To be absolutely furious at bloody incompetent GP?

I thought topical oestrogen was available over the counter now but see it's only one type.

The OP wasn't unreasonable to refuse the male GP examining her - the first GP should have made proper notes.

But this does seem to be yet another example of NHS saying a silly little woman not knowing her own body. Can GPs please just listen to us? And comply with the NICE guidelines.

Again, not true. I don't actually know anyone who was examined prior to getting prescribed oestrogen cream - always given on the basis of description of symptoms.

Should of let GP exam you. No medical professional is going to diagnose you without an examination.

It would make far more sense to try the oestrogen cream first. The biopsy is very invasive, I've seen several woman say the area has never recovered properly after it's done.

You should see a gynaecologist those symptoms n could also be lichen sclerosis which can only be treated with dermovate. You will need a have a skin biopsy to confirm it.

Can you do an e consult? I was getting a lot of UTIs and read that they can be caused by menopause. So I wrote to GP and said what I'd read and was it worth a go due to being late 40s
I got a text back to say she agreed and it's helped loads.
With hrt it def seems to depend on your gp :( I know docs traditionally saw people to prescribe but I think as one has you'd think other would have gone with that and then tried next line of help...topical hrt

Have you had a good look at your vulva. Please check out LICHEN SCLEROSIS. This can often be misdiagnosed. Do you also have white patches down there, itching and splitting skin which can be sore.

What this comes down to is that if you're a woman with money, you can get exactly what you want by using online services or menopause clinics. If you have no money, it's down to luck whether or not you get appropriate care in a timely manner.

YABU. Nice guidelines are guideline and are often misunderstood. If there are a multiple potential causes the GP will go with whichever one they think is right at the time. You’re entitled to ask for a referral and they’re entitled to refuse.

She had always been examined. Nice guidelines say HRT should be prescribed in symptoms only. I have vaginal.atrophy and never been examined, as have lots of women on this thread.

Im guessing you haven't read the Nice guidelines.

It really shouldn't be this frustrating to obtain HRT full stop. I thought we'd moved on from this years ago.
I'm constantly dismayed when I read threads like this😥

Are you a Dr OP? Because diagnosing yourself via google and NICE guidelines isn't always accurate. This could be due to menopause, it could also be for other reasons. By all means ask for a gynae referral, but refusing to be examined and then having a strop because the Dr didn't give you what you wanted isn't ok.

If the cream was totally safe you could buy it OTC without needing an online doctor to sign it off.

You can buy Gina OTC. Which is what makes the insistence that the OP has not one but two intimate exams plus a gynae referral especially ridiculous.

What the doctor thinks is irrelevant. Its about the patient not the doctor.

Vaginal atrophy is regularly diagnosed from symptoms - a pelvic exam is not an essential, especially in cases where there is history of trauma. Its especially an issue when confronted with an unknown male doctor - at the very least she should have been offered a female HCP for the exam.

The GP who did examine her failed to record the diagnosis in the notes. That's a failure on their part resulting in a CSA survivor being put in the position of intimate exam by unknown man or no treatment.

Whichever way you look at it its poor practice.

Of course it's intimate. Yes from the GP's perspective it's not and they've seen dozens of women with no clothes on just that week, but for the patient it is. Which is why a decent GP recognises that, offers a chaperone etc etc.

So many of us have stories about what GPs said or did when we presented with menopause symptoms, the general lack of knowledge out there is shocking. Even though I'd had a hysterectomy (which can mean you enter menopause sooner than ordinarily) I was offered two lots of antidepressants and one lot of folic acid (wtf??) before joining the dots myself and asking for HRT, which is what I needed all along.

It’s not intimate though. The doctor spends no longer thinking about one patient’s vagina than the next patient’s tonsils!

It is to the patient, particularly one like the OP who has been the victim of SA.

I can't believe your GP hasn't just prescribed it! I had an over the phone appointment with my lady GP and she said any lady over 45 they treat the symptoms of being peri menopausal. My only symptom ( so far) was feeling like I was getting a UTI all the time and being uncomfortable and she didn't hesitate to prescribe the vaginal HRT cream Estriol and omg it has changed my life! How can one little cream be so life changing? I would try and see a different doctor at the practice you shouldn't have to suffer like this. Good luck x

I made a lot of points but you pick up on that one only.

If the cream was totally safe you could buy it OTC without needing an online doctor to sign it off.

It’s not intimate though. The doctor spends no longer thinking about one patient’s vagina than the next patient’s tonsils!

This website states this:

Women already taking systemic HRT can only buy Gina if they have previously had similar vaginal estrogen or their GP has confirmed that Gina is a good option for them.

In the meantime try changing your toilet roll!! I all of a sudden developed a reaction to most toilet rolls and can now only just Andrex gentle. Worth a try

Because it’s an online service and you don’t expect the same level of medical attention when you essentially self-diagnose

They are still licensed doctors who are signing off on a prescription, it's no different.

The fact is that low-dose oestrogen cream is a very safe treatment and not just giving it in the first instance, never mind two examinations and a gynae referal, is utterly ridiculous.

For this reason YABU and wasting NHS GP appt slots ontop of that.

No woman should be castigated for refusing an intimate medical examination by a male doctor that she was not expecting.

And I'm beyond tired of the suggestion that we should be fawningly grateful for, and protect the NHS. We pay for it, and it hardly structures itself as a model of efficiency.

There is no need for women to be referred to a specialist gynae for something like Vagifem. This is standard stuff. @ItchDrivingMeInsane I would go back to your practice and ask to speak to someone privately about what has happened and that you still need to resolve this. Can you see someone asap. Be factual but your aim is to get yourself sorted as opposed to assigning blame at this stage. I had Vagifem prescribed with no one looking at me and I'm on HRT. I was having UTI issues as well. Vagisil is cooling for the itch too but is a temporary solution.

I’m in the middle of something like this I think and am having amazing trouble getting a gp appointment but that’s another thread.

Iv been diagnosed with early menopause and taking hrt.
Can I ask though my symptoms are on labia majora rather than the minora though.
very very itchy although try not to itch it. swelling and bleeding (prob from scratching while asleep) change in texture of the skin to wrinkly and puffy. Although this is combined with very sensitive and very very dry labial minora.

sorry everyone TMI!! Does this sound like vaginal atrophy? I’m obviously not trying to get a diagnosis over the internet but until I can see a gp I was wondering if this thread sounds familiar to what I’m describing and is being discussed.

good luck op, you shouldn’t have to go to Superdrug or wait a year to get some relief!