Ten years or so ago I went through what I refer to as my summer of cancer. The final act in that play was a radical hysterectomy. I've been on hormone replacement therapy ever since. Almost every doctor I've seen since then has been horrified, not only by the length of time I've been on HRT but also the strength of my dose. The original doctor who diagnosed my cancer and spearheaded my treatment advised me that the concerns about HRT and breast cancer didn't apply to people like me, who have neither uterus nor ovaries. I've never had the slightest interest in going off HRT so that was just the information I needed to press on.
Being of a certain age, the topic of HRT and whether or not to remain on it comes up in conversation fairly often when my girlfriends and I get together. All of my friends who were on HRT have opted to go off it by some means or another. I believe that both of my sisters are at least peri-menapausal and neither has opted for HRT.
I battled with severe hormonal issues, both physical and emotional since I was thirteen or fourteen. It wasn't until I went on HRT in my mid-thirties that I finally got some relief and could honestly say that I felt good for days and weeks at a time. I attributed that to the constant steady supply of a regulated amount of hormones; something that I clearly was not producing naturally. Give that up? I don't think so!
My original doctor long since moved away to become the head of a women's VA hospital in Florida and her practice was taken over by another wonderful woman of whom I am very fond. That woman was a firm believe in no HRT or, at the very least, the smallest dosage of HRT that one could get by on. Because she respected me and believed that I had a right to make well-informed decisions about my own health care, she supported me in my wish to continue on HRT. Periodically she would raise the topic, ensuring that I was aware of the risks and issues involved, but ultimately would go along with my choice.
When you are on HRT your prescription runs for one year and is not renewable until you go in for your annual pap smear; or at least that's the way it has always worked for me. It's annoying but it ensures that you keep coming back. Overall, probably a good system. Fast forward to Virginia. Here I was, prescription running out. I had to find a doctor, have my exam and get it renewed. I called my insurance company and they gave me the name and number of a local general practice that was covered by my plan. Although not an OB/Gyn practice, they would do pap smears. I made my appointment and in I went. The doctor who saw me was very nice but completely unwilling to extend my now ten year long HRT habit. He was just not comfortable with it but was willing to refer me to a gynecologist in the area; effectively putting the decision in someone else's hands.
All this consternation on the part of so many different doctors made me take another look at the subject. Although the aging aspects of menopause aren't terribly exciting to a 48-year-old single woman, overall the physical aspects of menopause; hot flashes and night sweats, weren't a major concern for me. Being plunged back into the emotional turmoil that I experienced for thirty years of my life was significantly less inviting. It's been ten years and I had no interest in going back.
Nevertheless, on December 22nd I decided to take the plunge. I've not had a hormone pill since. I've had a few hot flashes but considering the below-freezing weather we been enjoying ever since, that hasn't been an entirely unwelcome development! There has been no sign of the emotional turmoil of which I was so afraid. If those problems were brought on by the uneven levels of hormones being produced by my body, clearly that is no longer an issue. Perhaps the complete lack of hormones produces the same result as a steady level of hormones in that regard.
Financially it's not a big deal as I wasn't paying terribly much for the hormones anyway but it will be nice not to be taking a pill every day. It will be doubly nice not to have the Damoclean sword of a migraine hanging over my head; the inevitable result of missing a pill one day and then taking it the next.
I don't know how it's going to be in the long run but I am cautiously optimistic.
Where do you stand on Hormone Replacement Therapy? Are you using it? If not, why not? If you stopped, why did you stop and how did you go about it? Anyone using the Bio-Identicals?
Tuesday, January 05, 2010
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9 comments:
Good for you for going off the HRT!I urge you as soon as possible) to read Dr. John Lee's book, "What You Doctor May NOT Tell You About Menopause!" It covers the HRT issue and promotes biodentical progesterone as the ONE hormone needed during peri & post menopause, and he addresses the specific needs of a woman who has experienced the loss of her uterus and ovaries. The book will really open your eyes! The only time I experienced fatigue, weight gain, high cholesterol, hot flashes, etc after menopause was when I quit using the progesterone for a while. No more! I'll never go off of it again! But read the book and decide for yourself. BTW, my doctor is in agreement with Dr. Lee. The bioidentical product I use is called Renewed Balance and I get it at my local natural health store. Alot of those places will carry the book as well.
Thanks for the information Jill. I'll go looking for the book & the Renewed Balance as soon as the weather lifts!
Wow. What a big change for you. I'm struggling along without the HRT. The hot flashes, night sweats and sleeplessness are unpleasant but manageable. If they weren't, I'd be considering the hormone replacement or some other option. For now, though, I'm getting along fine. Glad to hear you are too!
HRT for men has such a bad reputation (steroids) that I tend to keep it private. But you know who I am. Since you asked for our input about the subject, I thought I'd try and bring a male perspective - which really isn't too much different from the benefits and risks of taking HRT as a woman it seems.
Several years ago I started losing muscle, gaining fat, getting depressed, losing motivation at work and losing my sex drive. The doctor was convinced it was depression and wanted to put me on antidepressants. Having never been the depressed type, I was convinced otherwise. I researched my symptoms online and discovered that they all matched that of low testosterone. Back to the doctor for tests and indeed my testosterone levels were that of a 65 year old man. I was 31 at the time.
Further tests revealed that my testes were fine and an MRI revealed that my pituitary was fine. Apparently the third cog in that HPTA (hypothalamus, Pituitary, Testicular axis) was not producing the two neurotransmitters (LSH / FSH) that would instruct the pituitary to create the hormone (GnRH) that would instruct the testes to create the hormone testosterone in adequate levels for someone of my age.
Why my hypothalamus decided to stop working full time I'll never know, but I'm hoping it has to do with dietary and environmental factors and that once I get away from pollutants in the city and a diet of processed foods containing high levels of BPA and other estrogen-mimicking chemicals... I'm hoping I can eventually come off of the HRT.
HRT for men has its own set of problems. Among them are an increased risk of prostate cancer and heart disease. More importantly, I don't like the idea of being dependent on a drug for my manhood. It bothers me.
And reading your problems with obtaining your medication in Virginia brings this fact home for me. The boogeyman "steroids" have had such a bad rap due to athletes abusing them, I'm afraid one of these days I'm not going to get my prescription (either that or because we don't have healthcare or some unforseeable future event) and suddenly I will lapse into severe depression, fat gain, lethargy, and generally just be miserable for many years.
Here's the thing that troubles me: My testes are fine... or they were, at least. But when you introduce external sources of testosterone into the male body his natural production ceases completely because it is deemed not needed and the body seeks to reach homeostasis. In the process the testes stop working and this is why bodybuilders have grapenuts, so to speak.
Soooo, the longer I'm on this stuff, the less chance I have of recovering. But I spent three years miserable, tired, angry, depressed, with a deteriorating body before finally going on HRT (and it was fixed almost overnight) so the idea of going back to that scares the sh*t out of me.
On the other hand, I could stay on HRT for the rest of my life, which - if I live to be 83 - would be as long as I've been alive so far PLUS another decade! That's a loooooong time for someone to be on HRT and at that point I wonder what the risks would be. Has it even been studied? The good news is I'd have the testosterone of a 35 year old into my 60s, which could come in useful for a busy old farmer ;-). Of course, that doesn't do me much good if I'm dying of prostate cancer or have a heart attack.
Anyway, I guess the point is I feel your frustration and I'm glad you have a chance to find your way out of the cycle of HRT. Thank you for sharing your story with us. I know mine is a very personal one and can imagine yours is as well.
@Cheryl - Good luck and hang in there! Are you taking any OTC remedies?
@Author - Thank you so much for sharing your story. I never think of HRT as being a male issue. It's good to have a reminder. For me the emotional issues far outweigh the physical and, once having experienced that nightmare, it's hard to do anything that might take you back there.
Good luck to you on your journey. Who knows, maybe science will come up with a safer alternative long before you hit 83!
Mary, correction - I meant to say Restored Balance, not "renewed!" Oopsie. It's packaged in a blue cylindrical tube container - makes dispensing the product easy.
I think the winter weather will be with you for a while and getting worse later in the week! Better make a grocery run! Stay warm and cozy.
I went through early menopause and have been on HRT for 18 years. Last May I decided it was time to get off it. I've been on half the dose for 9 months now and I'm feeling fine. I will likely be on a quarter dose for another year after this.
When I started into menopause I had a serious problem with moods. I would have happily killed anything, and working with students that didn't go over well. I called my hormone pills my happy pills.
Glad to be getting off them now though. I would rather not interfere with what nature has in store for me, but I'm sure my students are glad I did.
I know just what you mean Shirley. It's a lot easier to deal with moods when we don't have to see anyone else, isn't it?! Most of my friends went the reducing dosage route and it seemed to work well. I don't know why I decided to go cold turkey but I just did and it seems to be working for me.
Refusenik, total refusenik.
My gynecologist repeatedly tried to get me on HRT before my periods stopped. He told me it would protect my bones from osteoporosis, and that if I didn't take it I would soon develop heart disease, and that it would keep my skin and hair looking young.
All, it develops, sales pitches from Big Pharma that the guy bought into.
I never felt better than I did after my periods stopped: no more headaches, no more crippling bellyaches, no more deep indigo blues, no more homicidal moods. Heaven! Hot flashes and insomnia were more than a fair trade-off for all that.
You have to wonder why any woman would want to continue bleeding every month for the rest of her life.
You have to wonder why any woman would want to go back on estrogen when it gives her screaming three- and four-day marathon headaches.
You have to wonder why any woman would want brown spots on her face, after it took five years to get rid of the ones caused by the birth-control pills.
You have to wonder why any woman would want to keep on with the mood springs, the irritability, and the depression associated with female hormones when she could be free of all that once and for all.
And gee...you have to wonder why a doctor who specializes in caring for women would fail to consider those issues.
A Recommendation Author's comments are well taken when you have a real, documented pathology. In his case HRT is a medical treatment for a medical condition.
But aging is NOT a medical condition. Getting older is not a pathology. It's a normal part of life.
A friend of mine took bioidenticals for a while. She liked them. But when our employer cut our wages with furloughs, she stopped taking them as a cost-cutting measure. Even though she's now back up to as normal a wage as our beloved employer ever paid, she never went back on them. She doesn't seem to miss them.
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