So confused!! : Hi everyone me again... - British Heart Fou...

British Heart Foundation

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So confused!!

Madge11 profile image

Hi everyone me again 😉

Are there any ladies here who might know about taking hrt having had heart attack and double bypass? I'm really struggling with symptoms 😪 I was previously advised not to use hrt because of cardiac issues and I'm sure I saw an article recently saying women who have had a heart attack shouldn't be given hrt? Does anyone know if this is correct! I've been waiting for an appointment with menopause clinic only to find out today that it's been suspended cuz there's to many people waiting and it's funded by a charity and initially only available for a year!! So I've been put on waiting list for gynaecology but I won't get an appointment before next spring arghhhh ( my husband is not impressed 🤣🤣🤣).

Any advice would be appreciated...

25 Replies
MichaelJH profile image
MichaelJHHeart Star

OK I know I am a boy 🧒 and not a girl 🧑 but as an amateur cardiogist I would like to make some suggestions. Firstly read this link:

bhf.org.uk/informationsuppo...

and follow up with a call to the BHF nurses.

Madge11 profile image
Madge11 in reply to MichaelJH

Hi Michael

Well I wasn't expecting a reply from a boy 🧑 😉..but thank you. I've read the information and it makes sense...I also rang and spoke to a bhf nurse recently and wasn't particularly helpful 😢...I asked the question about a report that had been published by laclet journal ( not sure if spelt correctly) and it said that women's health and cardiologist advise women who have had a heart attack shouldn't be prescribed hrt. I'm not sure if this just for tablet form or gel aswel,that's what I was trying to find out but the nurse I spoke to didn't know and my gp suggested the referral but there's obviously a long wait list which is understandable. That's why I was asking if anybody knew about the report or experiencing similar problems 😒

Milkfairy profile image
MilkfairyHeart Star in reply to Madge11

Hello Madge11,

It was the Lancet Women and Cardiovascular Disease Commission published in May this year that suggested HRT should not be taken by women who have had a heart attack.

I will have a look for the exact reference.

Also the European Society Of Cardiology guidelines for the management of chronic coronary syndromes suggests that women over 60 do not benefit from taking HRT.

The next issue is the quality of your life which is important. Hopefully by speaking to a Menopause Specialist and Cardiologist you can make an informed choice about which risks are acceptable for you and the various options available.

I agree the answer is difficult to find and it's confusing!

Have you had a look at the British menopause society?

thebms.org.uk/

Milkfairy profile image
MilkfairyHeart Star

This article is written by Prof Angela Maas, she wrote a Woman's Heart and was a co author of the Lancet women and cardiovascular disease Commission report.

academic.oup.com/eurheartj/...

Not to add fuel to the fire, but I am very sure HRT is not advised for menopausal women because it can be a contributing risk factor for developing hormone , estrogen, positive breast cancer, the most common type in older women. This is my understanding but please when you see a gynecologist you could ask about it and get their opinion. I came to know this thru my experience with breast cancer.

Milkfairy profile image
MilkfairyHeart Star in reply to Jack2019

Can you please provide research evidence for your view?

There is unfortunately alot of conflicting evidence about the use of HRT and it's effects on women's overall health.

I also feel that women need accurate evidence based information about what is the best decision for them as individuals.

Some women's quality of life out trumps other risks which need to be quantified with care.

Jack2019 profile image
Jack2019 in reply to Milkfairy

I don't have evidence, what I have is long conversations with my oncologist on things that are contributing risk factors, and HRT was clearly talked about. I trust the oncologist has done his due diligence. I would certainly hope a different oncologist would not have a different opinion. I am not suggesting HRT leads to breast cancer but it is something that may contribute should you find yourself with a diagnosis. Yes quality of life is important. I was sharing my opinion from experience so she can discuss with her medical professional.

Milkfairy profile image
MilkfairyHeart Star in reply to Jack2019

I agree an informed choice is important following a discussion with a healthcare professional.

Here in the UK, the National Institute of Clinical Excellence recommends that HRT should not be prescribed to women with

'Current, past, or suspected breast cancer.Known or suspected oestrogen-dependent cancer.'

I would suggest any women seeks the advice of a menopause specialist for this reason.

The issue for the original poster is that there is conflicting evidence about the possible risks of HRT if you have had a heart attack.

Hi I’ve been told by several health professionals that it’s not a good idea to be on hrt - I’ve had heart attack & bypass. I’m now taking evening primrose oil to try to help- although my symptoms are more irritability than flushes etc. There is a good app called Balance- that my company who are doing lots around menopause suggest. There is a part of that about alternatives to hrt. The health people I have spoken to all say risk outweighs reward for us hearties. Good luck

Hi Madge... My GP adviced me not to go on HRT, as a heart patient it is not good for me as it increases chances of a heart attack. So my advice is avoid going on HRT for your own safety as risks are higher then cure. Try alternatives, like herble remedies from Holland and Barratt.

Hi Madge 11.

I’m so pleased to see your question and the replies on this forum! I had AVR in June 2020 after being diagnosed with severe aortic stenosis completely out of the blue in March of the same year.

I had been taking HRT for about 5 years up until that point and had to stop prior to surgery . I was concerned at the time because I felt that HRT had been directly responsible for improving both my mental and aspects of my physical health.

About six months after surgery , when I was able to speak to a GP or cardiologist, I asked on various occasions if I would be able to resume taking HRT. Like you I’ve been struggling with symptoms . The answer has always been no, but with little research evidence to support this claim. So I’m reading these comments with great interest. It was months after surgery before I started to question if the symptoms i was experiencing were menopause related rather than as a result of surgery .

I’m pleased that I’ve been directed towards available research so I can explore for myself. My experience of asking these questions of the medical profession ( all of whom were male) is that they seem to be relying on older, potentially flawed research to make sweeping generalisations about areas where they do not have the specialist knowledge.

I appreciate that people feel the risk is potentially greater for anyone with an underlying cardiovascular condition. But what evidence is that based on? What are the risks and who is in a position to make that judgement call by balancing up available research? Finding answers to these questions is not easy, but we only have to cast our minds back to the negative impact of flawed research used to take thousands of women off HRT, with consequences for their mental and physical well-being .

Madge 11, and anyone else who’s interested, I’d be keen to follow up on this . Would anyone be interested in exploring this together and pooling our resources?

Clare

jeelpie profile image
jeelpie in reply to CM66

hi I would be interested in doing research, im 52 and have recently had a heart attack, my doctor promptly took me off hrt, im now having terrible symptoms! prior to going on to hrt I did a lot of research and evidence suggests it is good for your heart health etc.. Dr Louise newson is a menopause specialist and I have read her books, also the NICE guidelines are very informative, no one has given me any real detail as to why I can no longer take hrt, according to menopause specialists you can? I'm so confused and need answers backed up with facts, I would love to go back on hrt, but as of this moment I'm scared to x

If you visit a website called Menopause Matters there is a lot of information there. I think there is also a facility to message it’s founder to ask a question for a small fee. There is also a large and active forum with members helping with advice and personal experiences. You might get some help there.

Hi Madge I’m 80 now and because of heart trouble with me and other family members,GP and hospital would never allow me HRT. Had to cope menopause with no help.As was told it can cause heart attacks and strokes. Maybe has changed after all these years.Let’s hope something new has been found now, I would check up on it

Hi Madge

I had a heart attack pre menopause and was told at the time that I should never take HRT. I got by on evening primrose oil and yoga.

Looking back I’m personally glad I didn’t start HRT because it would have to be for life (as I understand it if you stop the menopause symptoms will start again) plus I take enough meds as it is.

JennyRx profile image
JennyRx in reply to Jay777

They don’t give you HRT for life. Now it’s usually a max of 5 years. And, yes, it does delay the symptoms and they can sometimes return after you stop.

Jay777 profile image
Jay777 in reply to JennyRx

Ah ok, I have a couple of friends who have been on it for much longer than that and say they will never stop!

JennyRx profile image
JennyRx in reply to Jay777

Well that’s up to their GP. I’m very glad I never went on it as I was found to have fast growing estrogen dependent breast cancer.

Jay777 profile image
Jay777 in reply to JennyRx

Very sorry to hear that Jenny. As I said above, I was pleased to have had the decision made for me - HRT isn’t for everyone for sure.

Hi, I was diagnosed with heart disease last year and had a stent fitted. Although I didn’t have a heart attack. The cardiac rehab team knew I wanted to start hrt as I’d suffered symptoms. Their opinion was that anything that would help me to have more energy and help me to exercise would outweigh the risks and give me more benefits. I rang the bhf helpline and they said the same. I saw a menopause specialist who is also a consultant gynae privately who sought advise from a Dr on the menopause society committee and they advised him that it would not be a contraindication to starting hrt. There are risks as with many medicines and you and your gp or medical adviser will need to weigh these risks up. I feel really sad and mixed up about this but I chose quality of life and hrt has helped me with this. The idea is to start on the lowest poss dose and i was told patches/gel/sprays are less risk than tablets. I am only 48 and I want to feel as good as poss and for me its a risk Im willing to take but its a very personal choice and may not suit everyone. Do you have a cardac nurse you could speak to for advise?

Hi Madge11. I have been on Hrt since i was 47 now 62. I couldn’t cope with the awful menopausal symptoms. Following my angioplasty and stent procedure last year. It was suggested by my cardiologist that i should think about coming off or changing to gel from tablet form. I changed to the gel which works just the same. I do worry about the risks but quality of life is equally important

Hi Madge, I too was told to stop HRT prior to my bypass and after about a year I asked my GP if I could go back on it because of symptoms. She wrote to my cardiologiest who suggested a very small dose and maybe patches. I didn;t get on with patches and went on a small dose pill. This worked very well for me and my GP was supportive of me getting it. I also have a risk of breast cancer in my family however the benefits do outweigh the risks in my case, everyone is different. I am now off HRT as I wanted to see what would happen if I did stop because as a previous poster has said all it does is delay the menopause. I have been fine, just a few flushes in the morning, but glad I did take it. I suggest you speak to your GP and ask them to write a letter to your cardio consultant. There are so many advancements in the treatment of the menopause now and I hear gel is good too. Menopause matters website is good for information, best of luck x

Hi, would your GP be able to liaise with other professionals (multi disciplinary) to find answers for you? Everything I've read from the articles posted here seem to point to transdermal HRT being ok, but none of them mention if this is the case if you've had a heart attack.

I hope you find answers, no one understands how debilitating menopause symptoms can be unless they've experienced them.

Hi Madge,

I’m sorry to hear about your heart attack and double bypass. I hope you are recovering well regardless of the menopause symptoms?

I have hypertrophic cardiomyopathy with an icd on board. I went through an early menopause at 36 and had such debilitating symptoms I had to take hrt. I’ve now taken it for nearly 10 years, but all bio identical and transdermal. Patches for oestrogen and pessaries for progesterone. As I am still only 47 the doctors and hormone specialists insist I stay on it until at least 50 but I have been told I can stay on it as long as I feel I want to after 50.

I have learnt quite a bit about hormones over the years after seeing countless docs (private and NHS!) and reading many books, but like you I am still confused as to heart health and hrt? My cardiologist has never ever had a problem with it and the specialists I’ve seen say I am better to stay on it - I think if there were enormous risks then I would have hoped they would let me know?! Who knows? I certainly feel better on hrt, I sleep, my skin looks pretty line free, and I have more energy.

Would it be possible for you to pay for a private consultation to get the ball rolling? I’d definitely explore the options rather than going through months of symptoms. It’s tricky as I don’t know what your symptoms are, but you do have to weigh up quality of life like some of the past posts say - I find it nearly impossible to sleep without hrt so it’s easy to see that not sleeping is going to take me down more quickly than an unproven hrt/heart related issue so for now I stick with it.

I have to be honest, it has not been an easy journey the 10 years I’ve been on hrt. Hrt in itself is not without problems but keep an open mind and get the right advice, you will work out what way is best to go for you personally at this stage in your life. Everybody has a different menopause, some people sail through it, some people take herbal remedies and meditate but for me the only thing that worked was hrt.

Good luck with it all. 😊

Emma

I was on HRT for a year over twenty years ago but fortunately had massive migraines with aura so was immediately taken off them. In those days doctor’s were telling women they were a must and we would feel so much better on them. All I felt was extra weight and I was so pleased to be off them. The side effects of being off them do not last long and I have enjoyed a good active life without them. I really think I would have had a stroke if I had continued taking them and maybe a heart attack much sooner

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