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 was having brain fog, insomnia, and 10+ hot flashes per day. It was absolutely impacting my quality of life. My gyn started me on HRT when I was 52 and in peri (hadn’t had a period in 7 months at that point). We reviewed all of my risk factors and will revisit in 5 years if not sooner, which she says puts me at minimal increased risk, a trade off I find acceptable.

[Anonymous]

I'm on nothing. 54.

I was prescribed progesterone only BC pills to control heavy bleeding last year--but ditched them as they made feel bloated, gain weight and loosing hair.

I stopped having periods and I had a few cases of hot flushed (wouldn't even categorize as true hot flashes) and pretty much nothing else.

I had a pretty crazy long perimenopause with very irregular periods--long, close together, heavy, non-existent, mid cycle bleeding, anxiety crazy moods from mid 40s-51.

Now it seems like everything just stopped and I feel pretty good. I still exercise 6 days per week, sleep is a little crappy but I think it's more spouse's snoring.

My mom had a very easy transition w/out HRT so hope this is it. I'm not going to take it unless I had annoying, intolerable symptoms.

[Anonymous]

^^ oh I found a few supplements that truly seemed to help with few symptoms I had.

phosphatidyl serine. Completely cleared brain fog and lowered cortisol/anxiety. Got it thru amazon after reading about hormones and natural supplements.

I wanted to try things like that before going the hormone route because worried about BC risk with dense breasts too.

[Anonymous]

Anonymous wrote:I have been remarkably fortunate to experience almost no unpleasant side effects from menopause. Is there still a reason to take hrt for me? (And no I’ve never done yoga!)

No. Same

I'm not taking them and I have good skin still, not dry and my hair is staying on my head.

[Anonymous]

Anonymous wrote:I'm 39, and after several years of what, in hindsight, was probably perimenopause (periods of decreasing frequency, DOR/secondary infertility) I am now approaching the full year mark without a period. My gyn didn't mention HRT, but I'm wondering if I need to address it at my upcoming annual. Other than the amenorrhea, I can't say I have any real symptoms, so not sure if it's indicated or not?

I had amenorrhea in my early thirties and thank goodness I found Dr. James Simon in DC. He’s a leader in menopause research. He put me on HRT to protect my brain and bone health 10 years ago. I trust him more than any doctor I ever met. He will spend an hour or more each appointment talking about all his research and menopause. He understands the whole body is connected and will talk to you about your mental health, physical health, sexual health, etc. Anyone on the fence about HRT should go see him and pick his brain.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I'm 39, and after several years of what, in hindsight, was probably perimenopause (periods of decreasing frequency, DOR/secondary infertility) I am now approaching the full year mark without a period. My gyn didn't mention HRT, but I'm wondering if I need to address it at my upcoming annual. Other than the amenorrhea, I can't say I have any real symptoms, so not sure if it's indicated or not?

I had amenorrhea in my early thirties and thank goodness I found Dr. James Simon in DC. He’s a leader in menopause research. He put me on HRT to protect my brain and bone health 10 years ago. I trust him more than any doctor I ever met. He will spend an hour or more each appointment talking about all his research and menopause. He understands the whole body is connected and will talk to you about your mental health, physical health, sexual health, etc. Anyone on the fence about HRT should go see him and pick his brain.

Darn, looks like he doesn't accept insurance. Do you mind sharing what an appointment costs you to see him? How does it work from an insurance standpoint if you need lab work, etc?

[Anonymous]

Said it before and I will say it again, this website is the best: https://www.myalloy.com/

[Anonymous]

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.

[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.

Interesting. I've had the opposite experience, same as PP's. But luckily I've had great doctors/NPs/nurses in general, and I woudn't favor either gender in choosing who to see.

[Anonymous]

OP, we all will become twisted old hags if we manage to live long enough. HRT will not change that. What is your goal with HRT? Reduction of menopause symptoms? Bone or heart protection? HRT is not some magic pill -- there are definite risks, but it is up to you to decide if the risks are worth the rewards for your particular situation. If you think HRT will "keep you young", you are mistaken.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Most of the doctors are relying on an old poorly designed study from over 20 years ago. The more recent studies show that IF YOU START HRT BEFORE you are fully through menopause it has significant benefits in protecting your heart and brain. If you wait until you are in your 60s, it’s too late because those receptors have turned off and so your body isn’t able to make appropriate use of the hormones and the effect is negative.

This contradicts 14:24.

From my mother's abysmal experience with HRT, I'm not touching it. Also, it doesn't make sense to me for "normal" menopause. And the constantly changing medical recommendations do not inspire me to change my mind.

+1 my mom had a horrific 18 months on hrt and died of ovarian cancer 15 years later.

Most women do not have a horrific experience with HRT. It has also changed a lot over the years. In the WHI study, they were taking synthetic oral estrogen and progestin. Now it’s often given as a bioidentical estrogen transdermal patch with bioidentical oral progesterone, which has lower risks of side effects. There is always a small risk of breast cancer, of course, but often the benefits outweigh the risk. My mother and grandmother both had osteoporosis, and I am in almost in menopause at age 45, so I am taking HRT for now.

This is not conclusive:


From the Mayo Clinic:
Are bioidentical or natural hormones safer and more effective than hormones used in traditional hormone therapy for menopause symptoms?
Answer From Tatnai Burnett, M.D.

"No, they aren't. According to the Food and Drug Administration (FDA) and several medical specialty groups, the hormones marketed as "bioidentical" and "natural" aren't safer than hormones used in traditional hormone therapy. There's also no evidence that they're any more effective.

The term "bioidentical" means the hormones in the product are chemically identical to those your body produces. In fact, the hormones in bioidentical medications may not be any different from those in traditional hormone therapy. Several hormone therapy products approved by the FDA and prescribed by doctors or other health care providers contain bioidentical hormones."

https://www.mayoclinic.org/diseases-conditions/menopause/expert-answers/bioidentical-hormones/faq-20058460


From the Cleveland Clinic:
Conventional hormone therapy vs. bioidentical hormone therapy
"Compounded bioidentical hormones are advertised as being a safer, more effective, natural and individualized alternative to conventional hormone therapy. However, these claims remain unsupported. Also, the lack of FDA oversight for compounded hormones generates additional risks regarding the purity and safety of compounded bioidentical hormones."

https://my.clevelandclinic.org/health/treatments/15660-bioidentical-hormones


From Harvard Medical School:
Are bioidentical hormones superior to hormone medications?
January 1, 2022
By Toni Golen, MD, Editor in Chief, Harvard Women's Health Watch; Editorial Advisory Board Member, Harvard Health Publishing; Contributor, and Hope Ricciotti, MD, Editor at Large, Harvard Women's Health Watch

"While advertisers may claim that these bioidentical hormones are "natural" alternatives to hormone medications, the truth is that the two are often very similar — but bioidenticals may come with less quality assurance. Many FDA-approved hormone therapies also meet the description of a bioidentical (although they're not usually advertised this way). In some cases, they are actually made using the same ingredients as bioidentical hormones. There's little evidence that bioidenticals are superior to FDA-approved hormone medications, and in fact, bioidenticals may be riskier, because they aren't scrutinized or tested by the FDA to verify dose and purity."

https://www.health.harvard.edu/womens-health/are-bioidentical-hormones-superior-to-hormone-medications

[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.

I also wondered the same thing, but never went on HRT after menopause 4 years ago.

I was just diagnosed with Estrogen+ breast cancer. That means my cancer feeds off of estrogen. As much as 80% of breast cancer is hormone receptor positive.

So, I'm pretty happy now that I didn't do HRT, because it would have accelerated my cancer.

Now I will take an aromatase inhibitor for 5-10 years. AIs get rid of estrogen in your body that is leftover after menopause (like from fat). So, I may have more menopause symptoms, but I won't have cancer!

[Anonymous]

I’m seeing a lot of studies that indicate it’s better to start it relatively early or not at all:
https://www.cnn.com/2023/04/03/health/alzheimers-hormone-replacement-therapy-wellness/index.html

Once those hormone receptors shut off after menopause, it can be really damaging.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I tried it initially a few years back and it made me very short-tempered and target - kinda like taking prednisone. Roid rage. I have pretty bad symptoms. Maybe I should try again? I’m only 48 and have been in full menopause for 5 years.

You get “roid rage” from anabolic steroids, which is totally different than prednisone. This post demonstrates how little people know about medicine. The views posted here on HRT and the above are ignorant. Embarrassingly so!

I’m not saying it was roid rage. I’m saying it felt like they. Calling someone ignorant for attempting to describe the sensation of being on HRT is not helpful in guiding more women to effective treatment.

NP, and a little off topic, but last time I was on high dose prednisone I could have stabbed a puppy. I have never felt such instantaneous rage. It was terrifying. And this is a relatively common reaction to high dose steroids. Every doctor I mention it to just smiles and says, yeah, some people have that reaction.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Most of the doctors are relying on an old poorly designed study from over 20 years ago. The more recent studies show that IF YOU START HRT BEFORE you are fully through menopause it has significant benefits in protecting your heart and brain. If you wait until you are in your 60s, it’s too late because those receptors have turned off and so your body isn’t able to make appropriate use of the hormones and the effect is negative.

This contradicts 14:24.

From my mother's abysmal experience with HRT, I'm not touching it. Also, it doesn't make sense to me for "normal" menopause. And the constantly changing medical recommendations do not inspire me to change my mind.

+1 my mom had a horrific 18 months on hrt and died of ovarian cancer 15 years later.

My mom also had a really terrible time after HRT and passed away from ovarian cancer. If menopause after 47, my doc doesn't recommend.