I'd like to come off HRT. What should I do?

Do previous problems with the Pill rule out HRT?

Hot flushes

Night and day sweats after coming off HRT

Question

I had a hysterectomy a few years ago. I was given HRT patches, but because I have sensitive skin they did not work.

I then went onto Premarin 1.25mg, which I have taken ever since, but it has made my migraines worse.

I now wish to come off HRT. What do you recommend?

Answer

Some people do seem to be particularly sensitive to HRT patches. It is worth knowing that the original reservoir patches contained alcohol that irritated some women's skin. These have been superceded to some extent by the more modern matrix patches. These contain an adhesive that is less irritating, although it can still produce an allergy in an unfortunate few.

Presuming that you have tried these matrix patches on a clean and dry area of the skin, preferably the upper buttock, then HRT tablets would be the next alternative.

You mention that you are taking the tablets as well as Aerodiol nasal spray, which allows you to top up your oestrogen level according to the symptoms you get. Unfortunately this has made your migraines worse, which sometimes happens in susceptible people.

There are a number of things that may be helpful. If the Premarin and Aerodiol are controlling the hot flushes and other menopausal symptoms, you might like to talk to your doctor about taking propranolol as well as your HRT.

Propranolol is an excellent preventative treatment for migraine and can also reduce hot flushes. You would need to take this tablet on a daily basis, however, because some people do experience some lethargy when taking it.

You may not wish to take three different medications simultaneously and there are alternatives to HRT. The Amarant Trust offer excellent independent opinions regarding the treatment of the menopause and all its symptoms. You might like to contact them if you want further information.

Helpful nutritional supplements include vitamin E, evening primrose oil, magnesium and ginseng. Try Clary sage, geranium and lemon aromatherapy too. Herbal infusions of sage can help.

Also, try to keep your temperature down. Use a desktop fan or small battery-operated fan that you can carry in your handbag, and use a water spray as well.

Wear several layers of thin clothing so you can shed layers easily without stress and embarrassment. Cut down on hot drinks, especially those containing caffeine, and cut down on alcohol too - this is a potent cause of hot flushes.

Finally, increase your intake of phytoestrogens, which are oestrogens derived from plants. Excellent sources are red clover supplements, linseeds, lentils and other pulses, soya products and seeds.

Yours sincerely

The Medical Team

<<Back



The documents contained in this web site are presented for information purposes only. The material is in no way intended to replace professional medical care or attention by a qualified practitioner. The materials in this web site cannot and should not be used as a basis for diagnosis or choice of treatment. Conditions for use



© Copyright 1998 - 2004 NetDoctor.co.uk - All rights reserved