If I wanted to go private who would I see?

[lurchermummy]

Hi, I'm 50 and menopausal, not having a lot of joy at GP. I had my thyroid tested, they said it was okay but I know standard GP tests are not that great, I asked to have my testosterone tested (zero sex drive) and they said no. I have a coil fitted and am using estrodot patches but I'm not happy, have come out in spots, put weight on, and my boobs are bigger (they were already a J cup!). I feel like GP is not a menopause specialist and would like to see someone who really knows what they're talking about, so I'm considering going private but I don't know who I need...do I need an endocrinologist? I've had a look on line but the only ones I can find are naturopaths, and I don't really want to go down that route at the moment. Any thoughts? If it makes any difference I'm in Gloucestershire. Thanks.

You need an gynaecologist who has an interest in menopause.
Start with your local private hospitals- BUPA, Nuffield, Spire etc. (You might have to look at a 20-30 mile radius).
Look at their consultants (on their websites.) Most consultants nowadays have their own websites anyway. Choose someone who says they treat menopause (huge variation in what consultants have as their pet interests!)

Fees vary from anything from £180-£250 for a 1st appt then usually half of that for a follow up twice a year(ish)

It's possible the Mirena is giving you spots due to the progestogen in it. I got terrible acne types spots on the Pill years ago with the same type of progestogen. Big boobs might settle down or maybe you need to reduce the estrogen dose.

Thanks there is a Spire near me I'll have a look there.

I go to one in Nuffield but not near you unfortunately. I paid £180 to see her for 40 mins and it was worth it. I am going back for a 3 month check for 20 mins next week. She then said I can join her online site to email her and get repeat prescriptions etc. It was expensive but I was at the stage where I didn't care and was happy to forgo other things to feel better. Mine is a private GP who is a menopause specialist. She knows her onions. My GP tried to give me antidepressants and didn't even mention menopause at all till I brought it up which baffles me as I am not the one with the medical degree. I am 49 so its not like I wasn't in the age frame.

Go onto menopause matters and search to see if anyone has come up with a name in your area and failing that put up a post. My GP was recommended to me on that site.

Depending on where in Gloucestershire you are, although it means going across to Wiltshire I guess Wroughton might not be too far? If it is do-able, the Ridgeway hospital in Wroughton (which is a BMI one) is IMO very good. My gynaecologist there is David Griffiths, he is an endometriosis specialist (which is what I saw him for - he was absolutely excellent) but does list menopausal issues as something he can assist with on his website so he might be worth considering.

I see a private menopause specialist in London. It is expensive, but so far (and I'm only a couple of months in) the care I have had has been tip top. I wouldn't dream of seeing my regular GP about menopause - it's a specialist field.

The programme I'm on includes regular blood tests, every other appointment is face to face, with telephone consultations in between. I can email her with any queries at any time and she responds within the day at no extra cost. Next time I see her (September) I'm having the DEXA scan and a smear test.

I can't over-emphasise how much the care differs from the NHS approach and as far as I'm concerned, it's worth every penny, but I appreciate that it isn't available to everyone.

It is worth it though to get your life back.

Hi thanks all. I'ver actually decided to stop using the hrt patches. I haven't noticed any difference yet. My sleep quality is bad but I put that down to the hot weather. I might ask to get the mirena taken out, not sure yet (I do like not having periods). Moneys a bit tight at the moment but I think some good quality advice would be worth the investment.

I was getting nowhere with GP etc. I asked to be referred to menopause clinic. A the clinic I listed a load of symptoms I was having...was told most were not related to menopause and sent on my way with their website details which would help. Looked at website and on virtually first page were all symptoms I had spoken about -all listed in black and white on the website symptom checker! Their website! That was final straw for me. I had been near breaking point by the time I had got to this clinic and this tipped me over. I made an appointment at spires with Dr who was menopause specialist and it was like night and day. Was £150 and worth every penny. She listened, explained the reasons behind the symptoms and then started looking at what could be done. I was given a direct mobile number to call to speak to her if I had anything else come to mind that I hadn't told her at the 40 min. appointment. I can't take HRT due to a heart issue (according to GP/menopause clinic) so she wrote to my cardiologist (no one else had consulted him) for his opinion, looked into studies of women with my heart issue and HRT and a million other things. The cardiologist came back to her saying he felt HRT would be no problem. She called me right away and told me this but after all her research had decided on what she felt would be a better approach, but that we could look at HRT if no improvement. After years of being swept around the lamp post it took 40 mins and £150 to have a plan in place.

I love the NHS and until recently would never have used private health care - it goes against every principle I have. However I had reached a point where my principles were as nothing compared to the horror of what I was experiencing and more importantly , the horror my family were dealing with alongside me.

Finally.... for problems sleeping, aches and pains - give magnesium a try. It has been a wonder supplement for me. If you read the "mad diet" it explains how magnesium has decreased in our foods due to changes in the food industry/ mass production etc. Then think back to your grandparents medicine cabinets - where most things were prevention rather than cure - and magnesium featured massively. I take 2 magnesium tablets at night and I have seen a huge change in my sleep with added bonus of less joint pain etc. Worth a try at least. I hope things improve for you soon

Lurcher, for what it's worth, i've got the mirena and I used the patches for a while but tests showed, despite this, I was still hardly absorbing any oestrogen. I switched to Estrogel and mentally/emotionally (Where I was struggling), the change has been huge. I feel so much better.

This might be an option?
Although any estrogen will likely increase your boobs.

I can't take HRT due to a heart issue (according to GP/menopause clinic) so she wrote to my cardiologist (no one else had consulted him) for his opinion, looked into studies of women with my heart issue and HRT and a million other things. The cardiologist came back to her saying he felt HRT would be no problem. She called me right away and told me this but after all her research had decided on what she felt would be a better approach, but that we could look at HRT if no improvement.

This is what my consultant would say too I think. He''s written extensively on menopause and travels the world to give talks and talk to other meno experts. Heart disease is not a contraindication unless it's a recent stroke or heart attack or you have ongoing heart issues.

A lot of recent research- the Danish studies into HRT and CVD were positive.

The NHS is great for life threatening stuff (though compared with Europe it isn't that great really, especially for cancer) but it's rubbish for stuff like meno (on the whole.) There aren't the resources and GPs aren't trained. I think they get something like 1 lecture on meno in their entire training.

Yes, I think that there just aren't enough specialists on the NHS for menopause - that traditionally, women experiencing emotional issues in their forties, for example, were given anti-depressants, which the NICE guidelines now contradict.

I think it's very much a lottery re: GPs and their helpfulness re: menopause.

I recommend the Studd Clinic website for information.

If London is not too far from you it's worth going there (even though expensive and long wait for an appointment).

I have read very negative reports about that place. They offier no variation usually on what is prescribed (other than shorter durations of progesterone) and appears to recommend mandatory tests which can cost over £1K (blood, bone density, pelvic scans...) Fine if you have insurance but be aware.
There are also very negative comments around about the 'bedside manner', offhand following up, and unavailability if needed between appts.