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Should I still start HRT
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An_257316 posted:
Having turned 50 - I hadn't seen a period in over six months so I took my symptoms list to my GP and after discussion it was decided I start HRT. Since that consultation and before having started the HRT I saw a period (probably first in 6/7 months)

So my question is , Is it still right to start the HRT or do I now wait as I'm clearly not in the menopause as I thought I was?
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georgiagail responded:
Since you are not yet in menopause there is no need to start hormone replacement therapy.


Gail
 
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Mary Jane Minkin, MD responded:
Dear An_257316,
Ovarian function during perimenopause is quite variable. Sounds like your ovaries did something ( you had a period!)-are your symptoms better at the moment? If you are feeling fine, great-then no need to take anything, If you are still having considerable symptoms, one option would be to take a low dose birth control pill, as long as you are a good pill candidate (in good health and a non smoker)-Birth control pills can control erratic bleeding and other symptoms as well.
Good luck,
Mary Jane
 
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notepad replied to Mary Jane Minkin, MD's response:
To be honest the symptoms went during my period but as that lessened so they returned with avengence.

To be honest I'm scared to start hrt because of the increase in breast cancer (as suggested by my gp) as all of my older female relations have had breast cancer I'm now scared to increase my chances, as a result I'm left feeling quite vulnerable , with no advice or support. My husband says that I can't take hrt as to increase my chances (family history) is selfish, but I feel so rough all of the time that the respite given to me by this random period was a godsend.

I'm so lst
 
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Mary Jane Minkin, MD replied to notepad's response:
Dear notepad,
So let's get the exact numbers for your husband! Unfortunately, family history does increase chances of being diagnosed with breast cancer, but the main increase is from 1st degree relatives (mother, sister, daughter)-and it sounds like your family history is a bit more distant. After 5 years of full dose estrogen therapy (Prempro 0.625/2.5 mg) there was a slight increased risk in being diagnosed with breast cancer; the baseline group was diagnosed in 30/10,000 women per year; the Prempro group had 38/10,000 women per year, or an increased risk of 8/10,000 women per year-this was on full dose prempro, after 5 years of treatment. You would probably be given a lower dose; and you probably won't need therapy for 5 years. (and a family history does not increase that increased risk from therapy-it increases the baseline risk). So if you need intervention, don't be afraid to think about estrogen. If you haven't tried over the counter therapies like black cohosh and soy products (something like Icool)-you might want to give them a go.
Good luck,
Mary Jane
 
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notepad replied to Mary Jane Minkin, MD's response:
Thank you so much for your reply, it makes such a difference to know someone is listening and understands where I'm coming from as I'm so confused. Re: history - its hit my mother, sister, aunt, grandmother all on my mothers side. My husbands position is entrenched and as such it is causing a lot of grief which on top of the symptoms have made me somewhat emotional which doesn't help. I appreciate he's position, he's scared - but so am I, I have guilt because he tells me that if I do get it then I've got to face my children and tell them it's my fault, I brought it on myself. I'm soldiering on but the hot sweats, confusion, bloated feeling, extreme fatigue, headaches, cramps etc is running me into the ground, he sees this and tells me I look rough but I can't see a way round it. over the counter stuff is also a non starter as he doesn't agree with "crack-pot, homemade" remedies as he puts it " you don't know what they can do to you, they aren't regulated etc etc etc it's doing my head in to be honest . I understand and respect that he wants what's best for me but I'm imploding.
 
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Mary Jane Minkin, MD replied to notepad's response:
Dear notepad,
If indeed your mother, sister,aunt and grandmother have been diagnosed with breast cancer, most importantly you should have BRCA testing; I think any genetic counselor would recommend that-and then your followup would certainly be different, depending on what was found. Your health care provider certainly can hook you up with a genetics tester. You can reassure your husband that there is plenty of literature on Remifemin; it is regulated in Germany. There is also some literature on Icool. I hope they help you.
Would your husband let you think about birth control pills? They would be likely to help you as well-
Good luck,
Mary Jane
 
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notepad replied to Mary Jane Minkin, MD's response:
Hi, I've never been offered testing, it's never been mentioned.

At this moment in time I don't know which way is up to be honest. Since going to the gp I've now had another period and to say it was extremely heavy is an understatement. Its made me dizzy, lightheaded when standing and physically sick - never have I experienced one so heavy or for so long all I want to do now is sleep I have no energy at all and it's showing no signs of lessening. Is this normal? Is this how it goes??
 
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Mary Jane Minkin, MD replied to notepad's response:
Dear notepad,
Given your issues, you might want to visit with a gynecologist who has some experience dealing with perimenopausal issues. You really do sound like an excellent candidate for a low dose birth control pill; it would likely help control your bleeding and your other symptoms. And a gynecologist would be able to help advise you on BRCA testing.
Good luck,
Mary Jane


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