While making a video blog recently, which you may have seen, one question has bothered me and I suspect it bothers a lot of women.
Many, many women on long term HRT are reluctant to come off in case the dreaded hot flushes come back to make their lives miserable. That can be managed so that they can come off standard HRT easily. I am so used to finding that fear of coming off standard HRT that I have never considered the opposite until now. It begs the question: if I once start on any form of hormone therapy, will I have to take it for life?
The answer of course is: No. Taking hormone treatment is partly dictated by symptoms, and partly by principles of preventive medicine. But no one has to take hormones forever. Oestrogen is taken primarily to combat hot flushes and for a period restricted to 5 years post menopause. From time to time you should try coming down in dosage, to see if you can wean off the oestrogen. Progesterone can be taken for much longer, and there is anecdotal and scientific evidence to suggest that really much older women can benefit from it for moods, bones and alertness.
But even then hormones are not expected to be forever. Take them while the symptoms persist, and every now and then test to see whether you are coming out the other side of menopause. That’s another reason for repeated testing of your levels every so often.
If you are my patient, don’t be afraid to remind me to give you a break from oestrogen now and then! But if you are managing your hormones on your own, take a break every 12-18 months to see whether you still need the oestrogen. This is different from the other 2 types of breaks: the break from Day 25 of the month to the 1st of the next month, and the limit of 5 years total of oestrogen after you hit menopause. Here I’m talking about a break to test whether you still need the oestrogen at all.
So there is no fear of dependency on hormones if they are well managed.
Regards
Maura
