Who here is on it and what are your thoughts. I’ve read it helps with skin elasticity and insomnia. Once upon time my doc suggested it but I was worried about breast cancer. Now I read at my age both estrogen and testosterone are recommended.
I didn’t want to take HRT because my mom’s breast cancer may have been caused by HRT. When I hit menopause, the estrogen drop was an amazing thing - rather than experiencing the terrible effects of menopause that plague a lot of women, I felt wonderful. My horrible cramps were no more, my adult acne disappeared, my migraines disappeared. I loved it, and I never felt a need to consider HRT.
What I didn’t think about was the bone loss caused by menopause, which may have been lessened if I had taken HRT when I first hit menopause. I am almost 20 years into it now, and IMO the risks outweigh any possible benefits for me at this point.
I think that it’s important to work with a trusted doctor when making this decision, which ultimately is up to each woman. I don’t like hearing people say that the risks are minimal, because they may not be for an individual woman. Then again, the benefits may outweigh the risks for another woman.
Like everything related to being female, it ain’t easy!
5 Likes
This is one of many articles saying the black box warning claiming HRT increases the risk of CA is unsupported in some cases
here’s another:
1 Like
D’s friend is an OB/GYN, and D has talked with her about this. She works with a few women who have had terrible experiences with menopause, so she’s interested in the HRT conversation. If they can determine what constitutes “younger” as opposed to “older,” as well as what age the risks begin to outweigh the benefits, that would be helpful. (Of course, that would involve research that’s restricted to females …)
According to Mayo Clinic:
- Age. If you start menopause hormone therapy at age 60 or older, or it has been more than 10 years since menopause, your risk of serious complications increases. But if you start menopause hormone therapy before age 60 or within 10 years of menopause, the benefits may outweigh the risks.
- Type of menopause hormone therapy. The risks of menopause hormone therapy depend on whether you take estrogen alone or with a progestogen. The dose and type of estrogen also can affect risk.
1 Like
If you have no increased hereditary risk of breast cancer, I think the benefits greatly outweigh the risks. The study used to correlate HRT and breast cancer years ago has been debunked bc HRT was given to older women already passed menopause. I would encourage you to follow Dr Mary Claire and to listen to Hubermans podcast on it. Eye opening in terms of the cardiac & bone protection not to mention that it helps to alleviate menopause symptoms including insomnia, hot flashes and collagen loss.
2 Likes
I had a hormone-driven (estrogen and progesterone) breast cancer but genetic tests revealed no genetic cause.
One in 8 women gets breast cancer, and 80% of those cancers are hormone-driven. Many are not hereditary.
Of course treatment for a hormone-driven cancer is the opposite of HRT. It is like super menopause when aromatase inhibitors eliminate all the estrogen from the body. After menopause the adrenals still produce estrogen. Five years of treatment left me with spinal fractures and thin skin.
I am grateful I never did HRT. I would be regretting and blaming myself for my cancer. My menopause symptoms weren’t terrible so I am not advising anyone here on what to do in this complicated situation, for those with awful menopausal symptoms. I saw hot flashes as “power surges”! I know that some really suffer.
2 Likes
There are different types of estrogen therapies, used for different purposes and perhaps with different concerns. There are pills, and patches (I have never used these) but also vaginal creams/tablets/rings that are topical and don’t raise estrogen levels in the blood. I have used those. They work for genital/urinary symptoms, but won’t do anything for hot flashes, sleep issues, or other systemic menopause things. The black box warning is on ALL of these, although my doctor (and some quoted in the article) say that makes no sense for the topical estrogen. I believe all the studies that resulted in the warning involved pills only, not creams.
Just want to suggest getting a referral to a Gyn who specializes in older women/post menopause if your own Gyn seems uncertain about what to do.
My own OB-Gyn (who I liked a lot) was still delivering babies, referring out to fertility specialists, etc. when I needed menopause support. A friend suggested I try someone else (I had been complaining that as I was leaving my office for an appointment, the receptionist called to say that Dr. A was still at the hospital with a complicated C-section and I’d have to reschedule).
Gotta say- someone who focuses on a different part of the female life-cycle was a really positive change for me. Menopause isn’t as dramatic as getting prenatal care and delivering babies, but if you’re 50 and could live until 95, that’s a LOT of years of getting “second best” from healthcare providers if they’re focused on staying current on fertile women and their needs.
My new doc was emphatic- we could manage menopause without HRT (at least in the near term- and she was right) and she was also much more on top of some other stuff that has come up. And very strong relationships with two of the gynecological oncologists in the area.
Worth a phone call or two to see who in your insurance plan is accepting new patients?
4 Likes
I must be the only one here on HRT. I was on a bioidentical compounded one, but after my old gyn retired I switched to a menopause specialist and she prefers that some of the meds don’t go through the liver, so I am on a patch 2x/week and a pill HS. I also have some topical stuff from a compounding pharmacy but it didn’t seem to make much difference. TBH I am not sure any of it helps a lot (I still wake up briefly most nights) but I want to protect my bones . I am also on RX for osteopenia, and one broken pelvis was enough, since I don’t want to give up skiing.
3 Likes
I have learned a lot about HRT in the last year. A somewhat random conversation with my Dr led me down a rabbit hole through which I learned that the alarming conclusions in the Women’s Health Initiative study (which was responsible for the almost immediate cessation of HRT for menopausal women) had been firmly debunked 20 years ago. To put it mildly, I am so angry at the whole medical system now.
I turned 60 this year and have officially been in menopause since I was 44. I had an uneventful menopause-no hot flashes, night sweats, etc. (Looking back though, I am sure that my extreme mood swings may have been partly a symptom of menopause and NOT just the fact I had a preteen/teen daughter in the house. 
) Because I was basically asymptomatic, have no health issues outside of migraines, AND because I thought HRT was off the table, I never brought the subject up with my PCP or my OB/GYN.
And, here’s thing that makes me angry: neither did they! One would think that with such a MASSIVE change in understanding and recommendations concerning menopause and HRT, someone along the way would have wanted me to know I had options–ones that may have dramatically improved my quality of life, health, and even life expectancy.
I do not have a family history of breast cancer. I do however have a family history of severe osteoporosis (including my grandfather), heart disease, and dementia–ALL risks which the medical industry has known for a very long time are SIGNIFICANTLY mitigated by HRT.
A year ago, I learned that there is pretty solid evidence that topical estrogen cream can slow aging in the face so when it was time for my Retin A refill, I asked my newish (4 years)PCP about a scrip for that, and he casually asked me if I wanted to try systemic HRT (estradiol patches). I was blown away because at that t ime I had no idea that was even an option. Although there was some question about whether or not I still have enough functioning estrogen receptors for the patches to work, I did some research and decided to try them. After a year, I can’t say for sure that I’ve had any noticeable benefits (though I do think the nighttime progesterone tablets have improved my sleep quality), but I have another DEXA scan coming up, so we’ll see if my osteopenia numbers have improved at all.
I am also going to see a new gyn who specializes in treating menopausal women so we’ll see what she says about how long I can stay on HRT–which, given my family risk factors, I do want to do as long as possible. According to Mary Clare Haver, that 60 cut off age is arbitrary and there are lots of other factors to take into consideration when deciding to stop the treatment.
In the meantime, I have made sure all the 30 something women in my life know this is an option and that when the time comes, they have an MD who is a proactive advocate for their health, including being interested in and educated about HRT options and possible benefits.
9 Likes
I too had a pretty easy peri menopause and transition. Or so I thought.
No hot flashes or issues sleeping etc.
But I did have increased anxiety and many heart palpitations. I ended up on an anti depressant for a while but I often wonder if HRT would have been better.
I worry about protecting my heart and bone health.
I follow Dr Mary Claire Haver and Dr Kelly Casperson and they have really interesting science-backed information
3 Likes
I was peri-menopausal in my mid-40s. I used an estrogen patch in my mid-50s for a few years. There is no history of bc in my family. I’m now 76, and no bc so far. 
YMMV.
2 Likes
I have been on bioidentical hormones made by a compounding clinic for 14 years, since I was 48 or so. I started out with testosterone and progesterone, and since I didn’t go through menopause until I was 56, they didn’t start me out on estrogen till around 57. I go to the Longevity Clinic in Kirkland, WA, and they have been on the “cutting edge” of this (they claim).
If you can afford it and you don’t have a health related reason not to do this, you would be absolutely nuts not to. The huge reduction in breast cancer risk (particularly because of testosterone), other cancers, stronger bones, brain, body fat, muscle recovery, sleep, mental health, a bazillion reasons to do this. But your doctor has to know what they are doing, they HAVE to measure and give you the right amount for you. There are consequences for screwing it up.
Do it! Yesterday!
4 Likes
That is so maddening. My PCP totally blew it off when I asked about HRT, why do you even need it? Fortunately I joined a specialty clinic, and that doctor told me the study was flawed and BS. But do not take just estrogen, insist on the full regime of progesterone and testosterone. I also take hormones like pregnenelone, DHEA and vitamin D.
3 Likes
Thanks for the recommendations. I do have vitamin D3. Have not added testosterone but recently had a full panel of hormone lab tests done and it was super low, so I will bring this up also. Have not even heard of pregnenolone. Off to read up on that.
It is infuriating. You KNOW if there was pretty definitive research out that indicated a man’s risk of developing heart disease could be substantially reduced with a very safe medication, they would have all heard from their Drs about it. I feel like my docs not even bringing the topic up is totally malpractice.
ETA: Based on your experience at the Kirkland clinic, I think I will try to get an appointment there! I’d rather drive there than Seattle anyway.
2 Likes
I started on estrogen patch and progesterone pill just about 2 years ago. It took a few months of upping the dosage on the patch to stop my hot flashes, but since then it has been great. I also take a D3 vitamin every day for my bone health.
2 Likes
You probably know this, but just in case….it’s vital you take a K2 supplement as well so that the increased calcium absorption from your D3 supplement is directed to your bones and not your arteries. Another tidbit of info doctors are negligent in knowing and/or sharing with their patients.
5 Likes
Thank you. I did not know this!
1 Like
Yeah, I like the Kirkland clinic because it’s close and my doctor is the head of the clinic, and works out of there. It is costly, though, about $380 or so a month, and that doesn’t include supplements or hormones. My insurance actually reimburses much of it (out of network, lab tests).
If you listen to Dr. Mixon on the radio on Saturdays (570 and 770 AM), you may get the gist of it. Forget the chest beating silliness that he does, I think he’s taking too much testosterone.
Often, my Dr Ummat is on his show.
If you don’t want to pay this kind of money, a decent endocrinologist or really good PCP should be able to prescribe estrogen, progesterone and testosterone. If they only know how to prescribe estrogen for women, go elsewhere, because the other hormones are very, very important.
2 Likes
(Replying during Mariners game commercials🙂)
Thank you! I would be happy to pay that for a year or two just to get advice from an actual expert. I like the endocrinologist idea too. What Is really like is to find someone who only treats menopausal women.
2 Likes