DR refusing HRT

[pink1173]

Hi- I really need some help and advice please.

I’m 47 and had peri symptoms since I was 42. I have now had no periods for 17 months. Just after Christmas I went to the doctors because the symptoms were worse and I couldn’t sleep at all. My mum had endometrial cancer a few years ago so because of this they wanted me to have an internal exam to check all was ok before I was prescribed HRT. I also had blood tests etc. All was clear with the internal but then lock down happened so I left it a while to go back to the doctors.
So, at the start of July I had a phone consultation and the doctor said ok no problem but as you have to had blood tests for 6 months let’s do those again just to make sure nothing else is going on. Had the blood tests all fine. Had to make another appointment but spoke to a different doctor. She was not happy about giving me HRT and told me to eat a soy yogurt every day and prescribed anti depressants and high blood pressure tablets. This was all to do with my mum having cancer.

She did say she would write to the Gynaecologist and ask for advice. Fast forward and I had a letter from the doctor yesterday to say the Gynaecologist said it was fine for me to have HRT but that she had discussed it with two other doctors at the surgery and even though she respects the expert advice the three doctors would not be prescribing me HRT due to the risk!

I am at my wits end. I do not sleep ever and I am a teacher and so worried about going back to school in September and feeling like this. Can anybody give me any advice please? Thanks!

Go to a different dr at the practice? You could call and ask the receptionist if any of the gps specialise in menopause.

I found a great Dr at my practice after having a fight with a previous one. I had to have blood tests etc...... but now have finally got the patches (although I can't start them until my next period which is a hassle but hey I at least have them)

I think you need to find another dr and if necessary pay to see one privately- someone who knows what they are doing.

You are having an early menopause.

NONE of the risks of HRT apply to women under 50 anyway AND there is no connection between your mum's cancer and you using hrt.

I'm gobsmacked at how a GP can argue with the decision and advice of a consultant! How dare she!

If the gynae that was consulted works privately, see them, or ask your GP for a referral to her on the NHS for a 2nd opinion.

Hi @pink1173 sorry- you are 47 now so this isn't an early menopause, but everything I wrote earlier today applies :)

It's very specific advice in the NICE meno guidelines - and that includes no ADs or BP tabs for women who can use HRT.

This is a link to a GP training tutorial about HRT and how to prescribe.

www.gp-training.net/training/tutorials/clinical/gynaecology/hrt.htm

There is no absolute contra-indicationg to the prescribing of HRT in post-menopausal women. Extra caution may need to be exercised in the following situations:

Active breast cancer / undiagnosed breast lump
Active thrombo-embolic disease (phlebitis does not constitute thrombo-embolic disease)
Undiagnosed vaginal bleeding
Untreated/uncontrolled hypertension
Coronary artery disease
Breast Cancer

It's quite long, but it's very clear which women cannot use HRT abd it even says there are NO absolute contraindications for HRT.
Here is there list of 'warning' conditions.

Absolute contra-indications

There is no absolute contra-indicationg to the prescribing of HRT in post-menopausal women. Extra caution may need to be exercised in the following situations:

Active breast cancer / undiagnosed breast lump
Active thrombo-embolic disease (phlebitis does not constitute thrombo-embolic disease)
Undiagnosed vaginal bleeding
Untreated/uncontrolled hypertension
Coronary artery disease
Breast Cancer

Endometrial cancer has many causes including being overweight and smoking (so it can be a lifestyle cancer.)

If used correctly, HRT should make no difference to your risk and your mother's history of it is not in any recognised list of risks.

oops- same list tiwce.

Thanks @JinglingHellsBells. I have read the guidelines and thought I must be going mad! Goi g to make another appointment tomorrow and if they won’t prescribe then I am going to ask for a referral.

OP your GP sounds scarily like mine. She also likes to discuss HRT with the other GPs at the practice and is very negative / adverse for the slightest reason. If you are in NE England, it could be the same doctor.

I've also got a thread in AIBU at the moment, as I'm bloody livid at being constantly offered antidepressants for chronic pain and menopause symptoms, when none of my symptoms are to do with feeling down or depressed.

Hope you get sorted. Think I only have one more hoop to jump through then I should be prescribed HRT in a couple of weeks. I've read all the NICE guidelines and weighed up the pros and cons so fingers crossed.

Request a referral to a menopause clinic at a hospital, there are a few countrywide.

Request a referral to a menopause clinic at a hospital, there are a few countrywide.
But the wait can be 6+ weeks.

If you can afford £250 for a private appt it's worth it,

I had a GP like this, I ended up saying "Here are the NICE guidelines, here are my symptoms. I'm not asking for HRT, I require a prescription for it."

My symptoms cleared up within a week on HRT - it's miraculous

The attitude of NHS GPs is mind-boggling. I read too many posts like this and I don't understand how there can be such a lack of consensus among doctors. In my own practice, I spoke to three - the first refused to believe I was perimeno (I was 47) and said my irregular cycles must be bleeding from polyps, the second was anti HRT and recommended black cohosh (unregulated herb with safety issues) and ADs, the third was very breezily pro HRT but prescribed me the wrong bloody type, continous oestrogen only. Absolute joke! Go private if you can OP. You say your mum had cancer a few years ago - I take it she was 60/70s or so? I thought it was only a contraindication (if even that) if you had a close female relative who had a womb/breast cancer when under 50?

As for soya yoghurt - 🤣 I eat or drink soya every day and I have had terrible meno symptoms! If only it was that easy!

Just a quick update - I went for a second opinion and the doctor I spoke to managed to get the whole surgery an education session with the Gynaecologist and I now have some HRT! Has taken a while but hopefully now the GPs at the surgery have more knowledge and women will get the help they need!
Thanks for all of your comments.

good news

My Doctor is completely the opposite...she says all women 45 and over should have HRT because of all the additional benefits it brings. She has specialised in body/bio identical hormones and is flabbergasted by her out of date colleagues.