Three Drs at practice refuse to prescribe HRT

[Therewere5inthebed]

Sorry for the disordered post, so miserable and anxious.
I'm 44, had peri symptoms since 2002, DM was through meno and out the other side by 41.
I have really been struggling with physical symptoms for the last yr, have had citilopram prescribed for this however this does absolutely nothing about the physical symptoms.
My periods are all over the place and I flood for two days and am then done.

I have ridiculous brain fog and loose my temper very quickly when I've always been a calm person.

I am so tired all the time, can fall asleep anywhere but wake up at 3 every morning without fail.
Despite this the worst thing is muscle stiffness and pain. It's so debilitating.

I had a total knee replacement a yr ago and I have put on weight since being unable to exercise for the last few years but I am dieting and have lost 3/4 stone since the end of April.

Three GP's have refused me HRT due to the risk of DVT and strokes, I've requested patches but I've repeatedly been told that the risks are still there however the hormones are given.
I've quoted NICE guidelines until I'm blue in the face but all I'm met with is resistance.
I've been in again today and been refused again and I feel like sitting here sobbing as I can't continue like this.

I understand the risks, I've done so much research but if I'm not so stiff and sore or tired it would be so much easier to loose the weight. I can barely walk when I get out of bed.

Sorry for the rant but have no idea where to go from here..

I had a call back yesterday evening and the doctor that I saw last asked to have a chat with me, she's a locum that has previously worked at the practice long term although I hadn't seen her before.

She told me that she'd looked into my records as she really felt they needed to do something to help me as I was just so despondent when I left, and couldn't believe how many times I'd been pushed from pillar to post and dismissed. She apologised profusely and promised to do what she could to help.

The upshot is that they're still concerned about my weight but can see that I'm actively loosing it and they've booked me in for a FSH and full blood screening on Monday. They should have the results back by Thursday and if it proves that my levels are low enough they will give me patches..
still not NICE compliant as they say no tests necessary once 45 and I only have a few months to go but it's a start.

I feel relieved that someone has listened to me and just a bit concerned that they may not consider my levels low enough to warrant treatment despite my symptoms. If this is the case I will ask for a referral to a specialist as the symptoms are beyond a joke.

Fingers crossed the FSH results will be conclusive and I can start feeling better.

If they don't come back inconclusive there is clearly something else untoward going on but the other tests will hopefully give some answers to why I feel so terrible all of the time.

I'm not a smoker and never have been in answer to Crumbs
My BP is spot on too.

There is absolutely no point doing a FSH test unless it's from days 2-5 of a cycle. And then you have to have two done over 2 months. The tests shows your hormones on the day only and in peri they can be sky high one day and low the next. Any GP should know this.

NICE guidelines are not mandatory , but they are there are a pointer Always. I assume from your post you are a GP or admin for GPs?

The NICE guidelines were years in the making and included top meno consultants. GPs can ignore them but where are they looking for alternative training and guidance? Fair enough if they go on BMS meno courses, but if they are not, and ignorant, then that's really not good enough.

The point is, there is no added risk above the woman's baseline risk if she uses transdermal HRT. The risks of HRT do not apply to women under 50 anyway (unless they have preexisting conditions.)

Sorry but in your case There I'd be finding a consultant, handing over £200 or so and getting sorted. It's not worth this hassle of fighting the NHS system.

I've had my blood test results back and they were on the low side of normal.

There is a new Locum at the practice who was a Gynaecologist in Spain before moving to the uk and I was lucky enough to see him today.

He's recommended the Merina Coil and thinks it will help with my symptoms but I had it (admittedly 7 yrs ago) and didn't get on with it. He said that my body has changed a lot in 7 yrs and may be perfect for me now but I'm concerned about the brain fog and forgetfulness remaining. He's asked me to research it see what I think and get back to him.

Has anybody had this and found that it helped with all symptoms including muscle stiffness and forgetfulness?

He has however prescribed Eleste 1mg for three months but has said he may not repeat it depending on the side effects I have. I'm hoping to have no side effects and to get the prescription continued but am willing to go elsewhere if they work for me and they refuse to repeat the prescription.

Currently that is not an option I have.

I'm confused.

Why did he offer you a Mirena coil? This is for birth control or heavy periods. It can be used as the progestogen side of HRT but never on its own for HRT.

I've had a quick re-read of your thread and am baffled.

Are you saying that because you are overweight, your GPs are refusing you HRT?

As has been said already this is completely wrong.

If you were at risk of a DVT then you should NOT be on pill form HRT anyway, you should have been given patches, or gel + mirena, or gel plus a separate progestogen (which would be a pill as there is no other sort.)

I think it's disgusting that you are being treated so badly and you ought to consider reporting your practice to the RCOGPs. They are not aware of how to prescribe HRT, or in what form, and are not working within current guidelines.

As a last resort you may like to go to the website Menopause Matters. The director is Dr Currie, consultant gynaecologist, chair of the BMS. She will answer questions on meno and HRT for a £25 fee which is ploughed back into the site. You can take her reply to your GP, if she recommends you should have transdermal HRT.

Just to add, you email Dr Currie off the site- there is usually a link on the Home page. Sometimes she is too busy and puts questions on hold.

She will not reply on the forum- it's a private email to you.

You might get more support on the forum to add some more 'ammunition' to your requests at the GPs.

Thank you Polly
The Dr today said that he can see that although I'm a bit overweight i'm very muscular and toned which obviously increases my BMI and there needs to be an element of common sense involved, which was why he was happy to prescribe pills.

I'm really not sure about the coil anyway and told him this as I had it 7 yrs ago and didn't get on with it.

I'm just going to take the pills and see how they work out for me then push for more towards the end of the three months, if they refuse at this point I'll take things further then.

Thank you for the tip about Dr Currie too. Hopefully I won't need it but if I do I'll go to my next appmt armed with info.

I'm 57,definitely over weight but my BP is fine and no other risk factors.I have been given patches and progesterone tabs ,bloods taken to only to see if there were any other reasons for my tiredness not to check hormone levels.Keep pushing it really is worth it.