Advice on using HRT please

Posted by love4life @love4life, Wed, Feb 20 2:25pm

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.

Hi, @love4life – welcome to Mayo Clinic Connect. Deciding whether to pursue hormone replacement therapy (HRT) is a big decision, and a personal one to make in concert with your doctor. Glad things are went so well with treating your papillary thyroid cancer.

Hoping that other members will have some input for you on whether to pursue HRT to preserve your health for the future. Please meet @catherinelewis @jenniferhunter @mainelady @judiff @nurse89 @becsbuddy.

Is your doctor suggesting you consider HRT at this time, @love4life? Will you tell us more about your interest in HRT to preserve your future health?

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@love4life it’s great that you came to this site for a big decision and hard decision. Are you experiencing problem symptoms? Done lots of research? Had a real good talk with your doctor? I was only on HRT for a few years before all the studies came out so I’m not a great one to talk about what they did for me. You might write down your symptoms and rate them from ‘awful’ to just a ‘nuisance’ and how they affect your life. Then set up an appointment with your doctor. As a nurse, I wouldn’t recommend HRT unless the problems are difficult to manage, and then only after talking with a doctor. You might see a gynecologist—they specialize in menopause. Let us know what you learn and decide!

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@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

REPLY

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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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.

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@becsbuddy

@love4life it’s great that you came to this site for a big decision and hard decision. Are you experiencing problem symptoms? Done lots of research? Had a real good talk with your doctor? I was only on HRT for a few years before all the studies came out so I’m not a great one to talk about what they did for me. You might write down your symptoms and rate them from ‘awful’ to just a ‘nuisance’ and how they affect your life. Then set up an appointment with your doctor. As a nurse, I wouldn’t recommend HRT unless the problems are difficult to manage, and then only after talking with a doctor. You might see a gynecologist—they specialize in menopause. Let us know what you learn and decide!

Jump to this post

Thank you very much.

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@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.

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@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
@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
@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/.

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