GP attitudes to HRT.

[CallistoSol]

I'm new to HRT, having just been prescribed progesterone 14 days on and 14 days off and oestrogen gel (forget the names). It has been life changing and I am feeling better in so many ways.

My GP was fab, from filling out the online form to picking up my prescription was only 7 days including a weekend. In that time I had a telephone consultation and went in for a blood pressure test. All incredibly positive.

I realise how lucky I am, but why is there so much pushback from other GP's? Why is HRT not prescribed as standard to women who are struggling with symptoms? Is it just another element of the patriarchy? Do GP's have a vested interest in not prescribing HRT? It seems so bizarre.

I presume they treat each patient as individuals and make a judgement. If HRT was completely without risk you'd be able to buy it over the counter.

But that's not true. There is loads of anecdotal evidence that a lot of women need to really fight to be prescribed HRT.

Well you appear to have got yours ok.

Are you a journalist?

Yes reading these threads there's a huge variation of reactions from GPs.

My surgery is great. With things like this they love it when I already know what I want. I know it's not always possible to know the best option beforehand though.

@Phlicker

Well you appear to have got yours ok. Are you a journalist?

No I'm not, bizarre that you would assume that. Are you usually unpleasant?

@MostIneptThatEverStepped

Yes reading these threads there's a huge variation of reactions from GPs.

My surgery is great. With things like this they love it when I already know what I want. I know it's not always possible to know the best option beforehand though.

Exactly what I found with my GP. I do think I'm lucky and I did change practice a few years ago as I could only get a mirena coil at my previous practice and wanted a copper coil, so may not have had the same response there.

I've no idea if it's backed up by stats, but it does seem that male GP's (of a certain age?) are very unsympathetic about menopause symptoms.

The PP is not being unpleasant. Like many of us, they are well used to journos pretending to be bona-fide posters, and using MN as an information-gathering resource for their articles.

I think a deliberately dismissive answer is unpleasant and unnecessary, but whatever.

@Phlicker

I presume they treat each patient as individuals and make a judgement. If HRT was completely without risk you'd be able to buy it over the counter.

@Phlicker You can in some European countries, incl Spain.

There does seem to be a huge variation with quite a lot of women essentially being told, it's a normal part of life put up and shut up.

Not sure why the OP is getting shit for this post tbh

@CallistoSol There are many reasons, the main one being an over-emphasis on the risks, especially by the media, and not enough on the benefits.

Most recently, the Lancet published a paper (last August) which appeared to show higher risks of HRT yet it's been disputed by all menopause experts and the British Menopause Society published a very terse response to it.

The Lancet article told GPs to only prescribe HRT for a short time etc etc and basically turned the clock back 20 years.

I can tell you that the UK's meno experts were up in arms about it and you might like to read this.

Michael Baum is one of the best breast c specialists in the world.

He also appeared on Morning TV ( see youtube) discussing this .

So, GPs tend to react to headlines which don't give the full picture. They don't bother to drill down into the details of research.
The basis for the lancet article was an observational study not a double blind placebo trial. So it wasn't the best research.

Sorry if this is detailed but I do write for the media on HRT and health, so have to look at all of this anyway :) as well as for my own benefit.

[Link removed by MNHQ at OP's request]

Whoops very silly link there. Try this www.menopausedoctor.co.uk/menopause/breast-cancer-risks-from-hrt-by-leading-breast-cancer-specialist-professor-michael-baum

JinglingHellsBells wow insulting much? Can we stop with the GP bashing please. Yes of course GPs just prescribe on the basis of Daily Mail headlines... not like we have been literally taught critical appraisal or have a medical degree or have spent years doing post grad training and sitting exams for our position or anything... Even the OP who by her own admission had a very positive experience with her GP is with this thread actively inviting people to slag doctors off. In the middle of a pandemic. It’s not appreciated.

I spoke to a male gp first and he was all at sea. It was like being in the 1950s. And he's normally a switched on guy. He directed me to the "hard to get hold of" female gp.I did eventually. "No need for you to suffer " she said. And then I had to deal with the supply shortages but she gave me some tips on which local chemists might be able to get it quickest.

@Iceskatingfan I wasn't at all trying to incite people to slag GPs off. How did you reach that conclusion? And I didn't read @JinglingHellsBells comments as GP bashing either. Some totally weird responses to this thread.

@JinglingHellsBells thank you for the info, I'll have a read. Do you have any insights into why the Lancet would publish that paper? Is there a vested interest in not prescribing HRT?

I had a job getting mine even though the menopause gave me a breakdown. Female GP said she didn't have time to go through all the HRT thing???
Its not like I talk the hind leg off the donkey in the surgery I just had a few short questions about it.
Finally got it and it was life changing, who wants to be a fat, sweaty ragey mess?
I'm angry that we can't get testosterone prescribed here for loss of libido like they do in the states, I'd be quite happy to buy it privately but it isn't allowed I've tried. So its ok for me to totally lose my libido and for my marriage to collapse then?
My friends who take it in the states say it's also life changing.
I really feel the medical establishment don't give a shit about womens issues sometimes.

@NiceGerbil

There does seem to be a huge variation with quite a lot of women essentially being told, it's a normal part of life put up and shut up.

Not sure why the OP is getting shit for this post tbh

Funny how men aren't told "You're impotent? Your old Deal with it it"

Funny also, how despite Visgra also having potential side effects, they are handed out like Smarties.

Older women are treated like shit.
Fact.

Also Viagra was originally researched for reducing pre menstrual/ menstrual issues and was really successful but as soon as they realised the hard cock thing they saw the £££ and pursued that instead. The fuckers.

OP you can’t see how a thread entitled “GP attitudes to HRT” could attract attention from people who have an axe to grind with GPs? And really, you can’t see how a journalist saying “GPs tend to react to headlines and don’t drill down into the details of research” is kind of insulting? Imagine if there are constant threads on here criticising how you do your job while you put yourself at risk every day in a pandemic?

@Iceskatingfan

JinglingHellsBells wow insulting much? Can we stop with the GP bashing please. Yes of course GPs just prescribe on the basis of Daily Mail headlines... not like we have been literally taught critical appraisal or have a medical degree or have spent years doing post grad training and sitting exams for our position or anything... Even the OP who by her own admission had a very positive experience with her GP is with this thread actively inviting people to slag doctors off. In the middle of a pandemic. It’s not appreciated.

So you are a GP?

I'm pleased if you have had training in menopause, either invested in by yourself or your practice. Because meno training at med school is half a day.

But the majority of GPs have not. You may not be aware of it, but the BMS has been running menopause training for years and an annual conference, to educate and train GPs on menopause and HRT.

Why would they bother if there was no need?

Maybe you are new to this section of MN.

If so, might be worth reading some of the many posts where women have been refused HRT, been wrongly prescribed HRT (like told to use estrogen gel as vaginal treatment) and often given combined continuous HRT when it was not appropriate.

These posts come up almost daily so make your own assessment.

@Iceskatingfan

OP you can’t see how a thread entitled “GP attitudes to HRT” could attract attention from people who have an axe to grind with GPs? And really, you can’t see how a journalist saying “GPs tend to react to headlines and don’t drill down into the details of research” is kind of insulting? Imagine if there are constant threads on here criticising how you do your job while you put yourself at risk every day in a pandemic?

I think the OP has raised some valid concerns. Menopause isn't merely "something to be Got Through. That's a very old fashioned ed nor to mention oitdated attitude. A large majority of women have debilitating menopausal symptoms that never go away. Women are living longer. whjch means that some women are expected to suffer for the whole of the second half of their lives! That's a long time to suffer. It's inhumane to refuse hrt to these women imo

@Iceskatingfan

OP you can’t see how a thread entitled “GP attitudes to HRT” could attract attention from people who have an axe to grind with GPs? And really, you can’t see how a journalist saying “GPs tend to react to headlines and don’t drill down into the details of research” is kind of insulting? Imagine if there are constant threads on here criticising how you do your job while you put yourself at risk every day in a pandemic?

Your 'outrage' is inviting a LOT of responses from women who use this forum to tell you of their dire experiences.

Are you aware of the petition #makemenopausematter and all the work of UK menopause consultants, to try to train GPs?

Honestly, if you are unaware of the poor treatment of menopause for the vast majority of women, it's very surprising.

[quote CallistoSol]@JinglingHellsBells thank you for the info, I'll have a read. Do you have any insights into why the Lancet would publish that paper? Is there a vested interest in not prescribing HRT?[/quote]
The Lancet publishes a lot of research papers but whether they have links with certain research universities or authors of papers is not something I am aware of.

in response to some posts here, the majority of GPs do not have the time to read all the research embedded in the article.

Michael Baum is quoted as saying that as a Professor with 50 years' experience reading those kinds of stats, it would take him a week to read it and digest the implications.

How many GPs have the time to do that?

What happens is that newspapers reach for the headline of the report and that's what is published.

The BMS kicked back against it in a tone they rarely use but by then many women had been sent letters by their GP's practice, to come and discuss [and come off?] HRT.

I can't imagine the workload of the average GP, and having to 'know everything' must be exhausting and stressful. Maybe GPs should be able to specialise more within a practice so that there would be a womens health specialist.

I'm really wondering about vested interests in menopause treatment because denying women HRT seems so embedded in the system. Or maybe it is just because older women don't matter so who cares anyway