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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Had A Heart Attack. Stent Put In. Advised To Discontinue HRT. What Can Be Take In Place Of HRT?

I recently had a heart attack and had a stent put in. Now my doctor wants me to discontinue my HRT. I was taking Estridiol 2mg. I had a complete hysterectomy 12/09 and a complete thyroidectomy 11/11 and now this. Needless to say I am not in the mood for hot flashes or any more mood swings. Could you please advise me as to what I might be able to take in place of the HRT. Thank you so much for your time.
Sat, 27 Jul 2013
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General & Family Physician 's  Response
Hello,
Thanks for the query to H.C.M. Forum.
Your heart doctor is right , give up estradiol .
In place of estradiol , you can use clonidine ( 0.1-0.2 mg/day)
OR
Vitamin E ( 400 to 800 I U /DAY)
OR
Consumption of soya based products .
All these or any one of them will help you to overcome your symptoms as hot flushes etc.
Good luck.
Dr. HET
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Cardiologist Dr. Milan Ashokkumar Mehta's  Response
intake of artificial oestrogen does increase chances of thromboembolism and this is well proved in clinical trials.
It may increase chances of your stent getting blocked therefore I would strongly recommend you to not to continue your hrt treatment and you should still look for some alternative your mood and skin problem.

For your mood problem you may consider low doz of anti depression medication or a mood stabilizer.
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General & Family Physician Dr. Athish Peter Margos R's  Response
Heart attack is a result of thrombosis in the blood vessels supplying your heart that results in its complete occlusion and hence damage to heart. Stent was put in to open up the block.But thrombosis can result within the stent also and in that case, there will be recurrence of heart attack and the prognosis for survival becomes very poor.Hence two things become very necessary.One is to take medicines that will inhibit thrombosis in form of antiplatelets and another is to avoid all thrombogenic factors.Estradiol is highly thrombogenic and is an absolute contraindication in post stent patients.So,you cannot take it in future.
Mood swings and hot flashes can be managed by other safer means.Natural relaxation techniques may be helpful.Small dose of sedatives may be taken.With time you will be able to put up with it as you get more used to it.
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Had A Heart Attack. Stent Put In. Advised To Discontinue HRT. What Can Be Take In Place Of HRT?

Hello, Thanks for the query to H.C.M. Forum. Your heart doctor is right , give up estradiol . In place of estradiol , you can use clonidine ( 0.1-0.2 mg/day) OR Vitamin E ( 400 to 800 I U /DAY) OR Consumption of soya based products . All these or any one of them will help you to overcome your symptoms as hot flushes etc. Good luck. Dr. HET