Going private in London/at home without paying a fortune

[Vodkacranberryplease]

Hi all. I'm 55 which I can't fucking believe on eostrogel (not doing it every day) and urestogen (sp? the progesterone one). I have various symptoms and tbh just don't know what's menopause and what's not. I'm still pretty young in many ways, still have a sex drive, but I'm currently bleeding a lot (days of it now) and don't have my usual get up and go - in fact it went a while ago. I had hot flushes years ago but they went.

Anyway I think I want to see a professional and want to look at things like low dose testosterone, plus have my hormones properly checked out. I went to Marion glucks clinic years ago and saw an awful woman plus it cost a fortune.

Can anyone recommend a good practitioner/clinic? I know with some you can send off and do tests at home first and with social distancing etc it would be better. But I'm in London so can see someone here too. I don't really want someone who is too naturopathy I want facts on all of my hormones and how to deal with them. It's like trying to figure out particle physics and even the threads here are bewildering and there doesn't seem to be any 'standard' set of symptoms!

The British Menopause Society has a list of specialists in their Home page of the website. You can see all their contact details there.

I'd caution you though that very few specialists bother with tests for estrogen because it can vary over the day AND if you are using HRT ,

(I have been told this myself.)

The way to treat what you are experiencing is to get the right amount of Utrogestan. How much do you use? Are you using it daily or 12 days a month?
Why are you not using the gel daily?

It sounds perhaps as if you are not using what you have in the right way- that's gel daily, Utrogestan wither 200mgs x 12 days per month, or 100mgs daily every day.

What were you told to use?

Op the person you want is Nick Panay.

I was using the gel and progesterone daily but I didn't feel any different. I've used progesterone contraception in the past and it made me feel really down. They told me it was for preventing cancer and I notice no difference if I take it or not. But I don't know what I'm looking for so it's hard to tell.

I'll look up Dr Panay. It's so hard with the clutter of experts everywhere- being on an association website is no guarantee of anything as I've found out the hard way.

I don’t want to take hormones as menopause is a natural part of getting older and I want to get on with it. However I couldnt cope with almost permanent bleeding, water retention in abdomen and boobs, night sweats, tiredness, not sleeping, crying, brain fog and general anxiety about nothing in particular.

I go private for acupuncture and she’s sorted all of these things out. No more problems. I’d recommend it. But not from some part timer that does it now and again to support other therapies, an actual acupuncturist whose done it for years day in day out and has good reviews.

It’s so good I honestly don’t know why more people don’t try it. The fear of the unknown I suppose.

It’s now apparently going into the NICE guidelines, not sure what conditions for, hopefully conception, pregnancy and women's hormones.

on eostrogel (not doing it every day)

I was using the gel and progesterone daily but I didn't feel any different

I can offer a advice but need more info.
How long have you been using this type of HRT and what exactly are you using each day?
Which is it? What are you doing now?
Bleeding is normal with this regime, often for 6 months, off and on.

See someone privately if you want to, but a good start would be to use the gel and Utrogestan properly.

It's not to prevent cancer in the way I think you mean.
If anyone with a uterus uses estrogen, they must use progesterone too, to stop the womb lining getting too thick (which in time could lead to cancer.)

That means every day for gel- not hit and miss - and you need to work on getting the right dose.

Who is prescribing this now for you?

You should have been told to use 2 pumps to start then increase to 3 and possibly 4 if you need to, to control flushes and other symptoms.

What symptoms are bothering you now?

Not everyone can afford regular acupuncture- it's often £50+ a week and needed weekly for a while.

I know you asked for private, but prior to covid, many family planning clinics ran menopause clinics. Sessions were 1:2:1 with either a specialist nurse or gynae Dr, not a group type session. Just adding it, as it might been something you werent aware of. Not sure if they have re-opened, but you could check what is available in your local area as an alternative.

I'm pretty keen on acupuncture as it happens. I'd love to find a good one - it's just that London is so full of people practicing all kinds of things badly.

Someone recommended a menopause guy but he's a consultant. At the top of that field. So £500 an hour I should think.

And the nhs won't do testosterone. I'm with Babylon which is the app and I could probably book something through them but it would be good to find someone who can look at everything and make recommendations not based on what's cheapest/approved by nice. Some do bioidentical which would be good but not caught up with it.

The last time I had tests with my GP they would only tell me I was going into the menopause. Hardly ground breaking. No tests for other hormones for sleep etc. I don't even know if eostrogen gel is the right thing and whether I'd be better off with vaginal gel/cream.

@Vodkacranberryplease Just going back to what I posted earlier.

I am using that type of HRT (over 10 years) and see a private consultant. I can tell you that most/ all will not do blood tests, because the way they decide if HRT is right for you is whether the dose and type works. So don't get hung up on testing- it's not necessary.

My advice is that you start using what you have been given (by your GP?) on a regular basis and see if things improve. This is what any dr will suggest first.

If you are not using gel daily OR have been using gel/ Utrogestan for under 6 months, it is usual to have bleeding until the progesterone thins the lining enough for it never to bleed.

If you have been on it for over 6 months and are bleeding, you need to see a dr perhaps for a scan or an adjustment of the dose. I'm not sure if you mean you are spotting, or having what seems like a period, or how long it's been going on.

Testosterone is not available on the NHS. It is given mainly for libido. It doesn't sound from your first post if you need it.

The cost of private consultations is around £300 for the first appt and less for follow ups. Blood tests are extra. But as I said, blood tests tell nothing and they would not be accurate anyway if you are using hormones because they would only show how much your body had absorbed on that particular day.

At the moment, it's worth trying using 2 pumps of gel daily, and taking Utrogestan 100mgs every day. If you still feel unwell, increase the gel to 3 pumps after maybe 3 weeks. See how that goes.

but it would be good to find someone who can look at everything and make recommendations not based on what's cheapest/approved by nice

NICE does not suggest types of HRT.

I see a top consultant and his preferred HRT is gel and Utrogestan. You can't and won't get anything different paying privately, only a tweak to the dose.

Ok well I am comfortable with the form of hrt I've been given - I didn't notice any difference when doing it regularly apart from it stopped the stress incontinence (so embarrassing- nearly did a name change before even posting that).

Today I am bleeding heavily so will need to talk to the doctor anyway. I use Babylon and some of the gps are pretty clued up on hrt. The problem as ever is you don't know what you don't know so remembering what to ask about/understanding what could be hormones and what is unlikely to be is difficult. Especially in a 10 minute slot.

I just feel in the last couple of years I've lost my motivation and hormones effect literally everything. You read about these women who are given antidepressants etc then decide to try hrt and suddenly rediscover their zest for life, lose weight, have glowing skin, bags of energy etc. That's not happening to me. And I'd like it to.

@Elieza can I ask are you in London? If so where is your acupuncturist?

@Vodkacranberryplease Do you have access to a GP? (Other than online ones with Babylon?)

It's impossible to say why you are bleeding from what you have said here.

It could be that you are using the HRT in an incorrect way (ie not regularly.) That can cause bleeding.

Have you been skipping the estrogen gel, or the Utrogestan? (or both?)

If you are several years post-meno (no periods for 12 months or more) any bleeding has to be investigated urgently, with a scan at least. Your GP has to arrange this.

The rule is you are seen within 2 weeks for the scan.

If you have used hrt only 'now and then' this could well be why you are bleeding BUT it could also be something more serious.

I think I know how Babylon works and I don't think they are the right route for this- you will need a letter of referral from your GP to a consultant to carry out the scans. Babylon MAY be able to refer you, as may a private GP - plenty of those in London.

You aren't saying exactly what you have been doing with your HRT but suddenly stopping, or getting the ratio of gel to progesterone wrong, can cause a bleed. BUT any GP will want to send you for a scan to rule out anything serious, before the discuss anything else.

Sorry OP, I’m in central Scotland.