Almost 53 What to expect at1st GP appointment for HRT

[whatisforteamum]

I be tried to just take supplements for my health so far.The GP is doing blood tests as I have a mirena cool so no idea if my periods have stopped.I've been feeling exhausted and a bit irritable.Unsure if I have flushes as I do get warm but not so much sweaty.I have three baths a day as I work in a hot environment.
My mum has ha d advanced ovarian cancer so never rushed to get on hrt.
What should I expect?.Would hrt perhaps help with my anxiety

Unless your GP is a menopause expert the odds are you will not get anything from them in terms of help.

You need to have a think about what you want.

It's up to you to ask for HRT if you want to try it.

Blood tests are not done for menopause on women over 45.These are the NICE menopause guidelines. So your GP is off to a wrong start already.

ps no connection between your mum's cancer and you using HRT.
HRT does not cause ovarian cancer but you should perhaps be screened now and then for any hereditary risk of your mum's cancer.

Thank you.The receptionist called they have decided I'm at the menopause based on symptoms.No blood test required.
My Mum has had genetic testing to see if there is a cancer gene.We were told it was negative.However I will always be vigilant as my df died of cancer too.
I have an appointment thur to discuss HRT.The thing is I work long hours so it is hard to see what is health related exhaustion and what is work related.

gosh, how do you get 3 baths/day in?? I mean, how do you fit them around work & life, etc. How long is each bath?

Have a look at the menopause matters website, lots of helpful info in there including about HRT. You should have a think about what type of HRT you would like to try before you go to the appointment (tablets, patches etc). The GP will be able to advise which specific ones are suitable for you individually. Unfortunately a 10 minute appointment isn't long enough to go though everything so you should have done a bit of research in advance. Usually it's a case of trying something for a couple of months and seeing how you get on with it, you can always change to an alternative if needed.

The GP will be able to advise which specific ones are suitable for you individually.
Unlikely ! Read the comments on Twitter by people trying to raise the profile of menopause and get mandatory GP training in it. #makemenopausematter petition
It's quite shocking. GPs get 3 hrs on menopause at med school.

OP, sorry you've been having a bad time. Yes to Menopause Matters. I was able to wangle a menopause consult on my work medical insurance scheme, so just giving you the download in case it helps:

They did a blood test which showed all my lady hormones were flatlining, but also that my thyroid had packed in (a common thing with women our age, so worth testing).

The hotshot Harley St. hormone expert put me on a) estrogen patches b) Mirena and c) testosterone, to add a bit of libido oomph but also, allegedly, mental clarity (this was a cream imported from Australia, not available on NHS, but there are other sources of testosterone.) And then sent me to an endocrinologist for a big dose of levothyroxine to sort out the thyroid.

Depending where you are, there are bits of the NHS that are less useless than others when it comes to menopause. There's a a menopause centre at Chelsea and Westminster hospital that's run by some brilliant people (I haven't been myself but know of them.)

HRT is not as unsafe as many people think. There should be help available for you. Depending on how knowledgeable your GP is, you may need to be politely persistent. You don't have to feel awful. Good luck...

@JinglingHellsBells what I meant it that the GP can advise which specific brand of HRT you will need depending on your history and stage of menopause (e.g. cyclical, continuous combined) but the OP should already have an idea of what general type she wants to try (patches, tablets etc).

Hopefully the GP isn't relying on what they were taught in medical school which could be 20 years ago. Things move on and GPs (like all healthcare professionals) keep up to date with continuous lifelong learning.

Sadly, this forum and menopause matters is full of tales from women whose GPs have given them exactly the wrong type of HRT.

Half don't seem to even know there are 2 types for peri and post meno (and send women away saying as long as they are not having flushes OR having periods, they can't have HRT.)

I spend a lot of time on social media as it aligns with my work and I can assure you that most GPs do not know what you think they ought to!

They get the training I mentioned and many do not learn anything beyond that.

Just read most of the posts on this forum from women who have had early meno misdiagnosed, given ADs not HRT, given Estogel to use vaginally (I'm not making it up...- it was here a few years ago) and more......

The level of ignorance is truly appalling.

@Summertime06

There was a dr and a menopause counsellor in ITV This Morning 2 weeks ago. They are pushing for mandatory training for GPs. These are just some of what they have been told by women.

My GP refused me HRT as I'm too old (52) and post menopause, also said why would I need to replace what my body has given up

Just had a message from a distraught woman who saw GP yesterday. She prepared for her appointment, took a symptom list, clearly peri menopausal, only to be told ‘we only prescribe HRT for hot flushes’ this poor woman does not have those so no HRT for her

So many women struggling to get the right advice and support from their GPs at menopause. Sadly GPs receive very little, if any menopause education even though it affects 51% of the population.

Thanks for the replies😃I'm up at six have a bath before work.quick bath\good wash at 3 then full bath again when I get in at 1030.No wonder I'm exhausted😂😂.Seriously though I have tried to research diets to help and supplements like soy I take.
I read online on of the hormones is associated with ovarian cancer.Also the GP asking his female colleagues!!! Any way I do have a mirena coil so no idea when periods would be stopped.
One more question I guess I need oestrogen however birth control pills made me feel nauseas in my 20s.Is this likely to be similar?

You work from soon after 6am-10:30pm & have a bath mid shift at 3pm, mid-shift? Good lord woman. No wonder you're feeling unwell. When do you do chores or even get some sleep.

Chores before work and dh does.The rest.

what on earth can you be doing which means you work till 10,30pm (or at least don't get home till then) and manage to have a bath mid afternoon? Seriously, this kind of poor work-life balance is going to make you feel rotten regardless of meno, hormones, the lot!

Can't you reduce your work hours because whatever you are doing (if it's for a company) you are being exploited and should not be working those hours.

HRT is not linked to ovarian cancer or if so, it's an extremely rarely.

You already have the Mirena coil.

All you need for HRT now is estrogen. This can be a patch or gel. These are preferred now over tablets.

Your GP is supposed to treat your symptoms, not do blood tests. Blood tests are unreliable and a waste of time and NHS money.
That's why NICE says only offer to women under age 45 who may have a premature menopause and def need HRT .

Just ask your GP for estrogen and see if it helps.

And do something about your work- you will end up ill doing those kinds of hours.

The estrogen in HRT is very different to the Pill. It's the same as our own whereas the Pill is synthetic and a larger dose.

Cancer Research UK says that some types of HRT increases risk of getting many types of cancer. But it's a very small increase in the cancers. Something like one extra case of ovarian cancer per 1000 women who take HRT for 5 yrs. You could see that as a very small risk. Most the risk for getting these cancers comes not from HRT but rather comes from genetics and/or lifestyle history & choices. You may be risking poor quality of life if you don't take HRT. So there is no risk free option, just choosing which balance of risks you prefer.

Thank u.yes just reading up on oestrogen now.I am glad the dose is lower in hrt than the pill it made me feel horrible.My mirena is about six years old....I was advised to leave it in a while when it was.rev iewed.No idea how much hormone it would be emitting by now.I am a chef in a fast paced environment looking for another job.I just applied for one with some weekends off and evenings off.😃 Thanks ladies for your advise.I was previously offered ADs and had some CBT.

Yes Medschool rat.I'm sure my cancer risk will be from both my parents having advanced cancer.I just wanted to get the all clear from Mums genetic testing before enquiring about H RT.I understand the health benefits to my heart and bones will be beneficial though.

The Mirena is licensed for 4 years as part of HRT so you would need it replacing.

Cancer is very random- it doesn't have to be genetic.
I think the hereditary risk of all breast cancer is no more than 5%.

Are you not eligible for regular testing /scanning if you are worried? You could have an annual pelvic ultrasound scan of your ovaries if your GP feels you have an added risk. Some women get these done privately anyway as part of their own health screening.

Good luck with your job hunt!

Thank you.

My male GP was great, started me on a suitable HRT and put up with me changing it 5 times until I found somethng that suited me.
Saw one female GP about my marriage going down the pan because of my reduced sex drive and she said she doesn't really have time to listen to all that and why is sex so important at my age

They told me that mirena can stay in for longer if you’re menopausal (I’m 53 and have had it for 7 years). However, am having hot flushes and rages as well as anxiety now so am sure I am due for some HRT. But how do I know which one I need?

@Fleetheart - I understood that the progesterone which is released by the Mirena runs out after 5 years... presumably post menopause the pregnancy risk is no longer an issue, but I would have thought that the benefits of the progesterone were no longer present after 7 years?

My consultant was keen to continue me on Mirena for both contraception and to address perimenopause symptoms, along with Estrogel.

Disclaimer: I have no medical background so am happy to be corrected!

So I probably need new coil too then.what symptoms does estrogel give?

Honestly you'd be better seeing I you have a community HRT/gynae clinic, get the mirena replaces and see what they say. Our local service is brilliant (london)