HRT to be sold over the counter!

Marydoll

*trisher*, I hope you dont mind me saying, but Espee lives in the Glasgow area.

Apologies then.She had posted she was in warmer climes so I wrongly assumed she lived there.
But she's still wrong about the recommendations for scans.

Maybee70 I think that's possible.

I'm just outside of Glasgow ,I've had two fractures ,a wrist when I tripped over someones foot in my sitting room...it broke in 2 places and a foot when I slipped on the stairs in a rush to get to a crying GD.Both before I had my patches ,I was not offered a scan despite my mother having osteoporosis for years.When she died she had lost several inches ,had a dowagers hump and and weighed just over 4 stone.She took the calcium pill for years ,it had no effect because her illness hadn't been caught soon enough .

Thankfully my gynae guy says I can stay on HRT for life .I have so desire to end up in the pain my mother was in .
Why does it bother some women what others put in or on their own bodies ,surely its our choice and no one elses business,if we know the risks and are willing to take them .

Of course it doesn't bother me what you put in your body paddyanne54. But the idea that only on HRT can you lead an active life after the menopause really does. It's simply not true. No one can tell who is on HRT although they may claim to be able to, and some conditions just need treatment not a drug which affects the whole body.
I wonder if it is the Sottish health service which isn't doing scans. It certainly happens here. Possibly Covid has affected it as well, but it has been desired policy for ages.

Perhaps I'm just a bit more intimidating and doctors daren't ignore my request for a scan.

I checked the NHS Inform Scotland site, but the information is not quite the same as the NHS site you provided a link to, Trisher,

This from NHS Lothian, may help clarify things here.

When to refer:
New Patients
Patients aged >50 with low trauma fracture.
Patients aged >50 with vertebral fracture (confirmed by x-ray or other imaging)
Patients age>50 with clinical risk factors for osteoporosis in whom the 10-year risk of any fracture is >10%.
Patients of any age with a low trauma hip fracture.

I have had osteoporosis from my thirties and have bi-annual Dexa scans.
I am at very high risk, as I have RA, long term, high dose steroid use and contributory genetic factors. I have had numerous stress fractures (some which have never healed) and two vertebraic fractures held together with cement, as I was part of a successful trial, funded by the Mayo clinic, which allowed me to keep on working.

However, due to my multiple comorbidities, despite a hysterectomy, I have never been been prescribed HRT. My surgeon left my ovaries for that reason.
Unfortunately, HRT is not suitable for everyone, so I battled through the menopause, with no intervention at all.

Up until recently, I attended the endicronology clinic, where my condition was managed.
However, just before the pandemic, a new, bone mineral unit was opened in Glasgow, a one stop shop, where patients, with osteoporosis are treated by a doctor who specialises in treating osteoporosis patients. How much more efficient and co-ordinated things are now.

trisher

Espee I am not the one posting inaccuracies. I know you are not living in the UK so possily you are unaware of the real facts. A DEXA scan is recommended after any fall wich results in a fracture www.nhs.uk/conditions/dexa-scan/why-its-done/
Several years ago a nurse in my local A&E told me they automatically scan now after a fracture.

My doctor simply believed me when I said there was a family history of osteoporosis. He didn't know my family so went on my word.

Silverlady333 2 weeks ago I tripped in the road, fell flat on my face, landing on one knee, two hands and my nose. Pools of blood from my nose but otherwise completely OK. Had two black eyes a few days later, but no broken bones. No HRT. No medication at all since 2010. Calcium and Vit D supplements, a healthy diet and exercise. And I have had osteoporosis. HRT is largely irrelevant.

agnurse I believe that diagnosis of osteoporosis in men and younger people was being sadly neglected which was why an automatic DEXA was introduced.

trisher. I am resident in the U.K. and am aware of the facts. Once again YOU are misinformed.

You stated that “Most NHS hospitals now schedule a scan for anyone who has a bone fracture.” This is absolutely incorrect.

The NHS only performs DEXA scans where there is evidence of clinical cost effectiveness. Even the link you provided makes it clear that they are not offered to everyone. I suggest you read it. Providing links only confirms your point if it actually states in the link the point you were trying to make.
If indeed a nurse told you (many moons ago) that they automatically scan after a fracture I suggest she missed out the bit about ‘in the elderly or the under 50s with other risk factors’.

Please stop providing misleading information to fellow Gransnet users. “I believe” is not fact.

I was automatically offered a Dexa scan after I broke my leg in two places. It wasn’t an osteoporotic break, but they offered it anyway. That’s in Scotland.

As for HRT, I’ve no opinion on how women choose to manage their health, it’s up to them and we’re lucky to have the choice.

I don’t believe that you can tell who is on HRT and who isn’t. I’m 67 and have been mistaken for my young GD’s mother before now even though I don’t take HRT. It fair makes my day when that happens!

trisher

Of course it doesn't bother me what you put in your body paddyanne54. But the idea that only on HRT can you lead an active life after the menopause really does. It's simply not true. No one can tell who is on HRT although they may claim to be able to, and some conditions just need treatment not a drug which affects the whole body.
I wonder if it is the Sottish health service which isn't doing scans. It certainly happens here. Possibly Covid has affected it as well, but it has been desired policy for ages.

Perhaps I'm just a bit more intimidating and doctors daren't ignore my request for a scan.

Trisher
I don't recall anyone on here suggesting that only on HRT can one lead an active life...(I'll leave out the bit about after the menopause as people like me have no intention of ever getting to that stage) it is another of your misinterpretations.

We don't have a Scottish Health Service. The information I gave on DEXA scans was from the NHS guidelines, as was the link you provided which did not back up your assertions.
You are far from intimidating, just uninformed.

NHS England www.england.nhs.uk
NHS Scotland www.scot.nhs.uk

Fron the link I provided
A DEXA scan may be recommended if you have an increased risk of developing a bone problem like osteoporosis.
Your risk is increased if you:
have had a broken bone after a minor fall or injury.

You are far from intimidating, just uninformed. But I managed to get a scan without any broken bones, so I must have some sort of influence!

I think the important part is may be recommended. Not everyone of a certain age, who breaks a bone gets them, it wouldn't be possible to sustain that in an NHS already buckling, under pressure. ĎEXA scan appointments are like gold dust, I'm speaking from experience.
In the past I was given my two year appointment at my scan. Now I get it a few weeks before it is due.
Surely it has to, be a clinical decision, based on a number of factors?
Due to the pandemic, the lists, like all waiting list will be even longer now.

I must be very lucky I never really noticed the menopause. I was working full time and just got on with things. Never visited GP . Perhaps I should have and i would be better off now. I don't know it never entered my head at the time.

If you have sufficient oestrogen (a natural hormone that your body is accustomed to) your bones don’t thin. If you allow them to disintegrate through lack of oestrogen then you will have to take a cocktail of drugs to try to maintain sufficient bone mass to prevent the downward slide into osteoporosis
How"s that for misinformation Espee?
A short period of time on a specific drug is not a cocktail of drugs. Nor is osteoporosis an inevitability if you don't take oestrogen. Calcium and Vitamin D are much more important, as is weight bearing exercise.

Sorry trsher The retention of bone density via HRT is a bonus! Like I said before no amount of weight bearing exerciser ot dexa scans or infusions is going to fix vaginal atrophy!

I guess even if sold OTC, it’ll still be after a consultation with the pharmacist, rather than off the shelf?

Silverlady333

Sorry trsher The retention of bone density via HRT is a bonus! Like I said before no amount of weight bearing exerciser ot dexa scans or infusions is going to fix vaginal atrophy!

Perhaps it is but that isn't what Espee actually said. She said you needed a cocktail of drugs if you didn't use HRT to maintain suficient bone mass. That's entirely false. You have a short period of taking a drug and if you take supplements and do weight bearing exercise your bone density not only stabalises it improves. Oestrogen will help but I suppose it depends if you want a lifetime on a drug or just a short period.
Personally I've always thought less intervention is better
As for vaginal atrophy that's entirely a different matter so lets not confuse the two.
I've no objection at all to people taking HRT for diagnosed medical conditions. I just refute the idea that it's a magic fix-all or that it is even necessary sometimes.

By the way the youngest person I know taking HRT (early 50s) is currently waiting for a cataract operation. Until she did research she didn't know that if you drink alcohol when you take HRT your chances of getting a cataract increase hugely, no one bothered to warn her. Her life has been massively impacted she lives in an isolated place and hasn't been able to drive this winter.

Well trisher it's a good job I only drink alcohol once in a blue moon.
Seriously though most medications have side effects. You have to weigh up the good against the bad. I have just been reading about he main side effects associated with bisphosphonates taken for ostephorosis They include:

irritation to the foodpipe
swallowing problems
stomach pain

www.nhs.uk/conditions/osteoporosis/treatment/

Silverlady333

Well trisher it's a good job I only drink alcohol once in a blue moon.
Seriously though most medications have side effects. You have to weigh up the good against the bad. I have just been reading about he main side effects associated with bisphosphonates taken for ostephorosis They include:

irritation to the foodpipe
swallowing problems
stomach pain

www.nhs.uk/conditions/osteoporosis/treatment/

If that happens. as it did for me, after long term use, you can have it as an infusion.
I have an annual one, it takes twenty minutes and even for me, with my many drug allergies, no side effects.

Marydoll I am glad you found something that works for you. We are all different and what works for one person will not necessarily work for another.
I can't help but think this thread has been derailed with comments about osteoporosis. The OP talked about a form of HRT which is topically applied via the vagina where it will be absorbed through the mucus membranes. Not via the rest of the internal organs. It will be of great benefit to those who are suffering with vaginal dryness and all of it's associated problems.
Yes it may be a ploy to make women pay for it as it is already available by prescription.
However there are some ladies too embarrassed to talk to their GP about such things. Maybe it will help them.

I totally agree with your last line, Silverlady, especially are many GPs are male.

trisher

Silverlady333

Sorry trsher The retention of bone density via HRT is a bonus! Like I said before no amount of weight bearing exerciser ot dexa scans or infusions is going to fix vaginal atrophy!

Perhaps it is but that isn't what Espee actually said. She said you needed a cocktail of drugs if you didn't use HRT to maintain suficient bone mass. That's entirely false. You have a short period of taking a drug and if you take supplements and do weight bearing exercise your bone density not only stabalises it improves. Oestrogen will help but I suppose it depends if you want a lifetime on a drug or just a short period.
Personally I've always thought less intervention is better
As for vaginal atrophy that's entirely a different matter so lets not confuse the two.
I've no objection at all to people taking HRT for diagnosed medical conditions. I just refute the idea that it's a magic fix-all or that it is even necessary sometimes.

By the way the youngest person I know taking HRT (early 50s) is currently waiting for a cataract operation. Until she did research she didn't know that if you drink alcohol when you take HRT your chances of getting a cataract increase hugely, no one bothered to warn her. Her life has been massively impacted she lives in an isolated place and hasn't been able to drive this winter.

trisher. My comment was directed to Onthemoors who had told us that she was no longer on oestrogen but now was on the osteopaenia/osteoporosis slippery slope. It is correct that she can take a combination/cocktail of drugs as you say you did over a period of 15 years to help prevent her suffering from osteoporosis.
Apparently you have no problems with YOU taking drugs but have problems with the likes of me replacing a natural hormone to help prevent osteoporosis and all the other long term post menopausal problems that crop up late in the dayfor so many such as vaginal atrophy, incontinence, osteoarthritis, prolapse, UTIs, depression, premature ageing, etc.
An ounce of prevention is worth a pound of cure
I am off out but will address your misinformation about cataracts later.

The ROS recommendation for osteopenia does not even mention drugs Espee. It recommends
Having low bone density can increase your risk of breaking a bone, but it doesn’t necessarily mean you are going to. It is just one of the risk factors for broken bones.
For many of us, having a lower than average bone density is normal, and most people with osteopenia do not need an osteoporosis medication.

Positive action for your bones
We recommend making positive lifestyle choices, to help your bones stay stronger for longer:

Find out about nutrition for bones, and adapt what you eat so you’re getting all the right foods for bones
Make sure you’re getting enough vitamin D from the sun and food you eat. You may find you can benefit from taking a vitamin D supplement
Much like muscle, bones need exercise to stay strong, so lead as active a lifestyle as possible
Find out if there are any other lifestyle factors you can change, to protect your bones

Really your scaremongering seems to be unlimited.
I have no objection to you choosing to take HRT I have real objections to you making false claims about osteoporosis and osteopenia. I've been diagnosed with both. I now have neither.

Sorry this thread has deteriorated into this discussion but if claims are to be made about HRT I would like to see them made properly and not on the basis of false information. I took a drug (not a cocktail or combination ) for just over 10 years. I am now completely free of bone problems. In a way I think the problem helped me because I took up more exercise. I always swam but I needed weight bearing exercise. Being conscious of deteriorating muscle strength I switched from Tai-chi to Pilates during lockdown. My core strength has improved and naturally this has a knock on effect for things like incontinence. I'd like to see a much more natural based approach to women's health which encouraged them to eat and exercise rather than seeking the sole solution in medication.

trisher
Osteopaenia is what my mother’s doctor called the thin edge of the wedge for osteoporosis. She didn’t get treatment at that point but had she insisted she might have avoided descent into full blown osteoporosis. I have taken preemptive steps to ensure this does not happen to me.

trisher
Regarding your statement that if you drink alcohol when taking HRT your chances of getting a cataract increase hugely.
I cannot dispute whether your friend was told that but I did join a discussion forum after that piece of Swedish research was published and there were at that point far more published research results which stated the contrary.
e.g. “ data from our studies and other studies suggest that the reduction in the risk of lens opacities may be an additional benefit of post menopausal oestrogen use” Katherine Worzala et al, The Framingham Studies, JAMA.
“oestrogen provides protection against cataract….and adds to an increasing body of evidence that HRT protects post menopausal women against various diseases.” Angela M Hales et al www.ncbi.nlm.nih.gov
“Post menopausal hormone use may play a protective role in cataract development” Kairan Lai et al. PLOS ONE

I apologise for not being able to do links but just Google “oestrogen and cataracts” to get up these and many other papers on the subject.

The Swedish study, the only one I know of to link heavy alcohol use and HRT to raised numbers of cataract removals was the topic of a forum in which it was pointed out that women on HRT are usually in better health for their age and highly proactive when it comes to their health so would naturally tend to choose to have their cataracts removed rather than put up with compromised vision.

Agree Silverlady but as I mentioned on my post above, will we be able to just pick it up off the shelf or will we need to speak to the pharmacist first, which would defeat the purpose for shy ladies!

So now women who don't use HRT don't bother about cataracts either! Honestly Espee I've heard of desperation but really!
I know several people who have had or are waiting for cataract operations. I don't know that any of them use HRT but they may do. My friend is the youngest only early 50s and it was her who said it was linked to alcohol use and no one had bothered to tell her when she went on it.
By all means use HRT but stop pretending it is the be-all and end-all for every possible condition older women might have, admit that there may be undesirable side effects and that as long as they are aware of them it is up to women to choose , but they should also be aware of the benefits of a healthy lifestyle, and just might choose that instead.

BlueSky Sun 06-Feb-22 18:29:46

Agree Silverlady but as I mentioned on my post above, will we be able to just pick it up off the shelf or will we need to speak to the pharmacist first, which would defeat the purpose for shy ladies!

Well they can always go to a pharmacy with a female pharmacist if need be.
Trying to specify you want to see a female GP is mission impossible!
I expect it will get to be like Thrush treatments where you are simply asked if you have used it before. The pharmacists have rules and regulations too and an obligation to make sure the customer knows what they are buying.