Related Topics: Features, HRT, Menopause, Osteoporosis

How to come off Hormone Replacement Therapy

If HRT is stopped suddenly the oestrogen levels will quickly drop to very low levels. This may not produce any symptoms at all, but in many women it causes most of the symptoms associated with the menopause to appear.

Dame Dr Shirley Bond

After trying HRT for a few months, or longer, many women wish to come off it due to side effects.  However, stopping HRT is not as easy as starting it.

If you want to stop your HRT you should always talk to your doctor first.

Having made the decision, you can if you wish just stop it – but this is not advisable.  Stopping suddenly can produce quite severe symptoms and it is better to wean yourself off the HRT over a period of time.

What’s Involved

When you are taking HRT you are artificially increasing your levels of oestrogen and, with traditional HRT, this may or may not be combined with a chemical progestogen to protect the uterus.

It is often thought that after the menopause women no longer make any oestrogen, but this is not true.  Another false belief is that women without ovaries do not make any oestrogen.

It should be remembered that women produce three different types of oestrogen: Oestradiol, Oestrone and Oestriol.  In a woman’s reproductive years most of her oestrogens are made in the ovaries and the main oestrogen is the strong oestradiol. After the menopause, a woman’s oestrogens are made in muscle and fatty tissue by the conversion of another hormone androstenediol into oestriol.  The amount of oestradiol produced at this time is very low.

The levels of oestrogen, usually oestradiol, in a woman taking HRT will be as high, or even higher, than the levels found in younger women. Certainly the levels will be much higher than would be normal.

If HRT is stopped suddenly the oestrogen levels will quickly drop to very low levels. This may not produce any symptoms at all, but in many women it causes most of the symptoms associated with the menopause to appear. These symptoms are sometimes more severe than they were before starting the HRT.

How To Come Off HRT

The best way to come off HRT is to do it slowly. The ways in which you do this will to some extent depend on the sort of HRT you are taking and the following are some suggestions:.

Tablets:

This will depend on whether your tablets are designed to produce a monthly bleed, which most women prefer, or not.

If you are having a monthly bleed then if the oestrogen tablets can be cut in half, or smaller, you can reduce the amount of oestrogen you are taking by doing this. It is always better to take a lower daily dose than to take the daily dose on alternate days. The progestogen should be kept at the same dosage.

You may find that when you reduce the oestrogen you do not experience a bleed in the usual way. This is not a cause for concern and is because the lower level of oestrogen has not built up such a thick lining to the uterus and it does not need to be shed.  Eventually you will reach a very low level of oestrogen and you can then try stopping completely and evaluate how you are.

If the tablets cannot be cut into smaller pieces then try taking the oestrogen on alternate days. The progestogen should be taken every day as before. You may find that you do not have a period but this is not important. When you find that you are taking only one or two oestrogen tablets a week then you can stop.

If you are taking a continuous combined oestrogen and progestogen tablet then you are probably not having  a monthly bleed. To reduce your dosage, try cutting the tablets in half. If this is not possible then take the tablets every other day and then every third day and increase the number of days between until you find that you can manage without them.

Patches:

These have become quite popular over the past few years but it is more difficult to reduce the dosage you receive and it will depend upon your type of patch.

It is important to remember that a patch is designed to contain an amount of oestrogen to be absorbed over the period of time that you are instructed to leave the patch in place. If you leave it on longer you will not be getting less oestrogen. You will not be getting any oestrogen at all. Some people do reduce their patches like this but there are better ways.

There are two ways in which the oestrogen and progestogen can be administered by patch. One has oestrogen patches and is combined with tablets of progestogen taken for 12 days each cycle. The other type has both oestrogen and progestogen in patch form. There are usually patches just containing oestrogen for the first part of the cycle and then patches containing both hormones for the later part of the cycle.

Look carefully at your patch. There are two main styles: one is called a matrix patch and is very flat, and the other seems to have liquid or gel in it.

If you have matrix patches it is very easy to reduce the amount of oestrogen you take each day. Cutting slices off the patch and gradually reducing it can do this. You should continue to take your progestogen tablets or the progestogen part of your patch as usual.  As with the tablets, as you reduce your oestrogen intake you may find that you no longer have a bleed if you have been experiencing one on your particular patch.

If your patches have gel in them you cannot cut them in half. The best way to reduce the amount of oestrogen that you absorb from the patch each day is to reduce the surface area of the patch.  You can do this by sticking a small piece of waterproof sticking plaster over an area of the absorbing surface that goes next to your skin. You can then leave the patch on for an extra day because the oestrogen in the patch will take longer to absorb because you have reduced the area over which it is absorbed. You then increase the size of your piece of sticking plaster and leave the patch on longer and longer. Then eventually you will no longer use it at all.

If you have had a hysterectomy and as a result are taking oestrogen on its own then you can reduce your oestrogen in the ways described above, forgetting about the progestogen.

The speed at which you reduce your oestrogen is entirely up to you and you will be guided by how you feel.

When you decide to stop your HRT there are certain things you should do.

First, do start to take a supplement specifically designed for dealing with the menopause. There are a number of these on the market and you should be able to obtain advice in a health store or Chemists.

Next, if you have been advised to take HRT for osteoporosis, or indeed if you have been on HRT for several years, it is important that you have a Bone Mineral Density Screening. The reason for this is that the oestrogens in HRT do not build up new bone but stop bone from breaking down. The oestrogens can only do this while you take them. The problem that can then arise is that when you stop taking the HRT then the old bone that you have retained will start to break down.

To sum up: in order to help your bones at this time it is essential to take the correct supplement for your bone health, exercise in order to build up new bone, and consider using natural progesterone to help you to build up new bone.

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Please feel free to discuss this article in the comments section below, but note that the author cannot respond to queries made there.
Comments 84
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rosemary | 9:04 pm, January 14th, 2011

I have been taking bio-identical HR creams for 18 months but my uterine lining has become thick and my dr. wants me to come off them. She said to cut down the number of days I use it each week til I am down to once a week (creams) and then stop taking them.and she prescribed prometrium starting now for 3 months for me to reduce the lining thickness and the risk of uterine cancer, What is your opinion of the use of prometrium in this case and how to come off the bio-identical hormones.

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dawn | 10:31 pm, March 17th, 2011

my docter as took me of hrt wiv out cuttin me down i ave been on them for 16yrs and now gettin side effects wot can i do 4 this or sould i go back 2 my docter.

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Julie Larratt | 11:57 am, October 2nd, 2012

Hi I have been taking HRT for about 10 yrs as I was post menopausal at the age of 40. I feel really well on HRT but the Dr as advised i come off it as the risk increase after 10 yrs. I have no breast cancer in the family of DVT . I have started to take a pill every other day but found the first day without it I have flushes during the night I’m not sure if I’m doing the right thing when i feel so well taking it.

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HS | 5:20 pm, October 7th, 2012

i am also in a dilemna..i take them feel better, when i try to go off them , i get angry, hot flushes, and depressed! and if i go off them..and perhaps i could live a longer life? does one choose between the quality of life .or longer life? hmmm..that is the question for each of us eh!

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Maham | 4:22 pm, October 24th, 2012

Hi Liz and LindaI’m concerned about your avdcie Linda re livial. I had endometriosis and had six injections of decapeptyl before a hysterectomy on 3 oct. Almost as soon as my injections kicked in I had menopausal symptoms, so was given livial. Livial worked really well and did not bring back the endo. My consultant told me that because of the hormone ( synthetic) in the livial, it wouldn’t act like oestrogen and so wouldn’t affect the endo. The injections worked very well but had to have the hyst because the injections couldn’t be done indefinitely. Compared with the quality of life before livial, I would definitely give it a try. It might not work for everyone, but don’t make a decision based on worry about endo as I was assured there’d be no problem. Hope you get something sorted out soonHazel

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Rigor | 10:40 pm, October 24th, 2012

Ovarian Cyst Surgery-Partial Hysterectomy done?I had a hystorectomy on June 2005 my Gyn rednmmeoced to leave my ovaries so they won’t have to put me on medications so young (I don’t consider myself that young but anyways) after all this I have been having constant pain on my right side is sharp and dull and sometimes I did not know how to describe it..so I went back and behold a ultrasound detected a small cyst on my right ovary.I have an appointment with the Gyn but not soon enough..now my question: since I had a hysterectomy I wonder what is going to be their approach about this painful and bothersome little cyst medication? or is this probably a simple surgery in the future? Any one out there with the same experience would be a lot of help )thnks.Those answers helped thnks. I am extending the days on my question maybe a girl out there has also gone by hysterectomy and also had ovaries taken out due to this in all i think my histeria is due to know wheather or not I am going to be proposed another surgery (?)thks

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sue | 6:32 am, November 13th, 2012

I have been on ellestte. duet 1 mg for 6 months and feel great on it , hot flushes stopped almost right away which was a god send . But my hair has been shedding since i started the tablets now only have half the head of hair i had before i started taking them ,my hair is

all over the house and anywhere i visit

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Linda | 12:26 pm, December 10th, 2012

Hi
I was fine on hrt for 13 yrs,dident go on it for menopause,but for bones,as I had polio as a child,the doctor took me off the hrt,I am now a complete wreck ,arms,wrists aching pain,cant turn over in bed ,sleep disorder,which I never suffered before,cant walk far at all without help,not sure if the late effects of polio contribute,or its just comming off the hrt.just need advice on what suppliment to take,doctors do not realise post polio syndrome. linda

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Carol | 3:11 pm, January 18th, 2013

I reduced my level of HRT by half about six months ago but am experiencing terrible pain in my arms, shoulders and lower bag and legs. How long does this usually go on for?

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Gerri | 8:20 pm, March 1st, 2013

I was on the Biohormones (compound). Iwas off of them for weeks, started not feeling well and had spotting so I started taking them again. Have been on them for 3 weeks and now I am spotting. Is this normal?

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AnnA Rushton | 11:02 am, March 2nd, 2013

Gerri – as your hormones rebalance old stored blood can be released, and the body can hold on to this for some time and can be linked to the degree of oestrogen dominance and how heavy your periods have been. Unless the bleeding is heavy or prolonged there is no cause for concern but if not then please see your doctor.

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Romy | 9:50 am, May 4th, 2013

Ive been on hrt tablets for three years,and wish to come off,Dr has advised to take one every other day,and then every two days,until I have weened myself off,I just want to know,will I start looking old,will my face start getting wrinkled,I get told I look young for my age,I know every one is talking about what will happen to the body,but no one is mentioning how you will look,please can anyone give me answers tahnk you

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AnnA Rushton | 1:44 pm, May 4th, 2013

How you age is dependent on many factors and coming off HRT is not likely to be a factor. If you are concerned then a cream such as 20-1 will give you both progesterone and oestrogen and it is oestrogen that increases the rate of cell turnover in the basal layer of the epidermis which makes skin appear plumper.

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Mary Hughes | 4:08 pm, June 7th, 2013

Hi, can you tell me where I can buy the
20-1 cream .I have come off HRT ,dont want to take pills .
Thank You
Mary Hughes

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AnnA Rushton | 9:41 am, June 18th, 2013

Mary you can buy 20-1 at http://www.wellsprings-health.com

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Cindy Maxwell | 6:57 pm, August 22nd, 2013

I am 57 yrs. old. stopped taking estrodiol 2 years ago, but have continued taking 200 mg. of prometrium since then. Can I just stop taking the prometrium “cold turkey” ? They are in gel form so I cannot cut them.

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AnnA Rushton | 3:50 pm, August 23rd, 2013

You would need to speak to your GP Cindy as Prometrium is a high dose progesterone and although the cream formulas can be stopped immediately we do not know what the withdrawal from a pessary like this would be.

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Julie E | 9:05 pm, July 16th, 2014

I have been on the Minivelle patch for one month, and have gained weight to the point where I am crawling out of my skin. I stopped taking it, and am now just using the vaginal cream. I would rather have hot flashes then feel like the Michelin man. For me, it was not worth it.

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carol walls | 1:32 pm, August 10th, 2014

Hi Shirley
I am 62 years old my Dr has taken me off hrt as my blood presser went up.she says i have got to come off it some time.the nurse has been taking my blood presser now with 10mg tablets it is back as it was.
I have been off hrt for one year before
nearly had a break down.could not coupe with anything at all.my gp put me back on it last year but has since left.
I now have a new gp who is very good
but wants me off the hrt because of the risks and my age. she says she will put me back on it when my blood presser goes down.I have to see my gp next week she says I will have to syn a form so she is not to blame if anything happens to me I am going to ask if I can go back on it for a while and then start to reduce them slowly and see if that will work. but I think I am one of those people who will never get rid of the menopause symptons long as I Live?

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kim | 7:40 am, August 13th, 2014

Hi I’m evorel 50 and two weeks I go I just stopped using the patches no reason just wanted to see if I could go without I’m now wanting to go back after realising I’m better on them my Dr put me on them because before I w as due a period I use to feel like crying my head felt really strange I didn’t feel ill but just couldn’t describe it I just felt rather strange before a period was due but now that j don’t get periods,and have a marina coil fitted as well was just wondering wether I could just start my patches again starting on a new day

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AnnA Rushton | 10:01 am, August 13th, 2014

Stopping HRT immediately is never a good idea as you can severe withdrawal. You need to speak to your doctor on how to manage your patches as you are having both oestrogen and synthetic progestins in the coil.

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susan mcpartland | 7:58 pm, August 13th, 2014

Hi i have stopped taking HRT Livial but seem to be gaining lots of weight is this normal ?

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AnnA Rushton | 11:48 pm, August 14th, 2014

When you stop HRT, particulately if done suddenly, then symptoms can be severe and in this case production of oestrogen switches to the fat cells in the abdomen, stomach and thighs.

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Sarah Fuchs | 10:12 am, August 31st, 2014

Hi. I am very confused. I had a total hysterectomy when I was 32 years old and was on Premarin for many years. I started taking Livial 9 years ago and I’m now 65. I look 10 years younger and am still sexually active. I go to a specialist once a year to have him check my breasts and I also have a mammograph and ultrasound once a year now. He thinks that I should stop all HRT. My GP doesn’t see why I should come off Livial. I ran out of my pills 4 days ago and am thinking maybe I should stop taking Livial now. I don’t know what to do. Overall I am healthy besides high cholesterol (medicated). I’ve been getting a lot of leg cramps recently – more than a month now. What should I do?

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AnnA Rushton | 1:49 pm, September 1st, 2014

Sarah we can’t comment on your doctors recommendations. Certainly 5 years is now the maximum time suggested for women to be on HRT because of the risks but no HRT should be stopped suddenly because of the risk of severe side symptoms on withdrawal. For women with such a long history of HRT use you would be better if you intend coming off HRT to use a combination cream such as 20-1 which has both progesterone and oestrogen.

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Mickey | 11:05 am, October 3rd, 2014

I have been on bio-identical HRT for over a year now. Will be 50 this month. My OB Gyn suggested I was having a hard time with depression prior to it so she was coming at it from that angle.
I want to get off of it due to lack of finances. I read in all the comments that going off cold turkey has severe symptoms what are some of the symptoms to be expected? How does one combat them? Please help

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AnnA Rushton | 5:36 pm, October 3rd, 2014

As Dr Coope’s article explains, coming off HRT suddenly is never a good idea as severe menopausal symptoms such as flushes and sweats usually result. Slow withdrawal and supplemention with bioidentical progesterone is the best route.

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Amanda | 10:31 pm, October 23rd, 2014

I am weaning off my oestrogen patches slowly, I have been on them for about 10 or more years, I am now having difficulty with getting to sleep at night, is this a side effect !

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AnnA Rushton | 8:54 am, October 24th, 2014

Amanda slowly is best and so increase your progesterone cream as this is the hormone that helps you sleep. Stay on the dosage of patch you have reduced to until you get your sleep under control and then reduce again.

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Joan | 4:05 am, October 29th, 2014

I am weaning off bio-identical hormone cream. I was on 4 “clicks” of the dispenser per day. Doc suggested I do 3 clicks and if symptoms occur go back up for a couple of days, 3 for a couple of days, etc, then when no symptoms use just 3 clicks for a while, if no symptoms keep reducing. However, he gave me no time frame. So far I have had a few hot flashes, but am doing ok. How quickly can I move off? multiple weeks at each level, one week at each level? I am confused how to proceed.

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AnnA Rushton | 7:39 am, October 29th, 2014

We don’t know this form of HRT Joan but your doctor is correct, there is no time frame, you just reduce gradually until you are symptom free but generally a week at each level would be average.

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Joan | 3:02 pm, October 30th, 2014

Thank you for responding. I have had some symptoms, so am going back to 3 clicks a day. Also, I read where sometimes one had gut symptoms, and I am feeling slightly nauseous. Do you suggest a pro-biotic?

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AnnA Rushton | 4:57 pm, October 30th, 2014

Many practitioners do advocate using a probiotic as it can certainly improve the gut health.

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AnnA Rushton | 11:38 am, November 9th, 2014

It always advisable to withdraw slowly from HRT due to the very high levels of hormones it contains and certainly that is what is recommended by bioidentical doctors and professionals working with complementary health. Unfortunately many doctors do not always follow this advice and terminate HRT suddenly which accounts for the severity of the symptoms that can follow withdrawal.

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Marcella | 10:16 pm, January 18th, 2015

I have been on Premarin for 35 years following a complete hysterectomy. I attempted to wean myself off of it a few years ago. Felt like I had the flu along with suicidal thoughts. At the age of 65 Medicare has sent a letter saying they will no longer cover the cost of the Premarin. I am fearful of not taking the Premarin as I don’t think I would survive the withdrawal. At my age, should I still be taking an HRT? Any suggestions? Please help.

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AnnA Rushton | 5:57 pm, January 20th, 2015

Marcella 5 years is now the maximum recommended time to be on HRT so if you still have symptoms you probably want to consider an alternative. Never a good idea to come off quickly but given the length of time you have been on it you would be better with a combination cream such as 20-1 which is a natural HRT replacement. You would need to use it at the same time as you withdraw from Premarin and would need the double dose for at least the first month.

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Marlene | 1:49 pm, January 26th, 2015

Hi there. I have been on activelle which I take every day for 10 years now. I did try to quit a few times but had so much side effects I went back on it. Now my doctor wants me to stop taking it. The thing is there is hardly any info available about how to taper of this which annoys me a lot. I tried taking no pil on wednesday and saturday but got so sick. Now on those 2 days I take a half. (have to cut the pills which is not easy) but I still have hot flashes and lots of cramp even going slowly.Decided to make an appointment not with my own male doctor but with a female one. Is it normal to feel so horrible when reducing so little? thanks.

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AnnA Rushton | 11:11 am, January 28th, 2015

Unfortunately Marlene it does depend on the level of oestrogen dominance as to how you react to coming off HRT and with 10 years of unopposed oestrogen that means you are more likely to have a severe reaction.

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Cheryl | 7:19 pm, February 13th, 2015

I have been on hrt for 14 years due to going through the menopause at 40. My gp tells me the early years don’t count as hrt is only replacing the hormones my body would make naturally. I feel it’s maybe time to try and wean myself off it, my gp suggested when I was ready, start taking it every other day. You advise to keep taking the progesterone whilst I do this, when should I stop taking this?

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AnnA Rushton | 11:21 am, February 23rd, 2015

Unfortunately Marlene it will depend on the severity of your symptoms as to how you are affected when coming off HRT.
.

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AnnA Rushton | 11:27 am, February 23rd, 2015

Cheryl definitely use Serenity while coming off HRT and follow the guidelines in the article.

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Angela | 1:24 am, February 26th, 2015

I was on bio-idential hormones for only 3 months. I decided to stop suddenly without consultation. I am now experiencing a prolonged menstral bleeding almost 3 weeks. I am not sure if my body will fix itself or if there is anything I should do.

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AnnA Rushton | 1:32 pm, February 26th, 2015

You can get bleeding as hormones rebalance as it often the shedding of endometrial lining but such a prolonged bleed should be investigated by your Doctor Angela.

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Mrs Margaret Hosie | 7:17 pm, March 3rd, 2015

Been taking Livial HRT since having a hysterectomy at the age of 38. No problems whatsoever, I felt remarkably well and looked ten years younger. However after being advised to gradually reduce them over two years, then finally come off them completely, I have experienced terrible horrible hot flushes and the nasty headaches and generally feeling nausea and deeply depressed. I am age 69. Dr. has put me back on the Livial.” Praise the Lord”. I prefer a high quality existence rather than all those horrible embarrassing symptoms and having to have two showers every day, sometimes three.

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Susan Daugherty | 5:59 am, March 31st, 2015

Wish I had seen this post before stopping my estradiol 3 weeks ago. I’ve had hot flashes, insomnia, temper flare ups, etc., but I think it is calming down some. Now what? Osteoporosis runs in the family soe bone deterioration worries me. I’ve also experienced “foggy brain” and that is really frustrating! Suggestions?

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AnnA Rushton | 11:53 am, March 31st, 2015

Susan you need progesterone and oestrogen for your bones, but women who have come off HRT often do better with 20-1 as a combined cream gives you a natural bioidentical form of HRT. Progesterone will help with the foggy brain too – but see this article for help with osteoporosis.
http://www.bio-hormone-health.com/2012/11/23/how-much-progesterone-do-i-need-for-osteoporosis/

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Pamela Herne | 9:55 am, April 2nd, 2015

I have been on HRT patches for 30yrs i have moved and my new doctor wants to take me off the hrt how do i come off patches slowly.I am 78yrs old.Ihave tried several times but get severe hot flushes.

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Pamela Herne | 10:09 am, April 2nd, 2015

Hello its me again i sent a comment 10 mins ago and forgot to say the patches i am on are Estaderm MX 50 i asked you how i can come off these slowly.
thank you.

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AnnA Rushton | 1:09 pm, April 2nd, 2015

As Dr Coope states in the article Pamela with oestrogen only HRT you cut it down over two months once you have started using Serenity at the same time. It is very important you go slowly to reduce your withdrawal symptoms but women are different so you will have to experiment. You can just cut a small amount from the patch in the first instance – say a quarter or less and do that for two weeks, then reduce so you have perhaps half the patch for two weeks. If symptoms are manageable cut down a further quarter for two weeks then stop. If symptoms are severe when cutting down stay on that amount longer and just go at the pace your body wants to.

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Dee | 9:54 am, April 8th, 2015

Hi there I’ve been on HRT for 5yrs and Dr Recomended to stay on only five years, I took my last pill 6days ago, since coming off I’ve felt Tired, lack of energy, and severe migraine headaches in the evening, my eyes are very red n soar, I’ve had a slight numbness in my hands n fingers. But I’m having to wear dark glasses at night as the light is unbearable, I’m wondering if the bad headaches are part of the lack of HRT as I’ve read several comments and no one mentions headaches just hot flushes please advise if this is a symptom

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AnnA Rushton | 1:21 pm, April 8th, 2015

It is down to the plunging hormone levels that happen when you come off HRT which is why we recommend slow reduction and supplementing with bioidentical hormones. As you already off it, you would be best Dee to use a combined progesterone and oestrogen cream such as 20-1 to build up your levels to deal with your symptoms and certainly headaches are related to oestrogen so the sudden withdrawal can have triggered them.

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niran | 8:16 pm, April 11th, 2015

I started elest duet2mg 3 weeks ago I got urine infection stomache pain today I started spotting can I stop the tablet

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AnnA Rushton | 10:50 am, April 12th, 2015

Niran this is a question for the doctor who prescribed Elleste for you as we do not have information on HRT.

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Dee | 3:24 am, April 29th, 2015

I began the bio-identical pellet HRT in January, 2015…..began having rages within 5 days. Dr. took me off of the Thyroid Synergy and Adren-All that they prescribed at the same time, stating that these two meds were the cause of the rages. The rages subsided a little bit but they kept me on the progesterone and DHEA….after 3 months, I had my second pellet put in just 10 days ago and the rages are worse now than ever. I have been reading about some of the side effects of progesterone and I keep continuously keep reading comments about how women are having these serious rages. I cannot stay on this pellet or continue with the progesterone because I’m fearful for my life or hurting someone, the rages get that bad. I’ll take the hot flashes and night sweats any day over the horrible rages.

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AnnA Rushton | 10:12 am, April 29th, 2015

Dee you need to speak to your doctor as implants are very different in nature to cream forms of bioidentical hormones. There are no side effects associated with transdermal progesterone creams, though there are with synthetic progestins, and they are acknowledged as the best way to deliver hormones safely. This article may be helpful: http://www.bio-hormone-health.com/2014/03/10/transdermal-creams-confirmed-as-best-for-hormone-use/

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Romy | 5:59 am, May 11th, 2015

I am 50 with regular periods. Have been using pill prometrium for 7 years, added cream (sleep poor, sweats) in jan 2015 with a progesterone level of 6 just tested now at 142. No sweats. Sleep not 100% but ok. Some weight gain, breasts larger.

Not sure what to think….thoughts

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AnnA Rushton | 4:03 pm, May 11th, 2015

Romy we cannot comment on your drug as we are not medical staff, but it is an oral form of progesterone that passes through the liver and has to be given in much higher doses to compensate for this. Cream application has much lower doses and no reported side effects but if you are having weight gain and enlarged breasts that normally indicates some oestrogen dominance so we suggest you discuss this with your doctor as you may be over sensitising your oestrogen receptors.

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Sarah L | 11:05 am, May 25th, 2015

I am coming to the last 4 days of the second month of Elleste Duet 1mg and I have put on a rapid half a stone especially round the tops of my legs and middle. So much so that stretch marks have appeared! I now want to stop. Can I just stop at the end of the packet as I’ve only been on it for 2 months? Is the weight gain due to there being too much oestrogen for me? More than my body requires? Is it worth me trying another type of hrt or will they all do the same thing to me?

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Tonda | 3:34 pm, May 25th, 2015

I tried going off hrt and started having hot flashes so doctor said I could go back on how long will it take for the hot flashes to go away

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AnnA Rushton | 1:08 pm, May 26th, 2015

Tonda we cannot comment on how long your flashes while on HRT will take as it varies in individual women and it is impossible to say as the high levels of hormones in HRT mask the symptoms.

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Lynnie | 6:03 pm, June 14th, 2015

I had been taking hrt tablets for about 2yrs I decided to stop taking them as it only prevents the symptoms and you would have to go through it eventually but since I stopped taking them I’ve put on over a stone is this normal I just stopped I did not wean myself off them

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AnnA Rushton | 8:12 am, June 15th, 2015

Yes weight gain at menopause is normal Lynnie but will depend on the degree of oestrogen dominance you have and coming off HRT suddenly can increase symptoms. This article will help: http://www.bio-hormone-health.com/2014/06/06/what-signs-of-oestrogen-dominance-do-you-have/

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beverley hilder | 1:25 pm, June 17th, 2015

Hi I had a hysterectomy and ovaries removed at the age of 38 and tried several types of hrt. and finally settled on Evorel first taking 50 and now I take 25 changing the patch twice a week. I am 58year old and tried a few times without success. my GP mentioned again I have been on it a long time and suggested I try stop taking it he said you will go straight through the menopause which shouldn’t last two long them that will be it i will be over it. well this is my third week and I am not sleeping really bad heads and absolutely wet through on and of and feeling terrible. I have just put a patch back on and want to ask would I be better leaving the patch on longer or chopping it in half each patch contains 1.6mg Estradiol that Absorption rate 25 micrograms of Estiradiol in 24hrs please advice thanks

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AnnA Rushton | 9:44 am, June 18th, 2015

As the article indicates Beverley it is never a good idea to come off HRT suddenly as you go into immediate menopause and there is no knowing how long that will last. Leave the patch on until you can support it with progesterone (Serenity) then reduce the dosage gradually and monitor your symptoms. If you still need oestrogen when off the patch you can switch to a combination cream (20-1).

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Diane | 11:20 am, June 18th, 2015

Hi
I have been on Hrt for 26 years, after a two week bleed my doctor has taken me off it cold turkey. After ten days I have
Strange side effects, heavy eyelids,
Aching arms, and occasional hot flushes,no mood swings very vague and forgetful, I am wondering how long it take before I have no estogen in my body.
Will my bones deteriorate? I am 66 and look and feel early fifties. Also my hair is suddenly unruly and feels wired.
Has anyone else had the same symptoms?

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AnnA Rushton | 8:52 am, June 19th, 2015

Unfortunately this is what happens when you stop directly and your symptoms relate to your body trying to adjust to the rapid drop in the high level of synthetic hormones your body had become used to on HRT. We would suggest you need a combination cream such as 20-1 to restore naturally those hormone levels and protect your bones from osteoporosis.

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Loretta Kent | 7:02 am, June 25th, 2015

I am 70 year old and have been on HRT for 38 years. Finally 2years ago my doctor cut my Estradiol down to 0.5 and the Medroxypr to 2.5. One week ago they discovered a blood clot in my leg and I stopped cold turkey. I play tennis and swim daily. I’m shaky, weak, very tired and have a head ache. How long before this passes?

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AnnA Rushton | 7:55 pm, June 25th, 2015

Loretta unfortunately you have been on HRT so long it can take quite a while for your body to adjust to the crash of the hormones, particularly if it is stopped suddenly. If you want to support your withdrawal you could use bioidentical progesterone cream to help rebalance your hormones and get symptoms under control.

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Dolores Lombardi | 9:39 pm, July 6th, 2015

My sister is on bio-dentical hormone replacement since Sept. 2004. She does 4 pumps per day. She decided to ween herself off of them taking 2 or 3 pumps now she not taken any. She doesn’t feel well but I don’t know if it’s the hormones because she may have depression. are there any side effects by stopping it. She didn’t feel good on them & don’t feel good off them. What can she do?

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AnnA Rushton | 4:40 pm, July 7th, 2015

Dolores your sister should contact whoever she obtained the hormones from to ask their advice, as products vary in their strength and intensity. Generally there are no withdrawal symptoms on bioidentical cream formulations but she may be on a higher dose and if she has not felt benefit being on them or off them then she needs to see her doctor to investigate exactly what the problem is.

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Irene B. Lomayani | 2:49 pm, July 16th, 2015

In 1996 I had total removal of the uterus, Fallopian tubes and overies due to severe fibroids. My doctor put me on HRT to avoid premature menopause.
It has been 19 years now and I am getting to 70 years old.

After 5 years, I wanted to quit due to scaring negative literature. My doctor encouraged me to continue but put me on Premarin 0.3 mg daily,a relatively lower doze.

I have been feeling great. But. I tried to wean myself off by taking the tablets on alternative days. Flushes and sweating were uncomfortable. I have regular medical check ups including mammogram, pep smear….an so far all is fine. My breast however, appear fuller. I go to the gym regularly. I take food supplements: calcium, vit C, centrum and Omega 3,6&9.

When and how can I safely quit with less side effects. I live in Africa so the alternative medicines and creams mentioned above are out of reach. Please advise.

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AnnA Rushton | 3:34 pm, July 16th, 2015

Irene after so long on HRT it is difficult to come off easily but we suggest you don’t cut down until you can support yourself with a bioidentical cream and 20-1 would be best for this purpose. Use it alongside your HRT for a week or so and then cut down the HRT very gradually and this will help minimise the withdrawal symptoms, but having been on it as long as you have there may still be some.

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Veronica Cooksey | 5:30 pm, July 26th, 2015

reading these comments has helped me to realise I’m not alone. I have been taking HRT for 25 years but for the last 18 months I decided to come off them and try another alternative. Ive tried others in the past but because I was really young, they didn’t work. So now I decided to try Evorel 50 which had really bad side effects; numbness down one side of face and very weird head sensations which were awful.
Now I’m back on Estrodial Implants which I finally feel myself so for me I’d rather have a quality of life then not being able to go out feel depressed, moody, irritable, nauseous and dizzy most of the time. I will and some stage come off all together, but right now I’ve got a life to lead.

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AnnA Rushton | 9:54 am, July 27th, 2015

It is always best to come off HRT slowly Veronica so you may want to consider using progesterone to balance the oestrogen of the implants now and that will help with both your current symptoms and support you if you do decide to stop HRT.

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Jane | 8:24 am, July 28th, 2015

I had a total hysterectomy at the age of 34, I am now 51 and have been on HRT since my hysterectomy, my GP advised I come off HRT, for a couple of weeks I reduced my HRT, taking it every other day, I then decided to stop all together, I am now feeling absolutely horrendous, hot and cold flushes constantly throughout the day and night and severe headaches and migraines, also constantly throughout the day, I feel like my head and eyes are going to burst, I cant sleep and I am exhausted … I cant take much more of this … please, please help me

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AnnA Rushton | 6:55 pm, July 28th, 2015

Jane unfortunately, as the article indicates, it is never good to come off HRT too suddenly and without the support of bioidentical hormones during the transition as withdrawal symptoms can be very severe. If you still have your HRT we would suggest you go back to every other day until you have some 20-1 to use alongside it and then you can gradually taper it off.

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Jill | 4:43 pm, August 2nd, 2015

I have been on HRT for 25 years following an oopherectomy . I tried to come off cold turkey about four years ago but flushes etc were awful. I went back on to Indivina, lowest dose , but now my GP would like me to come off. I have had Polymyalgia Rheumatica for three years and am not sure I could cope with anything else. The steroid side effects are bad enough, she has told me to think about it and maybe start taking it alternate days. I am 64 . What is the 20-1 that keeps getting mentioned. I would be very grateful for any help.

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AnnA Rushton | 11:40 am, August 3rd, 2015

20-1 is a combination cream containing both progesterone and oestrogen Jill and is a bioidentical HRT replacement. You can use it as you cut down your HRT and then afterwards to help with your symptoms. Bioidentical hormones do not have side effects or withdrawal symptoms so can safely used alongside your HRT.

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Jill | 2:32 pm, August 3rd, 2015

Is the cream available UK either on prescription or privately. Many thanks got your prompt reply Ann.

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AnnA Rushton | 11:40 am, August 4th, 2015

GP’s can prescribe on the NHS but it is entirely at the discretion of the practice or you can obtain a private prescription – however the simplest option – and least expensive – is to order directly. Two private GP’s who do prescribe – Dr Shirely Bond and Dr Tony Coope – can be found at this link:

http://www.bio-hormone-health.com/2014/09/10/bioidentical-hormones-found-beneficial-after-hysterectomy/

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Heather Nel | 4:10 am, August 9th, 2015

Been on Estradot 50 patches for 20years after complete historectomy. How do I proceed to go off. Facial skin very dry and itchy scalp with hair thinning. Is this a side affect of HRT ?

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AnnA Rushton | 4:47 pm, August 9th, 2015

Heather with such a very long time on HRT you must discuss this with your doctor as withdrawal symptoms could be severe. Start first as the article suggests and add progesterone at the same time as you are cutting down on your patches. When you are off the patches you can then switch to a combination cream if you still need some oestrogen.

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Debbie Elias | 1:13 pm, September 2nd, 2015

I’ve been taking Livial nearly 11 months,due to a total hystrecomi, felt really good so I came off tablets, it’s been 1 month and I feel like I’m falling apart, aches and pains , arms legs, tummy, lower back and breast, I also have cysts in my breast , gone back on tablets , it’s been nearly 2 weeks, feeling really yuk !!

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AnnA Rushton | 3:10 pm, September 2nd, 2015

Unfortunately Debbie your hormones crashed from the very high levels in the HRT when you stopped, but bioidentical hormones do not have these side effects or withdrawal symptoms. You may find this helpful:
http://www.bio-hormone-health.com/2012/04/17/hrt-or-bioidentical-hormones-heres-why/

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