Women with complex medical issues are often dismissed when they inquire about hormone replacement therapy. Because of her history of DVT my patient received the same message from multiple sources. No! You can’t take HRT. As she relays her story of misery my patient was greatly relieved I was aware of the studies demonstrating how HRT can be prescribed with a history of blood clots. If you have a complex medical history and are suffering schedule an appointment.
Actual patient story
After menopause, I suffered hot flashes, mood swings, fatigue, and memory issues, all of which affected me personally and professionally. Because I have a history of estrogen-fueled cancer in my family, I resisted hormone replacement therapy (HRT) and worked with my doctor to find alternative therapies for my symptoms – which consisted largely of anti-depressants/anti-anxiolytics. I tried different drug combinations for a year and a half without success.
I knew I wasn’t functioning well, I didn’t feel well, and I knew these issues were noticeable at work. As a last-ditch effort, I turned to HRT and was shocked at how quickly my symptoms resolved. One month into oral HRT therapy, I felt functional again and my annual mammograms remained clean.
Fast forward a few years, and I had a hip replacement and moved across the country. I don’t like being confined to small spaces, so when I bought a car and drove it across country to my college student, I drove 44 hours round trip in two days. At the end of the trip, my right leg was swollen, sore, and progressively worsened; an orthopedist ordered an ultrasound and I was diagnosed with deep vein thrombosis (DVT). There were 5 blood clots in my leg.
I sought care from a hematologist, who advised discontinuation of HRT to mitigate the risk of future DVT. My symptoms quickly returned with vengeance; my memory was so affected that when a coworker asked me my husband’s name, I couldn’t recall. I was alarmed and my general practitioner agreed to revisit previous therapies. Still miserable after several months, I asked about resuming HRT and was advised not to.
Because I was already a patient at Advanced Women’s Health Institute, I decided to see Dr Moore. Dr Moore was aware of articles suggesting estrogen delivered through a skin patch might be safe even with a history of DVT. We reviewed medical records from the hematologist, and I was prescribed estradiol patches with oral progesterone and a low-dose anticoagulant.
Today my symptoms are again minimal. I’m hopeful that if I continue with a watchful eye, I can live comfortably and maintain employment. HRT is an effective therapy for women who are unable to achieve relief in other ways and research suggests it is safe for most. Under the care of an informed specialist, HRT can be safe even for women like me.
