I've been prescribed HRT!! What's it like?

[MortyFide]

I was lined up for a mirena coil change with the GP today, but having had peri-menopause symptoms for over a year (probably two), I was determined to have a conversation about those issues while I was there. I've had FSH tests before but they were normal last year.

The GP called me to cancel the appt anyway due to coronavirus, but I listed my symptoms on the phone with her - and she instantly suggested trying HRT. I'm glad but I'm suddenly worried about what to expect!

I've had a mirena coil for 10 years so when I eventually get a new one it'll be my third. I don't have periods at all, but my other symptoms are:

Rage and intolerance/irritability
Low mood, easily tearful
Brain fog and loss of confidence
Hot flushes of a kind (bright red/purple face and chest for an hour or so, sometimes on one side only)
Leaking urine
Occasional night sweats/overheating
Nausea at night and some mornings
Breast tenderness
Joint and muscle pain

I've been prescribed oestrogen gel, plus progesterone just until I get my new coil (then I can ditch that apparently and just use the gel).

I've read that some women felt like they got their life back! I'm excited but nervous...any experiences to share?

i had a new mirena a couple of years back to deal with horrendous periods and then turns out I have been sticking out all the hot flushes, not sleeping, painful bones for TWO whole years, I thought it was just the one, memory problems and finally went back and got some gel and been on that since december

and yes...feel so much more like me...sleeping through the night, my ankles never trouble me and everything else is just soooooo normal

I started with one squirt....and spreading that on inner thighs with some of the excess on upper arms now I am up to two squirts!

I have had some very minimal spotting...at the start of using the gel and then again when I went up to two squirts and again when I started putting the excess on my arms, but not even enough to warrant a panty liner really (tmi, sorry!)

I would really recommend this as the simplest option ...gel and mirena.

My mistake Jingling, I had 45 in my mind as the point at which they would prescribe HRT without a blood test - I was first blood tested at 44 and as it was normal was told to wait until symptoms were unmanageable, that was my thinking. But in fairness I was tested again at 46 and told the same again, so what do I know! Ignore me Parrot.

That sounds promising Laurie, I would should be getting my new mirena now but have to wait until CV has settled down and they are happy to see non-urgent patients in person again.

Update from me - I did an e-consult to my GP practice today, specifying the GP who is the Women's Health lead for the practice. They replied promptly asking for a few more details, will have to wait till Monday now but at least I have started the ball rolling. I am overweight which might be a factor against it though.

Don't worry Expletive, I am too...BMI 36. No other risk factors though.

Hi MortyFide, congrats on actually getting somewhere with a GP! i am exactly the same as you, 47 with identical symptoms. I had my initial appt to discuss with GP booked and now it's been cancelled, but it's news to me that they can prescribe HRT over the phone. Did your GP say anything about blood pressure etc or did they just agree to the prescription? Were there any conditions? My GP's treatment room is closed I think but I think I could get a reading at the chemist's. Thanks.

Hi Jackdaw, our surgery is good at phone consultations! It's a big medical group and they have 4 surgeries in the area, and a huge team that triage calls, arrange appts and callbacks, and strict timings for different types of calls. It works really well, I can't fault them.

Yes she did ask about history of breast cancer, and blood pressure - mine hadn't been done recently but all my historical readings have been quite low (despite being overweight). She encouraged me to get it done at a pharmacy and call it in when I could, but as I've never had high BP she seemed satisfied.

@MortyFide @jackdawdawn

Prescribing rules for hrt are that you need a health check annually- that means your BP and a chat about your overall health and risk factors.

Weight is not a contraindication for hrt unless it's linked to high BP.
You can buy a BP monitor from Boots or Amazon for about £30.

Weight it relevant though for use of hrt and health.
The biggest risk factor for breast cancer is being overweight. Stats show it raises the risk to around 28 more cases per 1000 women compared to 4 more cases for hrt.

worth trying to lose the extra pounds!

Yes, that's why I want to start HRT, I am too sore and fed up and inclined to overheat to exercise, and I have gained weight. I know being overweight and inactive is a far bigger breast cancer risk factor and I'm going to push that argument with the GP! thanks.

That's me too, I have been overweight for many years so can't blame the menopause, but I am heavier than ever now and in a vicious circle of feeling anxious/down, comfort eating, etc. I exercise sporadically but am limited a bit by prolapses, which can also be exacerbated by hormonal changes at menopause, I stressed this in my e form. I had to pop in and do a BP reading in the waiting room, it was a bit high but historically it's been ok so will wait and see what GP says. I feel motivated to try and lose some after the of having to tell the receptionist my weight, but I lose about 9lbs typically then get complacent and put it on again.

The 'anxious eating' is a weird thing. I don't feel the slightest inclination to eat properly although I know it is wrong. Like you lost, about 9lb before Xmas and have now regained it!

I've eaten fairly well today. 5 a day ticked off, only a small amount of bread, no butter or crisps (my big weaknesses). Late evening is a danger time for snacking though. On the plus side I don't smoke and very rarely drink alcohol.

My update. I managed to have a GP telephone consultation an I remained firm and persistent. They prescribed me gel HRT as I have a merina.

I pick up the prescription on monday, so am optimistic.

Excellent news! Fingers crossed.

I'm on day 3 of oestrogel, just one pump per day as advised to start off with - that weird headache and cramps I had on day 1 must have been coincidence because I haven't noticed anything else since.

I do feel anxious, but that's the thought of dealing with this brand new puppy for the foreseeable. I forgot what hard work they are, I'm sure my life is over haha.

Spoke to GP on the phone today. It was depressing.

He said I was far too young for menopause (I'm nearly 48) and that my aching joints, fatigue and slightly erratic periods pointed to other things - inflammatory disease and possible uterine malignancy(!). He has referred me for a scan. I have no pain or bleeding. I also have hot flushes. He didn't seem to associate these with menopause. The surgery is not doing blood tests at the moment. Was totally dismissive of my request for a trial of HRT. What is it with doctors? I will go to the scan. God I am fed up. How much is a private consultation - though I daresay these are also very restricted right now. Where do I go from here? Second opinion?

Ask to see another gp. A female gp was great with me until she moved practice. Be persistent.

I have today had my first squirt of HRT gel. I am feeling optimistic.

@jackdawdawn when I read posts like yours I want to spit blood.
Are these people actually drs???

The average age of menopause is 51.
The range is 45- 56.

So you are 48.

Did you insist you are in peri menopause?

How can he suggest a scan when you have hot flushes? That is truly beyond comprehension.

I would not go for a scan. It is a waste of your time and it is waste of the drs time because there are women with potential cancer who are waiting for scans. I would actually say that to your GP and refuse the appt. You do not fulfil any of the criteria for a scan.

Hot flushes and he suggests a scan? What planet is he on????

A private appt is likely to be in the region of £250. You will get 45- 60 mins for that.

There is unlikely to be any impact on appts as it's gynaecology and has not relation to CV.

Most consultants would see you anywhere from a week to 4 weeks.

Your GP is utterly useless and you need to change to someone better.
It's beyond ridiculous.

Thanks JHB. My own thoughts exactly. He is an awful GP and made a prescribing error for one of my children - I should have changed then.

I felt as if we were having different conversations. He clearly had not read the NICE guidelines. How could he? They clearly state that a woman over 45 with vasomotor symptoms is to be treated as perimenopausal. No blood tests necessary

I was very angry, it made me think of all the women years ago who were dismissed for having endo symptoms. Same sort of patronising arrogant male BS!

I spoke of having had a period two weeks early (it was four days of typical menstrual-type bleeding) and he said it sounded like abnormal bleeding. Hence the scan. I don't actually mind the idea of a scan and a blood profile, to rule out thyroid conditions etc. It was his dismissal of any notion that I could be experiencing perimenopause symptoms that I found so hard to take.

The trouble is I am going to find it hard to get someone else at this time, now normal life is suspended.

I am going to try and lose some weight and cut out caffeine over the next few weeks...that may help a little, but I do need HRT, I know my own body!

To be honest @jackdawdawn I'd avoid going into a hospital for a scan simply as it exposes you to the risk of CV by being in a public place.
I'd also refuse on the grounds it's taking a slot that is perhaps more essential for someone else.

The rule for abnormal bleeding is to be scanned within 2 weeks. So your dr is putting you forward for something that is classed as urgent as it's the 'cancer pathway'. You don't need this, and as hospitals are now stopping routine operations, your dr ought not be sending you for a scan which is of no use anyway.

Abnormal bleeding and urgent scans are for women who are post menopause and have not had a period for a year.

Erratic periods in women under 50 do not come into this category unless there is also flooding and other symptoms.

I can't see how you would be worse off now trying to get a private appt. Most are done in small private hospitals anyway- not NHS hospitals.

Have a look at the website of your local private hospitals for gynaes who deal with menopause, or look at the website of the British Menopause Society under the tab Specialists.

I know of many through my work so if you want any info on who to see, ask me.

I am really annoyed at having to pay £100s for something the NHS should be providing, which could be so easily provided at little cost.

I live in NI where women's healthcare is generally dire - we don't even have legal termination, FFS. There are no NHS menopause specialists unless your GP refers you to a hospital, and since mine refuses point blank to believe that any woman under 50 could possibly be menopausal, there is no chance of that. The GP is my first and last port of call.

A question -if a private doc prescribes HRT initially, does the NHS GP have to honour that and issue prescriptions?

How is everyone doing? I have just realised I am 4 weeks into using the HRT gel. I think it has had a great effect on me. Improved mood, (less of the rage, more motivated to do things) and sleeping better (ignore that I am writing this at 5am).

I double checked with my husband and he thinks there has been a big improvement.

Maybe it is placebo effect, but whatever it is, I think something is working (could also just be lighter nights and sunshine)

How about you lot?

@jackdawdawn the menopause clinic at RVH is meant to be very good.

I see a gynaecologist privately and she writes the prescription and I take it to the GP. It's not for HRT though.

At the RVH in Belfast? I have not heard of that - the only one I know of is for severe cases at the Mater, which is via GP referral only, not much use when your GP thinks the menopause only happens to 52 year olds. There is also Dr Siobhan Kirk's private menopause clinic but that is closed at the moment.

Sorry maybe it is in the Mater.