Hormone therapy with endometriosis

[Bowbenji]

Hi,I was hoping for some help regarding hrt. My doctors have put me on oestrogen and utrogestan 100mg but the warnings on the side effects states special care if have endometriosis. Obviously endo feds from estrogen and progestogen. I'm a bit stuck on the right thing to do. My doctor does know my history of endo. Any suggestions greatly appreciated xx

[Lindle]

That's interesting - I hadn't seen that warning for utrogestan before (just spotted it on the leaflet). It is well recognised that oestrogen-only isn't recommended as it is unopposed oestradiol that drives the inflammatory process. But that occurs within endo cells themselves without regard to circulating levels and it's not really clear how oestrogen HRT affects the process although it is associated with a small risk of recurrence and malignancy.

Then again combined HRT has its risks too but on balance the ESHRE guideline recommends the latter. Your age comes into play as well since clearly all the sort of risks involved - breast cancer, coronary heart disease, stroke etc - increase with age itself, so it is a case of weighing up all the risks against how unmanageable your symptoms are.

I'm not sure anyone on here can really give any suggestions. I run an endo group and actually we've stopped discussions on HRT as it is so dependent on the individual and really only they can weigh up the risks. The (full) ESHRE guideline has quite an extensive section now on menopause and HRT which might help:

eshre.eu/Guidelines-and-Leg...

[TealBananaPeel]

hi,

I have Endometriosis and Adenomyosis and I’m on HRT.

There is info on @themenocharity themenopausecharity.org/ about endo and hrt.

Also the @balancemenopause app balance-menopause.com/balan...

And Dr Louise Newson @menopause_doctor instagram.com/menopause_doc... has a podcast episode where she spoke to an expert endo specialist who is expert about managing HRT and endo…

This is Spotify but on any platform open.spotify.com/show/7dCct...

The episode about endometriosis and HRT is no 88 - open.spotify.com/episode/7s...

I’m on HRT and they gave me continuous progesterone (Even though perimenopausal so still getting periods) to try and control the endo and stop me having periods however I was bleeding all the time (I have Adenomyosis too so perhaps why) so went back to having progesterone 3 weeks then 1 week off, it has settled the bleeding down a bit but most times I think they gust give it you continually (the progesterone) when you have Endo.

I think -(I haven’t listened to it recently so check) the difference with Endo and HRT is that usually once periods completely stop they don’t necessarily bother with the progesterone part anymore but for endo they keep giving you Progesterone.

Here’s the Endometriosis and HRT fact sheet from the Balance Menopause App website (it’s also on the balance app) - balance-menopause.com/menop...