Blood test needed before HRT can be prescribed?

[angelicagreenery]

I finally have a phone appointment for HRT (I've been trying for ages and had one cancelled a while ago). I wasn't given an in person appointment as apparently I'd need a blood test first. I didn't get to give any of my history over the phone as it was just the receptionist, but I think I'm the 'right' age for HRT without testing first, plus (on checking my Fitbit) my last period was in January but before that was 22nd July.
I've been struggling with hot flushes (the overheating is ridiculously impacting), disrupted sleep, and anxiety if that's a symptom?

Will I be able to be prescribed with HRT over the phone does anyone know?

I don't think you get a blood test to diagnose menopause - that's just wrong

They may want to test other things to check you ok to take it - you could ask what they are testing for ?

If you’re over 45 and having symptoms, your GP should just prescribe HRT without the need for a blood test.

No, it’s unnecessary unless you are young and they want to rule out other possibilities.

Because your hormone levels fluctuate, they can’t definitely say “no, you don’t need HRT” from a blood test.

https://patient.info/news-and-features/can-blood-tests-help-to-manage-menopause-and-hrt

Thank you! So if a blood test is recommended I should ask what it's for.

I was in a slight panic there that I'd have to wait for a blood test before being prescribed and even then possibly not being able to get it. I'd hope that with one period since July 2022 that would be a strong indicator that I'm almost, if not actually, in menopause.

Has anyone been prescribed over the phone alone? I thought they might need to check blood pressure for some reason, though I'm possibly thinking of something else.

I had it prescribed over zoom by a private gynae. She did need my BP but by chance I’d had that done at my GP a few weeks earlier and she was happy to accept that.

Oh dear! I've been trying for ages to get an in person appointment and there just aren't any available. I was on the phone as soon as they opened the phone lines (you have to call for a same day appointment).

Oh well, fingers crossed.

While bloods can be used as a guide, HRT should be prescribed based on symptoms - see the NICE guidelines about this.

I have had the same OP, they asked me to get bloods tested when it was the first 3 days of my cycle. It was quite a fuss to try and sort that out as blood tests were booked up and it took several months

Now this has come back as 'Normal, no action required'. I also have low iron levels so they are treating that instead and need more bloods for that.

I had an initial phone appointment with my GP, she then invited me in for a F-to-F appointment later the same day because there were some available but she did say it wasn’t essential (her exact words were “some women find it easier to talk about this face to face so the appointment is there if you’d like it”). She prescribed patches without carrying out any blood tests - they are of very limited benefit in identifying menopause, good practice now is to go by age and symptoms - although I think she did take my blood pressure since I was there, and checked on the system that my smears and mammograms were up to date. I had a subsequent telephone review about five months later at which she swapped me from patches to gel without needing to see me, with just a recommendation to have an annual BP check.

I got it in a phone appointment. Changed my life.

Yes, I got it prescribed in an over the phone appointment but she did require a recent BP and weigh in which I'd had a few weeks earlier at an asthma review. Also wanted to check mammogram and smear test were up to date but I had already booked a smear so that showed on the system.

At my 3 month review, she was happy to give me a 6 month supply (before Utrogestan restriction) when I gave her a home BP reading.

Thanks all! Fingers crossed. Though first that I actually receive the promised afternoon call, as I'm still waiting.

Any progress @angelicagreenery?

Yes, thanks! I received a callback the next day.

I'm booked to see the nurse for blood pressure on Tuesday (and possibly BMI check if I heard correctly), but otherwise I can definitely have HRT - she mentioned combined something-or-other and a patch. I'm to have a three month supply to start off with.

My appointment for blood pressure to be checked was cancelled this morning. Another 10 days for the next available appointment

I had been looking forward to starting HRT this week.

Can't you check it at home and tell them the result? A lot of practices accept this.

@angelicagreenery That's really poor, could you get it checked at a pharmacy and just ring them with it?

Most GPs will accept your own blood pressure reading and its handy to have the BP monitor at home, I just give it to them over the phone. Or pop into Boots or a pharmacy and they could do it. They may take bloods sometimes to check testosterone, if you go on T they need bloodwork annually.

It is poor.

I didn't know it was possible to have it checked at a pharmacy. I asked if there was anything sooner but wasn't given alternative options. It took me me half an hour to get through this morning, and I wondered if they might fit me in with the doctor as it's mainly same day appointments.

I'm sure she mentioned BMI check, but nothing else and no blood tests, but that would just involve weighing wouldn't it.

All these tests seem a bit OTT!

Transdermal HRT like patches have no risk of blood clots and your BP isn't that important (not enough to delay prescribing it.) You can buy a BP monitor off Amazon and take it yourself. Everyone should do this anyway, as a matter of course, to keep an eye on it.

BMI- likewise- weigh yourself?

Yes the OTT testing and checks for HRT is exhausting. I just paid £160 for my next testosterone blood test as my GP will not run a test. The management of all this is tiresome and draining.

I just phoned the GP, requested it after chatting about symptoms and she prescribed it there and then. I am 43.

No blood pressure needed?

I wish mine had just done that. I'd have my prescription already.

No @angelicagreenery but then I am on blood pressure medication and it's reviewed by the surgery annually anyhow.

I'm going to look into it. Yes, it might be useful to have something here, at home, to check BP for future.
I also have weighing scales somewhere.