1. < Women's Health

Advice on using HRT please: What are the pros & cons?

Posted by love4life @love4life, Feb 20, 2019

Dear friends,

please kindly help me make an informed decision regarding HRT (Hormone replacement therapy for menopause). I am not sure whether I should use it. I am 45 years old, and I lost menstrual cycles. I have no gynaecological problems and no menopausal symptoms. Actually, I feel great.
Three years ago, I had total thyroidectomy due to papillary thyroid cancer. I also did RAI therapy. Thanks God, I am completely healed (as this type of cancer is curable due to developments in medicine).
I suspect that I lost cycle a bit earlier due to all these problems with thyroid, as I noticed changes in cycle after RAI therapy.

Anyway, I have to make a decision now on whether to use HRT, not due to menopausal symptoms (I do not have them), but in order to preserve my health for the future. I read the Mayo clinic guideliness, but as it happened in 45 for me (last period when I was 44), I am not sure in which age group I belong. Am I prematurely in menopause or not? If "normal" is between 45-55, what is 44? Should I use it until "normal" age for menopause, which is 51, or everything between 45-55 is normal....meaning....I am almost normal:))) LOL.

I found conflicting research and opinions regarding HRT, especially regarding the risk for breast cancer. For instance, on one site I found information that HRT "increases breast cancer risk by about 75%", while everywhere else it says that there is a risk, but it is small. As I am healed from thyroid cancer, I wish to care about my health and not increase the risk for other cancers.

In particular, I would like to understand whether it is possible to care for my health with other medicine or supplements (like vitamin D, calcium, omega 3-6-9 etc.), instead of HRT?

I would like to understand whether I will miss something important for my health if I avoid taking HRT now.

Sorry for such a long post, but I needed to explain in order to present a clear picture. Thank you so much for your advice.

I wish you all great health and happiness!

🙂

P.S. I included links to sources I mentioned in the post, but had to delete them, as the message could not be posted with links.

Interested in more discussions like this? Go to the Women's Health Support Group.

love4life | @love4life | Feb 21, 2019

Hi everyone!
Thank you all for taking time to comment my post, I appreciate it.

I see that some of you asked whether I have menopausal symptoms. I have already explained that I feel great and I do not have any menopausal symptoms. Please kindly read my post.

I am not sure if I am on the right place. I thought this was a community of patients and doctors, where I may ask a question and get an answer from doctors and patients with similar issues.

I am trying to understand whether HRT is necessary for a someone with no menopausal symptoms.

Thank you.

REPLY
1 reply
love4life | @love4life | Feb 21, 2019
In reply to @colleenyoung "@love4life, I add my welcome. I see that you wanted to post a links to provide..." + (show)
@colleenyoung

@love4life, I add my welcome. I see that you wanted to post a links to provide references to your post above. New members cannot post web links for a few days. We do this to protect the community from spammers, i.e., people who join only to post links to sell something, etc.

Clearly the links you wished to share are a helpful and useful link for the community. Please allow me to post the for you. You will be able to post links by the end of next week.

- HRT guidelines from Mayo Clinic: https://www.mayoclinic.org/diseases-conditions/menopause/in-depth/hormone-therapy/art-20046372
- Conflicting research and opinions regarding HRT, especially regarding the risk for breast cancer. For instance, here: https://www.breastcancer.org/risk/factors/hrt

Jump to this post

Thank you so much Colleen for posting links.

REPLY
Lisa Lucier | @lisalucier | Feb 21, 2019
In reply to @love4life "Hi everyone! Thank you all for taking time to comment my post, I appreciate it. I..." + (show)
@love4life

Hi everyone!
Thank you all for taking time to comment my post, I appreciate it.

I see that some of you asked whether I have menopausal symptoms. I have already explained that I feel great and I do not have any menopausal symptoms. Please kindly read my post.

I am not sure if I am on the right place. I thought this was a community of patients and doctors, where I may ask a question and get an answer from doctors and patients with similar issues.

I am trying to understand whether HRT is necessary for a someone with no menopausal symptoms.

Thank you.

Jump to this post

Hi, @love4life - Mayo Clinic Connect is a community of patients supporting one another and exchanging information. We are not medical professionals and don't provide medical advice. I believe this will provide some useful information for you on Connect https://connect.mayoclinic.org/page/about-connect/tab/aboutconnect/.

I hope you will find a lot of value in interaction with members here who bring a wealth of health and medical learnings from what they have personally lived.

So, while we can't provide medical professional responses to whether HRT is necessary for a someone with no menopausal symptoms, I trust you will find others sharing their experiences helpful to add perspective as you look into the idea of HRT and weigh any risks, and look at possibilities for caring for your health with other medicine or supplements instead of HRT.

What are your thoughts so far, @love4life, from researching some of the supplements you mentioned?

REPLY
1 reply
love4life | @love4life | Feb 22, 2019
In reply to @lisalucier "Hi, @love4life - Mayo Clinic Connect is a community of patients supporting one another and exchanging..." + (show)
@lisalucier

Hi, @love4life - Mayo Clinic Connect is a community of patients supporting one another and exchanging information. We are not medical professionals and don't provide medical advice. I believe this will provide some useful information for you on Connect https://connect.mayoclinic.org/page/about-connect/tab/aboutconnect/.

I hope you will find a lot of value in interaction with members here who bring a wealth of health and medical learnings from what they have personally lived.

So, while we can't provide medical professional responses to whether HRT is necessary for a someone with no menopausal symptoms, I trust you will find others sharing their experiences helpful to add perspective as you look into the idea of HRT and weigh any risks, and look at possibilities for caring for your health with other medicine or supplements instead of HRT.

What are your thoughts so far, @love4life, from researching some of the supplements you mentioned?

Jump to this post

Thank you Lisa for all clarifications.

Responding to your last question, I think it is better not to take HRT due to controversial and contradictory data. Better be safe than sorry. For instance, some websites (copied in the previous posts) say that there is a 75%chance of getting breast cancer if you use HRT. However, others say that the risks are very low. No research was done for women below 50 using HRT. Nobody can say for sure. I guess it is difficult for doctors making recommendations on the basis of such conflicting research. However, I think it is not fair to put all the burden on the patient. Doctors say that this is a patient's decision. Yes, I have no problem making a decision, but I need to be explained which data is correct. The 75% chance and no chance for getting breast cancer are two completely different information.

So far, I would rather not take HRT, and focus on prevention of diseases which might develop in the future due to the lack of estrogen and progesterone. These diseases (which may or may not develop) are osteoporosis and cardiovascular diseases. I am taking Vitamin D and calcium as prevention of osteoporosis (under endocrinologist supervision). I am not taking anything for prevention of cardiovascular disease. I just try to eat healthy.

However, I am not sure if I am being smart or not.

I discussed this with many doctors and each one of them has a different opinion, which all focus on risks for breast cancer.

REPLY
Lisa Lucier | @lisalucier | Feb 22, 2019
In reply to @pattitoo "Are you having symptoms of menopause? Having hot flashes? One OTC that can help somewhat is..." + (show)
@pattitoo

Are you having symptoms of menopause? Having hot flashes? One OTC that can help somewhat is Vitamin E d-alpha tocopherol NOT the dl-alpha tocopherol. The latter is synthetic. I had a surgical menopause, was in my earliest 40's, was put on a tablet daily of Premarin .625, it was controlling the hot flashes to a point. Eventually I was on 2 a day, one AM other PM, gradually have cut down considerably. I am 76 and yes I still have hot flashes. We all differ, I feel you would know if you are experiencing symptoms that would need estrogen. Bear in mind how many years ago treatment was different. A GYN is a must IMHO, maybe see another until you feel at ease.
For now, I don't take the tablets ,only use the Premarin Vaginal Cream, the cream will bypass the liver.
Best wishes for good decisions.

(how i wish there was a thread for FOSAMAX and other meds similar. I am to start it and am not overly comfortable with 2 doctor's views, some of the side effects concern me, For the past few years
my bone scans had been good., not now! For bone health, I have been on Calcium and Vitamin D and magnesium for years)

Jump to this post

Hi, @pattitoo, just wanted to mention you might check out this discussion in which alendronic acid (fosamax) is discussed, in addition to denosumab (Prolia) https://connect.mayoclinic.org/discussion/prolix-treatment-for-osteoporosis. You could also start a new discussion about alendronic acid (fosamax) in particular in the Bones, Joints & Muscles group https://connect.mayoclinic.org/group/arthritis-and-joint-conditions-268850/.

REPLY
lioness | @lioness | Nov 14, 2019
In reply to @rd1 "I reached menopause directly after I turned 40, and my doctor recommended HRT, where I took..." + (show)
@rd1

I reached menopause directly after I turned 40, and my doctor recommended HRT, where I took both, oestrogen (BI-EST (50-50) 2 mg/ 1 ml cream, apply 1 ml per day, and progesterone 50 mg (take 10 capsules per month). This is taken from a compounding Pharmacey that is plant based in compounding its medications.
This was mainly to protect the bones and stop the hot flashes and sleep discomforts. I am now 44, and so have been using this medication for four years, but recently I have been hearing more about the increased breast cancer risk to HRT users and I am not sure which path to take. I saw a 2nd opinion from a different doctor which explained that there are two schools of thought, one that recommends HRT and one that doesn’t, and she was from the 2nd school, so she prescribed for me a medicine that does not have any hormones, which is Manhae’ but is used to ease the menopause symptoms.

I am not sure which path to take... I surely want to protect my bones, but not on the expenses of increasing breast cancer chances! I do not have any history of breast cancer in my family, not that I know of, but still it sounds scary! How can I decide?

Jump to this post

@rd1 Welcome to our forum here on connect . We cant diagnose but help with what we know . When I went through menopause and had issues the Dr put me on HRT When I heard so much about breast cancer and HRT I started to look into other meds mainly herbal meds and used Black Cohash it is a plant based estrogen it controlled my hot flashes and hormonal problems. Good luck .

REPLY
rd1 | @rd1 | Nov 14, 2019

I reached menopause directly after I turned 40, and my doctor recommended HRT, where I took both, oestrogen (BI-EST (50-50) 2 mg/ 1 ml cream, apply 1 ml per day, and progesterone 50 mg (take 10 capsules per month). This is taken from a compounding Pharmacey that is plant based in compounding its medications.
This was mainly to protect the bones and stop the hot flashes and sleep discomforts. I am now 44, and so have been using this medication for four years, but recently I have been hearing more about the increased breast cancer risk to HRT users and I am not sure which path to take. I saw a 2nd opinion from a different doctor which explained that there are two schools of thought, one that recommends HRT and one that doesn’t, and she was from the 2nd school, so she prescribed for me a medicine that does not have any hormones, which is Manhae’ but is used to ease the menopause symptoms.

I am not sure which path to take... I surely want to protect my bones, but not on the expenses of increasing breast cancer chances! I do not have any history of breast cancer in my family, not that I know of, but still it sounds scary! How can I decide?

REPLY
2 replies
Lisa Lucier | @lisalucier | Nov 16, 2019
In reply to @rd1 "I reached menopause directly after I turned 40, and my doctor recommended HRT, where I took..." + (show)
@rd1

I reached menopause directly after I turned 40, and my doctor recommended HRT, where I took both, oestrogen (BI-EST (50-50) 2 mg/ 1 ml cream, apply 1 ml per day, and progesterone 50 mg (take 10 capsules per month). This is taken from a compounding Pharmacey that is plant based in compounding its medications.
This was mainly to protect the bones and stop the hot flashes and sleep discomforts. I am now 44, and so have been using this medication for four years, but recently I have been hearing more about the increased breast cancer risk to HRT users and I am not sure which path to take. I saw a 2nd opinion from a different doctor which explained that there are two schools of thought, one that recommends HRT and one that doesn’t, and she was from the 2nd school, so she prescribed for me a medicine that does not have any hormones, which is Manhae’ but is used to ease the menopause symptoms.

I am not sure which path to take... I surely want to protect my bones, but not on the expenses of increasing breast cancer chances! I do not have any history of breast cancer in my family, not that I know of, but still it sounds scary! How can I decide?

Jump to this post

HI, @rd1 - welcome to Mayo Clinic Connect. It would indeed be confusing to read and hear about differing opinions on hormone replacement therapy (or HRT). As you are seeking answers, I thought it might be good to move your post to this existing discussion on HRT so that you can meet members like @pattitoo, @love4life @becsbuddy. @lioness and @cancersucks may also have some input on the pros and cons of HRT and weighing bone protection and potential increased breast cancer risk.

You might find this Mayo Clinic article on HRT useful https://www.mayoclinic.org/diseases-conditions/menopause/in-depth/hormone-therapy/art-20046372.

Have you started taking the Manhae’ food supplement you mentioned was prescribed by the second doctor you saw? If so, how is that going so far?

REPLY
fotula | @fotula | Nov 16, 2019
In reply to @pattitoo "Are you having symptoms of menopause? Having hot flashes? One OTC that can help somewhat is..." + (show)
@pattitoo

Are you having symptoms of menopause? Having hot flashes? One OTC that can help somewhat is Vitamin E d-alpha tocopherol NOT the dl-alpha tocopherol. The latter is synthetic. I had a surgical menopause, was in my earliest 40's, was put on a tablet daily of Premarin .625, it was controlling the hot flashes to a point. Eventually I was on 2 a day, one AM other PM, gradually have cut down considerably. I am 76 and yes I still have hot flashes. We all differ, I feel you would know if you are experiencing symptoms that would need estrogen. Bear in mind how many years ago treatment was different. A GYN is a must IMHO, maybe see another until you feel at ease.
For now, I don't take the tablets ,only use the Premarin Vaginal Cream, the cream will bypass the liver.
Best wishes for good decisions.

(how i wish there was a thread for FOSAMAX and other meds similar. I am to start it and am not overly comfortable with 2 doctor's views, some of the side effects concern me, For the past few years
my bone scans had been good., not now! For bone health, I have been on Calcium and Vitamin D and magnesium for years)

Jump to this post

I don't use any of the bone sparing medications because of the side effects. My chiropractor recommended Bone Restore with Vitamin K2. These are sold thru Life Extension. They contain 3 types of calcium, Vit D, magnesium, K2, etc. The K2 is important because it keeps the calcium in your bones and directs it away from your arteries. I read several scholarly articles from the National Institute of Health and they all recommended the K2 along with the calcium. Hope this helps.

REPLY
mirandarees | @mirandarees | Jan 8, 2020

Can somebody please advise me on the above, I'm 44 and perimenopause. I was taking Evorel but my pharmacy are unable to get this. I've been prescribed this instead. I would really appreciate any advice on anything to do with perimenopause please. I don't have anyone to turn to who is going through this. Thank you ❤️

REPLY
View MoreView Less
Please sign in or register to post a reply.