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Just got my first HRT - Interesting GP experience

3 replies

WombatChocolate · 28/01/2022 19:54

Am 49 with irregular periods which are tailing off, anxiety, hot flushes and loss of libido.

Did some reading on MN and on the Newsome website and a couple of others. I had decided I wanted a transdermal oestrogen and probably Utrogestan as micronised progestin - but I have migraine with aura, so wasn’t too sure if I could have it.

Last week I had an appointment with a GP. It was a woman and she was quickly said HRT could help given my symptoms. She first offered me tablets for both the oestrogen and progesterone. When I said I’d prefer transdermal gel she said okay and offered the coil. When I mentioned Utogestan she reluctantly said okay. She also mentioned I should have a BP measurement done. Then I mentioned migraine with aura, which threw her a bit. She said she needed to speak with the pharmacist about it, but would get back to me and let me know when a prescription was sent across to pharmacy.

All good I thought.
Then no word and so I called the surgery 4 days later to find all that was recorded was that I needed a BP check and was interested in HRT.

Today I had another appointment. This time a man, and much better, although it didn’t start well.

When I mentioned migraine with aura, the first thing he said was it contraindicated HRT so wouldn’t be possible due to blood clot risk. I challenged him and asked about transdermal and the fact reports say transdermal is safer and oestrogel doesn’t heighten risks of blood clots. He agreed. I then asked about Utrogestan and some reading I had done which suggested that cyclical utogestan can worsen migraines with aura due to the varying levels of it, as it’s not taken continuously. I asked if it would be possible to have it continuously on low dose.

He hummed and hahed a bit and said continuous progesterone was for women whose periods have stopped - I knew this was likely. I think he was reading up as I was talking…maybe I’m imaging that. And then he said ‘yes’ you can have it continuously - that it’s off licence given continuously for someone with periods still, but given your migraines, maintaining a steady level is a justifiable choice and we will try it. I was really surprised - so I asked him if he was genuinely happy with that, and that I didn’t want to tell him what was best for me, as he is the expert, but he confirmed that what I was getting was right for my situation.

And he wrote me a prescription, answered all my questions about how and when to take each element, and about what to do when I ran out (return to GP for 3 month review) and that they would give me 3 months supply and if all okay would give me more later.

I am starting with 1 pump of Oestrogel and taking 1 Utrogestan tablet per night.

30 mins later I had been to the pharmacy and had the stuff in my hands.

So I actually think it went quite well and better than my first appointment. When I raised questions and mentioned details from my reading, he didn’t get defensive about it but engaged in a conversation with me about pros and cons and my particular situation. He seemed to appreciate the fact I’d done some reading and that made him willing to discuss it with me rather than just insisting on his first thought.

The only pity is that he was a locum, so when I have my 3 month follow up, I probably speak to him again.

So I’m excited to start. I’m not quite sure what to expect in terms of bleeding (length or regularity) or any other symptoms. Any thoughts or advice welcome.

And thanks to MN and other websites, I felt informed going into that meeting today. Hoping to feel much more my old self again soon.

OP posts:
Koshnique · 31/01/2022 18:27

How are you getting on OP?

Its really interesting to read about your experiences with different GPs.

WombatChocolate · 31/01/2022 20:49

I’m doing okay - 4 days in. Haven’t see. Any significant changes to my symptoms yet.

Am not sure what bleeding to expect on the regime I’m having. Does HRT stop natural periods if you’re still having the odd one usually, if you’ve gone onto continuous HRT? Thanks.

OP posts:
Utterlyexhausted · 01/02/2022 03:06

You're still very early days in your usage but I'm certain your symptoms will start to ease soon.

I also suffer from migraine & take continuous micronized progesterone..thank you for explaining what your locum said re: this! I'm in the states & find that my gynecologist, although very good, doesn't explain things well 🙄

As for periods, mine are starting to get much lighter. I did have a few months of bad cramping but that seems to have passed now. It'll be even better if/when they stop altogether! I personally benefited from reduced migraine once I started progesterone (I started progesterone, then was given estrogen patches after a clear uterine biopsy) if you still suffer with the migraines, you could try a higher dose..it's normal to have to tweak the doses a bit I'm finding.

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