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So what now?

(5 Posts)
Lozzamas Mon 02-Jan-17 23:59:42

Am post meno. Have had issues with vulva itching, stress incontinence, night sweats and insomnia. My GP took blood tests and suggested HRT - Everol Conti. First few weeks things were great, then violent mood swings, irritable, back and arms itching furiously, Har loss, allergies to my usual face cream etc. Have gradually reduced the patches attempting to find a reasonable dose, have been off patches all together for 3 days - know I won't be clear of the hormones as yet but my itching has reduced, but sleep disturbance has returned, aggression reducing. That makes me think I either need a microscopic amount of HRT or to put up with the Meno issues. Spoke to GP about changing prescription and they have said they would suspect a progesterone intolerance that makes me unsuitable for HRT and they would want me to stop HRT after a year anyway, they only suggest it for short term relief. So she feels ther is not much point in experimenting as we are 4 months into the year and if I can't tolerate the standard formulation the year will be over before we find a suitable combination. They have suggested I could stay on an estrogeon vaginal cream - which from what I read may help the Vulva itching assuming it returns, but won't help any other symptoms? Anyone else had rashes, allergies and itching and aggression with HRT? Does it mean I am unsuitable for standard formulations - or did you find another "brand" had better results?

PollyPerky Tue 03-Jan-17 08:37:30

Why this 'year' thing? Are you 59 and your GP thinks you have to stop at 60?

I think you need to either change your GP, take along a copy of the NICE guidelines on menopause/HRT (online) and suggest she reads it or goes on a course, or find a private consultant who can treat you properly.
Your GP is terribly out of touch. I've never heard of anyone saying it's for a year only. I've used it for 8 years and am now in my 60s. My dr is a top UK menopause consultant.

The main issues in the NICE report were:

-Treatment is individualised for each woman
-There are NO time limits on the use of HRT( 2-5 year 'rule' blown out of the water)
-It is the WOMAN's choice whether to use HRT( as long as she has no medical reasons not to be able to use it
-Drs have to inform women of the small risks, then the decision is the woman's.

You may be intolerant to the synthetic progesterone. There are other options:
-first, a monthly cycle so you only use progesterone for 10 days a month ( and you'd have a light period every 4 weeks). Being post meno doesn't mean you HAVE to use continuous HRT - you can use sequential.
-swapping the progestogen in the patch for micronised progesterone (natural progesterone)
-using a Mirena coil and a separate oestrogen (gel or patch)

The bonus of gel is you can change the dose yourself, applying anything from 1 pump to 4, to find what helps you.

I've used sequential HRT for 8 years - beginning in peri and carrying on afterwards. I don't want to change to continuous as I don't want to use progesterone every day.

Seriously, look for another GP or if necessary a good consultant who knows what to do!

Lozzamas Tue 03-Jan-17 16:15:55

Thanks for the advice- when we first discussed Hrt she did say it would only be short term - she and it's her view only countenances Hrt for its beneficial effects on osteoporosis etc. She doesnt believe in providing continuous support for a natural process unless you have a significantly raised risks that HRT can prevent. I won't be 60 next year, but she has said that she does not prescribe HRT for the over 60's. So if I continue down that road I'll probably need to change doctors. Can't use Mirena had one removed some time ago as we didn't get on together, so it sounds like I need to try natural progesterone.
I think I need to look for a private consultant - as if I'm going to invest time and money and my well being getting this right I want the right help to do so and to keep on it if I can make it suit.

PollyPerky Tue 03-Jan-17 18:58:27

Unbelievable!

So she's happy to refuse treatment to women based on her own 'beliefs'?
Does she apply the same logic to patients with diabetes or men with prostate problems? She sounds mad, frankly and her behaviour is also completely unethical. She is not ALLOWED to refuse you treatment ,unless it is dangerous for you. I think you ought to remind her of this, quite honestly and shove the NICE guidelines at her! The choice to use HRT is YOURS and her role is to tell you the risks.

I hope you find someone to help- she's clearly not up to the job. sad

PollyPerky Tue 03-Jan-17 22:33:57

Just to add having thought about this some more....

do you feel up to talking to her about her 'beliefs'? For the sake of other women even if you find a private dr?

No dr can deny treatment because of their 'beliefs'- this is science, not religion.

If she doesn't like HRT she needs to tell you why and you need to ask her why.

If it's risks, then she needs to explain why a year on HRT is, in her view, the limit. And you should explain the NICE guidelines to her.

She sounds completely out of touch and misinformed. A large number of women have meno symptoms for up to 20 years or more. Does she think they don't need treatment?

Saying she only prescribes HRT for a year unless there is risk of osteoporosis is ridiculous. She needs to explain why.

Is this the policy at the practice or is it just her view?

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