Which HRT?

[NYnachos]

I've been to see my GP as I have lots of peri menopause symptoms. Blood tests have come back normal for everything (including estrogen).

I'm hoping I'll still be given HRT - that's in accordance withNICE guidance isn't it?

Any thoughts on which HRT is worth trying? GP said I'll need a combined patch (any other combination eg gel & tablet would need to be prescribed by a consultant) but I have no clue about this.

GP said I'll need a combined patch (any other combination eg gel & tablet would need to be prescribed by a consultant) but I have no clue about this.

That's completely untrue.

You need to challenge your dr on that.

Thousands of women use gel and a progesterone on the NHS prescribed by a GP.

Either your GP doesn't know how to prescribe or they are trying to save money.

Unless you are under 45 your GP has been advised by NICE not to test estrogen levels or FSH levels, only for other illnesses that could mimic menopause symptoms. HRT is prescribed on the basis of symptoms in women over 45.

Your gr should give you the choice of patches, pills or gel.
If you have gel you need a 2nd prescription for a progesterone. This is usually Utrogestan but can be the mini pill (at the right dose), the Mirena coil or Norethisterone.

I think the GP was saying that she doesn't feel confident enough on the subject to prescribe separately...

That is totally ridiculous.

She's paid to do a job. As a professional on a 6 figure salary.

She can find prescribing doses online or speak to the British Menopause Society.

Is there no other dr you can see?

So despite having about 75% of the listed symptoms, and being 45yo, the GP won't give me HRT because my hormone blood test came back normal and I'm still having periods. To be fair, she's referred me to the menopause clinic, but no clue how long that'll take to come through...

Your GP sounds useless.

You ought to have reminded her that the reason NICE says do not do blood tests is because they often show 'normal' and are unreliable.

You really do have to state your case and not allow drs to treat you so badly.

I know it's easy to say, but you have to sometimes educate them!

I did remind her if that, but she told me that she couldn't give me HRT because I'm still having periods.

Wow.
GPs must deal with women every day who need advice and treatment for menopause symptoms.
I can't believe that a GP could be so inept.
Dreadful.

I was at peri with regular but lighter periods and awful menopause symptoms. Find an expert!

That's ridiculous.
I use evorel sequi. They are back in stock next month so if you can wait a few weeks you could try those?

I'm hopeful that the menopause clinic will be more helpful...

I'm outraged that a GP is so ignorant about prescribing HRT. What else is she clueless on? Heart disease? Diabetes? Underative thyroid?

So your GP doesn't even know that there are 2 types of hrt- for women having natural periods and women who aren't having periods?

Might you report her to the practice manager?

How many other women like you are being given incorrect treatment by her?

She definitely knows about different HRT because we had a conversation about it. So frustrating.

I don't understand.

If she knows women can have sequential hrt which is for women still having periods, how could she say you couldn't have hrt as you still had periods?

What did you say to her when she came out with all of that?

Surely she needed to be told that hrt is for women having or not having periods?

I hope sh gets feedback from the menopause clinic and they tell her she is wasting their time and ought to be able to manage simple cases of meno like yours and not rush to send everyone to them!

Menopause clinics are for cases that are beyond the scope of GPs.

She sounds useless. Is she very young and still learning or old and out of touch?

She's 40s/50s - and usually good, but told me that she can't prescribe HRT if my hormone levels are fine & I'm still having periods.

I told her that NICE guidelines say diagnosis should on the basis of symptoms, not hormone levels, but that's what she said.

Any other cause for my symptoms (thyroid, iron levels etc) was fine.

Hi My daughter did not get place in her choice of schools and has been offered a place in a school that she doesn't want to go to. What is the rate of success with appeals on the grounds of commuting, bullying and safety of the child. Please advise

OP, your GP must know that there is HRT for those who have no periods (conti) and a different kind for those who do (sequi).

@NYnachos I wonder if you really made your point to the GP?
If she sat there and ignored the advice of NICE why did you not remind her and refuse to leave until she explained her reasons?

Periods= hrt can be used
Blood tests = not for women over 45 and meaningless and inaccurate

All in the NICE guidelines.

I really wouldn't allow her to walk over you and talk nonsense.
These guidelines are online. Print them off and take them to her or to the meno clinic.

Even if it's hard, you need to fight your corner, politely but be assertive.

Seriously, I've done this. She told me I was too young for the menopause (45), I said I was within the age bracket (which starts at 45), she told me the average age is 51.

She said I needed blood tests to rule anything else out (thyroid, iron etc) which I agreed to, then has said that because hormone levels were normal & I still have regular periods, she's not prepared to prescribe HRT. I told her that NICE guidance states that menopause should be diagnosed on the basis of symptoms, not hormones and she just repeated her position above.

So I've waved NICE guidance at her & she's not moving.

And this last discussion (post blood tests) was over the phone. She's just saying that she's not prescribing and that's it.

I could never take anything with progesterone in it without violent side effects not even the pill, luckily I'm on oestrogen only which has no side effects and is amazing.

I think you have a few courses of action

1 see another GP in the practice if you can
2 change practices if you can
3 consider raising a complaint with the practice with regard to inappropriate (no) treatment

I realise may not be something you want to do but she is not working within medical guidelines.

Can you report her?

I have a recommendation from a private GP who specialises in menopause so hopefully I'll be able to speak to someone in the know & get their input.