New to HRT-which treatment ???

[Cecy69]

Hi - I have an under active thyroid and taking medication . There are so many different types of HRT how does a GP decide on treatment ? Could two different GPs suggest different treatments or is there a straight forward way of deciding on HRT ? Thanks all 😀

[SarahJane1471]

Look up the balance-app by Dr Louise Newsom, this will explain everything x

[Cecy69 in reply to SarahJane1471]

Hi The Balance app is where I started - it reviews all the different HRT options which is great but how do I figure out which one I would be prescribed ?

[SarahJane1471 in reply to Cecy69]

You ask/tell your GP which one you want 🤷‍♀️. They all know that women are advocating for themselves now. So pick which you want and go get it 👍.If you have no uterus then estrogen only as gel/patch/spray. If you still have a uterus then you will need to add progesterone which is usually taken as the tablet. But there is a combination patch as well.

All are now body identical and safe in fact it is now realised there are health benefits to HRT

[radd]

Cecy69,

Welcome to our forum,

You take whichever HRT replaces your missing hormones, either single or combined therapy which come in tablet form, skin patches, gel, implants or pessaries .

There are different cycling methods depending on menopausal symptoms, periods and doctors advice. For instance many dose continuously when post-menopausal but my endo tells me to dose progesterone 25 days out of 28 so I still have a bleed to reduce cancer risk.

The safest are the 'body identical' as are a closer match to our own. Estrogel (oestrogen gel) + Ustrogesteron (progesterone capsule) are commonly favoured. Some prefer an oestrogen spray as it dries quicker than the gel but my GP said it was more expensive so only prescribes when the gel isn't available (there has been a national shortage).

[Legoparis]

I agree with these comments and only add my experience of HRT as an example

I have hashimotos and take 125 Levo also gluten free and started on bio identical hormone patches (combination) for 2years aged 52 after severe symptoms -they worked but I found using them a real pfaff I was then given trial of vaginal gel and didn’t find that practical so then tried pills ( Femeston Conti calendar pack) I’m now 65 and still use them in fact dread the day I have to come off -I am around 1stone heavier than when 21 and can live with that

I don’t have any heart or blood pressure issues so GP ok

Expect to chop and change a bit at first and keep a record of symptoms as can be subjective depending on day of month -best of luck

[CoeliacMum1]

If you fill in the symptoms bit on the app (balance) and then read which hrt you’d prefer to have, take that information to the GP, they will then go on your history and sometimes family history for certain things to see if there’s one thing that would suit you better or to start you on a lower dose if needs must.They usually need to look at taking your Blood Pressure to check you out… general things like weight too but shouldn’t stop you being prescribed it.

There’s very few people that can’t take it because of other health things, and usually there are some ways around it with products, specifically to work for you if the run of the mill way is out the question.

Oestrogel (Oestrogen in the form of estradiol) and other topical oestrogen formulas and utrogestan (micronised progesterone) tablet is safest option and depending on your cycle or predicament you will start cyclically (break off from taking progesterone to bleed) or continuous depending on your circumstances … Ironically my GP stuck me on continuous but since I’ve had to go cyclically, even though at 56 I’m still perimenopausal.

Usually you’re put on a trial and have a review of things after 3months it can take a while to settle and get the dosage right for you.

If had hysterectomy depending on what type of surgery, you might be offered different combinations of hrt to some, as progesterone is used to keep the lining of the uterus lining thin and healthy.

This Endometrial lining can get too thick without progesterone and is why it’s offered as micronised natural/bio-identical progesterone (safer choice than synthetic progestins) or offered to consider a Mirena coil, depending on your needs.

[Cecy69]

Girls - you are all amazing ! Thank you all so much for responding . Lots of food for thought . Not sure if I am more confused but think I will go back to the Balance app . Then it seems it’s trial and error . Will the GP do bloods to work out which hormone replacement I need ?

[SarahJane1471 in reply to Cecy69]

No. They diagnose with symptoms. If you have a uterus you will be given estrogen and progesterone.