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Menopause

HRT for the over-60s

(127 Posts)
preferredplanet Wed 22-Jun-11 12:24:30

I'm posting on behalf of my mum, who's 66 and was on HRT for many years, but started to come off it earlier this year. Since then, she's had terrible menopausal symptoms of sweating (having to shower more or less every hour at times!) and general ill-being (if that's the opposite of wellbeing!) - fatigue, fuzzy head etc etc.

She's tried various natural remedies such as cohosh, flax seed etc, and they seem to work temporarily then wear off, and she's back to the symptoms again. Docs have said it could be 2 or 3 years before she's over the menopause and she's getting desperate and saying she's going to give it another couple of weeks, then ask to go back on a low-dose HRT. She says there are risks associated with that but she's in a low category. Does anyone know what these risks are?

And if anyone has any experience of this or advice, I'd be most grateful, for her. Thanks in advance.

harrigran Wed 22-Jun-11 12:36:58

I think I would leave the natural remedies alone, all prescribed drugs are thoroughly tested but some natural ones can cause liver damage. Suggest a check up with Doctor, these symptoms can be caused by other conditions too.

baggythecrust! Wed 22-Jun-11 12:51:09

Did her GP mention withdrawal symptoms? Never been on HRT so just wondering if it could be that.

JessM Wed 22-Jun-11 13:12:22

Hear hear Harrigran. Black Cohosh for instance eventually shown to have no effect on this, and possibly causes liver damage in some people.
Your poor mum. Back to the doctor. I believe there are one or two other things they can try. The only risk of HRT that I am aware of is increased tendency to breast cancer. Not trivial when you think it is v common. Around 1 in 10 of us. Hence if you have any BC in the family you are advised to steer clear.

preferredplanet Wed 22-Jun-11 13:24:38

Bloody hell, liver damage?! Will advise her of that asap. Many thanks for the replies so far, I appreciate it. Don't know about withdrawal symptoms, baggy.

I will make sure she goes back and asks about the other possibilities. The "methadone" of HRT, as it were! grin. I just know she's having a pretty miserable time of it at the moment. Thanks.

glammanana Wed 22-Jun-11 13:43:22

preferredplanet,I have taken HRT at differant strengths since I was 40 and
had a very bad cancer problem so had to have inplants of HRT then tablet
form it took a bit of getting right but we got there in the end.Over the years my
GP has ajusted the dose so it is now very low,i came off it 4 years ago
and suffered badly so he put me on the lowest dosage and everything is ok
now,I hope you mum goes and has another chat with her GP things get
better for her,I feel great now and have loads of energy etc and am now 61
in September

glassortwo Wed 22-Jun-11 13:46:04

I have been to the Doctors this morning for my 6 month HRT repeat, I am only 55, Dr has said I should be thinking of coming off and that he will probably draw the line at another prescription in 6 months, my blood pressure etc is normal and have regular breast screening and examination.

I got home and am thinking to my self should I bite the bullet and stop now before I start this new prescrition or do I wait! He did not say if it was a case of just stopping them or decreasing the dose. does anybody have any experience on this.

Magsie Wed 22-Jun-11 17:10:19

As I understand it, when you take HRT you are just delaying the menopause by taking the hormones your body no longer produces. When you stop taking HRT, you will then develop menopausal symptoms to some degree. During a "natural" menopause (without HRT) the levels of hormone reduce gradually but if you stop taking HRT abruptly (cold turkey) you can develop severe symptoms because the hormone levels drop very quickly. I think current thought is to reduce the dose of HRT gradually over the course of weeks or months. I'm sure this is best done under a doctor's supervision but some doctors are more sympathetic than others with regard to menopausal symptoms.

GillieB Wed 22-Jun-11 18:03:57

I only took HRT for about fourteen months when I was in my fifties - I was still having problems with tiredness, saw another doctor and that's when they discovered that I have a very underactive thyroid. My doctor suggested that I gradually withdrew from the HRT - from one a day to one every two days, and then three days, etc. I guess my menopausal symptoms then lasted for about another six months. This slow withdrawal system certainly worked for me - perhaps it will work for your mum.

jogginggirl Wed 22-Jun-11 20:00:03

I'm sure Magsie is right, I took HRT for 10 years with one 12 month break. When I finally stopped about 18 months ago (due to cancer scare), my menopause symptoms were much worse, I struggled for a while but started to exercise more, lost weight and follow a sensible diet. I tried a lot of natural remedies but didn't find them helpful. I now feel much better, very occasional hot flush, but no symptoms to speak of. I am coming up to 60 and hope I have seen the last of it. I'm absolutely sure that a slow withdrawal from HRT would be better but I had no choice. Hope pp's mum finds a solution that suits her, good luck.

preferredplanet Wed 22-Jun-11 21:22:16

Thanks everyone, it seems that gradual withdrawal is the way to go - I'll need to ask her though, I'm sure she'd gone down to only taking her HRT every other day in an effort to make the change not quite so drastic, but looks like that really didn't help. Hm, every third day, possibly? I'll def get her to go back to her GP, many thanks.

susie511 Fri 24-Jun-11 17:43:28

I was on HRT for nearly 10 years, having had severe menopausal symptoms from the age of 48. 18 months ago my GP told me that I had been on it for long enough - but couldn't suggest the best way to do it. After much research (and, frankly, there is very little information out there) I decided that - like coming off any drug - it was probably best done very very slowly. For 2 months, I dropped one pill a week. The following 2 months I dropped another one (so that I was taking only 5 a week). After another 2 months I dropped a third pill (in fact, I went to taking one every other day.) I then bought a pill-cutter from the chemist, and went to half a pill a day for 2 months. Then dropped one of these ... eventually I ended up on 1 pill for a week ... then finished. I am convinced that the very gradual coming off was the way to do it. The whole process took over a year but, apart from some hot flushes for the first 6 months I was off HRT, now I am more of less sympton-free - just the occasional flush at night. So, when wanting to come off HRT, be brave but DO IT SLOWLY!

grannyactivist Fri 24-Jun-11 21:04:49

I went through the menopause at the same time as I was diagnosed with an underactive thyroid. I can't describe how tired and ill I felt. As for hot flushes, I'm sure my presence raised room temperatures by at least five degrees. My wonderful GP put me on HRT and a year or so ago reduced the dose to one tablet every other day. I hadn't really thought about coming off it until I read this thread and I can't say I'm looking forward to a return of the menopausal nightmare. GULP I expect my GP will reduce the dose bit by bit, and as she's really considerate and kind I'm confident she'll give me good advice.

sylvia2036 Fri 24-Jun-11 21:37:34

I had a fully hysterectomy when I was 45 and was immediately put on HRT and continued with it until I was 60, which is 2 years ago now. I was advised by my doc to reduce the tablets over a period of a few weeks, which I did and I had menopausal symptoms but they were not extreme - the odd hot flush every few days but they stopped after about 3 months. The worst thing about coming off HRT though is that it has totally messed up my sex life! One becomes dry in a certain area and trying to sort that problem out is no fun - I've tried all the various creams etc - in fact I am seriously thinking of going back on to HRT if my doctor will prescribe it again. I know the risks - my father died of breast cancer -but I also love my husband more.

harrigran Fri 24-Jun-11 23:59:08

I find that a little KY lubricant is all that is required to getting everything running smoothly grin

susiecb Sat 25-Jun-11 08:52:38

I'm 58 and been on Tibolone for several years for awful hot flushes at night meaning no sleep at all so found it difficult to keep down my job. My doctor has said he has given me my last six month script as there is an increased risk of heart disease and stroke associated with long term use. I have Lupus so I dont need anything else! I am weaning myself off now and as I no longer work I think I will be able to manage. What I did say to the GP is I dont want other things to change especially growing a beard and going off my husband if you know what I mean! he says I wont - will keep you posted.

SophiesMum Wed 06-Jul-11 13:48:04

Just like Sylvia I have had a full hysterectomy (but at 50) and thereafter went on to HRT implants twice a year. For the last few years though I have only been having the implants once a year (I am now 62) My Consultant is very much on the ball and specializes in this area, and we have an in depth discussion every time I see him. I have wondered if it was time I stopped taking HRT but when we talk about the risks and the benefits, the benefits always seem to outweigh the risks. How long will I carry on taking HRT, I don't know, but I do worry about how I will feel when I do finally stop. However, I think if you have faith in, and have a good relationship with your doctor/consultant, then that helps you with making this sort of decision. I agree with Harrigran about natural remedies for this sort of thing, best avoided I think.

glassortwo Wed 06-Jul-11 14:02:49

Well I have made the decision to cut back on my HRT, so I have started to slowly reduce the dose over the sixth month precription I have, and see how I cope, I am onto my 3rd week of reduced and it seems to be ok. Dont know if it is too early to see any changes yet!

purplenanny Fri 08-Jul-11 09:42:35

Hi, is anyone taking hrt for osteo-arthritis. I came off hrt 18 months ago after taking for 1 year and my pain has increased greatly since then. Apparently it is eostrogen that helps but I am worried about going back on hrt because of the risks. I am 2 years in to menopause and 55.

cariad25 Thu 30-May-13 02:00:13

Interesting that you should mention HRT and arthritus 'purplenanny'...I am now 65 and after being on Tibleone for approx 15 years was told by the doc it was time to stop much to my disgust! Well after about 6 months I developed pain in so many areas of my body and it has got so bad now that I can hardly walk because it is in my toes and feet, my knees are very bad and I could have an op toomorrow in one of them if I wanted, my fingers are terrible, crooked and ugly and painful! So all in all not good...I did know before stopping that this might happen but didn't envisage it being quite so dramatic and terrible!
There are other disadvantages like the flushes which have been bad, lack of energy and just feeling my age and quite often because of the pain and discomfort much older! I regret so much having to come of HRT and although I understand the docs professional position in this (I did have two 'break through' bleeds, both nothing when investigated) I am very low risk, no heart disease or breast cancer in the family and I have extremely low blood pressure.
However a minor miracle has occured! I saw a gynea last week, a lovely elderly gentleman who I have seen before, he examined me and spent ages talking and asking questions after which he started talking about HRT and asking me how I felt about having to stop taking it...he then told me he wasn't sure that women were supposed to do without it anyway as in the not too distant past women died not long after going into the menopause and so didn't have to live and suffer for years and years sans oestrogen! He said that I was very low risk and that he would write to my doc and ask her to reconsider giving me a low dose, mainly I think with the arthritus in mind as he could see how bad it is....well after I got up off the floor I thanked him profusely and floated home!
I will however only really believe it when I get that prescription in my hand but as I had a left over month's supply I couldn't resist jumping the gun and have started on it already so I hope to goodness the doc is in agreement or I can see myself having to buy it privately online...I am determined to take it and at least give it a go to see if it helps, it may not of course but time will tell!
Sorry this post is ssss long!

Reddevil3 Thu 30-May-13 09:30:37

Oh cariad how I sympathise with you. I had been on Kliofem for several years, changed countries and doctors so went to get my next 3 months supply. Female Dr. refused, told me I had to stop (I was 67) so I had to stop. (She didn't ask about any family or personal history of breast cancer) No suggestion of letting my body down lightly ie. one every other day.
SO..... I started getting hot flushes, vaginal dryness, aches and pains- horrible!
2 years later, having moved again and got married again (I was widowed in 2005) new GP referred me to a lovely gynaecologist as I was having big problems with sex, splitting and bleeding every time. (Not very good for the libido!) He suggested doing a sort of permanent episiotomy to help things.
Went through all that, all the post op discomfort etc.
Slight improvement but all the other symptoms, hot flushes etc. were still there, so went to new GP, (having moved yet again) and on bended knee, pleaded for a supply of Kliofem. He asked about family history etc. and gave it to me!!!!! It's not on a repeat prescription, and I have to go and ask for it every 3 months, but it's definitely worth it. (I'd crawl there to get it!)
I've got my life back, no aches or hot flushes, more energy- wonderful!
I feel that the whole sad story could have been prevented if the first GP had had a bit more understanding/empathy/ sympathy/ information.
My brother is a surgeon and his wife has just started HRT and he is happy about it. I haven't told him the whole story but he thinks it's really bad luck I saw that particular woman in the first place.
Sorry about this diatribe!

Scruffpup Fri 26-Jul-13 01:47:35

I have been on HRT since I was 26 when I had a total hysterectomy. I am now approaching 53 and have recently moved so have a new GP. Th first thing she said was that I should come off HRT as I am now of menopause age. I am really reluctant to do so as I already have many of the symptoms/conditions mentioned in the previous comments such as dry skin, brittle hair and nails, aching joints and horribly twisted arthritic fingers. Really can't face any further deterioration let alone the flushes. Is it really necessary? I have none of the risk factors mentioned so am wondering if I just struck unlucky with my GP, my previous GP never mentioned it at all

j08 Fri 26-Jul-13 09:59:36

I think it's best to go through the menopause naturally. Put up with the symptons. They don't last for ever. Obviously, it's going to be easier to do this at 50 rather than 60.

Ariadne Fri 26-Jul-13 10:14:23

I was on HRT for about 10 years, then diagnosed with breast cancer - an oestrogen positive tumour - and was taken off HRT straight away, of course. I honestly can't decide whether or not the HRT was a contributory factor, but I do know it made my life bearable! I was suffering so much with all the usual symptoms plus something like the worst PMT ever.

Then chemo solved any menopause problems anyway..

Bez Fri 26-Jul-13 10:16:58

Some people can go through the menopause naturally and I would agree that ideally that would be best but for those of us that had symptoms so severe it impacts our daily lives that is a bad situation which HRT can alleviate. I took it for about twelve years and the first time I came off - had taken it every other day for two months to lessen the impact I had dreadful symptoms again - GP put me back on it and the next time I did as someone else on here and took it for 6 days a week for a couple of months and then five etc. I kept an absolute diary about when to take etc and this time I was fairly OK - had some symptoms like the flushes but this time they were bearable and of extremely short duration and eventually they stopped.
Good luck to anyone wishing to come off HRT. I did not know they did lower doses now and that might have been a better option for me had I known about them ten years ago.