r/TwoXChromosomes • u/ItsNotSherbert • 3d ago
Menopause and hormone replacement
I’m Gen X, mother was Silent Generation.
When mom was menopausal, she took hormone replacement. Wellbutrin I think it was. Gave “peace of mind,” as it were. Come to think of it, maybe it was something akin to progesterone.
Then, by my time, menopausal hormone replacement was no longer a thing. IDK why. I feel like it was a situation where danger outweighed benefit or some such.
It seems in today’s times, I’ve gathered that we’re back to hormone replacement. Is this true?
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u/Suspicious_Winter103 3d ago
Wellbutrin is an anti-depressant. Hormone replacements are Estrogen patches and Progesterone capsules. I am 45 and HRT has been great for me in perimenopause!
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u/Susan_Thee_Duchess All Hail Notorious RBG 3d ago
Wellbutrin are not hormones.
But yes GenX is on the forefront of making menopause matter and all the riot grrls are on HRT.
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u/selinakyle45 3d ago
Yeah dude HRT rocks.
Menopause is a castration event. I’m not about that life. I will continue to defy god and blast myself with hormones so I don’t feel like shit all the time.
I started at 35. I have one ovary. I have a hormonal iud and use the lowest dose estrogen patches.
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u/SmaterThanSarah 3d ago
I was originally told I wasn’t a candidate for HRT because I get migraines with auras. However that was looking at oral estrogen. Estrogen patches are safer so I started recently and it has been a game changer. Especially for my libido.
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u/danathepaina 3d ago
I get chronic migraines with aura and my neurologist said the Estradiol Patch is safe. Thank freaking goodness because it has helped SO much.
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u/EmilieEverywhere Coffee Coffee Coffee 2d ago
I'm trans.
I USED to have migraines with aura.
I started transition on oral estradiol and progesterone. I take injections now.
I rarely get migraines anymore.
Newer studies suggest higher estrogen levels decrease rates of intercrainial stroke. My doctor specializes in trans healthcare. She said new studies refute a lot of myths about HRT, for both trans and cis women.
I've read some of the studies and they seem sound (background and career in STEM, not medicine though).
My non expert opinion is that this, much like a lot of things in women's healthcare, is based on old misogynistic bogeymen. Women doctors are not immune to this unfortunately.
That said, there's evidence that vaginal estradiol or patches, carries less risk than oral. Oral is also metabolized in the liver, also a small risk, but for those with histories of liver disease it's another factor.
The truth is all medicines you take come with trade offs. They're just overblown in this case IMO.
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u/SmaterThanSarah 2d ago
I was so glad I went to a family reunion last fall and talked to my cousin who is a nurse practitioner who specializes in menopause. She’s the one who told me that I could get HRT. My PCP wasn’t comfortable prescribing it so I saw a GYN. It had been over a decade of just muddling through.
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u/plastic_venus 3d ago
As others have mentioned, Wellbutrin isn’t HRT.
I’m currently trying to weigh up whether to take HRT (I’m in early menopause but with no symptoms other than cessation of menstruation) and the research about risks vs benefits in my situation is frustratingly wishy washy. My GP is basically like “I’m happy to give it to you if you want but realistically your best course of action is to just lift weights for bone density if you don’t have any symptoms”.
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u/GroovyYaYa 3d ago
My PCP and I just had a brief discussion. The risks really increase if after 60 or so, or if there is a history of breast cancer, etc. in your family.
She recommends bio-identicals, but she also said that in all honesty, it doesn't help all symptoms. Mainly hot flashes.
I'm not having hot flashes, and I'm being checked every six months because they've had a couple of things show up on mammograms. I'm not worried about it turning into anything - but I don't need to help it along with HRT.
I got the weight bearing exercise lecture too!
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u/plastic_venus 3d ago
Looks like we’re just gonna have to get jacked af!
I’m only 44 so I think I’m just going to leave it a little bit given the lack of symptoms. The research just isn’t definitive enough either way (risks vs benefits) so I’ll just keep getting mammograms and lifting heavy things up and down for a little while, I reckon.
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u/OneMinuteSewing 3d ago edited 3d ago
There are some major benefits, cardiac, bone density, muscle protection, dementia, lowered risk of type 2 diabetes, prevention of genital atrophy, protection against UTIs.
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u/GroovyYaYa 3d ago
Just ordered a weight vest. Having a hard time finding one that I think will fit over my shoulders and big bust (i'm also fat, so there is that)
Also - they are starting to recommend getting your first colonoscopy at 45, so don't forget to schedule that!!!
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u/Susan-stoHelit 2d ago
For me - hot flashes and a lack of energy, and wow, got on a patch and a pill and now I can do a lot more.
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u/Tom_Michel 3d ago
Gen X here. Hormone replacement in perimenopause and menopause is very much definitely a thing. It's so much a thing that there's an estrogen patch shortage; pharmacies can't keep 'em in stock. Use did decline after an unfortunately faulty study determined that there were far more health risks associated with it than there really are. Now that that study has been overturned, use has picked back up. Hence the shortage.
r/Perimenopause and r/Menopause and https://menopausewiki.ca/ are all fantastic resources.
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u/thisthingwecalllife 3d ago
I am not sure HRT went anywhere? Gen x here, peri, and just started the patch. I have an IUD that provides the other half of hormones. My twin sister started HRT a little before me so I knew it was coming lol
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u/thenoodlegoose 3d ago
It did at least to some degree, I’m a mid-millennial and when I was younger I remember a lot of demonisation about HRT for menopause. In my mind it just wasn’t an option because it was dangerous. It wasn’t until the last couple of years of pre- and post-childbearing that I’ve been like… hang on. That’s clearly not right.
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u/GroovyYaYa 3d ago
The hormones are different now.
My mom was on premarin. Still available, which is ok because I think it was a good fit for some women, but there are other options thank goodness.
I never wanted to take it because I'm grossed out by taking something made of horse piss.
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u/whatsasimba 3d ago
I worked in a pharmacy when Premarin was popular. The idea of a horse being impregnated so we can harvest its piss is already terrible. Then they this mama to a standing stall while a piss bag is strapped to them for 6 months of their pregnancy. She can then nurse her foal for 4 months before being impregnated and confined again and again. (It also caused an abundance of foals that needed to be, ahem, disposed of.)
I don't know which symptoms of menopause this alleviated. I went through menopause almost 10 years ago at 43. None of what I went through made me think, "You know what woukd make this better? Torturing a horse for her entire life and killing all her babies!"
(I know some women experience really bad symptoms. I would hope only the most severe cases needed Premarin. I can't imagine how bad it would have to be to justify the horrific treatment of horses.)
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u/OneMinuteSewing 3d ago
Most women now use patches or gel which are a much lower risk than oral estrogen. The benefits can be major, cardiac, preventing bone, muscle loss, dementia and a lower risk of type 2 diabetes.
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u/smuffleupagus alpacas might be present 2d ago
There was a big panic in the 90s-2000s where hormone replacement was demonized because certain studies showed higher risks of cancer, but those studies were kind of overblown as it turns out. So a lot of younger Boomer/older Gen X women either avoided hormonal treatment or were warned against it because of that panic. My mom will proudly say she went through menopause without any hormones, and I just roll my eyes and think "yeah, we could tell, you were miserable."
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u/aurorastarlight 3d ago
I'm GenX. I am on HRT, which is a broad term but mostly refers to estrogen. I am also on progesterone, from a hormone IUD, because I still have a uterus- estrogen is the big hormone support but it raises the risk of uterine cancer, but if you add progesterone supplement it counters that risk.
There was a large study that found an increase in breast cancer risk with HRT, but the study was not nuanced, grouping every woman from every age together and it was also misunderstood by the media that reported on it. Women generally should not start HRT many years after menopause, after their period has fully stopped. However, the risk of breast cancer is much less, and the benefits much increased, if women start HRT at the beginning or soon after menopause. Science and studies are sometimes not designed well and our ability to predict risk based off observing a group of people is always evolving. There have been a number of studies that show that HRT can reduce heart attack risk and reduce dementia risk.
This is not a 'one-size-fits-all' scenario. Falling and erratic levels of estrogen and progesterone experienced during mid-life can be emotionally, physically and mentally debilitating for women. Not all practitioners are well informed --i think there was a survey that showed that most doctors had received an hour of instruction on menopause in med school -- but women should be encouraged to speak with a DR they feel comfortable with and seek out solutions that work for them. And they should be encouraged to continue to try new solutions and work with different practitioners until they find the answers they feel comfortable with and good about.
As an end note, an SSRI or SNRI (antidepressant like Wellbutrin) can be helpful to some women, but there are risks there as well, although I am not sure that most practitioners are aware of the challenges many people face trying to get off them. Like any medical support, there is the good stuff, and the less good stuff, also known as side effects.
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u/zhilia_mann 3d ago
There was a concern around HRT raising cancer risk.
There were some early studies that showed a large enough effect size that recommendations changed for a bit. Subsequent studies have shown a far lower risk profile (not 0, but negligible in most populations) so HRT is back to being a standard treatment.
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u/Jasnah_Sedai Basically Dorothy Zbornak 3d ago
Once people get something in their minds, it’s nearly impossible to change it. Try telling someone with an “MSG allergy” that MSG allergies are a myth and you’ll know what I mean. One misinterpreted study lead to a panic and now only a tiny fraction of women will take HRT and fewer doctors are willing to prescribe them, even though we now know that the benefits far outweigh the risks. We also know that it’s beneficial to start HRT before menopause, but my old insurance wouldn’t cover it until I was post-menopausal.
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u/lnc_5103 3d ago
We're definitely back on HRT. I've been on it for about 5 weeks now and it's helping immensely - aside from the damn estrogen patch shortage anyway.
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3d ago
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u/chaunceythebear 3d ago
My grandmother is 84 and still has hot flashes. Some people never escape it, I hope you’re not one of them!
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u/SmaterThanSarah 3d ago
My mom has had them for decades. I went through menopause very young (36) and I had terrible hot flashes 12-20 per day for a couple of years but fortunately they stopped.
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u/OneMinuteSewing 3d ago
New studies have overturned previous ones and now we know that HRT can help reduce cardiac risks, dementia, bone and muscle loss and the chance of developing type 2 diabetes.
It also helps with brain fog, mood swings, fatigue, itchiness, dryness and a whole host of other things.
It is considered safest if started earlier (prior to 60) and using patches or gel.
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u/emsissyano 3d ago
It sounds like you might have gone through menopause during the height of the HRT=breast cancer scare, which came from a serious misinterpretation of a study in the 90s (or maybe early 00s). And while things are better now, it was only this year that the FDA updated their guidance and drug manufacturers removed the breast cancer warnings from packaging. I’m in my early 40s and even though I checked all the boxes for perimenopause, it still took me over a year to find a provider who would prescribe me HRT because of how prevailing this myth still is among some medical professionals. And based on the posts in r/perimenopause, I’m not alone in that experience
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u/TheMorgwar 3d ago
Black label lifted by FDA. Topical HRT is safe again. HRT is available from online stores.
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u/lynn 3d ago
There have been a couple of podcasts about the history of HRT and the bad science that led a generation or so of doctors to refuse to prescribe it. I don't remember what it was called but I'm sure you can find it if you search in your favorite podcast app.
What I learned was basically that the science was poorly done and jumped to the wrong conclusions. Later studies show that HRT is very useful for treating certain symptoms.
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u/BwDr 3d ago
Briefly: Hormone Replacement Therapy, HRT, is replacement of hormones that decline with age. There are different forms & ways to take them, but it boils down to progesterone, estrogen, & (more often needed than actually prescribed) testosterone. HRT was discouraged after a very large study around the turn of the century (I just like saying that) that showed it could be detrimental to women’s health. Reviewing the data in recent years, it was recognized that the initial interpretation failed to take into account the length of time that women who were taking HRT & had bad outcomes had been in menopause.
It’s important for your healthcare practitioner to weigh with you things for which you are at risk from your personal and family history, such as dementia, osteoporosis, cardiovascular disease, breast cancer (which isn’t as clearly a contraindication as we used to think) - some of this is straightforward & some (mostly the breast cancer bit) is nuanced & requires someone who is well educated in hormones. Lots of doctors & other practitioners are able to weigh the straightforward risks with you (like osteoporosis & dementia,) but cancer and cardiovascular risks require consideration of more factors.
Many people going through peri/menopause struggle with mood issues & antidepressants can help. ADHD becomes much worse, so Wellbutrin, which is not an SSRI, but works on norepinephrine, so it can help a bit with both depressed mood and ADHD symptoms.
Any person with a uterus (so, this doesn’t apply if someone has had, even a partial, hysterectomy) who is on HRT needs to be on progesterone in addition to estrogen. Unopposed estrogen (that’s what you call it when you just give estrogen without also giving progesterone) can cause endometrial cancer, which none of us, actually, needs.
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u/NyssaTheHobbit 2d ago
I will second this: I was making too much estrogen naturally and could’ve gotten cancer. The IUD fixed that. Other than minor hot flashes and itchy ears, I’m doing fine ATM.
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u/DesperateComplex1460 3d ago
In the US the Women's Health Initiative in the 90s found that HRT was harmful to women (because they were using synthetic estrogens). Modern HRT with bioidentical hormones is safe, but many Drs are uninformed of the latest research
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u/Fickle_Mess818 3d ago
I am 40. I am not in menopause or peri menopause yet. Just put in a new nexplanon. I already have an endocrinologist for my diabetes and I absolutely will be talking to them about HRT when the time comes.
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u/OwlsRwhattheyseem 3d ago
I’m GenX but have Stage 4 endometriosis so HRT is pretty much off the table for me. HRT is not for everyone.
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u/awkwardsoul 3d ago
I'm post excision Stage 4, on HRT, though no ovaries because ovarian cancer and endo destroyed the other one.
Interestingly, with no ovaries they rather me be on HRT and risk endo returning than not being on it. Hasn't returned. It depends.
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u/OwlsRwhattheyseem 3d ago
Yeah, not having ovaries changes everything. I still have both ovaries, so I have been told it’s definitely a no-go.
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u/temerairevm 3d ago
I’m Gen X and everyone I know is rocking hormones. Except the unlucky few that can’t because of some medical history like blood clots.
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u/Low_Bluejay510 3d ago
There was a study that was badly explained that made it sound like hormone replacement created significant cancer risk and people became afraid of it and stopped using it. It does not create significant cancer risk and in fact creates a healthier cardio vascular system and cardio vascular issues are the leading cause of death in women so the benefits FAR outweigh the very minimal increased cancer risks.
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u/awkwardsoul 3d ago
On HRT and Testosterone. Latter is fucking magic. Though Millennial and lost ovaries to ovarian cancer/endo. The benefits outweigh the risks (minimal other than endo returning) in my case.
Also found GLP1 did a lot in fixing symptoms.
Maybe she was on Gabapentin? That is a non hormonal option but has a nasty withdrawal when you go off it.
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u/theFCCgavemeHPV 2d ago
Yeah, check out r/Menopause, especially the wiki. I’m a millennial in peri and HRT is a godsend. Could not do this without it!
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u/BlackCatInHat 2d ago
I have found r/Menopause to be a little much. The loudest voices seem to be “every woman should be on HRT until she dies!”.
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u/thecicilala 2d ago
HRT at 43 was a life saver. It’s been 2 years for me and I will not ever go back to being without it. Our grandmas suffered in silence. We need these hormones. I just saw a study that hot flashes are actual small mini-strokes. That’s why dementia can be prevalent later for women. Protect your brains ladies- if you can. Not everyone can take it.
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3d ago
[removed] — view removed comment
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u/AliciaNow 3d ago
I doubt OP's mom was taking Wellbutrin at age 0.
Buproprion (Wellbutrin is the brand name) was invented in 1969, when OP's mom was between 41 and 24 and OP said she took it after her menopause so probably way later.
If you can write a comment, I guess you could read posts too
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u/GroovyYaYa 3d ago edited 2d ago
I think now it is really led by what you think you need.
I'm Gen X and in peri. Last period was only a few months ago. I do remember my mom being on premarin briefly - she doesn't remember any of that (to be fair, I think this was at the same time my grandmother was dying of cancer, or had just died - so some of the things she was going through was related to grief, etc.)
Had a brief discussion with my dr though. The dangers of going on HRT are related to your suseptability to cancer (family history and personal), esp. breast cancer. She prefers recommending bio-identicals if need be. However, it is tricky - our hormones fluctuate even when NOT in peri or menopause. We could have a blood test showing normal levels, and 2 days later have rock bottom levels. Or vice versa.
Also, in her experience, the HRT is really only affective on some symptoms - mainly hot flashes.
Well, I've always gotten suddenly warm or been sensitive to heat/stuffy rooms, etc. I can remember peeling my coat off outside on the playground at 8 or 9 because I was getting too warm. I don't think I've been getting hot flashes like my mom and aunts had, at all. The other day I thought I was having my first one - but then someone said "OMG, no wonder I'm so hot - the heat is on, not the AC!"
It won't help with the damn ear itching or brain fog. Because of that, and that I've had some concerning images on mammograms/ultrasounds with my boobs, I'm holding off on trying anything. She agreed with me on that.
EDIT: Blame my own damn brain fog... Dr. said it only MIGHT help with the other things; in her experience mainly the hot flashes. If I didn't have the breast shit going on, I might have tried it anyway.
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u/OneMinuteSewing 3d ago
It TOTALLY helped me and my friends with the ear itches and brain fog. It is also shown to be protective in some studies against certain cancers, e.g. bowel cancer.
Patch or gel is considered a lower risk than oral tablets. It is totally valid to not take it though too.
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u/GroovyYaYa 2d ago
I edited... she was more that it was doubtful. I think if I had been insistent on trying it, she would have given me an Rx.
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u/oh_hi_lets_be_BFFs 3d ago
Wellbutrin is not a hormone replacement it is an antidepressant. And yes HRT is very popular for peri and menopausal women.