To take, or not to take HRT!

Women's health
1

I'm 50 years old and haven't had a period for 22 months.  I began getting hot flushes soon after my periods stopped but they came and went, usually only lasting for a few weeks and then going for months.  They came back last October and haven't left this time. They are disturbing my sleep and I'm dreading hot weather.  I tried HRT in January but the GP gave me the wrong type and it made me have a period so I stopped taking it (I do not want periods again).  I went back and was given Kliofem, which also made me start to 'spot' so I came off immediately and had a full blown period.  Having read information the effects of HRT I'm pretty terrified about taking it - I meet women who tell me that they've taken it for years and it's wonderful, and others that say they wouldn't touch it - including my Mum and Aunt.  Am I being paranoid and suffering needlessly?  My GP said there are lots of others to try but I don't want to be worried in case I start an unexpected period all the time or that I will develop womb or breast cancer.  Also, I have a history of heart disease in my family. Arrrgh!  Going round in circles!

2

Hi,

I've posted extensively on Bioidentical HRT here so I won't repeat everything all over again. 

If you engage in any form of "HRT" you have these 3  options:

- Plant based: for progesterone Vitex + Yams for oestrogen Black Cohosh , soy Isofavones, etc

- BHRT - bioidentical HRT - phaumaceutical that haver the same molecules as the ones you have in your hormones: Progesterone - Utrogestan; oestrogen_ estradiol patches or gels;

- HRT - standard - this is the one that's cobnsidered the most dangerous and it's the one that was assessed negatively by the WHI 2002. 

My suggestion: never ever take "progestins"  - only natural progesterone and never ever take oral estradiol - just transdermal. You should be fine. 

However to combine natural progesterone and estradiol most doctors will suggest you to take them on a cyclic bais that mimes your owna natural 28 cycle. Bottom line: you most likely have periods. This is the safest option...

Ifg however you insist on not having period: you can do a 21-22 day/month continuous use of low dose natural progesterone (Utrogestan) + transdermal estradiol, then stop for a week and restart. Withthis option you should be able to be menstruation free. 

There's a lot toread about it. I suggest you to go to CEMCOR's website and read through. 

Take care. Teresa.

3

I'm sorr but I've pressed enter before finishing... I hope you get what I mean..

4

Hi Teresa,

Thanks for replying in such detail.  I will look into what you are saying - it sounds quite complicated.  Can I buy natural progesterone or ask for it from my GP?  You suggest that taking HRT that forces a period is the safest option, is that correct?  Finally, by transdermal do you mean patches?

Warm regards,

Trish

5

Hi Trish, 

I' m guessing you're in the UK... if you're in the US you have a few more options. So, If you're in the UK, or EU: 

- natural progesterone, also named Oral Micronized Progesterone (OMP) is prescription whose name is Utrogestan; the GP should be able to prescribe it; if you go for cyclic ( most likely implying having periods) you'll take it for 12 days each moth before "period".  

- Then you complement ths with estradiol (oestrogen) for 3 weeks; they overlap for some of this time; transdermal means the product's intake is through the skin - it can be patches or rub on gel.

What's safest is a matter for discussion with your Gyno (I would advise you to ask for a referral) based on your health history. It may even be that they consider the continuous system ( 3 weeks of both hormones + 1 week stop) is perfect for you and then you'll be period free. The cyclic system is to mime the female body's way of homones output - so considered more safe - but  as I said subject to assessment.

I would (I don't know if you're alredy using this) use some estriol (extra mild form of oestrogen) cream in the vulvar/vaginal area as it sustains local health and is virtually risk free even for cancer patients. The brand name is Ovestin and for this you'll also need a prescription.

If you have more doubts feel free to post them here. Take care. Teresa.

6

PS - as you'll see from CEMCOR's website OMP - Oral Micronized Progesterone in the US and Canada brand name is Prometrium instead of Utrogestan in Europe. Different name same product.

7

Thanks for all your help Teresa - that has given me something to work with

8

I'm PM you a "hot flushes" specific  link .

9

Hello mrpip64

Firstly my suggestion is get a Blood test, this will tell you if you are peri meno or full menopause.  Its unfortunate , but you will get a period no matter what you are prescribed.  I have posted before and my story what repost I am sure you will find it. Dont be a saint coz when it interrupt sleep its time to act.  HRT over a long say 7-10 years can be harmful, but if you keep a check on it ...as you are the only one that knows your body I think you will find your answers.

 

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oops  I forgot to mention good luck

11

Thanks  It's so hard not to be paranoid about the increased risks of breast and womb cancer - really not sure still, but I appreciate all the advice x

12

Hello M

You are the only one that can make a decision on what to try witht the guidance of your GP.  Whatever you take you are going to be a guinea pig like all of us.

Take care

Dianna