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.

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?

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@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?

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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?

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@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)

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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.

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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 ❤️

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Hi, @mirandarees - welcome to Mayo Clinic Connect. I wanted to let you know I moved your post on HRT Novo here to this discussion where others are discussing HRT.

Why was your pharmacy unable to get your previous HRT brand?

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Is there a hormone replacement that is safe to take with blood thinners

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@lbiscorner2300

Is there a hormone replacement that is safe to take with blood thinners

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@lbiscorner2300 That’s a really good question. I think it is best answered by a discussion with your doctor. Only your doctor knows your health history and why you are taking blood thinners.
Will you let me know what she/he says?

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@lbiscorner2300

Is there a hormone replacement that is safe to take with blood thinners

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Hi @lbiscorner2300,
According to his study from 2015,
- Women can take blood thinners, hormones without higher blood clot, bleeding risk, study shows https://www.sciencedaily.com/releases/2015/12/151222112950.htm

But I agree with @becsbuddy that this is a discussion you should have with your cardiologist to be sure HRT and blood thinners are okay for you specifically.

You may also be interested in joining the discussions in the Heart Rhythm Conditions group here: https://connect.mayoclinic.org/group/heart-rhythm-conditions/

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I am a 79 year old intersex woman, which means, my body hardly makes any, or no sex hormones. I take daily estrogen, progesterone and a bit of testosterone. These hormones allow me to live a normal, fulfilled life! Without those hormones, my life would be extremely miserable, and my bones would be very brittle.
I can only recommend the strongest to talk to your doctor for the possibility of HRT

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What are the prons and cons of hormone replacement therapy ? Bio dental and prescription ones ?

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