gp trying to insist on combi patches

[hrtfirsttimer]

just been for a chat to get started with hrt. Have done lots of reading and talking to some friends and asked for oestrogen patches and then utrogestan tablets. I mentioned that someone took these vaginally and she shut that idea down immediately. Said could have oestrogen pessaries but not progesterone vaginally.

I was firm but nice about saying I wanted the oestrogen patches and the utrogestan separately. She said she will bring it up at a surgery meeting and see if she can prescribe it as didn't see the difference.
But now I am worried other gps will overrule her for some reason.

What would you do? Stressed enough going and preparing for what to say so this has thrown me a bit.

She sounds as if she doesn't know what to prescribe. But she can't prescribe Utrogestan vaginally as it's off-label and something you can do yourself or with the approval of a consultant or informed GP, so that may have confused her.

Estrogen pessaries- you mean Vagifem for vaginal dryness?

Why is she comparing that with utrogestan?

yes that was it vagifem. I said it wasn't progesterone and then she started talking about combi patches. Have had friends who needed to change their oestrogen dose so how would you know with combi patches?

I’ve just had utrogestan prescribed for vaginal insertion - didn’t realise this was unusual. It was prescribed by NHS GP?

Are you still having periods? If you are, you can’t take progesterone continuously as you would with a combined patch. I have an Evorel patch on all the time, but take progesterone tablets for only 12 days each cycle.

If you have stopped having periods then you can use combined patches as you don’t need a break in the progesterone for a bleed.

Utrogestan comes as both tablets and vaginal pessaries - are you sure you’ve been given the tablets and not the pessaries?

She described them as tablets with an applicator but I haven’t yet picked them up so not 100% sure…..

@LeSquigh thats what I have. 200mg of utrogestan to be administered vaginally after I nearly lost my mind with horrendous depression and rage taking it orally.

So far this month it's going brilliantly. I just reuse one of the applicators each day though. Not sure what to do with the other 29 in the box!

That’ll be the pessaries, then.

Unfortunately it's all about money. GPs will also be very reluctant to prescribe testosterone too for the same reason.

I bypassed the GP and found a menopause specialist practice nurse and she was amazing!

Good luck!

update: Just had a text from the Gp to say patches and tablets will be waiting at local pharmacy to collect :)
Fingers crossed, now to get started on all this.

Confirmed they are 200 capsules with an applicator so described as neither tablets or pessaries 🤣 so now completely unsure. Like a poster above I was prescribed these instead of oral as I have a history of PMDD so doctor didn’t want to risk similar issues.