HRT Where do I start?

[Blossompink]

I'm in perimenopause, 55, have been for quite a while and have decided I need to start HRT.

My worst and most debilitating symptom is aching joints which have gone on for about 2 years. I feel like an old lady at times, stiff when I get up from sitting, walking is about the only exercise I can do and even that I can't do too much of. I get other symptoms too recently I have had dry eyes, itchy skin and scalp and losing a lot of hair.

I've put off taking HRT because of worries over increasing my risk of breast cancer. Had an initial talk with GP who said that there was only a very slightly increased risk of cancer, and said in my physical condition I can't carry on like this, and mentioned the risks of osteoporosis in later life.

What is the best way to go about this. I'm not sure whether to go to my GP or to a Menopause clinic. I'm worried that the GP (when I can get an appointment)! will be a very quick, basic service and put me on the basic (one size fits all) HRT. A bit like when you start the pill and everyone is given the same one. They will not do any blood tests or anything else. Whereas if I went to a Menopause clinic they would have the time (because I'm paying for 30-60 min appointment) do some bloods and prescribe a more 'tailored' HRT that is right for my body. Very grateful for any thoughts on this.

I'm interested in this too.

You may have got the wrong idea about menopause clinics.
It might be better actually to choose a private gynaecologist who deals with menopause.
There are unfortunately a lot of private meno clinics, sometimes staffed by GPs, who are making a lot of money from unnecessary tests.

You won't get a 'better form' of HRT by having a blood test.
Blood tests are for women in premature or early menopause, to confirm that.
They aren't for women your age and won't give any information that helps.

The way HRT is 'chosen' is by you doing a little bit of research yourself, so you can go along to an appt with some idea of what you might like.

eg Mirena coil and estrogen, as patch/gel/ tablet.
or just a patch
or tablets
or gel and tablets

The basic 'one fits all' HRT is (ironically) now one that was first used mainly by consultants and has become mainstream as the default type.

Wherever you go, GP, or privately, there will be a 3-month review to see if the type and dose of HRT is right for you. If it's not, you might increase the estrogen or try another type of progesterone.

It's something where you need to be a bit proactive and maybe think ahead about what you prefer.

Agree with Jingling.

When I went to my GP she asked what type of HRT I'd like. I already knew that I wanted oestrogen patch and utrogestan (which covers the need for progesterone).

I have since switched to the coil and increased the dose of my oestrogen.

Go in with an idea of what you want and then go from there.

I would try the GP first. When I made contact with my practice to go on HRT I found out that this is mainly dealt with by the nurse practitioner (who can prescribe). I had a good and thorough consultation with her and talked through the various options. I knew that I wanted to try Oestrogel and Utrogestan and she reiterated that currently transdermal treatments (gel or patches) are their first choice for most women.

Blood tests don't really confirm anything in peri - your hormone levels are fluctuating so could be ok on the day of your test but not ok the next. GPs will agree to HRT on the basis of symptoms, as per NICE guidelines.

My own GP (respected as the female health expert in the practice) recommended I look at this website to understand the options. As others have said, transdermal oestrogen is accepted as the preference - I'm on patches as was struggling to absorb the gel - and you have options for progesterone. Book in regular reviews to get the dose right, and again if your symptoms return as the dose may need tweaking.

Get the HRT pre payment certificate too, its the cost of two prescriptions for the year.

www.menopausematters.co.uk/

everyone is different OP & you won’t know what works best for you until you try. I’m now settled on patches but I started on tablets and then tried spray as well. It’s trial & error until you find the right combination for you