Hi
I am on prednisolone for PMR. I have also been on HRT for several years. I recently made the decision to reduce and come off HRT but now I am not so sure as steroids can cause osteoporosis but HRT can maintain bone health. I can’t find any research or robust articles on the pros and cons of staying on/coming off HRT whilst taking steroids. Is anyone able to share insights%/articles on this subject please?
If this helps, this is my experience.
I have been on HRT for 50 (yes I was 32 and now am 83) years. I had GCA (in remission) took the HRT all the time and still do.
Dexa scan after six months on Pred then every two years. Bones 97% first scan and when GCA went into remission still 97%.
The HRT I take is Premarin.
Hi jinasc, I believe yours is an oestrogen only HRT (only suitable for those who’ve had a hysterectomy I believe) which is thought to have less risks than combined oestrogen and progesterone. I was on the combined version for about 10 years until age 59 or 60. Unfortunately I developed a small breast cancer lump, discovered at age 64. My lump was oestrogen positive although I believe the majority are. I have no way of knowing whether HRT contributed in my case. Sorry can’t advise re use of HRT and pred.
pubmed.ncbi.nlm.nih.gov/794...
cedars-sinai.org/health-lib...
hormone.org/your-health-and...
all mention the use of HRT - and the main concern appears to be the use of HRT in older women and the risks believed to be associated with that, which, after all, are the reasons we consider stopping HRT in the first place. I have found that the good bone density I assume was due to years of use of HRT has been maintained despite being on pred for 11+ years at the last dexascan.
Can't quite match jinasc's record, but I have been on HRT for 40 years (Estraderm patches) and fully intend to continue.... for ever! One or two GPs over the years have thought I should stop and I have tried, but the hot flushes, night sweats, moodiness come back in spades, so with the blessing of my current GP I carry on. However, it has not prevented me from developing moderate osteoporosis, but who knows, the osteoporosis might be more acute without it, and I would definitely be a less happy person. That is my experience.
Hi CharmollieI have no research articles only personal experience/insight.
I have been on HRT for 2 1/2 years - I use oestrogen patches which I wear all the time and take progesterone 25 days out of 28. I was diagnosed with polymyalgic onset rheumatoid arthritis in February and have been taking prednisolone since then; I have also been taking methotrexate for about 7 or 8 weeks.
I have absolutely no intention of stopping HRT either now or at any point in the future; my life without it is horrendous and current research suggests that it is safe to continue HRT long-term whereas it used to be thought that it should be used for no more than 5 years.
I recently had a dexa bone density scan as part of the treatment and monitoring of my PMR/RA. I was extremely lucky to have good bones - the density is better than would normally be expected in a woman of my age (53). It is likely that this is a result of many years of long walks, running and aerobics and that the use of HRT has helped me to maintain my bone density however, this would not be a reason for me to continue taking HRT. My decision is based solely on my quality of life without it.
No doubt others will be along to share their thoughts and experiences.
I have been taking HRT patches for about 30years. I was attempting to reduce when I developed PMR. I have refused to come off them entirely, much to the frustration of my previous GP because I am trying to keep everything stable while I am reducing pred. I think if you reduce two things at the same time it is very difficult to see where symptoms are emanating from. Over the years I have had my patch changed from a combined one to an oestrogen only one, as I got older. 💐
What can I expect when reducing steroids? 
When steroids worsen depression?
Timing of taking steroids when traveling through time zones
When to start decreasing steroids
How do you know when you are ready to come off steroids completely?
