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[Zaza]

Quick question?
I'm need to be on HRT and have been led to believe that I am stalling the menopause and that when I eventually stop using it, I will need start from scratch and go through the menopause from the beginning.
That's a scary prospect for me, is this correct as it fills me with fear?

[Kate50]

Hi Zaza
I use to be worried about this as you get numerous opinions and I think my reasons behind it were about handing over control to something else and the thought of being at the mercy of an unpredictable future.  Now I'm so bad with symptoms my quality of life is better on hrt. From what I now know is some people can be on it for quite a while and then have a good stretch without it but a lot need it long term as you right you just postponing it.  But I've started to look at that differently now and not be fearful but more accepting. We live in a world where women live longer and want to be healthy and without hrt for some of us we wouldn't do.  Once I'm settled I won't be coming off it as I know now as soon as it's not working it's back ! My mum has been suffering for over 20 years with VA and I do and I'm not living like that.  If you had type1  diabetes you would take insulin everyday else you would die.  I know it's not quite the same but it's a way to get your head round it. We may have an ageing population but a lot of them are only around because of modern medicine.  Rather be healthy being old 😊

[Dancinggirl]

Hi Zaza - HRT can help you through the worst parts of the meno, it also helps to prevent early onset osteoporosis, protects your heart and also helps to reduce problems with vaginal atrophy and bladder problems - so basically it's well worth using HRT especially if you are under 50.  Whether you get bad meno symptoms when you come off it that is an unknown as it will vary from women to women.
I am approaching 60 and started my menopause in my mid 30s. I used HRt till I was 49 and took a 3 year break and developed nasty VA as a result of oestrogen deficiency.  I then,at the age of 53, went back on HRT for 4 and half years. Had another break for one years aged 57 and tried HRT again for one year. I'm now doing another break from HRT and so far my meno symptoms are not that bad. Will I go back on HRT? I'm not sure yet but I will continue using local oestrogen to help reduce my vaginal atrophy problems, probably for the rest of my life.
If you have been told you need HRT and it helps to maintain your quality of life then stay with it - you can take HRT well into you 60s or beyond if need be provided there are no health issues that prevent this. My best advice would be to live in the here and now and let the future take care of itself. DG x

[Kate50]

Well said!

[Hurdity]

Just to add that peri-menopause is the few years around menopause when periods become irregular and hormone levels fluctuate wildly and unpredictably as the ovaries begin to work less efficiently and then pack up at menopause itself. It is the homronal fluctuations that are the cause of the worst and obvious symptoms. Whether or not you take HRT this process will continue to happen (in the background) and your ovaries will eventually pack up. This process only happens once! So - as Dancinggirl says HRT takes you through the worst symptoms so that you don't notice it happening.

Some women will always get symptoms when they eventually stop HRT due to sensitivity to the decrease in oestrogen, but some won't. However the symptoms and consequences of oestrogen deficiency such as vaginal atrophy and osteoporosis for example can either worsen or happen later in post-menopause - whether or not you experience symptoms of flushes and sweats. There is an article here which tells you what happens to your body during peri-menopause:
http://www.menopausematters.co.uk/article-perils-of-the-perimenopause.php

As others have said - it is quality of life now and in the near future which is impoortant - and hopefully with the added bonus of healthier life later on too!

Of course it's not just about HRT - but is a good time to look at lifestyle - diet, exercise, weight, smoking, alcohol, stress and start to make healthier choices which will stand you in good stead

Hurdity x

[Zaza]

Thanks for your replies everyone. For me it's surgical menopause at age 51, now 54. I have had a horrendous time with meno and with some other complications. Initially I didn't use Hrt, however Shortly after surgery my body just went literally into meltdown with up to 20 severe sweats a day and body wasn't liking hrt. After about a year I came off it for 6 months and ended being off work for 4 months with exhaustion and had to restart hrt and it took this amount of time to stabilise. Ive been on 2mg sandrina gel now for 4 months again and trying to reduce to 1.5mg.

In the last couple of weeks, for the first time in 3 years I feel so much more like my old self (post op) Hence the question asking if I need to go through all this again from scratch when I stop or keep lowering the dose. Do you think I am someway through the worst part Hurdity and my body is finally adjusting after the shock of surgery?

Everything you all said was really helpful and made sense but I don't like the way I feel on hrt or off!! I suppose hrt is the better of two evils as at least I can function. I was wondering though why I am suddenly feeling stronger this time.

Thanks again
Zaza X

[Dancinggirl]

Hi Zaza - I assume you have had a hysterectomy - in which case you only need to take oestrogen (Sandrena is good) which is great.  It tends to be the progesterone that women who still have a uterus have to take that causes the problems and risks.  Unless you develop health issues that prevent you using oestrogen then you will probably be able to use oestrogen for the rest of your life - if I had a hyster I definitely would.  When you say you don't like the feeling of being on HRT, why??? If you were getting hot flushes then you weren't on enough oestrogen.
To be honest you should have been advised to go straight onto oestrogen after your hyster and you would probably have recovered sooner. If you feel good on 2mg then stick with this.  If you would like to reduce your dose then perhaps switch to Oestrogel - which is basically the same thing but allows you to adjust your dose.  With Oestrogel you could start by using 2 pumps per day and then reduce a bit or until you find the amount that keeps your meno symptoms under control.  Quality of life is very important and your risks with oestrogen alone HRT are very, very small -  in fact for you the benefits to your long term health will far outweigh any risks.
Do tell us why you don't like the way you feel on HRT - it should make you feel better. Many feel they are being weak if they use HRT but it is not being weak it is actually being sensible - life is short so why suffer - meno symptoms can last many years so don't suffer unnecessarily.  DG x

[Zaza]

Thanks for your advice dancingirl

After my hystectomy I didn't want to take hrt as had to stop the pill years ago and to be honest, I lost my sister inl law aged 52 to breast cancer  and my close friend has metastatic breast cancer (now in lungs) Both took hrt. So I've always been afraid of it. Apart from that I get side effects, gastritis, breathlessness and generally find it laborious using gel twice a day, it's a constant reminder of the fact my ovaries are gone and I am in the horrendous situation and there is no stop button, now or in the future. I feel I constantly worry about my health now and this makes me anxious. When I stopped taking it, despite all the horrible sweats, nausea and fuzziness etc, I physically felt better and more in control.

I know I've got to be on it but I am on such a high dose compared to people I know who have had oophorectomy. My aim is to very slowly reduce to 500mg. The sachets come in two strengths, I'm just hoping I can do this down the line. I think I could mentally cope on a lower dose. What do you think? X

[Dancinggirl]

Zara - I believe that for those women who have had a hyster, using oestrogen alone can actually reduce your risk of breast cancer!!!! I know 4 ladies who have had breast cancer (one died), they all sailed throughout their menopause with barely a flush so didn't use HRT -  so unless you have a close relative who has had oestrogen sensitive beast cancer your risks are very, very small and you may be more at risk if you don't use oestrogen.

I must also point out that at 52 you would be going through this whether you had your uterus and ovaries or not - it certainly wouldn't have been so sudden but the peri menopause stage can actually be the most challenging time for many women as we can go through many years of fluctuating hormones that bring all kinds of problems.  It is often not till women are actually post meno and find a good balance of HRt that they really start to feel their flushes and night sweats are under control.
There is still much debate about the true risks of HRT but I also read somewhere that research now shows if women use HRT for 5 years in their fifties it can lengthen life by about one and half years - it will certainly help to prevent life limiting problems like osteoporosis and heart disease. Using oestrogen will also help to prevent vaginal atrophy and bladder problems and believe me you don't want to risk getting those menopausal symptoms too early. If you are getting discomfort around you vaginal area then some additional local oestrogen like Vagifem is a good idea.
If you can find the right amount of oestrogen that keeps your flushes etc under control then I think this may be the answer to your problems.  If you were taking oral oestrogen then I could understand the gastritis but this is a very unusual side effect with transdermal use!!! I think the gastritis will be more to do with anxiety and diet - also do avoid NSAIDs painkillers like aspirin.
I have found that higher doses of oestrogen do give me some side effects and perhaps trying some Oestrogel and just using one pump per day, either morning or night, could be a good alternative for you.  I've never needed a particularly high dose to control my flushes and I suspect, from what you are saying, that you might be the same. However, it is worth taking enough oestrogen, not only for reducing meno symptoms but also for the protective element, so ideally you should use no less that one-two pumps of Oestrogel or one sachet of Sandrena per day. If you need the two sachets then do stick with this - it's fine.
You seem very anxious about using oestrogen but I do hope we have reassured you that you are doing the right thing.  Dg x