NHS waiting lists question - can any HCPs advise?

[PacificState]

I was referred to my local (Surrey) menopause service back in march - I have a slightly complex medical condition and the GP didn't know whether or not it is safe for me to take HRT (which I'd like to try if it's safe).

When I rang today the very nice lady on the phone said she was extremely sorry but there's no prospect of me being given an appointment in the next few months.

She advised me to try a walk-in centre - it felt like she was trying to tip me the wink that this would get me bumped up the list. Is there any use trying this? None of my meno symptoms are urgent or terrible, they're pretty normal.

(I know going private is an option)

Correct me if I am wrong, but my impression of a walk-in centre was it was a halfway house between a closed GP surgery (out of hours maybe) and A&E.

The point is, no one at a walk in centre is going to be a consultant gynae/ menopause consultant.

You might also be able to find out the answer to your issues yourself, as there are lots of videos and podcasts online featuring menopause consultants.

My own consultant (who trains other drs in menopause) has a list of no-nos to HRT, which include -

-current or recent breast cancer (if all-clear after many years it's possible to take some types, with advice.)
-2 first degree relatives with early breast cancer (and even then it's not a definite 'no')
-recent heart attack , blood clots or stroke
-current liver disease

There is also a list of 'be careful' which is not a no-no, but just be wary and includes gallstones.

Most other medical history is not relevant, especially using modern transdermal HRT.

Does any of this help?

Thanks very much @JinglingXmasbells. Yes that's what a walk-in is - I was wondering if she was trying to imply that a second referral from the walk-in centre would add some urgency to my original referral. I might be over-interpreting though, she was extremely apologetic so might just have signposted the walk in in case my meno symptoms were terrible (which they're not really)

My pre-existing condition is fibroids, but lots and lots of them and some of them very big. As I understand it the risk is that they cannot assess my risk of womb cancer because they can't see the endometrium at all. The GP didn't know what to advise. I have had a cursory google but I would like some actual medical advice really! But thank you.

I don't know if what I am going to say is of any help but here goes...

(I've been on HRT for years, had a lot of info during those years from my meno consultant, had biopsies/hysteroscopy/scans.)

I'm curious why they are talking about a cancer risk and fibroids and HRT- where is the joining of dots going on there?

If they are worried about your endometrium (anyway) because of all your fibroids, why are they not assessing that regardless of HRT? Hysteroscopy?

Fibroids don't turn cancerous , HRT itself doesn't cause cancerous uterine growths, so why do you need your endometrium assessing before HRT?

Fibroids are not a contraindication to HRT, per se.
HRT can sometimes cause heavier periods if you have fibroids, but if you are close to, or post menopause, you could use a continuous type of hrt that may even shrink the fibroids (they shrink after menopause anyway.)

Depending on the site of the fibroids, you may be able to have a Mirena coil which would stop/ reduce any bleeding on HRT.

Thanks @JinglingXmasbells that's useful. The GP brought up the endometrium - he said they like to be clear on your risks of ovarian, breast and womb cancer (not sure if this was specifically around HRT or just because I'm 50+). Tbh I wouldn't be amazed if he just wasn't sure and was being over-cautious. Maybe I'll see if I can talk to a different GP...

TBH he doesn't sound very sure of any of it.
I've never, ever heard of anyone having a 'womb MOT' before trying HRT.

Fibroids are not a contraindication to HRT. What my consultant says is that estrogen can make fibroids grow= more bleeding, but any woman with odd bleeding that is not linked to her own cycle, or an HRT cycle (a withdrawal bleed happens every month with some types) then it ought to be investigated.

Are you post menopause? You can use a type of HRT that doesn't cause a monthly withdrawal bleed. It may make no difference at all to your fibroids.

I'd suggest you talk to another dr. If your multiple fibroids were an issue now, then perhaps they should have talked to you about a hysterectomy?

Thanks Jingling that's really useful. Will just try going back to the GP and see if they have a GP who tends to deal with menopause I think!