Allergic reaction to patches, useless GPs now what?

[Whitehorsegirl]

I am having a nightmare of a journey trying to get the right HRT treatment out of my GP surgery. I need Combined HRT to deal with various symptoms.

So far I have been prescribed the wrong medication ( a topical cream for vaginal dryness only by a clueless GP who claimed it would then ''travel'' to the rest of my body) by one GP, then something that was out of stock everywhere (gel) by another and a third GP wanted to get advice from a consultant before giving me anything as I have had a partial hysterectomy (the consultant advice came back to use oestrogen and progesterone as I still have a cervix).

Finally two complaints to the surgery later (a male receptionist tried to blame me for needing repeat consultations and tried to say that there was no way a GP could have prescribed the wrong medication) on Friday I was prescribed patches by a 4th GP although I did warn him I had a history of having allergies to some types of plasters.

Yesterday was fine but today my skin has gone red and itchy under the patch so it again looks like I will have to go back to the GP.

I am really losing my patience over this.

Should I simply cut my loss and move to a new surgery ( I was planning to do that longer term after this mess anyway) or should I yet again make another appointment? I am reluctant to start again at a new surgery without at least trying to get a new prescription first, then leave.

Can anyone suggest what the safest way is to take Combined HRT? I was told the patch method was the safest one as it has lower risk of blood clot but obviously it is no longer an option for me.

Any advice would be most welcome. This has been going for 3 months now and my mental health is getting worse by the minute...I really did not think it would be so hard to be prescribed HRT and I am even considering reporting the surgery for malpractice at this stage, beyond simply going through their internal complaint system.

It seems far too many GPs are really not informed about menopause.

You can get gel for your skin instead, Sandrena or Oestrogel its called. But there have been shortages all year.

The thing about the cervix sounds a bit iffy to me as well! Try Menopause Matters website for a (proper) GP led expereince.

Tbf they don't know what is in stock then they prescribe. A stupid system really, surely it wouldn't be too complicated to have data available regarding what is available.

I'd go to your local chemist ask if their oestrogel supply issues have resolved, many places seem to have supply now, if yes then just do an econsult say the patches made your skin sore so please could you try oestrogel as it is now available.

Also regarding the first thing you said it is normal to be prescribed topical cream for vaginal atrophy, obviously if you wanted systemic hrt that is different. Not sure I'd have submitted a complaint though a phone conversation should have sorted it.

I used to get red sore areas under the patches until I started covering them with tattoo/wound dressing - it’s a clear sticky patch that goes over the HRT patch and stops any water getting under it or the edges scratching my skin. Honestly I nearly stopped using them as I couldn’t continue having these big red welts all over my bum and thighs, but covering them has stopped it completely.

@RoyKentsChestHair the dressings sound good. Is there a type you could recommend?

Waterproof Transparent Stretch Adhesive

This is the one I use. Definitely worth a try. I used to trim it down a bit so it wasn’t so huge - but now I’m single nobody gets to see it anyway so I don’t bother!

I've ordered that sticky patch. I've just started HRT and the first patch just lasted the week, the next one was 24 hours, 24 hrs and now holding on for 48 hrs ie 3 this week already (as per instructions to start anew but keep weekly changeover day the same) I can see where the patch has been each time so I'm hoping I don't get sensitised. I'm not a sweaty person so I'm disappointed at the poor stickability.

Intrigued at how better skin contact could produce less irritation.

To be fair to them they’ve responded to your issues - ok the vaginal oestrogen alone wouldn’t have been enough, but they prescribed gel. Supplies have been limited and inconsistent, we do check availability updates but they’re not real time and often by the time the pharmacy is issuing the script it’s changed.

Im surprised they’ve prescribed a combined preparation after hysterectomy, that’s generally only needed if you had endometriosis and left the cervix which could have endometrial tissue that might bleed. I guess if they needed to contact the consultant gynae then your case isn’t straightforward.

Now they’ve issued patches and different manufacturers use different adhesives, so sometimes it can be worth trying a different brand. However there aren’t as many combined patches as oestrogen only which limits it a bit.

If you really can’t get on with transdermal oestrogen you might need oral tablets but as you know these carry a very slightly higher risk.

I hope you can get it sorted.

Thanks @RoyKentsChestHair im going to order some.

Sometimes if something doesn't have a 100% seal the constant adhering, coming unstuck then resticking can cause the redness, like friction. So better adherence is always worth trying.

Using an alcohol wipe can also help to make sure skin in completely dry.

I'm allergic to plasters. Told GP before she prescribed, so have the gel.

I think it wax a combination of water getting underneath the patch where there was a tiny gap when the skin moved and also the edges can be quite sharp so they were scratching and irritating the skin.

I actually bought the sticky stuff to keep the patches on for longer but noticed that the redness stopped as a bonus!

By sealing it with the sticky stuff I’ve found that:

a) it stays put for 4 days
b) I don’t get a black sticky line left on my leg where the glue has got fluff stuck to it
c) I’m not left with a red welt where it was

The patches can creep and then they crease the skin underneath which is irritating. The adhesive also seeps round the edge of mine, so fluff sticks to it which is also making my skin sensitive. So I see how the extra dressing might help.
I'm tempted to try the gel again, but I struggle getting it to dry.

I think you should get a private consultation with a menopause gynecologist expert OP as you have a partial hysterectomy.

then the consultant can prescribe and the faffing about with the GP doesn’t have to happen. The GP prescribed topical not systemic oestrogen which you may need as well. I don’t see how you need progesterone as you don’t have endometrium to shed.

i know the cost is off putting especially with the cost of living etc, but if you possibly could I’d get an appointment with a consultant who knows your medical history, so they can then prescribe the perfect thing for you, even if it meant going short somewhere else.

It’s worth it to be on the right stuff for the rest of your life. Think of it as an investment in your life long health.

sorry your GP clinic seems to be crappy- you deserve better.

re the allergic reaction.
I tried the patches when the gel was short in the pharmacy a while back, and had an allergic reaction to them. When I stuck them on, in a day or two they itched like billy ho, and fell off leaving red squares behind that eventually calmed down.

i have a latex allergy and can’t use plasters. Apparently they changed the glue because of covid supply chain issues.

Apologies for not replying before!

Well, I had another and final consultation with a female GP last week.

Because of my history of allergy with various plasters and now the patch she said to go for oral HRT and she prescribed me the lowest available dose to try to avoid the risks as much as possible.

And yes I still have my cervix and my hysterectomy was for endometriosis and adenomyosis which I think is why they did not want to prescribe oestrogen only.

Actually after a week of taking it all my symptoms have almost vanished! (maybe it is a placebo effect as I was told it would take about 4 weeks). But finally I can sleep better, don't have hot flushes anymore and I have a bit more energy and feel less depressed. I was getting really concerned about my mental health so it is a relief.

I have a 3 month supply then a review.

But I think I might invest in a private consultation (if anyone is in London and can recommend somewhere please PM me) to discuss the longer term as also maybe in 3 months the HRT supply issues might have improved and there might be some alternatives (gel) that I could take to minimise the risks.

@JaniieJones ''Also regarding the first thing you said it is normal to be prescribed topical cream for vaginal atrophy, obviously if you wanted systemic hrt that is different. Not sure I'd have submitted a complaint though a phone conversation should have sorted it.'':

Well, I did question the GP during the consultation when she said she was going to prescribe me this vaginal cream. I had clearly told her I wanted systemic HRT for various symptoms, vaginal dryness was not one of my symptoms, and I asked her clearly if this cream would do anything to help my overall issues and she replied that the HRT would ''travel around my body'' from the vagina. She was so insistent I thought I might be mistaken in believing that a local cream would do nothing for me. Of course when I got home I read the medication's leaflet and did some research online and I realised what she had said was absolute and complete nonsense. It is in my view necessary to make a formal complaint when a GP so obviously has no idea of what she is talking about in term of menopause management and comes up with such dubious statements. I don't want any other woman to have the same experience and this GP obviously needs some serious training in that area...

I saw a female GP who asked me why i was using Oestrogel on my shoulders as it was for vaginal use.
I informed her it was a systemic HRT and she checked it out on computer as obviously didn't believe me.

amzn.eu/d/5HVHzsC
So far so good with the over tattoo dressing layer

Ah brilliant - glad it helped!

Glad to hear you’re feeling better on the tablets Whitehorse

Just to say I got 9 things of oestrogel in the first chemist I tried last week, so it may be that the shortage is easing (or I may have got lucky I guess). Anyway I have skin which is allergic to masses of things but I have no problem with oestrogel. Hth

@Whitehorsegirl im so pleased you’ve got some medication now. I felt much better on HRT after about 10 days, much better sleep and debilitating hot flushes got less and less.

I’ve been on it a year now and I wouldn’t be without it!

Unfortunately I've had to give up on patches as my skin reacted increasingly with each patch so now I join the ladies hunting down the oestrogen gels from pharmacy to pharmacy.