What happens when you stop taking HRT? Do you have another menopause and do your menopausal symptoms return? In this post, I explore what to expect and what you need to know if you are stopping or considering starting HRT.
Coming Off HRT Side Effects – What You Need to Know
Stopping HRT – Will I Notice the Difference?
HRT is a powerful drug. Our own sex hormones and prescribed hormones are steroids. It is not surprising then that HRT has the side effects it does for some women. The debate about HRT and the risk of side effects will continue about whether it is safe to take at all, or for how long, but most agree that it is not something to take forever. Which means that at some point, women who take it will need to stop.
As with many drugs, starting is easily done and the difficulties of stopping rarely discussed at the outset. However you felt being on HRT, there is a good chance you will notice its absence.
When I Stop HRT Do I Have Another Menopause?
The short answer is no but it may feel like it.
The term “menopause” is the when your periods stop – naturally, or from a surgical or pharmaceutical intervention. The peri-menopause is the run up to that. And the menopausal symptoms you may experience before, during and after menopause are mostly prompted by the changes in our hormonal levels. When you are coming off HRT, your body has to rebalance after the withdrawal of those additional hormones. This means the symptoms you will experience will be “menopausal” as you adjust.
Although, menopause is not all about hormones. It is far more than a life stage purely defined by hormonal flux. I realise it can feel like that at times. But it is also a potentially a positive, valuable and fulfilling time of transition in a woman’s life.
Coming Off HRT: Side Effects
Over the years I have seen so many women struggle as they try to stop and stay off HRT. The withdrawal process is underestimated. Just stopping cold turkey is not a good idea unless there is a medical emergency, surgery scheduled, etc.
It is an area I work with a lot in in practice. I often suggest that women taper the dose and work with their GP to tail off their last prescription(s). And we can also undertake preparatory work before actually stopping HRT. We aim to build in support on all levels – more of that later!
Based on what I see in practice I would say that when women are coming off HRT, the side effects they experience fall into three categories:
- Previous Menopausal Symptoms – if hot flushes, night sweats, achy joints, mood swings, etc. drove you to take HRT, chances are they will reappear when you stop taking it. Your menopause will probably have been and gone, but your system has to adapt to life without the extra hormones.
- HRT Withdrawal Symptoms – you may find you have new symptoms, or more intense “menopausal” symptoms as the extra pharmaceutical oestrogen is withdrawn.
- Symptoms Reduced or Suppressed by HRT – I have found that sometimes women have had hormonal or apparently unrelated conditions helped or masked by taking HRT. Once the HRT is stopped, if nothing has been done in the meantime to support or resolve the condition, it may return.
Coming Off HRT & Osteoporosis
What women are not usually told is that if they are taking HRT and have osteoporosis, osteopenia or are at risk, once they stop, their bone density will drop back to where it would have been anyway. There are also potential issues about how HRT affects the bone – does it actually make it stronger and healthier in the short or longer term?
You can read more about this particular issue in my blog HRT and Osteoporosis: What You Need to Know.
Is it Easier to Come Off Bioidentical HRT?
Bioidentical HRT is the new kid on the HRT block. I have not seen any data that convinces me of its long-term safety.
I think a lot of assumptions have been made about bioidentical HRT just because it is chemically the same as our own sex hormones, and in a lower dose. But if you are being exposed to levels higher than you would biologically expect to be at a given point in your life then logically that must invite some risk.
In practice, I see women just as hooked on the bioidentical variation than on standard HRT. If it is strong enough to make a difference, it is strong enough to run the risk of side effects, and to notice its withdrawal. My experience is that it is that it can be just as difficult to come off bioidentical HRT as it is standard HRT.
Coming Off HRT – Support Measures
The degree of difficulty will vary as each women and her situation is different. There is a lot you can do to ease the transition in terms of self-help.
- Do your best to ensure you are eating as healthily as possible. Making good decisions about what to eat and drink at menopause can often make the most incredible difference. Some food and drinks in particular can be worth avoiding or reducing significantly – these include sugar, caffeine and alcohol.
- Try to ensure you have enough exercise each week, ideally load bearing to support long-term bone health.
- If other health issues have or are likely to rear up, have a good look at them. See what steps to take to really work with them to improve your long-term health.
- Explore and pursue avenues that are creative and supportive. Let off some steam and have fun!
- Bump your own needs further up the list – if you don’t look after you who will? You are also creating a model for your children and grandchildren. What blueprint for life and self-care would you like to gift them?
- Get support from family, friends and if you get stuck, reach out for more help. Menopause is one of life’s certainties for women, but you can have a huge impact on how it is for you.
Coming Off HRT – Easing the Transition
As a practitioner I have been supporting women through this process for years. For some women, self-help strategies are enough. For those that struggle, we can offer extra support.
There are many aspects to consider and if you are a colleague, or just really interested, you can read an article I wrote about HRT Withdrawal Support Strategies for Homeopaths.
If you are taking HRT and thinking about stopping, prepare well and put as much support in place as you can. For those women who are on HRT and not ready to stop yet, I would suggest being as health-minded as possible. Also paying attention to your emotional life and quality of life. Because when you stop HRT, issues can magnify. And exploring this will ease that transition. With the added benefit of potentially improving your life and health now, and for the future.
In all instances, HRT creates a false hormonal layer and does not, I believe, offer much to improve our long or short-term health. So when you stop, you fall back upon your own resources. The more you build those resources, the better placed you will be.
If you are reading this and have not started taking HRT, I hope it has given you pause for thought. And to perhaps explore the benefits of taking a more natural approach at menopause.
I have been offering women information and support at menopause for over 15 years. If you visit my website page on menopause you can find out more about how I work. You can also access a great deal of information by reading my menopause blogs.
I hope you have found this blog Coming Off HRT Side Effects to be helpful. If you are interested in receiving more information and updates about upcoming Workshops, you can sign up to the Chantry Health Newsletter.
I see patients in Lewes in East Sussex, in West Sussex, and also via Skype. Please do Contact Me if you would like to arrange a free mini-appointment to see if my approach might suit you.