Thank you so much for this. I had a hysterectomy 12 years ago (uterus only, due to fibroids), and never took any MRT/HRT. I had some relatively mild menopause symptoms, the worst of which were hot flashes that mostly passed quickly.
But in the past few years I’ve experienced painful intercourse and a total lack of libido. I started on vaginal Estradiol and it’s helped a lot. I’ve also been going to therapy to try to tap back into feeling desire again. When I spoke with my gynecologist at my annual appointment last week about HRT, since it is indeed the hot topic now, she noted that I am the age where the window is closing to begin such treatment (I turn 60 next week). There are also concerns about my blood pressure and a strong family history of heart disease, which leads her to believe I’m not a good candidate to begin such treatment at this point in life. I trust her advice.
So, yeah, maybe I did miss the boat, but how? Not having worse symptoms a decade ago? I never saw a point in starting to take something for symptoms I didn’t have — I think very few women were advised to do that twelve years ago. The best we can do now is try to move forward with the treatments currently advisable. It’s easy to feel like you missed the boat when others are crowing about how great they feel. Truth is, most days I feel like I’m still 30 — until I look in the mirror, LOL.
Well I missed the HRT boat at age 60 but discovered HRT at age 70. I am now 75 and can say it’s been a life changer!! Vaginal dryness is gone so now sex is exciting and fun. My bone density has increased. I have maintained the energy to live an active lifestyle such as working out (including weight lifting), cycling, hiking, skiing and tennis. I know everyone’s body is different and responds differently to HRT but I would encourage anyone who thinks they have missed the boat to change their thinking!! It’s never too late to explore the hormone therapy that is right for you.
I have always had low LDLs but elevated HDLs before I received HRT and they have remained the same since. One thing that my blood work revealed five years ago was that my thyroid antibodies were very high at 119. Normal is 30 or below. I started taking a Thyroid medication but wondered if a change of diet would lower the antibodies. I eliminated cow dairy, which was so much apart of my diet. I substituted cow dairy for goat and sheep products. It worked!! My antibody count is now below 30 and I am off the Thyroid medication. I would say the change occurred over a six month period.
That’s good. Well low LDL and high HDL is the best profile to have and the one you want! Mine changed drastically through peri menopause and after to the opposite of what you have, which is not good. With a good profile it makes sense that they treated you as perhaps you did not have Cardiovascular risk due to your lipid profile. Luck of the draw for you!
Thank you for this post! It's hard not to feel regretful about not having taken MHT when there's an abundance of media about its magic benefits to overall health. This post is one of the few I've read offering sensible advice to those of us who've been excluded, for whatever reason, from the hormone zeal.
Reading this article made me feel so much better. I am 55 years old; I had been enjoying life and feeling great on HRT for two years (post menopause). Then I was diagnosed with endometrial cancer. It was caught early, thankfully, and the only treatment I needed was surgery. But now that we are in the "menopause moment", I do feel left out. I am doing my best to cope with all the symptoms of menopause, and am worried about avoiding all of these these ailments that come from no estrogen. After reading this, I now believe I can stay healthy in spite of not being able to have HRT. Thank you!
I too had a hysterectomy due to endometrial and cervical cancer. Is vaginal estrogen contraindicated in my case? Might it heighten the risk of recurrence? I am 79.
I’m 67. I started menopause after that flawed study and my immediate symptoms were mild, so I was never offered HRT. But ten years later, I have several problems that are related to loss of estrogen that no one ever warned me about, like acne so bad it leaves scars, foot pain and numbness, and something horrible called Lichen sclerosus. I’m using topical estrogen now, but can’t help but wonder if I could have avoided these problems. I tell my daughter and her friends to appreciate their estrogen while they have it, and ask for HRT if they need it later.
A great post, thank you! It may be with pointing out that according to Jerrilyn Prior, Professor of Endocrinology and founder of the Centre for Menstrual Cycle and Ovulation Research (CeMCOR), progesterone is still important for women without a uterus who are taking estrogen.
Yes it absolutely is part of the MHT “package”— just not as critical for the uterine cancer risk reduction for ppl who’ve had a hysterectomy. Thank you!
As an ER physician. I’m grateful for this education and perspective. The treatment of recurrent UTIs without consideration for topical estrogen is one that we as a specialty. Need to do better.
As a perimenopausal 50yo, I’d love to hear your thoughts specifically on the patch… I understand from the above that it helps with various general menopausal issues, but am curious whether it helps with/prevents genitourinary symptoms as well, or if vaginal estrogen specifically is the best for preventing genitourinary symptoms?
My doc is very wary of vaginal estrogen (not sure if it is the black box warning or what- she IS ok with compounded vaginal estradiol🤔) and I’m having trouble getting reliable info! I really appreciate the nuance you bring to these topics, so thank you.
The patch is an easy delivery system for systemic estrogen. It delivers estrogen everywhere, including the genitourinary system. So yes, it def can/should help with genitourinary symptoms - it’s one of the main reasons we prescribe systemic hormone therapy. Whether or not your patch will deliver enough estrogen to manage your symptoms depends on the patch dosing and the severity of your symptoms. Sometimes we use both systemic and topical hormones in tandem. It really depends on the person. I hope that helps!
Thank you for writing this though I remain unclear on cardio risk and know I can’t be alone. You wrote that if you have a woman over 60 w/ low cardiovascular risk you would put her on HrT but my concern is w/ menopause lowering the HDL and raising the LDL, and causing type B lipid profile -after years of that, how can we know if we are low risk enough. I used to be low risk and have no other risk factors (though have sleep apnea now) . I did a calcium scan before menopause for peace of mind and didn’t realize it was so much radiation and don’t want to repeat (bone scans every year for ten years and found out that was too much radiation). Even as a normal weight, fairly fit active woman with BMI of 22, the cholesterol and bone health is the challenge. Do weights but bad back, old athletics injuries and continuous plantar facia issues make that challenging but I stay with it. I’m terrified of estrogen but did just start the patch and micronized progesterone to get treatment but will need to continue considering. Hopefully the 2 years on a statin have helped. It seems inevitable to have some cardio risk BECAUSE of menopause. It is scary that so many doctors guided us so poorly. I went on fosomax for two years in late fifties and still no one suggested hormones. And when they did suggest- I was told it was 8 years - not 10 and since I was just over 8 years, I was terrified and now I wish I had started then. Feel like I can’t win and that Mis guidance from doctors has been frustrating and now I don’t trust my decisions. It’s sad.
72 yo. I have been searching for information related to dosing for women lilke me who missed the boat. Just diagnosed with osteoporosis and have had high cholesterol which I am trying to bring down with diet and exercise. Doctors--even the women--automatically throw Fosamax at me as the solution, but I am wary (fear of jaw necrosis). How can I educate THEM about HOW to evaluate ME for possible HRT therapy?
I was on HRT for 16 years felt great. Went off at 68, 2 years ago since have a family history of heart disease. So hot flashes, depression, & feeling low energy with brain fog & dry, no libido.
Wished did not go off.
Am using estrodial for dryness only. One good thing I suggest to all is heavy weight lifting. I had major arthritis in hands & tightening in knees. Arthritis gone & able to lift 115 IBS to my surprise.
Thank you so much for this. I had a hysterectomy 12 years ago (uterus only, due to fibroids), and never took any MRT/HRT. I had some relatively mild menopause symptoms, the worst of which were hot flashes that mostly passed quickly.
But in the past few years I’ve experienced painful intercourse and a total lack of libido. I started on vaginal Estradiol and it’s helped a lot. I’ve also been going to therapy to try to tap back into feeling desire again. When I spoke with my gynecologist at my annual appointment last week about HRT, since it is indeed the hot topic now, she noted that I am the age where the window is closing to begin such treatment (I turn 60 next week). There are also concerns about my blood pressure and a strong family history of heart disease, which leads her to believe I’m not a good candidate to begin such treatment at this point in life. I trust her advice.
So, yeah, maybe I did miss the boat, but how? Not having worse symptoms a decade ago? I never saw a point in starting to take something for symptoms I didn’t have — I think very few women were advised to do that twelve years ago. The best we can do now is try to move forward with the treatments currently advisable. It’s easy to feel like you missed the boat when others are crowing about how great they feel. Truth is, most days I feel like I’m still 30 — until I look in the mirror, LOL.
❤️❤️❤️
You’re not old and it’s never too late! Highly recommend it! I am on no other meds. I use Evamist and progesterone
Well I missed the HRT boat at age 60 but discovered HRT at age 70. I am now 75 and can say it’s been a life changer!! Vaginal dryness is gone so now sex is exciting and fun. My bone density has increased. I have maintained the energy to live an active lifestyle such as working out (including weight lifting), cycling, hiking, skiing and tennis. I know everyone’s body is different and responds differently to HRT but I would encourage anyone who thinks they have missed the boat to change their thinking!! It’s never too late to explore the hormone therapy that is right for you.
Wow! Good for you. This is good to hear. But I’m guessing maybe you don’t have cholesterol issues?
I have always had low LDLs but elevated HDLs before I received HRT and they have remained the same since. One thing that my blood work revealed five years ago was that my thyroid antibodies were very high at 119. Normal is 30 or below. I started taking a Thyroid medication but wondered if a change of diet would lower the antibodies. I eliminated cow dairy, which was so much apart of my diet. I substituted cow dairy for goat and sheep products. It worked!! My antibody count is now below 30 and I am off the Thyroid medication. I would say the change occurred over a six month period.
That’s good. Well low LDL and high HDL is the best profile to have and the one you want! Mine changed drastically through peri menopause and after to the opposite of what you have, which is not good. With a good profile it makes sense that they treated you as perhaps you did not have Cardiovascular risk due to your lipid profile. Luck of the draw for you!
Thank you for this post! It's hard not to feel regretful about not having taken MHT when there's an abundance of media about its magic benefits to overall health. This post is one of the few I've read offering sensible advice to those of us who've been excluded, for whatever reason, from the hormone zeal.
Thank you so much for the more balanced post on this topic.
Reading this article made me feel so much better. I am 55 years old; I had been enjoying life and feeling great on HRT for two years (post menopause). Then I was diagnosed with endometrial cancer. It was caught early, thankfully, and the only treatment I needed was surgery. But now that we are in the "menopause moment", I do feel left out. I am doing my best to cope with all the symptoms of menopause, and am worried about avoiding all of these these ailments that come from no estrogen. After reading this, I now believe I can stay healthy in spite of not being able to have HRT. Thank you!
I too had a hysterectomy due to endometrial and cervical cancer. Is vaginal estrogen contraindicated in my case? Might it heighten the risk of recurrence? I am 79.
My hysterectomy was three years ago.
It isn't contraindicated - so I suggest talking w your GYN!
GYN ONC surgeon says if there are any cancer cells left, the. Vaginal estrogen could fuel their growth.
I’m 67. I started menopause after that flawed study and my immediate symptoms were mild, so I was never offered HRT. But ten years later, I have several problems that are related to loss of estrogen that no one ever warned me about, like acne so bad it leaves scars, foot pain and numbness, and something horrible called Lichen sclerosus. I’m using topical estrogen now, but can’t help but wonder if I could have avoided these problems. I tell my daughter and her friends to appreciate their estrogen while they have it, and ask for HRT if they need it later.
A great post, thank you! It may be with pointing out that according to Jerrilyn Prior, Professor of Endocrinology and founder of the Centre for Menstrual Cycle and Ovulation Research (CeMCOR), progesterone is still important for women without a uterus who are taking estrogen.
Yes it absolutely is part of the MHT “package”— just not as critical for the uterine cancer risk reduction for ppl who’ve had a hysterectomy. Thank you!
As an ER physician. I’m grateful for this education and perspective. The treatment of recurrent UTIs without consideration for topical estrogen is one that we as a specialty. Need to do better.
As a perimenopausal 50yo, I’d love to hear your thoughts specifically on the patch… I understand from the above that it helps with various general menopausal issues, but am curious whether it helps with/prevents genitourinary symptoms as well, or if vaginal estrogen specifically is the best for preventing genitourinary symptoms?
My doc is very wary of vaginal estrogen (not sure if it is the black box warning or what- she IS ok with compounded vaginal estradiol🤔) and I’m having trouble getting reliable info! I really appreciate the nuance you bring to these topics, so thank you.
The patch is an easy delivery system for systemic estrogen. It delivers estrogen everywhere, including the genitourinary system. So yes, it def can/should help with genitourinary symptoms - it’s one of the main reasons we prescribe systemic hormone therapy. Whether or not your patch will deliver enough estrogen to manage your symptoms depends on the patch dosing and the severity of your symptoms. Sometimes we use both systemic and topical hormones in tandem. It really depends on the person. I hope that helps!
Thanks so much!
Thank you for writing this though I remain unclear on cardio risk and know I can’t be alone. You wrote that if you have a woman over 60 w/ low cardiovascular risk you would put her on HrT but my concern is w/ menopause lowering the HDL and raising the LDL, and causing type B lipid profile -after years of that, how can we know if we are low risk enough. I used to be low risk and have no other risk factors (though have sleep apnea now) . I did a calcium scan before menopause for peace of mind and didn’t realize it was so much radiation and don’t want to repeat (bone scans every year for ten years and found out that was too much radiation). Even as a normal weight, fairly fit active woman with BMI of 22, the cholesterol and bone health is the challenge. Do weights but bad back, old athletics injuries and continuous plantar facia issues make that challenging but I stay with it. I’m terrified of estrogen but did just start the patch and micronized progesterone to get treatment but will need to continue considering. Hopefully the 2 years on a statin have helped. It seems inevitable to have some cardio risk BECAUSE of menopause. It is scary that so many doctors guided us so poorly. I went on fosomax for two years in late fifties and still no one suggested hormones. And when they did suggest- I was told it was 8 years - not 10 and since I was just over 8 years, I was terrified and now I wish I had started then. Feel like I can’t win and that Mis guidance from doctors has been frustrating and now I don’t trust my decisions. It’s sad.
72 yo. I have been searching for information related to dosing for women lilke me who missed the boat. Just diagnosed with osteoporosis and have had high cholesterol which I am trying to bring down with diet and exercise. Doctors--even the women--automatically throw Fosamax at me as the solution, but I am wary (fear of jaw necrosis). How can I educate THEM about HOW to evaluate ME for possible HRT therapy?
I was on HRT for 16 years felt great. Went off at 68, 2 years ago since have a family history of heart disease. So hot flashes, depression, & feeling low energy with brain fog & dry, no libido.
Wished did not go off.
Am using estrodial for dryness only. One good thing I suggest to all is heavy weight lifting. I had major arthritis in hands & tightening in knees. Arthritis gone & able to lift 115 IBS to my surprise.