Doc appointment to ask about hrt

[OlderNotYetWiser]

Hi all,

I have a load of peri signs that have really worsened over the last few months and I have made a doctor appointment for Wednesday to ask for HRT. This is a telephone consult.

I am 47 and have a Mirena coil. I don't get hot flushes (my mum never either) but I feel really disassociated and flat/behind glass a lot recently, interspersed with some rage and anxiety.

I also have increasingly dry vulva and decreasing sex drive over the last few months. This has really ramped up the last few week.

I also get dizzy spells, numbness and cold/tingling in extremities , and a load of other things.

I'm hoping that the GP will be ok as the receptionist said she would try and book with someone that dealt with a lot of menopause women.

What should I be hoping for/expecting?

just either oestrogen patches or gel, or should I ask for something vaginal too for the start of atrophy signs?

I do a LOT of running (has helped keep me sane for the last couple of years)- will the patches withstand that, or would a gel be better?

Do you think they will prescribe over the phone (I've waited weeks for this appointment) or will they then make me wait longer and need to go for an in person appointment too?

I feel really at the end of my tether the last few days and am so hoping they will sort me with something and I can start it soon, or I'll probably spend a couple of days swinging between rage and tears.

thank you for any input !

Following - I have an in person appointment Thursday for the same reason. AFAIK if you have vaginal atrophy you need topical oestrogen in addition to gel/patches for systemic symptoms.

They will need BP readings

Needs to be Ian in person appointment.

They might not need BP readings. I know women who've been prescribed hrt via econsult or phone consult. Unless you have a complicated medical history there's no need for face to face really.

Just say you've read the NICE guidelines, you'd like bodyindentical hrt so oestrogel or a patch. I think gel would be better if you're a runner as patches may come unstuck. Then say you'll submit a review in 3mths. You might find it is sufficient to sort out any vagina atrophy so I'd hang on with vaginal oestrogen for now, you can always add it later if needed. Good luck!

I had a phone appointment last week, I talked about my symptoms, the doc talked about the benefits and potential risks of HRT, and the different types and 15mins later I had a prescription waiting.
I’d had a blood pressure test in surgery in oct/nov so she used that but as it was slightly on the high side (over 85) she recommended getting a BP monitor off Amazon. She suggested my bp might even go down if I felt better in myself. She said I’d have a phone call review after 3 months and I’d never need to go to the surgery if I was able to take bp readings at home.

Bloody Hell, I'm really upset now.

I've been waiting weeks for this bloody appointment and it's been the thought that it is nearly here that has got me through the last few days. I assumed since she said a phone appointment, and you can self order HRT from Superdrug or wherever that a phone appointment would be sufficient. If I need to wait another month after this for an actual proper appointment I'm not sure I can cope.

I did look into private appointments, but wasn't sure how that then went with getting it from the NHS doctor after.

I'm not sure whether to go into the clinic after I finish work tomorrow and try and speak to the receptionist and see if it can be changed, or if it will be a nurse check for blood pressure that can be squeezed in quickly.

Why are you upset? Only one poster has said you might need a BP check.
It's not usual or mandatory. Worst case, buy a BP monitor for around £25 and submit your readings to the GP. Lots of people are allowed to measure theirs at home for all sorts of things.

Most HRT does not raise BP, so it's not like the Pill- different product.

You won't be able to buy at Superdrug etc - not NHS prescription costs- but you can use Boots and Superdrug consult to get HRT ( so women say here.)

The other option is a private GP or a private menopause consultant. They would write to your GP with their recommendations for the type of HRT etc but legally, a GP doesn't have to agree (but they rarely refuse.)

Why not just see what happens! No need to get upset. The patches are fine they stay in in the bath or shower so I doubt they would come off running. I have vagirux pessary for dryness, just once a week Evorel patches and utrogestan. I got it via a private GP as mine misdiagnosed me for about 6 years and prescribed Setraline. The private doc wrote to Nhs one and they now prescribe it. I have the menopause certificate to get cheaper prescriptions so don't forget that if you get a prescription.

You don't need a face to face appointment. I was prescribed HRT after a phone appt. The GP just needed up to date blood pressure, which I emailed to her. If you don't have a blood pressure machine at home, it's easy to buy one.
I was given gel.

Just be prepared for a trip to more than one pharmacy, as there are shortages of HRT. I got mine eventually though.

Hi, very nervous and scared for a endometrial biopsy this week.

Was surprised when my Dr. suggested a biopsy after ultrasound showed lining at 5mm. Couple months ago lining was 7mm but I got my period couple days after ultrasound. I’m still peri at 54 and a bit over weight. No abnormal bleeding just skipped periods. Thanks for listening

I use PHlo the online pharmacy they have never had a shortage and they don't charge postage either. The go can send the script directly to them

Following, as I have an online consultation booked for may 15th.

When I was on Evorel Conti patches 6 years ago they needed to check my BP before issuing a repeat prescription, exactly like when I was on the contraceptive pill. There used to be a machine in the doctors waiting room which took your BP, when I needed a new prescription, I had to do a reading and hand to reception. This was obviously before COVID, not sure the machine is still there. I did find the stick fastness a problem on holiday sweating in the sun and got a bit sick of the glue marks permanently on my bum, hip or wherever..this was one of the reasons I gave up when I got to the age where I felt my peers were going through menopause! Obviously since I gave up this has become a hot topic..I suffered during my late 30's early 40s and was officially post menopause just before 45..and I know wonder if I should've 'stuck' with it 😬😏 good luck op

I've been on patches nearly a year now and haven't had any fall off. I run quite regularly too. I find it best to put them on the front of my thigh at the top.
And yes, worth having a chat about atrophy before you start getting any ghastly urinary symptoms.

I would have thought you wouldn't need a face to face appointment or BP checked to get HRT and definitely not for topical oestrogen (for the atrophy).

I was prescribed HRT by the nurse practitioner following a phone call consultation. I had recent BP, weight etc recorded by the surgery during my asthma review a few weeks earlier.

I did a telephone call for my 3 month HRT review and she asked me to submit my BP readings via a text link (after taking at home) and was then able to give me a 6 month prescription.

It seems as if a lot of GPs are obsessed with BP and HRT.

Maybe they think of it like the Pill?

Most HRT is body-identical estrogen now and so is micronised progesterone.

The Pill and older types of HRT contained a synthetic estrogen (CEE) that could raise BP.

Micronised progesterone (Utrogestan) actually lowers BP which is why dizziness is listed as a side effect (and it kicks in about 30 mins after taking it as I found out one night!)

I've only had a few BP checks in all the years on HRT, and my consultant is an expert who trains other drs (just maybe not the ones people refer to here!)

I had a positive experience at my appointment - GP did check BP and had bloods taken for general check and thyroid but she prescribed Evorel patches and Urogestan to try for 3 months. Good luck @OlderNotYetWiser

Thank you @Patchworksack ,

An update after my appointment - the doctor was lovely and very knowledgeable. I have gone with the gel (collected and started last night) and topical oestrogen cream but that is out of stock at the pharmacy for a few days.

I've got 3months worth and have to have another phone chat just before I run out unless any concerns before.

Thank you all for the support and advice- I'm hoping to feel more like me again sometime soon!

My arm and hand tingles have been ok today but that may just be coincidence at this point

Good on you OP. I read your thread and am glad your appointment went well. I know I have found the gel much better than the patches I started with, so I was hoping you’d get gel. It all takes a while to kick in and you might need a higher dose so don’t get discouraged if things take a while.

@OlderNotYetWiser please update with how you get on. I have actually slept straight through for 3 nights with the utrogestan and woken feeling human. I am now worried that I can only take it for half of each cycle, but the night sweats were worse leading up to my period so maybe I will be ok for the first half.

Hi all,

Sorry for the delay in updating - I can't switch username on the app and it was stuck on an old one. Every time I tried to log on to the website on my phone it just went to the app so I have deleted it!

Everything is going ok so far. The gel is working ok- 2 pumps a day and things are a bit better. My mood is generally more stable and my hand and arm tingles is much improved also. I think I probably will need 3 pumps though but will stick with 2 for now.

The vaginal cream is still out of stock at the pharmacy and in the end last week I went onto superdrug website where you can order some hrt online and get one of their doctors/pharmacists to approve a private prescription. I started that Saturday and feel a massive benefit from that already so glad I managed to get one. I need to chase the pharmacy in town to see if they have an update on when they are expecting it to arrive, or if I need to request an alternative.

I'm feeling very positive and much better overall - I feel almost tranquil at some points, the underlying anxiety buzz is definitely less. It's difficult to describe the difference but I think because it creeps up so gradually you forget what normal used to feel like.

I hope everyone is getting on ok