Why am I being pushed to use less oestrogen AND go continuous regime?

[complicatederraticandsweaty]

I've only been on HRT for 2 years, I'm 46 and am fighting to stay on current regime of 1.5mg sandrena and sequential utrogestan 200mg for 12 days a month.

Aside from problems with supply and being mucked about with patches that I couldn't get on with ..... largely I've been okay on this regime. The Utrogestan gives me headaches and heavier periods though and I'm not loving that but other than remove the old bitch womb, I don't want to change things right now.

I've tried going down to 1mg sachet per day but moods, sweats and sleep/energy just got worse again.

Current GP with these qualifications MBBS MRCGP DRCOG, is telling me she wants me on 1mg and continuous utrogestan 100mg daily, citing my current regime is 'stimulating my endometrium too much and as you're not even 50 yet and having your own hormones in the background, I'm worried you're having too much oestrogen.'

At the same time telling me I don't need to check my oestrogen levels as that would apparently be 'not important' 🤣 great contradiction there GP.

I'm pissed off, I'm as happy as I'm going to get but her new regime is going to send me up the shitter and I don't want to feel like I have to argue for my meds everytime I ask for them.

I've read that continuous regime can cause endometrial atrophy and a higher risk of breast cancer after 5 years ...higher than the risk of endometrial cancer on sequential.

Why is this GP pushing for continuous?

I don't mirena coil either so I'm waiting for her to suggest that little gem at some point.

Also she has great difficulty understanding that I need 1x sachet of 0.5mg sandrena AND 1 x sachet of 1mg sandrena per day to get the 1.5mg dose everyday, but she is currently expecting me to fuck about splitting 1mg sachets and trying to store the half sachet so it doesn't evaporate.
This is the same GP that advised it would be fine to rub in sandrena and oestrogel to make up the right dose with whatever I had left over from a previous prescription.

Is it really that hard to just give me what I want, what works in the correct dose or am I just pissing in the wind these days hoping a GP can at least read dosage guidelines?

Do her qualifications mean she's telling me correct up to date information about the effects of HRT? Does anyone know the current NHS stance on this please ?

I'm in Norfolk in a much struggling oversubscribed rural patient area. I'm probably expecting too much, but surely telling patients bollocks isn't the way to go?

It' s just my opinion but she's talking nonsense.

As long as you're having a bleed your lining should be fine (unless you're spotting loads in between.)

Yes you have your own hormones BUT you will possibly be ovulating too during some cycles and have your own progesterone as well.

She sounds a bit clueless TBH.

Her qualifications - DROCG- means she has a diploma in gynaecology. This, as far as I know, is the base line gynae training that many GPs do, and doesn't necessarily cover HRT.

The next level up is the MRCOG (Member of...) and consultants often have FRCOG (Fellow of...highest level after many years experience often as surgeons) which mine does, and I doubt they'd be saying what she is.

Having gynae training doesn't means she's trained in HRT.

I'd carry on as you are .

I agree with PP, also continuous is
only for post memo so you would probably having irregular bleeding. If there were concerns about womb lining as PP said you would be spotting in between but the answer to that would be to increase progesterone not change to continuous. Is there anyway you can change GP? x

I think you need to speak or try to speak to another doctor at the practice. I used to take sandrina when first started hrt but then stopped working and found it sticky and took a while to dry so changed to oestrogel which I find great. You can also take the progesterone tab vaginally less side effects. You do seem quite young for her to suggest continuous which I only changed to a few months ago but in my 50's and prefer it so much more. It is so difficult to get someone to talk to that actually knows anything at all. Stick to your guns and yes every doctor/nurse tries to shove that mirena coil onto us, are they getting commission. Wish you well and sorry not much help.