What to ask for at GP appointment?

[PermanentlyDizzy]

I’m just shy of 52 and for the past year have been battling what myself and my specialist assumed was an exacerbation of a chronic condition. It only dawned on us at my last consultation last month that, actually, all my symptoms are on the list for peri-menopause.

Difficult to tell family history of menopause age, because both my mother and grandmother had hysterectomies in their early 40’s, but my older sister was peri by my age with very similar symptoms and I tick every box, bar two, on the list of symptoms on the menopause society website.

I have a telephone appointment with my GP tomorrow and having tried everything we can to address the possibility of the symptoms being down to my chronic condition, I’m not going to back down on wanting to trial HRT. Annoyingly, we have a lovely female doctor, of roughly my age, who has a special interest in women’s health, but these days you just get allocated the next available appointment with whichever doctor that is. I’ve been waiting a month for this appointment, so don’t want to waste it.

I have complex migraine, including migraine with aura and a history of ischemic brain lesions, so topical/patches/gels would be the only option for me, but I am reading a lot about national shortages and I have enough of a faff accessing the meds for my health condition as it is, so would rather trial something that is not currently in short supply.

I’ve read up quite a bit and I think it’s essentially an oestrogen patch/gel/spray, plus micronised progesterone (don’t want to attempt a coil as have yet to find a nurse that can even manage a smear effectively and without a lot of pain due to my wonky uterus and my sister has similar issues and had awful problems with hers). I want to be clear what I should be asking for to, so I can be in control of the appointment.

Any advice would be appreciated.

Just state your symptoms and tell GP you would like to trial hrt. I tried but it made me put on weight so I came off of it.

That’s what I was planning, but I wondered if I need to be aware of what shortages there are, so I can avoid having to shop around chemists trying to get the prescription filled.

I hope I don’t gain weight on it, as I have already gained a fair bit over the last year and am putting abdominal weight on, when historically I have always had an hourglass figure with a proportionally small waist.

Insomnia is one of my worst symptoms though, which means, coupled with my health issues, exercising has been a real challenge for the past 12 months due to pretty extreme exhaustion. I’ve been existing on so little sleep, regularly 3-4 hours, but often only about an hour before I have to get up. I’m on my knees and something has to change.

TBH I don't think the shortages will last forever. It's in Besins' interests to increase production. They have just been overwhelmed as a result of the media drive. for HRT. They are aware of the issues and hopefully it's short term.

You have many options such as patches, gel and spray.

I wouldn't worry about weight gain, although obviously you need to do whatever you can to shift the excess :)

Poor sleep can contribute to weight gain.

I've used gel for almost 14 years and not put on weight. It's not inevitable by any means, although we all need less food when we are over 60.

Just ask your GP for what you want and give it a whirl!

Thank you.

Yes, I’m already working on losing the weight and it’s going down, far more slowly than it used to, but at least it’s going in the right direction now. Not easy when I feel so crappy, but I am desperate enough to try anything.

GP just called, lovely lady GP, listened to everything I said and was happy to prescribe. Gel 1-3 pumps per day and micronised progesterone, review when this prescription runs out or before if any worries or concerns.

Typical, pharmacy says they haven’t had the gel for months and aren’t expecting any more stock for months. So I am now back in the never-ending phone queue for the GP to ask them to prescribe something else.

@JinglingHellsBells

TBH I don't think the shortages will last forever. It's in Besins' interests to increase production. They have just been overwhelmed as a result of the media drive. for HRT. They are aware of the issues and hopefully it's short term.

You have many options such as patches, gel and spray.

I wouldn't worry about weight gain, although obviously you need to do whatever you can to shift the excess :)

Poor sleep can contribute to weight gain.

I've used gel for almost 14 years and not put on weight. It's not inevitable by any means, although we all need less food when we are over 60.

Just ask your GP for what you want and give it a whirl!

What do you mean by short term?

@PermanentlyDizzy

Typical, pharmacy says they haven’t had the gel for months and aren’t expecting any more stock for months. So I am now back in the never-ending phone queue for the GP to ask them to prescribe something else.

It might be a good idea to ask the pharmacy what they can get - Sandrena gel is an alternative, otherwise Lenzetto spray or Evorel/Estradot patches depending on dose - 25 or 50?)

Besins are currently sending out a stock answer to anyone enquiring saying they're expecting there to be further supply to pharmacies soon. Just seen that the BMS has posted an update: thebms.org.uk/news/british-menopause-society-update-on-hrt-supply/?fbclid=IwAR1FgQprV7RRWHZdUXRuBMW3YoDX07kQPGlvqVF9QfncFEvYiLLBdjZQTUw

@ChickenStripper I don't know what I mean by short term- a few more weeks maybe?

A friend of mine has been emailing the supply chain dept at Besins. They told her that they have increased the production recently to a much higher level than it was a few months ago- think they said up by 50%.

if it's affecting you personally, I suggest you do what she did and contact their customer services (email on the UK website) and ask for info.

Being cynical although there has been a greater demand for gel following the media discussions on HRT, many women do give up on it- as shown on threads here- so there may well be a drop-off effect from that.

However, Besins do say they are aware of it all and it won't do any harm to email them yourself.

@chickenstripper from the link left

Besins Healthcare (UK) HRT products
Oestrogel systemic estradiol gel.

Besins Healthcare (UK) Ltd has seen an exceptionally high demand for Oestrogel over recent months and in order to meet this demand our safety stocks have become depleted. This means that all new weekly deliveries into the country are being used immediately to fulfil current orders.

While we continue supplying Oestrogel to try and meet current demand and work to replenish our safety stock, some retail pharmacies may report Oestrogel as out of stock at their local wholesaler. We expect this should be a short-term issue and supplies would normally flow through to local wholesaler branches from the following weeks delivery.

Besin Healthcare is actually aware of the concerns that women will have if they are unable to fulfil their Oestrogel prescription, and we are doing everything we can to manage, increase and expedite supplies to retail pharmacies across the country through the wholesalers.

@over50andfab, realised on speaking to the GP that it’s best to avoid patches, as I have had reactions to medical adhesives in the past.

GP has issued a new prescription, but I have no idea what for as she sent it direct to the pharmacy. I couldn’t speak to her myself, she was sent a message by one of the care navigators.

Dad tried three pharmacies locally and they all said they’ve had none for months are aren’t expecting stock any time soon.

Thanks @JinglingHellsBells