I came off HRT at the signs of my heart attack (as the leaflet said to stop with chest pains) and was since told by cardiology team that HRT wasn't the cause, I was just one of the unlucky ones at 49 years old. It has been 8 months since my mild heart attack with one stent fitted and I'm doing OK. I now feel ready, I can feel my old menopausal symptoms returning and would like to go back on HRT, cardiology team are OK with this and have referred me back to GP for the same. However, I don't have much faith in the GP who has said she'll give me a little, her words! (25mg) when I came off it I was on (75mg). 25mg isn't going to be of any help as I am now further into the menopause than before. Has anyone had a heart attack and gone on to HRT?
HRT after heart attack: I came off HRT... - British Heart Fou...
HRT after heart attack
Hello Duvetdays15
There is so much conflicting advice about HRT and heart disease!
My understanding is that the recommendation is that if you do decide to take HRT it should not be for along time and with lower dose, patches and gels.
HRT doesn't prevent heart attacks or heart disease as such.
The Lancet Women and Cardiovascular Disease Commission Report published last year, (the 17 authors all Women Cardiologists )suggests that HRT is not advised if you've had a heart attack.
HRT is not recommended if you are 60 years old and over.
Quality of life is so important and hopefully your GP will make a shared decision with you.
It's for you to decide if the increased risks are acceptable to you.
Has your Cardiologist put in writing their advice?
Perhaps ask to be referred to a menopause specialist?
Here's a link to a previous discussion we had about HRT.
healthunlocked.com/bhf/post...
I hope you are able to access the treatment that is best for you as an individual.
Thanks for the info. Yes it's on my discharge papers about hrt and they are happy for me to be referred back to GP for it. GP isn't much help even with the heart meds they seem to be guessing, worryingly.
Can you see a different GP?
Perhaps ask for a referral to a menopause specialist or a Cardiologist who has an understanding of women and heart disease?
I've enquired about different GP at surgery. I was told by reception that 2 were "quite good" with these things! I am being referred locally to cardiology but who knows how long that will take! I'm considering going private for menopause.
It's not great having to fight to access the care you need.
Perhaps go and see the other GPs and see of they can help while you are waiting for your referral.
Hi yes I’ve had 2 cardiac events which they think have been heart attacks. I’m currently under investigations and about to take part in a medical trial for stable angina. I started HRT about a month ago. My GP has not suggested I reduce the amount of HRT meds and the cardiologist seems happy for me to continue what I am currently using. So far I would say my angina has been a bit more regular but I’ve also been under more stress and of course finding out I have blocked arteries and need further tests and a stent has not helped the stress, especially at the grand age of almost 50! I say go for it if HRT helped before you should definitely try again, I found my symptoms quite awful and the HRT seems to have alleviated some.
Hello sickandsore,
Would you be willing to share the name of the trial you are taking part in?
I live with angina and I am always interested in any research into the condition.
It is such a hard decision, the menopause is hard enough without cardio issues too. I had a HA last year 4 weeks after starting HRT gel, no idea if there is a connection but personally prefer not to risk it again. I found cutting out sugar massively reduced my menopause symptoms, no more night sweats etcGood luck with your journey x
Did you stop the gel at the point of heart attack? Did you ask cardiology team about it? I am worried about going back on it even though cardiology team said it wasn't the cause I wish my GP was more knowledgeable I don't have much faith in them which doesn't help.
Yes I did stop it straight after, although cardiology said it would be fine to continue
I believe that estrogen keeps your arteries young and flexible. That famous 2000 or 2002 Women's Health Initiate study has been so detrimental to the beliefs around HRT. I have heard that a lot of the results were wrong, but were published anyway. And somehow the negatives have persisted. GPs have not kept up with the latest research either. I honestly find a lot of GP are pretty bad at keeping up to date with newest findings.
My GP isn't knowledgeable at all on hrt, there is no one at the surgery who specialises in it. I am thinking of paying privately but can't afford it but need correct advice in this instance.
Just put of interest are you a woman with a lived experience of the menopause?
Have you got any recent research evidence to support your view that oestrogen 'keeps your arteries young and flexible.' ?
Unfortunately the menopause and heart disease is a complex issue and women are poorly served by Cardiologists, GPs and others regarding the benefits and risks of taking HRT.
What we need is upto date unbiased evidence based advice.
Yes to question one. I also have a medical science degree and so I have done quite extensive research on it and I can understand quite complex studies. I was just obviously paraphrasing and simplifying by saying estrogen keeps your arteries "young and flexible" but there are numerous studies on the effects of estrogen on human tissue.
Could you provide some studies please?
The Lancet Women and Cardiovascular Disease Commission Report published in 2021, does not recommend women should be prescribed HRT to prevent heart disease.
I can't at the moment. I am very busy, but I could at the weekend.
Excellent, I look forward to the information.
Would also be willing to share with the forum members a little bit about the heart condition you are living with?
It will help give context to your comments.
pubmed.ncbi.nlm.nih.gov/338...
ncbi.nlm.nih.gov/pmc/articl....
pubmed.ncbi.nlm.nih.gov/315...
pubmed.ncbi.nlm.nih.gov/241...
sciencedirect.com/science/a...
mdpi.com/1422-0067/21/12/43...
Thank you for taking the time to find and send these articles.
Had a GP who wouldn’t give my wife HRT because another patient’s family were sueing her after a stroke.
I believe if I'd been offered hrt 6 years ago when I was first told I was perimenopausal I wouldn't be in the position I am now. Although it may not have stopped a heart attack happening I would have been in a better place than 6 years of being treated for various ailments, having unnecessary treatments, which looking back now was the menopause and yet no one picked up on it.
I took HRT twenty eight years ago and developed really bad migraines with aura and was taken off them straight away I think for fear I might have a stroke. However looking back after I got over the hot sweats and emotional swings I actually felt good and went back to college and took some exams. If you can’t take HRT it’s not all bad once you go through the storm because it doesn’t last
I'm thinking of the long term benefits as well as it helping me now.
My GP says no to HRT as I wasn't on it before my HA at the age of 48.
I'm luck to work for a surgical robot company who's head is a gynaecologist and he brought in a specialist menopause dr to for a talk and I asked the question. Both the specialist and the head of my company laughed at this decision as "they wouldn't remove your ovaries if you had a HA at 30". I now waiting for a referral to the clinic run by the specialist who gave the talk!
Seems GP's need a lot more training on the matter. Mine certainly does! Good luck.
Hi Duvetdays15 I had a heart attack in January and was fitted with a stent, sadly got moderate damage though. I’m 49 and had a stressful few years. My health issues started back in august when I got bit by a tick & ended up with lymes disease. At the same time my periods just vanished. September and October had terrible hot flashes but still not sure if that was lymes or menopause 🤷🏻♀️ Then in October started struggling with hills. Back n forwards to doctors but ended up with heart attack in January. Within days my periods returned and have been regular ever since. I do worry about them stopping again as I felt horrendous. I’ve asked to go on HRT but they say it’s too soon. So I’ve been controlling it through diet n Plenty of walking. I try to stay away from processed food and sugars. I’ve read flax seed & soya are good for perimenopause symptoms. Dr Nitu Bajekal is great to follow on Instagram. Since HA I’ve lost 1& a half stone & feel much better. Sorry I can’t answer your question about HRT but feel for you it’s a horrible time.
Here's the latest advice from NICE, (National Institute for Clinical Excellence ) updated 2019, regarding HRT.
I am not sure it really helps though!
"Heart disease and stroke (cardiovascular disease)
Studies show that:
If you start HRT before you're 60 it does not increase your risk of cardiovascular disease.
HRT does not affect your risk of dying from cardiovascular disease.
HRT tablets (but not patches or gels) slightly raise the risk of stroke. However, it is important to remember that the risk of stroke in women under 60 is very low.
If you're already at higher risk of cardiovascular disease it may still be possible for you to take HRT but it will depend on your individual circumstances. Your GP can give you more information."
Hi I have been on HRT for 32 years I am now 72. I had a hysterectomy age 40 and immediately went into the menopause. About 7 years ago when there were some scares regarding HRT my GP wanted me off it. She referred me to a menopause clinic where I was seen by a very good understanding Consultant. We agreed I would try to reduce it and finally stop it. I did try but all my symptoms came back and I decided regardless of the risks I would continue to take it.
I was diagnosed with Angina over 20 years ago and recently had a further exacerbation of my symptoms, I had an angiogram earlier this year. I have some narrowing but didn’t require a stent-yet.I was also diagnosed with microvascular dysfunction.
I was put onto new medications including Clopidogrel and Isosorbide.
I have been on medication for high blood pressure for over 40 years.
Since worsening of my cardiac symptoms last year no one has mentioned me stopping HRT, I intend taking this until the day I die as I believe quality of life is preferable to quantity of life!
I hope everything works out for you. Good luck.
I'm now 74 and had a hysterectomy at 40 like you. I was only allowed HRT for 10 years. WhenI came off it I had no menopause symptoms at all but I am now suffering really badly from the lack of hormones; skin, joints etc and would dearly love to go back on some form of HRT but I doubt it would now be allowed at my age and post heart attack. It it worth asking do you think?
Hi Qualipop I don’t see the harm in you asking your GP all they can do is say no or yes. If the former they could explain why. I take oestrogen only but also use vaginal tablets Estradiol twice a week. However unlike you I haven’t had a heart attack so perhaps that would affect their decision as to whether it would be advisable to let you have HRT or not.
Good luck I hope you get some kind of help. This getting old is like a magical mystery tour we don’t know what each day will bring. x
Well I am a bit concerned that women can just pick up HRT at a pharmacy. I’m so glad I was monitored at that time (aged 50) by two really good doctors who took me off HRT straight away because I was having incredible migraines with auras and could have had a stroke.
You can't get hrt from a pharmacy. It has to be prescribed by a GP who at the time will take your BP, weight and height and go through the risk guidelines with you.
Sorry that news seems to be wrong then
Ah yes, there is a lot of conflicting evidence about being on HRT. Personally speaking and this of course isn’t a recommendation, just my personal experience - I am now 70, had an AVR 3 years ago, during which time the hospital took me off my HRT - well oestrogen - I was on 75mg patches. I went back on it, with my surgeon’s blessing, 6 weeks later. I’d also say I started on patches (I had a hysterectomy some years ago) when I was 50 and have been on them continuously, apart from my AVR, since. Wouldn’t want to live without them! My female gynaecologist tells me I can come off them when I’m 92 😁😁 Now I don’t want to sound blasé about these big decisions, I’m just sharing my personal story. Good luck. Sue x 🙏
Ive been on HRT since I was 47, I am now 63. I still work full time and intend to stay on it at least until I retire or beyond. I was diagnosed in Aug 2020 with coronary artery disease out of the blue following chest pains whilst running, angioplasty and one stent early Sep 2020, on all the usual medications, cardiologist suggested at the time that I think about coming off it but I instead decided to switch to the Gel instead of tablet form. Think we all have to just weigh up the risks v quality of life. Good luck
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