Medical Q&As

H.R.T. - still need it?

I am 54 and have been on HRT for five years following a total hysterectomy. My G.P. feels I should stay on it indefinitely. I would like to phase out HRT over a few months. Does HRT postpone the menopause?

I suspect that your GP wants you to continue with HRT in order for you to obtain the additional long-term benefits from the treatment such as prevention of osteoporosis and reducing the risk of coronary artery disease. Our thinking in relation to HRT has shifted from simply relieving the symptoms of the menopause to a preventive mindset where we attempt to reduce risk of the aforementioned conditions. Evidence suggests that you need to be on the treatment for at least five years in order to gain these benefits. You use the term total hysterectomy but do not say if your ovaries were also removed. If they were removed then you have already gone through a surgically induced menopause. If your ovaries were not removed then they have probably stopped producing hormones at this stage considering that you underwent surgery five years ago. HRT does not postpone the menopause. It simply supplements the declining levels of hormone being produced as the ovaries wind down their level of hormone production. Once the ovaries have shut down their production of hormones the HRT simply replaces your natural hormones with a synthetic replacement. If you really want to come off HRT then discuss it with your doctor. You donít have to stay on it if you donít wish to do so.