Question on hrt (gp being difficult)

[Hairgician]

So im starting this thread on belhalf of a family member.
Shes 43. History of heavy periods. Doesnt tolerate contraception pills.
First saw gp in april with peri symptoms anf irregular periods, but really heavy.
Gp put her on hrt of evorel sequi, one with the norethisterone. 50mg patches.
Worked for a while. Then all tbe symptoms came back again. Gp talked her into trying mirena. She gave up after 40.mins trying to fit it. Family member not wanting that anyway.
She then spoke to gp last week about changing the patch to oestrogen only and trying utrogestan with it. Gp had agreed and she was then to collect her script on monday past. Only when she went to pick it up it was for the same patch she had plus desosestrogel.
She called back to ssk for a diff gp , who she saw today.
Gp refused to budge on the idea of trying a different combo. Told her the bloods showed the only hormone she was lacking was oestrogen , therefore shes perimeno not meno. She told her to 'put that aside for now' when it was mentioned she cant tolerate the pill and wont be taking it.
She has prescribed yet again same patch but stronger and the gel also. Wouldnt entertain trying anything else.
I had forwarded on nice info and bms info re options to challenge the dr which she says she tried to do but this dr was very dismissive all through the appointment.
Any of you lovely ladies any more advice? @jingles any words of wisdom?? Shes at her wits end.

Sorry meant @Jingling

Firstly I think she needs to see a different doctor, she must not give up. Could you go with her?

The blood test was the right thing to do in terms of establishing that she's in peri menopause at 43, but if that's the case her estrogen levels would be fluctuating throughout her cycle, so I'm confused as to why the doctor has said estrogen is the only hormone she's lacking - that's what peri and menopause is, our estrogen levels falling?

The stronger combi patch will increase her estrogen (which is sensible as her symptoms have returned) but not the progesterone element - that's a standard amount and required to protect the womb lining.

You mention desosestrogel - is this estrogen gel or progesterone tablets? I'm not sure as you mention gel and the contraceptive pill.

Thanks for replying. I googled it and my understanding was that the desosetrel (sp) is the mini pill.
Her own gp has been on about contraception to her aswell, Which might explain her prescribing that. Even though shes divorced and not in a relationship/seeing anyone and told gp she doesnt get on with the pill at all.

If her patches are definitely combi patches, which are giving her progesterone as well as estrogen, then perhaps with the progesterone pill together with her still making her own progesterone, she's got too much progesterone in her system? That could make her feel like she's constantly got PMT.

If she doesn't want to take the contraceptive pill, she can just stop - it does not form part of her HRT. Perhaps the doctor believes it will help with her periods though?

Shes not taking the progesterone pill, as she doesnt tolerate contraceptive pill well. Her patch contains norethisterone . she wanted to try a different patch, oestrogen only and the utrogestan instead of the combi one shes on.

Gp refused to budge on the idea of trying a different combo. Told her the bloods showed the only hormone she was lacking was oestrogen , therefore shes perimeno not meno.

No one can be prescribed JUST estrogen. If they are using HRT and have a womb they also need a progestogen.

She told her to 'put that aside for now' when it was mentioned she cant tolerate the pill and wont be taking it.

Put what aside? The request for HRT?

She has prescribed yet again same patch but stronger and the gel also. Wouldnt entertain trying anything else.

This doesn't make any sense, sorry to say.

No one would/should be using a patch and gel.

Can you get your family member to join Mumsnet and explain or at least give the brand names of whatever she has been given?

She meant put aside that issue (hrt) for now. I couldnt believe it when she told me what she said.

But then she prescribed gel and a patch?

Can you explain as it's not clear what has happened.

She has prescribed the patch and gel but wouldnt budge re trying utrogestan. When she told gp she couldnt tolerate contraception and wanted to try it gp told her to 'put that aside for now', as in it doesnt matter. Seems she thinks as only oestrogen is low thats all she needs.