New UK guidelines for HRT - and a personal perspective

I've been taking HRT for around 9 years now - estrogen only, as I had a hysterectomy years ago (ovaries not removed).  Tablets didn't suit me and made me feel nauseous, so I tried patches and eventually settled on 80mcg Elleste solo patches, applied twice a week.  These relieved all the horrible symptoms and I felt normal again.

For the last couple of years my doctor has been hassling me to come off HRT, as I've been on it for over 5 years and am approaching 60 - I am currently 59.  Last year, I decided to try to bite the bullet and gradually reduce my dose.  I literally cut down by gradually cutting off a section of patch, until I was down to half a 80mcg patch.  The doctor  then prescribed me 40mcg patches.  I'd had a few symptoms but these seemed to wear off after a time.  I then started to cut down the 40 mcg patches and eventually moved onto a 25mcg patch (Estradot) .  My night sweats started to return and I definitely didn't feel myself - more emotional and worryingly more aches and pains.  I stuck with it, hoping the symptoms would fade with time and trying to do what my doctor thought was the right thing.  Then earlier this year, I started with a frozen shoulder.  I didn't know that's what it was at first - just thought I'd pulled a muscle and it would go away on it's own.  It got worse, rather than better and eventually drove me to the doctors to get the diagnosis.  The lack of sleep from the pain of the frozen shoulder was made worse by the return of the night sweats and feeling generally not myself.  I'd also read some views that there could be some sort of a link between menopause and frozen shoulder.  This isn't proven but needs some proper research, taking into account the sex and age profile of the majority of cases.  It is apparantly a very common symptoms in menopausal women in Japan.

Taking all this into account, I decided to approach my GP with a view to increasing my HRT dose again.  I was expecing resistance, so did some research in advance, trying to avoid the more cranky sites.  I actually found the latest NICE  draft guidelines - the National Institute for Health and Care Excellence are the body that gives advice to UK doctors.  They have re-examined the evidence from various studies and come up with new guidelines, weighing up the benefits as well as risks of HRT.  Yes, there are some risks but these seem to have been over-played to the extent of frightening many women off HRT.  There also seems to be a lower risk for Estrogen only HRT - and when applied as patches rather than taken orally.

My doctor didn't seem convinced - he hadn't read the draft guidelines (which have been officially published today) and trotted out the usual list of reasons why I shouldn't take HRT.  He even suggested I take antidepressants (SSRi) which can apparantly help stop night sweats but seemed to ignore my other symptoms and concerns.  Reading the possible side-effects of these, I really don't want to go down that route and they don't address my other issues.  I'd gone in rather determined (which isn't really me) and in the end persuaded him to give me a month's supply of the 40mcg patches, obviously against his better judgement!

After a couple of weeks back on the 40mcg patches, I'm already feeling more like my old self and don't think I'll need a higher dose to keep my symptoms at bay.  My skin feels better as does my mood and the night sweats seem to have subsided.  I'm not expecting it to cure my frozen shoulder, which I'm having physio and considering other treatment for.  Some of the other aches and pains seem to be subsiding though.  After reading all the pros and cons, I'm happy to stay on the HRT for the foreseeable future.  Lack of sleep due to night sweats alone, must be a heath risk in itself. 

Anyone considering taking HRT should read the new guidelines for themself - if you Google NICE's website you can find public information or read the full draft guidelines (long and technical).  You might find the benefits outweigh the risks for you.  I'd personally rather have a good quality of life than put up with horrible symptoms for fear of what may be very small risks that may never materialise.  

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