Surely this GP was mistaken?

[Iheartmysmart]

I had my first HRT review yesterday with a different GP to the one who originally prescribed it. When I first started using it I had been period free for over 12 months and being over 50 was put on a continuous regime.

Unfortunately I had a lot of random bleeding initially so my prescribing GP suggested changing to progesterone on 12 days per month which has been working well.

During yesterday’s review I was told that I shouldn’t be doing this, I had to go onto continuous and I also now need contraception as my periods had obviously come back! Was also told off for upping my gel to three pumps a day without permission.

Surely if my regime is working for me and I’m happy with it then it doesn’t matter how I use it. And the bleeding is just a breakthrough bleed similar to the combined pill. I’m almost 55 by the way.

Oh dear!

Why did they put you onto a sequi regime and now say that is wrong? Is this the same GP? Why do they think the monthly withdrawal bleed is a period? (If that's what they thought?)

The random bleeding you had at first on continuous is expected- guidance says it can carry on like that for 6 months because it takes that long to get the lining thin and for the estrogen/ progesterone to work in sync.

Your periods can't come back at 55. How on earth did they think that! And if they HAD come back, then the sequi regime is the right one! And you don't need contraception at 55. The odds of conceiving are almost zero.

No one HAS to go onto a continuous regime. I am not on it after 14 years on HRT (and am in my 60s.) I chose not to (and my consultant is happy with that.)

You also do not need permission to increase the estrogel dose by such a small amount.

Find another GP?

Thank you for replying. The GP I spoke to yesterday wasn’t my prescribing one and was actually from a different surgery entirely due to a recent merger.

I have absolutely no idea behind her thought process but she did seriously believe that the withdrawal bleed was a period and mentioned it several times whilst reiterating the importance of contraception now they were back!

My initial GP was more than happy for me to use the sequi regime as the random bleeds were proving annoying. She said it was entirely my choice if I wanted to stay with that method or try continuous again in the future.

I was pretty much decided on ignoring the ‘advice’ from yesterday anyway so thank you for confirming that it’s not me being daft.

Sadly I can’t change GP, no others in the area are taking new patients at the moment!

How annoying. Maybe she missed the HRT lectures at med school
The odds of getting pregnant at 55 are so rare it's not worth thinking about.

I'd carry on as you are as long as you can manage to get the prescriptions.

I'm almost laughing at the idea you need contraception. Sorry OP, is shit. I was given bizzare advice about contraception too when I went for HRT. You have to be well read and very assertive with them, alas.

I know! It’s absolutely ridiculous. I did laugh about it after the call but then have to confess that it made me a bit angry. We are putting our trust in these GPs to help us and some of them don’t even know the basics.

I know you just said you can’t change your GP but can you request an appointment with your original one in future? Has this GP left the practice?

To be honest I was caught off guard a bit as I wasn’t expecting a call. I’d assumed that I would need to book a review myself and was planning on doing so with my original GP. Had no idea until I answered my phone that I even had an appointment! If I have any problems I’ll just go back and speak to my first GP as she is still at the surgery.

I would imagine the HRT lecture at med school was about 2 minutes, just like the breastfeeding lecture.

Some GPs have taken a special interest in the subject and are very clued up. Others are bloody useless, like the one I saw first who told me to go for a walk and take some folic acid.