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

[Anonymous]

Just out of curiosity, for all the posters who insist on HRT to prevent osteoporosis, do you get regular blood work to check vitamin d?

I’m not for or against HRT, but it does shock me that gyns don’t order bloodwork to check vitamin d, b12, magnesium, as well as TSH before prescribing anything. A lot of symptoms can actually be caused by a vitamin d deficiency, which is common.

I think people assume that if they eat a varied diet and eat healthy, they aren’t deficient in anything, but some people do not absorb certain nutrients well — even if they eat all of the right things.

[Anonymous]

Anonymous wrote:Just out of curiosity, for all the posters who insist on HRT to prevent osteoporosis, do you get regular blood work to check vitamin d?

I’m not for or against HRT, but it does shock me that gyns don’t order bloodwork to check vitamin d, b12, magnesium, as well as TSH before prescribing anything. A lot of symptoms can actually be caused by a vitamin d deficiency, which is common.

I think people assume that if they eat a varied diet and eat healthy, they aren’t deficient in anything, but some people do not absorb certain nutrients well — even if they eat all of the right things.

Mine just did. Not for HRT, though. I’m not ready for that but for low-dose BCP. All within normal ranges.

[Anonymous]

Is vaginal estrogen cream safe since it’s small amount? My only symptom is dryness but nervous about all the risks of estrogen.

[Anonymous]

If you suffer from severe migraines, you should not take BC—not even a low dose. It puts you at risk for a stroke.

[Anonymous]

It’s extremely individual, and really dependent on the symptoms you have, your risk, and your age/relationship to menopause.

For me, APOE4 positive (mother, uncle, grandfather, grandmother, great aunt have Alzheimer’s with mom’s onset prior to 65) plus

terrible sleep at 46, 7 months no period, mood swings, dryness plus

No history of hormone receptive BC

HRT (estrogen patch, progesterone pills) have changed my life. I have no doubt. The doctors who refused to give it to me, suggesting instead 1) off label seizure meds for sleep; 2) surgery to fix prolapse so the dryness didn’t bother me (what?) were so uninformed as to be malpractice.

Go see a menopause specialist. pay out of pocket. Medical evidence is mounting for certain circumstances. My grandmother and great aunt were part of the Boston Nurses study that was halted in 2000! She developed Alzheimer’s and died within 3 years! her sister within 5!

It’s not a magic pill. But it can be very important for people like me.

https://med.stanford.edu/news/all-news/2013/02/accelerated-biological-aging-evident-in-women-with-alzheimers-risk-factor-but-inhibited-by-hormone-therapy-researchers-say.html

[Anonymous]

Anonymous wrote:Is vaginal estrogen cream safe since it’s small amount? My only symptom is dryness but nervous about all the risks of estrogen.

Yes. The estrogen in that case isn't systemic and stays localized.

[Anonymous]

Anonymous wrote: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.

This study though includes a lot of caveats, such as: “What we found is women who have early menopause or have a very late use of hormone therapy might be at higher risk, but only if they were already on the Alzheimer’s disease continuum, with elevated levels of amyloid,” she said. “Women with very low levels of amyloid and early menopause did not have such an association.”

And unfortunately there's been fraud and fabrication in Alzheimer's research, in one case a widely-accepted study has greatly misdirected Alzheimer's research for years:
https://www.science.org/content/article/potential-fabrication-research-images-threatens-key-theory-alzheimers-disease

[Anonymous]

Anonymous wrote:

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

I'm the first PP, and to be clear, I was talking about the FDA-approved bioidentical hormones (which are the patch and oral progesterone), NOT the compounded formulas. There may be some controversy, but the the fact is that the patch is transdermal and is less processed through the liver, which may reduce the blood clot risk.

[Anonymous]

Anonymous wrote:Just out of curiosity, for all the posters who insist on HRT to prevent osteoporosis, do you get regular blood work to check vitamin d?

I’m not for or against HRT, but it does shock me that gyns don’t order bloodwork to check vitamin d, b12, magnesium, as well as TSH before prescribing anything. A lot of symptoms can actually be caused by a vitamin d deficiency, which is common.

I think people assume that if they eat a varied diet and eat healthy, they aren’t deficient in anything, but some people do not absorb certain nutrients well — even if they eat all of the right things.

Yes, I get tested for those things. Early menopause is a known risk factor for osteoporosis because of the decline in estrogen. The estrogen patch is clinically approved to prevent bone loss post-menopause. (That's the only current approved clinical indication besides hot flashes). People with normal age of menopause, or lower risk of osteoporosis, may not benefit from it.

[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.

Sounds like Dr. Simon’s office staff is at it again. Are you here to berate other women for “being a handful”?

[Anonymous]

Anonymous wrote:

Anonymous wrote:Just out of curiosity, for all the posters who insist on HRT to prevent osteoporosis, do you get regular blood work to check vitamin d?

I’m not for or against HRT, but it does shock me that gyns don’t order bloodwork to check vitamin d, b12, magnesium, as well as TSH before prescribing anything. A lot of symptoms can actually be caused by a vitamin d deficiency, which is common.

I think people assume that if they eat a varied diet and eat healthy, they aren’t deficient in anything, but some people do not absorb certain nutrients well — even if they eat all of the right things.

Mine just did. Not for HRT, though. I’m not ready for that but for low-dose BCP. All within normal ranges.

Low dose BCP is still a higher dose of estrogen than HRT provides.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Just out of curiosity, for all the posters who insist on HRT to prevent osteoporosis, do you get regular blood work to check vitamin d?

I’m not for or against HRT, but it does shock me that gyns don’t order bloodwork to check vitamin d, b12, magnesium, as well as TSH before prescribing anything. A lot of symptoms can actually be caused by a vitamin d deficiency, which is common.

I think people assume that if they eat a varied diet and eat healthy, they aren’t deficient in anything, but some people do not absorb certain nutrients well — even if they eat all of the right things.

Mine just did. Not for HRT, though. I’m not ready for that but for low-dose BCP. All within normal ranges.

Low dose BCP is still a higher dose of estrogen than HRT provides.

Yes. Regardless, they don't give you HRT if your cycles are regular. Or, at least my doctor's office doesn't.

[Anonymous]

Anonymous wrote:No drug is a magic potion.

Grow up.

It takes decades to get cancer, so your friends would not be showing signs yet, of course.
And, I hate to tell you but you and they will grow old. It is inevitable (unless you die).

So be clear eyed about things.

I first got breast cancer diagnosed at 35. No family history. No signs of cancer every year after treatment, there had been no lymph node involvement. It’s 20 years now since diagnosis and treatment and now a tumor was found in my lung and it’s from my breast cancer I had 20 years ago based on the DNA. So women sometimes do have cancer cells not detected or seen in any testing but might start rapidly reproducing with new estrogen coming into the body.

Now I have to take drugs to stop estrogen in the hopes that the tumor will be starved.

So yeah, I look like a twisted old hag like someone said. Burnt looking hair, no eyebrows, dry skin, painful joints.

It totally sucks that estrogen feeds cancer but helps protect your heart. Having to make that choice sucks too.

[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.

I knew what you meant. Steroids make you feel like you want to jump out of your own skin.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Just out of curiosity, for all the posters who insist on HRT to prevent osteoporosis, do you get regular blood work to check vitamin d?

I’m not for or against HRT, but it does shock me that gyns don’t order bloodwork to check vitamin d, b12, magnesium, as well as TSH before prescribing anything. A lot of symptoms can actually be caused by a vitamin d deficiency, which is common.

I think people assume that if they eat a varied diet and eat healthy, they aren’t deficient in anything, but some people do not absorb certain nutrients well — even if they eat all of the right things.

Mine just did. Not for HRT, though. I’m not ready for that but for low-dose BCP. All within normal ranges.

Low dose BCP is still a higher dose of estrogen than HRT provides.

but you're fundamentally misunderstanding what the dr is saying.

if you are still having periods, you are still making estrogen. if you put hrt on TOP of that, you are exposing your body to higher levels of estrogen than if you take the pill. That's because the pill shuts down all your hormones and replaces them. make sense?