Why does my doctor say HRT for women under 50 is not safe but everyone around me is taking it and feeling good?

[Anonymous]

I just went back on the pill at age 46 after 15 years without it and I feel great. It is absolutely helping my peri symptoms. My GP put me on it while I'm waiting for an available appointment with a GYN. We'll see what the gyn says - I definitely have some questions. But if this is a valid, safe option, I'm excited to be on it for the next few years.

[Anonymous]

i asked this question from my friend who is an OBGYN. She said doctors are slow to change and many operate on antiquated outdated debunked information. She said women’s health suffers as a result.

[Anonymous]

HRT low dose estrogen patch and progesterone pill are lower dose than the BCP!

[Anonymous]

Anonymous wrote:it is SO FRUSTRATING.
I dont want to be an old twisted hag when i could have had magical youth potion. But my dr says evidence still strongly points to cancer risk. who is right? what to believe? halp.

Sorry, I haven't read everything, but I wouldn't rely on any doctor's advice without researching. As it happens, I have a doctor who is a proponent of HRT, and we do it the right way with regular blood work and check-ins. My doctor also has me on specific supplements based on blood work. I'm comfortable that science is on my side. I'm at my ideal weight again, I can focus at work, and I sleep 8 hours through the night, which is a significant shift from where I was a year ago before I started HRT.

[Anonymous]

Anonymous wrote:

Anonymous wrote:it is SO FRUSTRATING.
I dont want to be an old twisted hag when i could have had magical youth potion. But my dr says evidence still strongly points to cancer risk. who is right? what to believe? halp.

Sorry, I haven't read everything, but I wouldn't rely on any doctor's advice without researching. As it happens, I have a doctor who is a proponent of HRT, and we do it the right way with regular blood work and check-ins. My doctor also has me on specific supplements based on blood work. I'm comfortable that science is on my side. I'm at my ideal weight again, I can focus at work, and I sleep 8 hours through the night, which is a significant shift from where I was a year ago before I started HRT.

To be more specific, in case it is helpful to anyone else, progesterone (plus melatonin and ashwagandha at night) gave me my sleep back, testosterone helped me build lean and it restored my previously nonexistent sex drive, and a low dose of semaglutide plus T3 and T4 helped me lose the twenty lbs I gained due to kids and stress. Had I not gone to this doctor, I'd still be suffering from symptoms of a low thyroid because no doctor had ever tested it for me. I also take other supplements because my blood work revealed some deficiencies. Sadly, this is not covered by insurance. But I'm not exaggerating; it's life-changing in middle age.

[Anonymous]

Correct me if I’m wrong but HRT still increases cancer and stroke risk, even if not as much as previously thought.

Everyone makes their own choices. But every time I feel like it would be great to make the hot flashes go away, I remember that a stroke would be MUCH worse, and I decide again not to take HRT.

https://www.ahajournals.org/doi/10.1161/STROKEAHA.121.038659

[Anonymous]

Anonymous wrote:Correct me if I’m wrong but HRT still increases cancer and stroke risk, even if not as much as previously thought.

Everyone makes their own choices. But every time I feel like it would be great to make the hot flashes go away, I remember that a stroke would be MUCH worse, and I decide again not to take HRT.

https://www.ahajournals.org/doi/10.1161/STROKEAHA.121.038659

Have you also avoided oral contraception, as the risk factors seem even higher for oral contraception? Also, none of the doctors who prescribed my birth control have ever mentioned this risk, which is concerning to me.

[Anonymous]

Anonymous wrote:i asked this question from my friend who is an OBGYN. She said doctors are slow to change and many operate on antiquated outdated debunked information. She said women’s health suffers as a result.

Ask her what doctors will treat the women who have a stroke shortly after starting HRT … HRT significantly increases the risk of stroke in the first year taking it. I have a 12 year old - I don’t like hotflashes but I need to stay healthy for him. A stroke would be a disagree.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Correct me if I’m wrong but HRT still increases cancer and stroke risk, even if not as much as previously thought.

Everyone makes their own choices. But every time I feel like it would be great to make the hot flashes go away, I remember that a stroke would be MUCH worse, and I decide again not to take HRT.

https://www.ahajournals.org/doi/10.1161/STROKEAHA.121.038659

Have you also avoided oral contraception, as the risk factors seem even higher for oral contraception? Also, none of the doctors who prescribed my birth control have ever mentioned this risk, which is concerning to me.

I took the pill for a while and I also think people are cavalier about the stroke risk for the pill. Also lots of other unpleasant side effects of the pill. As a young woman I switched to the ring (less hormones) then to a copper IUD.

[Anonymous]

Anonymous wrote:

Anonymous wrote:i asked this question from my friend who is an OBGYN. She said doctors are slow to change and many operate on antiquated outdated debunked information. She said women’s health suffers as a result.

Ask her what doctors will treat the women who have a stroke shortly after starting HRT … HRT significantly increases the risk of stroke in the first year taking it. I have a 12 year old - I don’t like hotflashes but I need to stay healthy for him. A stroke would be a disagree.

But there is also research that says HRT in women <60 years of age and/or at or near menopause "significantly reduces all-cause mortality and cardiovascular disease (CVD)," and I would take an increased reduction of all-cause mortality at an increased risk of a stroke. The article also says, "Magnitude and type of HRT-associated risks, including breast cancer, stroke, and venous thromboembolism are rare (<10 events/10,000 women), not unique to HRT and comparable with other medications.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9178928/#:~:text=Initiated%20in%20women%20%3C60%20years,lowering%20fail%20to%20do%20so.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:i asked this question from my friend who is an OBGYN. She said doctors are slow to change and many operate on antiquated outdated debunked information. She said women’s health suffers as a result.

Ask her what doctors will treat the women who have a stroke shortly after starting HRT … HRT significantly increases the risk of stroke in the first year taking it. I have a 12 year old - I don’t like hotflashes but I need to stay healthy for him. A stroke would be a disagree.

But there is also research that says HRT in women <60 years of age and/or at or near menopause "significantly reduces all-cause mortality and cardiovascular disease (CVD)," and I would take an increased reduction of all-cause mortality at an increased risk of a stroke. The article also says, "Magnitude and type of HRT-associated risks, including breast cancer, stroke, and venous thromboembolism are rare (<10 events/10,000 women), not unique to HRT and comparable with other medications.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9178928/#:~:text=Initiated%20in%20women%20%3C60%20years,lowering%20fail%20to%20do%20so.

that’s a single paper.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:i asked this question from my friend who is an OBGYN. She said doctors are slow to change and many operate on antiquated outdated debunked information. She said women’s health suffers as a result.

Ask her what doctors will treat the women who have a stroke shortly after starting HRT … HRT significantly increases the risk of stroke in the first year taking it. I have a 12 year old - I don’t like hotflashes but I need to stay healthy for him. A stroke would be a disagree.

But there is also research that says HRT in women <60 years of age and/or at or near menopause "significantly reduces all-cause mortality and cardiovascular disease (CVD)," and I would take an increased reduction of all-cause mortality at an increased risk of a stroke. The article also says, "Magnitude and type of HRT-associated risks, including breast cancer, stroke, and venous thromboembolism are rare (<10 events/10,000 women), not unique to HRT and comparable with other medications.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9178928/#:~:text=Initiated%20in%20women%20%3C60%20years,lowering%20fail%20to%20do%20so.

that’s a single paper.

Is that a challenge?

Here's another paper published by the National Library of Medicine that states in the Abstract: "HRT may prevent chronic conditions when started in symptomatic women before the age of 60 years or within 10 years of the onset of the menopause, taking into consideration the characteristics and risk profiles of each given woman. The bulk of scientific evidence from preclinical, clinical, epidemiological, and also randomized studies indicates that wisely selected HRT is generally useful and rarely dangerous. Following simple and well-established rules, HRT benefits outweigh all of the possible risks. Progestogen choice can make the difference in terms of cardiovascular disease benefits."

https://pubmed.ncbi.nlm.nih.gov/30626218/#:~:text=In%20fact%2C%20climacteric%20symptoms%20are,replacement%20therapy;%20hypertension;%20osteoporosis.

And if you follow the suggested articles, there is scientific support that HRT is neuroprotective and reduces the risk of cardiovascular disease and osteoporosis.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:If you don't have cancer risk in your family, it really is doctor dependent on how they chose to read the info. I do my research and the two I have gone to, when I present my case for HRT, have no problem with it. I started at 49.

But I also go to younger women rather than any age male.

NP. I have always found male doctors to be more compassionate than female doctors, in any specialty. YMMV

Bull shite. I see the exact opposite. My first gyn was male and was mean and every yearly exam was painful and he made light of it. I hated the first ob I had who was male. He was rude and insulting. I had a rare genetic problem and he made light of it and I had to have a d&c. Male doctors, in general, have been awful in my experience.

+1. My male ob gyn was arrogant and dismissive. I treated myself to a woman doctor when I started menopause and never would go back.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:i asked this question from my friend who is an OBGYN. She said doctors are slow to change and many operate on antiquated outdated debunked information. She said women’s health suffers as a result.

Ask her what doctors will treat the women who have a stroke shortly after starting HRT … HRT significantly increases the risk of stroke in the first year taking it. I have a 12 year old - I don’t like hotflashes but I need to stay healthy for him. A stroke would be a disagree.

But there is also research that says HRT in women <60 years of age and/or at or near menopause "significantly reduces all-cause mortality and cardiovascular disease (CVD)," and I would take an increased reduction of all-cause mortality at an increased risk of a stroke. The article also says, "Magnitude and type of HRT-associated risks, including breast cancer, stroke, and venous thromboembolism are rare (<10 events/10,000 women), not unique to HRT and comparable with other medications.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9178928/#:~:text=Initiated%20in%20women%20%3C60%20years,lowering%20fail%20to%20do%20so.

that’s a single paper.

Is that a challenge?

Here's another paper published by the National Library of Medicine that states in the Abstract: "HRT may prevent chronic conditions when started in symptomatic women before the age of 60 years or within 10 years of the onset of the menopause, taking into consideration the characteristics and risk profiles of each given woman. The bulk of scientific evidence from preclinical, clinical, epidemiological, and also randomized studies indicates that wisely selected HRT is generally useful and rarely dangerous. Following simple and well-established rules, HRT benefits outweigh all of the possible risks. Progestogen choice can make the difference in terms of cardiovascular disease benefits."

https://pubmed.ncbi.nlm.nih.gov/30626218/#:~:text=In%20fact%2C%20climacteric%20symptoms%20are,replacement%20therapy;%20hypertension;%20osteoporosis.

And if you follow the suggested articles, there is scientific support that HRT is neuroprotective and reduces the risk of cardiovascular disease and osteoporosis.

There’s truly no good proof that HRT extends your life but some evidence that it increases stroke and cancer risk. For stroke risk, the risk is most acute when you first start. Personally I’m willing to deal with menopause symptoms. I don’t think any doctor in good conscience could recommend HRT to someone like me. Sure I’d love no hot flashes but really don’t want to be disabled by a stroke.

That said most people including doctors aren’t great at assessing risks and benefits of medication. But it’s not some misogynistic conspiracy theory.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:i asked this question from my friend who is an OBGYN. She said doctors are slow to change and many operate on antiquated outdated debunked information. She said women’s health suffers as a result.

Ask her what doctors will treat the women who have a stroke shortly after starting HRT … HRT significantly increases the risk of stroke in the first year taking it. I have a 12 year old - I don’t like hotflashes but I need to stay healthy for him. A stroke would be a disagree.

But there is also research that says HRT in women <60 years of age and/or at or near menopause "significantly reduces all-cause mortality and cardiovascular disease (CVD)," and I would take an increased reduction of all-cause mortality at an increased risk of a stroke. The article also says, "Magnitude and type of HRT-associated risks, including breast cancer, stroke, and venous thromboembolism are rare (<10 events/10,000 women), not unique to HRT and comparable with other medications.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9178928/#:~:text=Initiated%20in%20women%20%3C60%20years,lowering%20fail%20to%20do%20so.

that’s a single paper.

Is that a challenge?

Here's another paper published by the National Library of Medicine that states in the Abstract: "HRT may prevent chronic conditions when started in symptomatic women before the age of 60 years or within 10 years of the onset of the menopause, taking into consideration the characteristics and risk profiles of each given woman. The bulk of scientific evidence from preclinical, clinical, epidemiological, and also randomized studies indicates that wisely selected HRT is generally useful and rarely dangerous. Following simple and well-established rules, HRT benefits outweigh all of the possible risks. Progestogen choice can make the difference in terms of cardiovascular disease benefits."

https://pubmed.ncbi.nlm.nih.gov/30626218/#:~:text=In%20fact%2C%20climacteric%20symptoms%20are,replacement%20therapy;%20hypertension;%20osteoporosis.

And if you follow the suggested articles, there is scientific support that HRT is neuroprotective and reduces the risk of cardiovascular disease and osteoporosis.

“generally useful and rarely dangerous.” personally I prefer to avoid the rare but severe danger. There’s so much talk about how terrible menopause is lately but I can deal with it.