Mar
19
Let’s talk about HRT, baby, let’s talk about you and me ♬
I decided to try HRT again, specifically the estrogen patch. I have tried the patch before, not for any great length of time, and stopped doing so because it seemed like it was linked to an ongoing very unpleasant headache. I remember initially thinking the headache was caused by [insert random possibility] and tried all sorts of things like drinking more water, stopping Advil in case it was rebound headaches, etc, then finally concluding it was the patch, which I peeled off while mucking out Little Joe’s stall and dramatically hurled into a pile of manure.
WAS it the patch? I guess I will find out, with round two.
I wasn’t sure I was noticing any benefits to speak of, aside from an ummmm renewal of the ladygarden areas, which I have since addressed with a topical cream. (The cream works gangbusters, by the way.) But I wasn’t really having any dramatic hormonal symptoms to address, either.
I kinda figured I was all done with any hormone buffoonery — I’m 52, and it’s been well over a year since any kind of evident cycle. But did you know that being officially in menopause does NOT mean the bullshit party is over?? Even after years of perimenopause??? I did not know this and I would like to speak with the manager of women’s health because come the fuck on.
So anyway, I’ve been having the worst night sweats lately. Have you seen that terrific video of the Scottish mom lighting up her kids because they didn’t flush? DISGUSTEN!!! That’s how it feels to keep waking up in a clammy, slimy wet mess of damp sheets and slippery skin: disgusten.
Of course night sweats could be caused by something more dire that has yet to reveal itself, I love a good opportunity for some catastrophic/it’s-a-zebra-not-a-horse thinking! But it’s more likely that it’s hormonal fluctuations, especially for how I can feel perfectly temperate one moment and raging with heat the next.
If we’re going to be living in the worst of timelines, at least this one has telehealth options. It is very easy, if not inexpensive, to order HRT without having to deal with begging a doctor for a prescription. (Ditto bupropion and retinol.) I have some patches on their way to me now, and barring any repeat headaches, I plan to give them a longer shot this time. Not only would I love to get through the night without self-immolating but I am quite hopeful for some of the other touted benefits like thicker hair.
I really went back and forth and back and forth about HRT initially. It’s like, do I want to monkey with a normal, natural process that my body is going through? On the other hand, what if that normal natural process just plain sucks and is directly linked to negative outcomes like bone loss, risk of heart disease, body composition changes (I was already an apple shape, sob), and whack mental health?
It’s all so fraught and of course made more complicated by a patriarchal medical system that did shitty inaccurate HRT research years ago and then just like … never updated any recommendations after that?? It feels like an area of women’s life that is just archaic in terms of treatment and open discussion. “Whoah there little lady sounds like you’ve got a case of the Mondays. Have you tried smiling?”
Anyway, I got the meds from Winona. I also use Hers for retinol and generic Wellbutrin and Minoxidil (that last one has produced very few noticeable benefits but I keep hoping).
Anyone out there with a good HRT experience to share? I guess I’d rather not hear about the terrible no-good very bad experiences.
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I do not have any experience of HRT, but I do have a box of HRT spray in my china cupboard that I eye with apprehension every time I fetch a plate. Should I? Shouldn’t I? I talked to a friend who’s a gynaecologist and he wasn’t negative but also not like super duper positive and how am I supposed to decide things like these by myself? I’m not even a grown up! (I am apparently 50 years old but hey. Grown up-ness must be a mental state that I do not feel like I exist in.) Sorry for the novel! I could have just said ”no”.
Oh this could not be better-timed. I have recently for various reasons decided I MUST look into HRT, but I am so completely overwhelmed; and the main reason I am overwhelmed is that my primary doctor still believes in that old debunked study, and my OB/GYN practice will only let me see the nurse-midwives, who ask if I have tried St. John’s Wort and yoga and, like, licorice root or something. So I have been wondering who, WHO, to try to see—and of course bracing for the mess about whether insurance will cover it, or whether they’ll say they’ll cover it but then I’ll get a bill anyway and have to deal with it. And of course I might find someone, and my insurance will cover it, and it’ll turn out THEY TOO believe the debunked study!!! It’s all been so much on my mind, it felt almost eerie to see the title of your post!
Find a different doctor. Seriously. Educated practitioners can be found through https://menopause.org/
I went to Midi health (joinmidi.com) and did it all online. It was great!
When I was first prescribed the patch I too had headaches. Turns out all I needed was a smaller dose. And now I can sleep through the night again!
Yes! And, give it a good solid month if you see side effects to let them dissipate. My nausea was so terrible in the beginning, bringing me straight back to early pregnancy 😫 But…. Night heat waves/flushes were gone! Except… with the shortage my patch brand was changed and they came back!! So, you may need to try a different brand if you don’t get relief either. The bottom line for me, was I did experience relief and then I didn’t and then I sort of did…
Naomi Watts wrote about how life-changing HRT was in her memoir – and I was just chatting about it with my GYN. I’m earlier in the process than you – approaching perimenopause, and on birth control so effectively on HRT til I’m 50… But from what I remember my mom going through, if my doctor says it’s ok to do something to minimize my symptoms then DANG that’s what I’m doing.
I’m 48 and deep in the perimenopause trenches. I still have my cycle, but sometimes it’s twice a month, sometimes it’s delayed by two weeks–the guessing is so much fun! I also had weird itchiness in my feet, severe PMS, temperature disregulation (though not night sweats yet), lack of sleep, etc. When I asked my primary doc about all this, she surprised me by reciting all the old beliefs surrounding HRT. Luckily, she also said I needed to speak to a gyno about it, because it tuns out the gyno had read all the updated info about it and couldn’t WAIT to get me on the patch.
II’ve been on the lowest dose of estrogen via a patch since December 2025, which I use in conjunction with a nightly progesterone pill. The first three months had me experiencing some annoying symptoms like random bouts of nausea, some extreme bloating, some acne, and very irregular periods. BUT! It also cured my sleeplessness on DAY ONE. That progesterone pill is the best invention since air conditioning. The only negative symptom I still have is that my mouth waters excessively, but that’s more of a curiosity than an annoyance.
I change my patch out every Wednesday, so Tuesday nights tend to be my worst nights for sleep. I haven’t noticed my hair getting any thicker, but I don’t seem to be getting hot for no reason anymore, I’m not itchy and this month’s period came right when it was supposed to (but don’t know how long that part will last).
I am now an HRT proselytizer! Give me all the patches!
Literally the best thing I’ve ever done. Life changing – mood, energy, night sweats/hot flashes, hair loss, etc. all better / regulated now that I’ve been on the patch. i’ve upped my dose, mostly because the first 4-5 months of low dose did nothing until I basically called my doctor sobbing to fix it already, which she promptly did. 2 years later and I feel better than I have in years. Likely, the main thing it probably fixed was my energy, or lack thereof, which then unlocked things like, working out regularly again, sleeping, etc. all of which have downstream effects. I count myself super lucky to have an OBGYN/NP who is only slightly younger than myself, a woman, and understands.
HRT is amazing, I’ve been on it for 9 years and I’m not looking forward to stopping it. Helps me with the night sweats, hot flashes, memory issues, weight gain, mood fluctuations, and a list of other symptoms I don’t even like to talk about. Also, the topical cream comes in pill form that I found to be much more convenient.
Why would you have to stop?
Thank you for posting! 45 yo here, been on the lowest dose of patch for about a month. I haven’t had side effects, but also no relief as of yet for the night sweats. They are the most horrendous symptom….I am a person who detests being wet, ever! Waking up that way multiple times a night is SUCH a bummer and god knows we don’t need another reason to increase
the laundry loads. Please report back, these discussions are the only thing that keep me feeling sane about it all.
My Dr reassessed after each month/dose change until finally I went in highest dose twice weekly and found comprehensive relief. Hang in there! And suggest a dose increase :)
I love my patches. I get so excited about changing to a new one every Sunday. I’m almost 63 and have been on some form of HRT starting in my mid fifties. I started for classic symptoms, hot flashes being the worst. Then about four or five years ago I had to switch doctors and briefly saw a very old school woman who basically said I’d die of a blood clot if I didn’t get off the hormones. She scared the piss out of me so I went off the patch and was fucking miserable. Constant hot flashes, no sleep, the skin all around my lady parts cracked and itched constantly. I finally saw a GYN who specializes in menopause and she said WTF and slapped those patches back on pronto. In fact, she talked about new research that shows if you start HRT, especially in patch form, early in menopause, it actually improves cardiovascular health as you age. And the old breast cancer fear has been debunked. The right level of HRT helps with skin health, energy level, bone density, maintaining muscle mass, and just general well-being. I was on a super low dose but recently have developed some gluteal tendonopathy so my GP is bumping up my dosage a little. As far as I’m concerned, I’m on the patch forever. I use an estriol peach creme too. No one talks about menopausal itchy crotch but damn, it’s a thing! The creme cleared that right up.
I have been in menopause for about 3 1/2 years now (I’m 53) after 7 heinous years of perimenopause. About 5 weeks ago I started HRT after realizing that I did NOT have to keep suffering the hot flashes and night sweats and the Sahara-like sexual interactions. I am using the combi-patch and have absolutely noticed a difference in the hot flashes (maybe 1 since starting vs. 2 or 3 a day before) and the night sweats have DRASTICALLY reduced. Haven’t noticed a big change in the libido/lubrication areas, but am feeling very positive about the other changes. I am someone who suffers from migraines and has a prescription for those monsters, but have not had a migraine since beginning the patch. Good luck!
I was on HRT for years, close to 20yrs I think. Last year I had breast cancer and the bloodwork showed it was the kind that thrives on estrogen so I had to stop. The hot flashes started up again almost immediately and my oncologist recommended 400u vitamin E daily. It took about 2 months to fully kick in but I was pleasantly surprised that it worked! I have a mild hot flash maybe once a month or so.
could you share the name of the topical cream?
There are many over the counter options. The one with the catchiest name is Silky Peach Cream. Just look for the percentage of estriol listed in them and find the level that works for you.
I am almost 42 and believe I’m going through perimenopause. Just went to the doctor to get some hormone testing done because what I’m feeling is messed up to say the least.
Periods have definitely changed but regular, but how I feel isn’t normal and I wouldn’t say it’s MH, before my period starts these days I’m a raging mean b. Never heard to be like that. I’m emotional, I’m basically a nuts. Never felt like that in my life until about a year ago.
Seems a messed up ride ahead.
HRT! Oh my God, yes. I went through perimenopause early and hit menopause at 49. While my hot flashes weren’t terrible, my ladyparts were like the sahara to the point walking wasn’t a lot of fun. Add in brain fog, mood swings, dry skin everywhere else, hair loss…. My OB/GYN was iffy about it but my fantastic primary doctor took one listen to my symptoms and my other doc thoughts and said that is completely ridiculous. Why are women expected to suffer because it’s a “natural progression of menopause”? As she said, we have every right to feel normal and dammit hell yes. I’ve been on for three years now and am a constant champion of it whenever any of my friends complain about their symptoms. Aside from feeling normal, add in the cardiac and bone density benefits and it’s a win-win!
Although I haven’t used HRT, I went through early menopause at 41, 9 years ago. The hotflashes were the worst the in the few years before and after menopause.They are not as intense now, but it does feel like my temperature system is always out of wack these days. When I am cold and put on a sweater, then I get hot about .2 seconds later. Lesson learned: always have a t-shirt under warm layers so I can quickly strip them off, as needed.
A big enthusiastic shout out to the estrogen topical cream! It made s*x fun again and has kept near constant UTIs at bay (a delightful , unexpected menopause development).
A couple reccs for those who want to hear medical-based advice about menopause: the Ovary Active podcast (Lots of HRT discussion, pros and cons. Especially episode 9) by two female Gyn docs and Menopause Manifesto, book by another Gyn, Dr Jen Gunter (good background about what happens to the body in menopause and advice based on studies; she also has an informative Insta account and newsletter. She takes the supplement/wellness industry to task about their fake cures.)
I’m 52.5 and I’ve been rubbing Estrogen gel on alternating thighs each night at bedtime for about 15 months. My night sweats are GONE. I had also been starting to have the occasional hot flash during the day, almost always after eatting and I have a deep love for soups and coffee and I didn’t want to have to give those up.
I also got my old Mirena swapped out for a Lilleta so I haven’t had a real cycle in year but did have bleeidng for a couple days after inseration and I’ve spotted a couple of times since. So I think I still have at least one ovary trying to eject any reamining eggs I may have.
I’m also lucky to live in a small town where my famly dr is about 10 years younger than me so she’s been doing her homework. When I asked about HRT, she had me fill out a giant questionarre that we then went over in great detail and we follow up on about every 6 months.
Yes to the HRT, and seek a higher/lower dose if your symptoms aren’t resolving. In addition to losing the night sweats and random crying at work, I sleep way better and my joints ache less. And I fully believe you should seek a new provider if they tell you to suck it up or cite that 30-year old shit study that set women’s menopause health care back decades (find educated providers at https://menopause.org/). Books/podcasts by Dr. Kelly Casperson has great information on this topic.
Oh, I could write an entire autobiography focused solely on my experience with HRT and it would be 1,000 pages long. HRT saved my mental state during perimenopause. It was life changing for the first two years, then I developed a persistent lower back/hip pain that led me to fear I had ovarian cancer. Negative for that, but turns out I had estrogen positive breast cancer! After surgery for three lumpectomies, and fully past menopause, I had to stop taking HRT. I stepped down the estrogen gradually and the week I stopped progesterone, I lost ten pounds of water weight. It took about six months, but most of my peri side effects are gone completely; the rest are manageable with strategic supplements. My mental health has stayed stable. My lower back and hip pain are gone. My weight definitely gravitates toward my belly now, and I feel my collagen/skin tightness situation is worse. But gone is the stress of trying to fill my prescription for that damned patch every month.
TLDR: I think HRT was imperative for perimenopause, but once I was past menopause, I am mostly glad I am off of HRT. It reminds me of quitting smoking: it was such a b1tch to quit, I don’t want to start again! But if I know anything about HRT, it is that EVERY woman’s experience with it, and with the “change,” is completely individual, and there is a lot of societal pressure right now to get on HRT.
Ooh I’m super excited for you! I initially started through Evernow and had a great experience. I started on .0375 patch and 200 mg continuous progesterone (to minimize rapid migraine-inducing hormone shifts). It helped so much with realizing that the world was no longer completely grey and that there was still a spark of *me* way down in there. It also helped with generalized oversweating and, interestingly, road rage. I still yelled and cursed but suddenly my heart wasn’t in it.
II was abruptly dropped by Evernow after they instituted a new policy barring estrogen therapy with concurrent lamotrigine use. I looked at the literature, decided that it made sense as a policy for them, and concluded that there was no significant risk to my personal health (mood stuff) so continued. I asked my Kaiser PCP if I could get the same rx and told her that I’d been doing great on the regimen. She said no problem and also gave me some vaginal cream. I also got some tiny vagina pill suppositories that are easier to deal with than the cream so I can just use cream on the outside bits.
The main issue that I still deal with after 3 years are those miserable night sweats. They are consistently inconsistent but happen most nights along with near-constant swamp crotch. I’m bouncing around between .075 and .1 patches to try and find the sweet spot where there is no boob discomfort or headache but will stop the sweats. I’ve tried all types of sleepwear (including lots of merino wool) but have not yet found a giant terrycloth onesie which is what I really want.
I’m your neighbor about 40 miles to the north (YAY SUN!) and have been following your new adventures with curiosity and more than a smidge of jealousy. I’ve been a long time reader with two boys similar in age and am in couples counseling halfheartedly trying to revive a shit marriage. So yeah – so proud of you and I really appreciate you sharing about your experiences here. Fingers crossed that the HRT helps!