Gynaecologist's views on older women AIBU

[disappointedyetagain]

I'm using patches for HRT. They're not working very well and my GPs all seem to think the only other option is a pill version. I've tried this and although it worked well to start with, it made me very unwell emotionally. I already take the max of a well-known anti-depressant plus a low-does of an older version for pain I get with a chronic disabling condition I have.

Despite sweats that literally wash over me, I can no longer shower daily as the moment I hit the water, the patches slide off. I've tried different brands but my stretch marks cause little gaps that leave water seep between the skin and patch.

I finally got referred to a gynae and after a year-long wait, saw one yesterday. There are no menopause clinics in my area (only one in the country and that's out of my LHB). I can't afford to go private.

What a waste of time. I explained why the patches weren't working (falling off), she asked why I didn't put them on my arms. It says not to on the leaflet, so I told her.

Told her the problem with the pills, and then explained my medical history means I shouldn't have been prescribed them in the first place.

I asked her to prescribe the gel as I thought it might be my only other option but my GPs haven't heard of it. I then had to spell it for her to look it up in the BNF. She couldn't understand why I wanted the gel as it's the same ingredient as the patches. I repeated the problem I was having with the patches falling off.

She concluded that she'd be writing to my GP recommending anti-depressants and beta blockers (I also said I can't take them as I'm asthmatic).

She then asked how long I've been menopausal (2 years) and said that I only had another 2 years before it finished! I'm sitting there wishing for a crystal ball like she has, whilst wondering if she'd cope with another 700 nights of lost sleep due to menopausal night sweats.

I told her that my sister suffered through her menopause for over 10 years and that I knew women who were still taking HRT at 60.

Then she got vitriolic and practically spat at me that those older women only took it "to make them feel younger and look better so they could attract younger men".

WTAF?!

WIBU to complain about this doctor?

Is it me? Why am I getting doors slammed in my face for wanting a solution to the awful flushes and sweats that keep me awake? My condition is hard enough to live without dealing with something making it even more difficult.

I'm a long-term poster who's name-changed for this post as it's outing. I'd really like some sensible input and advice about this.

That sounds awful. Dismissive, condescending and frankly inaccurate. I’m nearly 60 and have been on HRT for 5 years. Without it I’m a sweating, flushing, aching wreck who can’t sleep as I had to shower and change my nightclothes and sheets every flipping night. It certainly isn’t to make me look younger and I have no wish to be in a relationship again.

You would not be unreasonable to complain .
What is your GP like? If the gel seems to best option for you bearing in mind you can’t take tablets and the patches are impractical, would they be able to prescribe it?

You are entitled to a see another specialist but then you have the issue of waiting again. So sorry this woman was so unhelpful. Are you able to travel to a hospital in another area? You don’t have to see one only within your own Trust area.

Can you stick them on with surgical tape type stuff?

I would complain. That’s incredibly rude.
Can you go private. I know it’s crazy, but if you could have one appointment with a specialist then you might find it changes everything. And you might only need one, then they can refer their suggestions back to your gp.

Thank you RyelandSheep

I can travel out of area, but won't be referred.

I've seen 5 different GPs and they've all said patches or pills. No one seems to have heard of the gel. One GP told me to stop wasting her time as it was ONLY patches or pills.

I'm in Wales. Am I missing something? If they're not allowed to prescribe the gel, then fair enough, but I've not read anything to say this.

What annoys me the most is that everyone I've seen so far has been a woman who hasn't hit menopausal age. I'm getting to the point of hoping that Karma really is a bitch!

Try different areas of body. I suggest you experiment.
Also, try to get hold of some Cavilon spray. Spray at site, let it dry then apply patch.
It's been known to help keep adhesives patches/dressings in place. HTH.

Rahul88 I've tried surgical tape but as soon as it gets wet it starts pulling the patches off with it.

I tried surgical tape holding clingfilm over the patch, but that was unsuccessful, too.

Holdingonbarely (love your name). It's £200 plus blood tests (that my GP refuses to do). I can't afford it, but am saving. I don't work as I have a chronic disabling disease (that would also out me if I mentioned it).

They might not be allowed to prescribed the gel in terms of budgeting. Depends on the CCG.
Have you looked at quotes for a private gynae consultation?

Why shouldn't you put the patches on your arms?

I would complain.

What she said was very uncalled for.

I think then you’ve just got to be a pushy motherfucker.
Look up nice guidelines. Research, go in and say this is what I need and I’m not taking no for an answer unless you can come up with a credible reason I can’t use the gel.
Have they even given you a proper reason they won’t allow the gel for you?

Lifeisabeach09 I've just ordered some of that spray from Amazon.

Thanks. I'll try it and let you know if it works in case someone else reading this thread has similar issues.

Will it stop absorption, though? I have tried it just about everywhere below the waist with no success. What with the stretch marks and the soaking with sweat, the patches haven't stood a chance even if they stick. I just can't get them to touch the skin fully. The minute I move they just crinkle.

disappointedyetagain - I am starting on this track; everytime I ask a question I get told 'because' or words to that effect

MN (sometimes) gets me more information - but I am struggling

I went from "you HAVE to have HRT" to "OK you don't" in the space of asking - what benefit to me will taking it cause?

I get so confused

My mum was on it for 10 years I think. Or near enough. She went through the menopause for a decade anyway (hell for everyone involved, glad it's over,absolutely.petrified of it now when it happens to me

Agedfanjo tell them you have a partner.

I've recently lost a very dear friend to cervical cancer. She was in her 70s and had lost her husband decades ago. She was given dilators to use to try to open herself up so she could have radiotherapy.

You definitely need to keep a functioning fanjo and not just for a man!

Another route for you.
My mum had really bad night sweats for years. She refused HRT (for the same reason she refused the pill before. She just doesn’t want to take hormones of any kind).
What helped her was acupuncture. Made a HUGE difference to her. Even though she still had some night sweats, she want drenched, she could sleep etc etc.

The gynaecologist was awful and I ca;see why you would want to complain.

I’m also surprised you can’t be referred to THE menopause clinic. I thought it was always ok to get a second opinion and that person didn’t have to be in your area. Maybe worth a try now that you’ve seen the consultant (and therefore have laready been referred)

I was offered anti depressants too
as a first stage, against nice guidelines, I have been really shocked by the lack of up to date knowledge by the people I have seen.

My friend has hrt pessaries, is that an option for you? I agree with pp sadly though, to get taken seriously with any gynae issue you have to be a pushy fucker (fortunately I have now perfected this!).

I was on HRT a woman Dr then refused to carry on prescribing it, as I'd been on it for four years.

2 years I bloody wish. I'm 11 years in.

Patches were crap for me. Duo Elleste ( I think it is) has been brilliant.

KatyMac I was told the basics by a very respected lady doctor at the GUM clinic I worked at.

She said she wouldn't have touched it years ago, but attended a conference last year where the updated facts were presented. She told me that she'd have had no hesitation taking it at the start of the menopause, but would be more wary later on. The heart-protective component she felt was more inportant than anything else.

Heart disease has taken most of the family on my father's side and all, including him, died in their early 50s. I'm keen to take it for that alone, not to mention all the other reasons I need it for.

My mum was in a body cast due to crumbled vertebrae from osteoporosis, so that is another very valid concern of mine.

OP- you may well have seen this website: www.menopausematters.co.uk but if you haven't seen it I would recommend it. It is written by a gynaecologist who specialises in menopause.

I am coming from a professional standpoint- from what you've said you would not be unreasonable to make a complaint about the way she spoke to you which was unprofessional.

As to advice re HRT- I am more than aware that you may not want to share details with strangers online, but can I ask why oral HRT shouldn't have been prescribed? I ask as it is also possible that even the topical may not be suitable either. I would also say that in women who haven't had hysterectomy that unopposed oestrogen (as most of the topical gels are) is not something I would prescribe under any circumstances. So unless you have had a hysterectomy, you would need a progestogen in some form. I suppose the exception to that rule is Vagifem/local vaginal oestrogen application for use in women with atrophic vaginitis/urogenital symptoms is slightly different but I would say.

The only other option, and this is only really used as a last resort, is the oestrogen implant (again only in women who haven't had a hysterectomy).

Hello, not sure if it is the same in Wales but ask for the patient charter and ask to see another gynae. Your allowed a second opinion.

She won't look at my atrophying fanjo because I don't have a partner and have no need of a functioning vagina.

Is she psychic that you'll never need it again? And that you don't need it for general comfort reasons never mind ease of smear tests, to facilitate a pelvic exam should you need one, or an intra-vaginal problem scan etc.?

You have been referred to a specialist but unless I’m incorrect, I think you are entitled to ask for a second referral if you wish. I’ve certainly been referred twice to different consultants before. And I believe you can request a referral to anyone anywhere in the country not just from the Trust within your area.

Have you looked to see if there are any NICE guidelines for the form of HRT you would like to try? Have you tried being very assertive with your GP and when they say just patches or pills ask why that is. And what is the reason the gel can’t be prescribed in your circumstances. It’s crap to have to fight your own corner but sometimes it gets you nowhere being nice and accepting of everything you are told.