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[BreezyBlue]

I was just wondering if anyone could advise me whether or not I should take HRT. I have recently been prescribed Evorel Conti and not sure whether to use it. I am 43 and post menopausal now. I went through premature mesopause and haven't had a period for about 5 years, other than one occasion of 'spotting' about 4 years ago. I had to have a pelvic scan to check if there were any underlying reasons and a bone density scan to check I'm not at risk of osteoporosis and all was fine. Leading up to the menopause I had awful fits of rage, anxiety and depression, sleeplessness and night sweats, etc. At the time I didn't know it was menopause and it all made send after I had been diagnosed.

The thing is, by the time I had eventually been diagnosed, I had already gone through the majority of symptoms so I chose at that time not to use HRT. I rarely get any symptoms of anxiety now and my night sweats are very few now. I have got to the stage though that I am fed up with brain fog that I still get & often struggle getting my words out in important meetings at work and feel it is holding me back. I am also concerned with loss of collagen and have been told HRT can remedy this. I also suffer with dry vagina, though I know you can get creams for this.

My GP prescribed Evorel Conti when I discussed my concerns, but now I know about possible side effects, I wonder whether I should use it, given that I have got over the worst of the symptoms, though I am still concerned about the symptoms I have and feel I am too young to have to endure them. I am concerned though that if I take the HRT and it doesn't suit me (I am terrified of weight gain and other possible side effects) that if I stop taking it, I might then go back to suffering from the horrendous menopausal symptoms I had in the first place. Can anyone who has been in a similar situation offer any advice please?

[Taz2]

Hi BreezyBlue. At your age it is really important to use HRT! This will protect your heart and bones up to the usual age of menopause which is around 50/51 years of age. You are merely replacing what your body should have been making naturally up to the normal menopause age. If you don't use HRT you may also be at risk from vaginal symptoms, which you are already experiencing to some degree,  and also the risk of pelvic floor problems. This is from the info in the drop down menu at the top of the page http://www.menopausematters.co.uk/menopause.php

In my opinion it would be a good thing for you to give Evorel Conti a try. If you do have problems with it then there are other HRTs to try. It can take a few goes to get the one that suits you. You really do need the extra oestrogen to protect your future health.

Taz  x

[Hurdity]

Hi BreezyBlue

  from me too!

I agree with Taz - it's not just about symptoms when you are that young - it's about protecting your future health. Studies have shown those with a premature menopause are more at risk from health problems in later life.

My personal view would be to actually try a separate oestrogen and progesterone for a while until your body gets used to the oestrogen - and then add a preparation with a progestogen  - then you can distinguish between any side effects you might experience. Not many GPs will sanction this though so you would probably need to see a specialist. However why not give them a go for 3 months and see how you feel?

Yes do get something for vaginal problems too - the preparations are listed here:
http://www.menopausematters.co.uk/local.php

Many women find Vagifem easiest to use.

Hurdity x 

[BreezyBlue]

Thank you for your replies. I wasn't expecting anyone would recommend that I take the HRT so the replies were a surprise. My doctor never offered or suggested HRT 5 years ago and I was only prescribed it after seeing a new doctor. I really thought that as I had got over the main hideous symptoms, there would be no need. I thought I was maybe considering it for the wrong reasons like loss of collagen, brain fog and vaginal symptoms. I thought I should maybe learn to live with these as they aren't a patch on the hideous anxiety attacks and fits of rage I used to endure!

I would be interested to know if, once you start HRT then stop using it, if all the symptoms start all over again. I couldn't bear that. I would also be interested to hear about any side effects. I used to have epilepsy in my youth but grew out if it. I am aware that HRT can cause epilepsy so this is something that concerns me. I am one of these who dislikes taking anything that isn't totally necessary!

After a painful smear, I got some oestrogen cream from the doctor for dry vagina as I'd not felt comfortable to use the Evorel Conti patches. The leaflet says that it can cause same potential side effects as the patches which I didn't expect (eg increased risk of epilepsy etc). Anyway, it doesn't mention a thing on the leaflet about effects on others, but thought I should look in to this. I found an article on the Internet (yes ok the Internet so who knows if it's true) that said a woman had been using it as a vaginal lubricant and her husband started gaining weight round his middle & growing breasts! They realised it was the oestrogen! Now my main concern here is not my partner, but gaining more weight around my middle! 😱

[Hurdity]

The question about whether symptoms start again aftrer stopping HRT will vary from woman to woman - and of course you won't know until you get there! The main point is that if you stop HRT - it's just the oestrogen decrease your body has to deal with then, because your hormones will no longer be fluctuating up and down as they do during peri-menopause. Some women experience flushes when they stop, which then decrease to nothing, but in others they continue. Other women stop HRT and don't notice it (from what I've read on here and in the few trials that have been conducted).

I can't comment on the epilepsy side of things - that would be for a specialist doctor to decide.

I agree the side effects/health warning list can be very alarming - when I was first prescribed vaginal pessaries before I started full HRT I nearly didn't use them because of the warnings. The fact is the warnings that are on all HRT types are the same regardless of product or type and probably if you read the small print it will say on the vag preparations) that some of these risks and side effects have been found on trials with women on full HRT rather than vag oestrogen.

I would be surprised if oestrogen transfer (from vaginal oestrogen at the specified dosage) was a significant problem for husbands as this will have been investigated before the products were licensed for use on the market! The amount of oestrogen absorbed (by women) from vaginal creams and pessaries is very very low. Some women experience a few side effects to start with especially if they are post-menopausal or nearly so, and have little of their own oestrogen. Once the tissues are plumped up (after the two week "loading" period) very little is absorbed into the system and side effects should cease.

Hope this helps 

Hurdity x

[Sunnydays]

Hi BB
I can empathise with you. Whilst I have not gone through an early meno, I went thru the peri meno phase 'unaided'! I'm 53 and simply got to a similar stage as you with brain fog plus lack of sleep. I delayed using a vaginal oestrogen because of the warnings on it but now use ovestin and it has been worth its weight in gold in ensuring all is ok down below. I'm still experimenting with the hrt to help the sleep etc; you do need to give it 3 months as your body might feel strange having a kick of oestrogen. The advice given to me was to start with just a quarter of a patch and build up so as to get your body used it. Hope this helps.

[Dorothy]

Hi BB, I can sympathise with your concern about weight gain as I have put a lot on round my middle since starting peri.  But I don't think it's due to the hormones I'm taking, more that everything is starting to sag and bulge in the wrong places!  I've found that being a lot more strict about my eating habits and exercise help keep it under control, as does accepting that this is part of growing older and I can't expect a 20-year-old waistline at 40!

It would be worth asking your GP about your concerns regarding epilepsy.  Regarding the general safety of HRT, it's really for each woman to weigh up risks v benefits for herself, but as others have mentioned, for those going into early menopause, it's important to consider future potential health problems as well as current symptoms when you make your choice.

I'm not sure I would bother with HRT if I were older as I don't like taking things unless I absolutely have to.  But in view of the higher health risks of an early menopause, I didn't feel I had a choice, especially in view of my family history of heart & bone trouble!

[BreezyBlue]

Thanks ladies for taking time to reply to me. It is very kind and much appreciated. Xx