Struggling to get GP appointment and HRT - advice please!!!

[rubyblue]

Hi, I'm in my early 50s and struggling get HRT. I've been experiencing perimenopause symptoms (racing heart, terrible mood/tearfulness, fatigue) for a couple of years but it's far worse recently. GP ran blood tests 2 years ago and said I was normal so it wasn't menopause, which I've since learned isn't necessarily true. I had a phone call in March and went through the whole explanation again with a different GP who again took more blood tests (don't know the results yet) and then I had to go for an ECG (normal). She said she wanted to see me in person to discuss HRT options but I've been told that will will June at the earliest for an appointment in advance so the receptionist said the only option is to ring for an emergency appointment and wait by the phone all day (which is a nightmare with my job). I'm at my wit's end. I burst into tears after this call as honestly, it just feels like it's a huge struggle to see a GP and then a battle to get HRT. Please, can anyone advise me on what I should say when I finally speak to her as I suspect I'll get fobbed off.

You'll find a lot of information on the menopause matters website but in the meantime:

Consider going private

if you cant do that, get an emergency appointment.

Print off the NICE guidelines on HRT provision and take them to your appointment.

Say youve researched it thoroughly, understand the pros and cons and would like to start Femoston 1/10. It's a great 'starter' dose and suits most people.

This is assuming that you still bleed and have a womb and dont have a history of cancer, DVT, high blood pressure or anything else which may throw a spanner in the works.

Dont be fobbed off. Polite but firm.

They say transdermal is safer then tablets so have a think if you r free would prefer, gel, spray or patches.
have a read of this website loads of info
https://www.balance-menopause.com/
or read about HRT on here
https://www.menopausematters.co.uk/oestrogens.php

Have you told the receptionist what you need the appointment for? I spoke to mine and the receptionist made an appointment with one of the practice nurses who was a menopause specialist.

The nurses are able to prescribe at my practice. Would it be quicker to see a prescribing nurse?

if you can afford it please consider going private. A consultation is generally less than £200- it was life changing for me after over a year of trying to get HRT through the GP. You may well only need a single consultation and the prescription can then be put through the GP so you aren’t paying privately for it.

Do you know of any private Menopause clinics in London? Is there a difference between them?

I went with Newsom Health to get onto HRT - it was a zoom appointment. Had to pay privately for some blood tests, but for me, it was worth it as I now get everything prescribed by my GP practice. I see the practice nurse.

You don't necessarily need a menopause clinic. @localnotailThey do exist - some are run by consultants but many are GPs who have had menopause training.

Google will throw up loads.

You can arrange a consultation with a consultant gynaecologist who deals with menopause and they are usually based in private hospitals.

If you are in central London, and have the finances, (expect to pay around £300 for a first appt) check out the websites of the main private hospitals, read their websites for info on gynaecologists and if they have expertise in menopause.

What symptoms are you telling the GP about?

If the first symptom you mention is racing heart, the GP will be channelled down an investigating the heart route, rather than a 'is this peri' route. Which is what seems to have happened to you.

If you open with irregular periods, mood swings, hot flushes then the GP starts thinking about peri.

Plus at over 45 you shouldn't be having hormone blood tests.

I would think about your opening statement about what your symptoms are, and arm yourself with a copy of the NICE guidance.

Talk about mood swings and night sweats and inability to sleep. For some reason, inability to sleep seems to make GPs prescribe.

but I've been told that will will June at the earliest for an appointment in advance so the receptionist said the only option is to ring for an emergency appointment and wait by the phone all day (which is a nightmare with my job)

Why do you need to wait over 5 weeks for an appt?
That's the real issue.

And vanished libido, if you're in a relationship.

Book the June appointment - you can always cancel if you don’t need it.
Take the good advice here about classic meno symptoms, read the NICE guidance, and prepare for your appointment.
In the meantime check out the Newson clinic (or another private clinic) for even more information and consider a private appointment to get you started if that’s affordable.

I had similar wrt appointments. Waited ages to see the GP to discuss starting HRT but they wanted to run bloods first (fair enough showed low folate). They just text me to say take folic acid nothing about HRT so had to ring again to get another appointment which was June. So pissed off with the symptoms I rang yesterday & got an emergency slot & was prescribed patches.

DD simply used econsult at our surgery and got a phone call the same day. HRT patches were prescribed over the phone. Not ideal but they work.

I completed an e consult for menopause symptoms, one of the questions was I want to trial HRT. I then had a phone call consultation and HRT was prescribed. It was a detailed phone consultation and luckily I had my BP taken a week previous in chemist which was sent the GP.

Thanks so much to everyone for advice. If I want to see the same GP who is trained in menopause and not an on the day emergency, I was told it would be June.

That's terrible.

What an absolute shitshow. For a start your two GPs are not following guidelines as they are supposed to be treating menopause based on symptoms not running pointless blood tests. Blood tests are only recommended for women under 45 to rule out other things like thyroid issues which might be causing the symptoms.

Take the emergency appointment. You are clearly suffering (I have been there, it's shit) and need that prescription. Sometimes you have to be arsey about it - just go in with a clear plan, you'd like to try HRT please. And whatever the GP says, just keep repeating you'd like to try HRT please.

And if you still get no joy, go private and put in a complaint about your doctor's lack of training and lack of knowledge and failure to adhere to the NICE guidelines. You can do this, and for me, the HRT helped within days. I went from being tearful, moody and unable to sleep to feeling more normal in about 72 hours.

That is really rough. I decided on Friday I'd had enough with my peri symptoms, filled in an online form for a callback, and after a phone call with a GP, I was given a prescription for HRT (patches) which I picked up the next morning.

Is there a possibility for a callback rather than face to face, if quicker? For me, I didn't feel I needed to be seen. Or any other GP who can deal with women's health?

@localnotail i’m not in London so not too sure (although I would assume there is a Newsom clinic there). I booked in with a gynaecologist who was also a menopause specialist at my nearest private hospital (Spire). I think this was more cost effective than a private menopause clinic and the consultant was very knowledgeable.

@localnotail a lot of menopause clinics operate online.

The British Menopause Society has a list of qualified practitioners on their website.

BUPA have a menopause package - you can see someone in person or online.

I went with the menopause trained nurse in the end as my clinic had two and it was taking forever to get an appointment.

This is true.

All I'd say is be 'wary' of some 'menopause clinics' as they are often set up by GPs with minimal experience or training . As a minimum they need the BMS training in prescribing HRT. Obviously some are very good but on the whole they are not much cheaper than seeing a consultant gynaecologist with menopause training and experience. I've seen clinics online charging £299 for an appt with a GP, and consultants in Harley St charging £350-ish. So shop around.