New to HRT

[Hysterectomyhysteria]

I had a total Hysterectomy including overies last month and have been prescribed Everol 50 patches.
I have a few symptoms which I didn't have pre Hysterectomy but don't know if the HRT is causing them iyswim.
My vagina is really dry and sore.
My skin is so dry I look like I am shedding it like a snake!
I have a on/off 'headache', if feels like I get a short sharp cramp in my brain a few times a day in the same place . It is so painful that it stops me in my tracks and makes me gasp.
I have really loose watery stools which are bright yellow with a strange smell which I seem to remember from changing by babies nappies sometimes (youngest is 15 now so it's a long time ago!).
I am having both cold and hot flushes.
And my brain is extremely foggy!
Apart from that I have nothing much to complain about!

[PollyPerky]

Just quickly - but sounds as if the dose is too low after a full hyster. Suggest you think about changing to gel Oestrogel so you can alter the dose ( and increase) until you find a level that control the symptoms. And ask for vaginal estrogen too- Vagifem or Ovestin. Use daily for at least 2 weeks then 2-3 x a week forever.

[Hysterectomyhysteria]

Gel? Would I rub that on skin? So I wouldn't have a patch? Clueless here!

[PollyPerky]

Yes. Google it- manufacturers have a whole website on it all :)

[Hysterectomyhysteria]

Thanks Polly, I Googled after my last post, why do I still not think to Google instinctively,?! 😀
I think that I prefer the sound of the gel to the patches as I hate seeing the patch on my skin.

[Hysterectomyhysteria]

Well. I went to my GP about changing my HRT and he actually said 'I have no idea, i don't deal with HRT. Phone your surgeon'. I have phoned her secretary and now waiting to hear back ......

[PollyPerky]

Change your GP! WTF is that comment supposed to mean! 50% of his patients will be women. Does he tell men he doesn't deal with prostates, or libiodo, or ED? I bet not. it really is shocking.
I think you ought to tell him he should go on a BMS course to learn about it. Bloody cheek.

[Hysterectomyhysteria]

I know Polly. I was gob smacked and just mumbled OK and off I went. I am so annoyed at myself! I am now a bit worried that my surgeon will charge me for a. Consultation and prescription as my surgery was done privately.

[Patchouli666]

What are your iron and haemoglobin levels like post op? The brain fog and tiredness could be linked to being anaemic.

[HysterectomyHysteria]

Sorry I didn't get a notification of your reply. I don't know my levels are. I will ask the consultant when I see her in three weeks.
I have seen another GP and she has prescribed oestrogel but wouldn't prescribe anything to use vaginally. She also couldn't tell me how a dose from the pump equates to the everol patch I am currently using.
Do you know @PollyPerky?

[PollyPerky]

Sorry- I don't understand why she would not prescribe vaginal estrogen- how did the conversation go? Did you ask? What did she say?

There is NO reason you can't have it, so you need to go back, insist or see another GP.

The starting dose for gel is 2 pumps. I don't know how that equates to a patch but try 2 pumps to begin- that is a medium dose.

[HysterectomyHysteria]

Thanks Polly, I asked about vaginal estrogen and she said that it isn't prescribed with other types of estrogen, it's a stand alone product so you have gel/patch/tablets OR vaginal - not both. She recommended that I buy a vaginal moisturiser.
How long until I know if 2 pumps are enough?

[SirVixofVixHall]

Can you see someone privately? Nick Panay is very highly thought of, a friend of mine saw him and he was extremely helpful. Other than that there is the Marion Gluck Clinic? I'm sure there are other people you could see who would be far kinder and more helpful than this.

[PollyPerky]

Oh FFS! See someone else! She ought to be struck off. That's total bollocks. You CAN have both- I've had both for 8 years from a Harley St consultant!

1:4 women need both.

You need to go back and tell her to ask someone who knows- ask her to read the NICE guidelines.

There is no need to put up with this nonsense from GPs.

Panay has a 6 month waiting list for private work.
Gluck is not good.

And anyway this is BASIC stuff about HRT which any GP ought to know.

Here is a link- see top box, left hand side- it says both may be necessary.

www.menopausematters.co.uk/pdf/HRT%20Guide%202016.pdf

Is there another GP at your practice?

[PollyPerky]

You might like to show her this from NICE (has she not bothered to read the guidelines?)

Urogenital atrophy

1.4.9 Offer vaginal oestrogen to women with urogenital atrophy (including those on systemic HRT) and continue treatment for as long as needed to relieve symptoms.

1.4.10 Consider vaginal oestrogen for women with urogenital atrophy in whom systemic HRT is contraindicated, after seeking advice from a healthcare professional with expertise in menopause.

1.4.11 If vaginal oestrogen does not relieve symptoms of urogenital atrophy, consider increasing the dose after seeking advice from a healthcare professional with expertise in menopause.

1.4.12 Explain to women with urogenital atrophy that:

symptoms often come back when treatment is stopped

adverse effects from vaginal oestrogen are very rare

they should report unscheduled vaginal bleeding to their GP.

1.4.13 Advise women with vaginal dryness that moisturisers and lubricants can be used alone or in addition to vaginal oestrogen.

1.4.14 Do not offer routine monitoring of endometrial thickness during treatment for urogenital atrophy.