How to action changes in hrt?

[KatyMac]

I recently had a phone appt with a menopause consultant

I'm getting vagifem loading doses (got)
Testosterone (getting today)
Stopping evoral conti and getting 75 patch and norisithone (sp) (not got these yet)

Do I wait and start them all together or stagger them in, and which do I start first if I do that

I cant remember what/if she said (brain fog)

It may be a good idea to give the patches a few weeks at least before adding testosterone as it'll be easier to pinpoint any unpleasant side effects.

Just start the vagifem now that won't make any difference.

@KatyMac I remember you posting about your up and coming appt a few weeks back.
TBH if you were paying for the appt, the consultant should have discussed what to do with your HRT.

Contact them and ask. You can contact her through her PA presumably?

Well there is no testosterone in the area - so that's a non-starter
And the gp might not action the letter for 4-6 weeks - so I took my copy and asked them to scan it in while I was there but it could still be some weeks before the gp/pharmacist will get back to me

She may well have don't @JinglingSpringbells but tbh my brain fog is causing me huge issues atm

So vagifem I can do that at least!
Now looking online for the testosterone

@KatyMac Many women who go to a private menopause specialist get a private prescription. This means you can take it anywhere, immediately. Yes, it means you will pay out for a month or two, at the recommended cost (not NHS fee) but when your GP has read the recommendations, you can usually obtain future prescriptions on the NHS.

You should ask the dr you saw to send you a private prescription to get you started.

She did but my local chemists don't have it and neither do the ones I have rung1

They aren't able to get that one atm so either I ask for a different one or I keep ringing round

I'm confused. Sorry!!!

Do you mean you can't get the testosterone, or the estrogen patch and Norethisterone?

You mentioned it would take your GP possibly 4 weeks to authorise your prescription from her. If you have a private prescription, can't you get some of it on that?

Testosterone for women is not available - you need a sort that men use but using a lower dose. This is the info from Besins on what is available (testosterone.) https://www.besinshealthcare.co.uk/wp-content/uploads/2023/07/BHUK_2023_563-Product-Supply-Update-July-23-v1.pdf

I cant afford all the prescriptions - it's taken months to save up for the appt never mind 3 prescriptions

I'm paying for the tostran gel but it's out of stock at my local chemists; the pharmacist suggested asking for a second prescription but I don't know if that will cost more

I'll get the vagifem no problem as I've had it before and I have a prepayment certificate (& I have some here from when I tried before - they wouldn't let me have loading doses)

You should talk again to the dr you paid to speak to.

There are very specific guidelines for using testosterone. Usually (and I don't know the details) they like regular blood tests while you use it and also you don't usually start it until your estrogen levels are stable.

A reputable consultant always puts a summary of the consultation in a letter which you should have been sent. A copy goes to your GP. That letter should tell you exactly what to do with your new meds.

If you don't have a letter, go back to the dr you spoke to and ask.

I will get back in touch & I have a letter

She has said all of the changes; just not an order or timeline

And she is asking the gp to do a lot:
Prescribe vagifem, change my hrt, test for testosterone in 3 months and annually, test my thyroid properly & carry one with the testosterone (tostran gel) when what she gives me runs out, (if I could get it!)

I'm going to London tomorrow so I'll try a different pharmacy

My GP was happy to prescribe testosterone but was clear that I needed to be sure my oestrogen prescription was at the right level before I started so was some months before I actually needed the testosterone. I really don’t think you should be starting them both at same time as how will you know what is working correctly. Once you are happy that oestrogen patches are doing everything you need them to, then you start testosterone to see if it adds any benefit. If it doesn’t do anything for you you don’t need to continue.

Tbh that's what my research is leading me to think
Tbh my comprehension skills are compromised but if I read and remember correctly, if I don't have enough oestrogen then some how the testosterone takes its place or converts or something

I think, and I will confirm with the specialist, my plan is
Start vagifem
get new hrt from gp
At the 3 month blood test, start the testosterone

Now at what point do I sneak the thyroid test in

If your GP is going to do all of this, it begs the question why they didn't do it for you anyway!

I hope you get on with it all okay but if you have any questions, the dr you paid to speak to is the person to ask.

GP refferred me to the hospital gyn consultant who said no increased oestrogen, no loading doses of vagifem and laughed when I mentioned testosterone

So 2 years later feeling worse I went to see a private consultant

I've finally got it all

It's been a performance! With the surgery admitting at one point they had written to the consultant but they weren't sure if they had posted it or not!