What is the process for getting HRT?

[Glitterblue]

I’m 47 and my periods started to go haywire maybe 2 years ago although it was maybe 6 years ago that I started to miss one a year. I think my last one was February but it was very very short and light - maybe 2 days, and before that it was a similar one last November and a proper one last May.

I’m getting a LOT of hot flushes and sweating now but more in the day than at night. Insomnia, feeling very low and absolutely exhausted even if I’m sleeping well. I had both hips replaced already due to osteoarthritis but don’t have any other aching joints at the moment since they were done. I don’t feel grumpy or have rages but I’m getting a lot of itching and dryness down below (the itching is on the outside, never inside). I have no motivation and feel completely overwhelmed a lot of the time.

Would it be worth my while asking for HRT and what process do they go through? I’ll have to do an econsult because you can’t make appointments now at our drs, and they are always so reluctant to prescribe anything ever! Do they normally just look at your symptoms and prescribe some form of HRT or are there blood tests or anything?

I’d been putting the chronic exhaustion down to having both hips replaced within a few months of each other but now I’m wondering if it’s the menopause causing it.

Go to the docs (if you can. Get an appointment!) and list all of your symptoms and explain the impact on your life. That’s it.

I was sent for a blood test to check thyroid and then prescribed HRT.

Here are the NICE guidelines for HRT.

https://www.nice.org.uk/guidance/ng23/chapter/Recommendations

There is now need for follicle-stimulating hormone tests to diagnose menopause in women aged over 45 years.

Crucially while they may want to do some blood tests to rule out other conditions (e.g. thyroid issues), at your age they should be willing to prescribe HRT on symptoms alone. I'd suggest doing a bit of research on the different options and the pros and cons of each so you can put in the econsult what you want. I was very lucky and filled in the econsult one day, got a call the next day for a chat where the GP said they'd had a cancellation so could fit my mirena coil (my chosen progesterone) the following day. They suggested starting the estrogen (I started with gel, now use spray which is so much less messy!) a fortnight later so that I could differentiate between any changes brought on by the two different hormones. I gave a blood pressure reading for the econsult which probably helped speed things up, as I didn't have to call in at the surgery to get that done.

Thank you everybody, that’s all really helpful. I just hope that I get a GP who actually understands because they’re few and far between in our surgery.

I’ve just been trying to battle through everything thinking it was the aftermath of 2 major surgeries fairly close together but I’ve been slowly realising there’s a lot more to menopause than the hot flushes! I’m waking up day after day feeling absolutely wiped out and lethargic, unmotivated, low mood especially in the morning and I just feel like a shadow of my former self - there has to be more to life than this!