pdf_files/comments_and_press_statements/ims_press_statement_15_03_13.pdfRisks associated with MHT are acknowledged, but benefits derived from MHT will generally
outweigh the risks for women under 60, or within 10 years of the menopause.The risks are
generally small.In view of the above, as Taz says - the GP should prescribe it - but you will need to be armed with all the info to demonstrate you know what you are talking about and prepared to take the risks because as things stand it seems like in your case, the benefits still outweigh the risks (just) and there isn't a moment to lose if you are keen!!
Personally I wouldn't touch fluoxetine with a barge-pole to deal with meno symptoms, when it's a hormone deficiency we are talking about.. It should only be used ( and sparingly) - for the purpose for which it was developed, and then only for a very limited period, to prevent dependence.
As honeybun says you won't necessarily get bleeding problems although you might get some spotting initially until you settle down.
If you do go down this route be sure to choose a transdermal method as this would be preferable at your age. Ideally you should go for separate oestrogen and progesterone which would mean Utrogestan ( micronised progesterone) - and you would have to make sure you insisted as many GPs are quite ignorant of what's available.
Hope this helps and keep posting!
Hurdity x
