GP has told me they don't prescribe HRT

[HRTRefusal]

I've been following this board and reading about HRT for over a year, trying to decide whether to take it or not. My symptoms have been getting worse and I decided I had to try because I'm fed up feeling like this, it's affecting my quality of life.

I had a GP call back this morning only to be told "we don't prescribe HRT because of the risks" I was offered anti depressants for anxiety/low mood, something else to help with my sleep issues and she could also give me something else that would help with sweats (I'd told her I have that under control with Red Clover). I have other symptoms but these are the ones she offered treatment for.

It was a real blow because it has taken me so long to decide I want to try HRT and I feel I was fobbed off tbh.

I'm in Scotland so I don't know if there are different approaches to menopause treatment here, I'd love to hear from anyone else who's GP doesn't prescribe HRT and whether you take anti depressants and sleep issue medication or whether you changed GP. I don't know where to go from here.

Send the email and wait. I doubt that you get a reply saying 'Yes our GP and surgery do not and will not prescribe HRT' -more likely an email or a phone calls arranging for you to go back in and 'there seems to be miscommunication -I wasn't saying no to HRT. Just trying to point out and risks and try other things rather than put you on HRT first ' ...............

@SummerDayWinterEvenings I have only ever seen female GPs about this and can categorically say that all three have been less than interested, one was totally dismissive and once she'd read out my blood test results actually sat in silence until I brought the consultation to a close.

Glad that you know some better people but really, this whole long-term health and mental health issue is clearly a massive inconvenience to female GPs as much as to male.

It is distressing. But it's middle-aged women, bit fat, bit down, being boring about brain fog and sweating and funny fannies. I suspect they find it hard to care with that presentation.

My GP practice (funnily enough in Dundee) is very pro HRT, I’m not on it yet, but I know of several people with the same practice who were prescribed patches with no issue. No faffing with tablets first, the GP asked for their preference and prescribed the patches

Is there a time limit on how long you can take HRT for ? As my GP said I couldn't keep on taking it after 5 years, but years down the line I'm still having hot flushes daily.

You could find another GP who will prescribe it.

I took it for about two years when I was peri-menopausal but gave it up because I had side effects and was also concerned about the risk of breast cancer. One side effect was depression - I was depressed anyway so obviously didn't want anything that would make it worse! I also had regular migraine (as I had when on the pill), and they stopped.

I never regretted giving it up, felt better very quickly. I did start to have flushes again but they weren't anything I couldn't cope with and gradually faded.

I have a friend in Tayside who is getting great treatment from her GP and the menopause clinic. Someone is obviously on top of the situation there, good for them.

I’ve been on HRT patches for more than 15 years from the age of 43. I’m in Scotland and my GP is very supportive. The risks are not as high as was first thought. I’ll stay on HRT as long as I can.

@SummerDayWinterEvenings - Thanks so much, I will use parts of this in my letter, however, I have to say that I now feel that if I have to go down this route and force my GP's hand I no longer feel confident discussing it with her and imagine she won't be supportive if I have side effects and want to try a different HRT....I still plan writing to them but I don't think I can sit and chat about symptoms and how I'm feeling now.

I have only ever seen female GPs about this and can categorically say that all three have been less than interested - My practice has 3 female GPs too, I was expecting a totally different outcome this morning because of that but hey, I think you're right, she just wasn't interested at all. After she said they don't do it she pointed out that there is a breast cancer risk and I didn't make an appointment for the breast screening clinic last year....why would that matter if they don't do HRT anyway, it was very finger pointing like I didn't deserve it because I've missed a screening that as far as I am concerned, I knew nothing about. If I had got a letter for screening I would have made an appointment so I don't know what happened there but I also don't see the relevance.

I'm a GP in Scotland and I'm on HRT....woe betide anyone who doesn't give me it. That's awful and quite simply they should prescribe it. You've more chance of getting breast cancer if you're fat than if you take HRT...can't find the link but there was a good one about the relative risks some time ago.

You could look at a specialist like Dr Newson for an assessment and get the prescription sent to your local practice for continuation of treatment

I should say they should prescribe it having looked at all the risks with you....please don't come back and say you're 75 and have had blood clots and breast cancer....then they'd be quite right not to prescribe it. But somehow I don't think you are.
Someone further up mentioned GPs "not being as clued up as the specialist clinics" ....why would you think we would be? Otherwise there would be no need for them.
We have a helpline we can email for advice which I do if I'm getting stuck. We also struggle to get patches just now. And some HRT formulations we are not allowed to prescribe

Nuts. You name it and I’ve tried it - all prescribed by my dr in Scotland. Only reason they will not prescribe is if you have had oestrogen based cancer in your past. Complain and see a different dr.

OMG that is so unbelieveably ignorant I simply cannot believe what I am hearing!!!!!
I've been on HRT for nigh on 15 years and have no intention of coming off it until I retire because my night sweats are so bad.
But she's happy to prescribe AD when you are not depressed and ALL of the side effects related to that. Amazing this incredible ignorance still persists.
It sounds more like it's based on her own beliefs rather than medical science.

A little different to you but I noticed my doctors have a huge list of things they won’t prescribe things for, I had a sinus problem for a year I got so sick of being told I couldn’t have anything I got private medical which included a online GP service. The private GP gave me medication for my sinuses straight away. Maybe worth having a private consultation to get the HRT prescription. (The prescription was so much cheaper too £21 for 4 items)

I should say they should prescribe it having looked at all the risks with you....please don't come back and say you're 75 - Hahaha no, mid 50s and I'm not in any high risk groups, no history of BC in the family etc. She told me "we don't prescribe HRT because of the risks" before discussing any symptoms and offering anti/ds

If your Gp says they were offering other things first @HRTRefusal then you need to discuss the NICE guidance with them.

NICE states very clearly that anti ds and blood pressure meds are NOT first line treatment for peri menopause, and the HRT is.

It's all in the NICE guidance pinned at the top of this forum here.

The whole thrust of the NICE guidance is that dealing with menopause is to be a discussion with the woman, where both are equal partners in her care.

The days of doctors telling you what to do are over. The patriarchal attitude (apply to female drs too) is over. Top consultants do not behave like this with their patients, but (some) GPs who are ignorant and who know something but not enough, are the worst. They are reading the media headlines on HRT but not bothering to go on courses, provided by the BMS, or read the research themselves. They latch onto a scary headline and take it was fact.

If your Gp says they were offering other things first @HRTRefusal* then you need to discuss the NICE guidance with them. - That's the thing though, she wasn't suggesting that we could try something else first* she clearly stated that they don't prescribe HRT.

Initially I will only be asking the practice manager to confirm that this is their policy, there is no email address so I need to write a bloody letter so not easy to send links or quote NHS/NICE guidlines

Well, yes, but she was offering you anti Ds as an alternative right from the word Go.

HRT is not a religion! It's not something a dr 'believes in' or not.
The guidance says drs should work in partnership with patients, and discuss the pros and cons, with women choosing to use what they wish.

There are even consultants who prescribe HRT to women with previous breast cancer. Great podcast on Liz Earle Wellbeing site with an interview with Kirsty Lang who has gone back onto HRT after her cancer.

Read as much as you can on the website of Dr Louise Newson and then you will be in a position to discuss again.

She has some great videos, fact sheets etc.

I'm in Scotland and am prescribed HRT patches and fluoxetine. The first deals with the sweats, the second deals with the mood swings. They try and take me off it every so often, but i become a raging hormonal wreck and cry all over them until they put me back on it again

Could someone please answer this question which I can’t find an answer for online, if you are peri menopausal or menopausal but have relatively mild symptoms that you can cope with, should you go on HRT anyway to protect your future health? If you do not go on HRT does that mean you will definitely suffer vaginal atrophy, heart and bone problems etc, I really don’t know what to do, my symptoms are mild and I can cope but really don’t want to suffer the issues I have listed, is a ‘natural’ menopause actually dangerous? apologies for my ignorance but I just don’t know what to do for the best.

Thanks Jingling, I watched a Dr Newson Video last night and called my Dr first thing this morning. If only we all had a GP like her eh.

@dementedma I don't have major problems with sweats since I started taking Red Clover last year but I'm glad you find the anti depressants work well for you too.

@ZaraCarmichaelshighheels I wish I had tried for HRT earlier, before the joint issues. You shouldn't need to have severe symptoms to take it.

I'm outraged that women are being denied HRT and offered ADs instead!

Disappointed to say the least that some of you have women GPs who are being dismissive.

I'm in London, aged 65 been on HRT for about 10 years - I'm registered at an all-women GPs practice and have regular reviews, etc.

@ZaraCarmichaelshighheels Try to answer some of that!

There is a bit of a two-tier system with HRT.

Many medical experts (meno consultants) would give you HRT if you wanted it for a) very mild symptoms or b) to protect your future health.

This is discussed in a podcast with consultant Nick Panay on the Liz Earle Wellbeing website where she asks him just that.

it is highly unlikely that a GP would do the same and would expect you to have real quality of life issues now with peri / post meno symptoms.

IF you had a bone density issue now, HRT is licensed for use in women under 60 as a treatment.

Some women do really well with no HRT so it's not accurate to say you would get osteoporosis, or heart disease without it. If your only symptoms are / were vaginal/bladder etc, they like to try vaginal estrogen first .

However, many women are at risk of osteoporosis without knowing until it's too late.

I wish all women age 55 were given an NHS bone density test and then they could choose the right treatment if needed before it was too late. In fact I think they should swap cervical screening for bone density scans because the number of women dying from osteo complications is hundreds of thousands a year, compared to around 2000 cervical cancer deaths.

So no, HRT is not essential if you have no symptoms, BUT for someone who has a family history of heart disease, or low bone density , or is at risk for other reasons, it's probably worth having that kind of discussion with a medical expert.

Thanks jingling. I will definitely be going back to my GP over this.