GP is hostile to HRT

[Austensource]

Whenever I speak to my GP about HRT she is always very negative about it. Her voice takes on a kind of condescending tone and she does a big exasperated sigh and says things like

“you’re only delaying the inevitable”

”the earlier you start hrt the sooner you will need to stop taking it”

“the higher the dose you take now the worse it will be for you when you need to stop”

”you can only take hrt for 5 years maximum”

”hrt won’t solve all your woes, I’d like to try you on an antidepressant”

”you should do more exercise, lose weight, stop drinking, stop smoking, eat more fresh fruit and veg to feel better”

”I can’t proscribe you both HRT patches and vaginal HRT because that would be too much estrogen for your body to cope with”

”you don’t need it, the menopause is a natural part of aging and we need to accept that”

I am not depressed, I haven’t had an alcoholic drink since I was a teenager, I don’t smoke and never have, I have always exercised, am not overweight and eat a healthy home cooked diet with at least 10 servings of fresh fruit and veg a day. None of that prevents my hot flushes, night sweats and the subsequent lack of sleep. I am in my mid 40s.

For the record she is about 50 herself and I assume she is also at least in perimenopause.

Why is she so hostile to HRT? I’ve read the nice guidance on hrt and the guidance from the British menopause society which goes against what she says. She seems to hate proscribing it and it was only because I went in having done a lot of research that I didn’t let her fob me off. I imagine lots of women if they haven’t looked at the nice guidelines and she is their first port of call will walk away empty handed.

I do now have an hrt patch and feel much better but as I said she won’t prescribe vaginal hrt for me because that would be “too much estrogen in my body” so I’m having to buy that privately which I can barely afford but I need it. If I ever need testosterone I doubt it would be prescribed by her either.

So frustrating, you’d think if anyone would be sympathetic about the menopause it would be a female GP in her 50s?

Omg you are ripe for HRT. Yes she’s right that you simply delay it but there are benefits to that including improving quality of life in the here and now as well as benefits later on including improved cognitive health. You need to see a different provider. Ask for bioidenticals - dodgy HRT outcomes were found in research with synthetic hormones

Op yes she should be sympathetic. However I find female doctors are not very supportive with women's problems. I went to my female gp with incredibly heavy periods due to peri menopause. Got told its part of being a woman 😳😳 i pushed for a gynaecologist appointment in the end. Female doctors are not very sympathetic at all

Change your GP

I'm not doubting her negativity but look at the downsides too, the risks are real and it doesn't solve everything. In fact I read a really interesting double blind trial where placebo wasn't that far behind! I'm older than you and not taking drugs except I have a mirena seems to be enough

Completely agree with this. Though really you'd think they'd be alot more sympathetic. Get another doctor op, this one's never going to help

Pressed too soon. The risks to me outweighed the benefits, I crunched the numbers

but aren't you increasing your risk of cancer by taking esp a double dose.
i personally wouldn't choose to do that.
menopausal symptoms can be v uncomfortable, i know, i'm older, but in my mind that doesn't come in the same league as raising the risk of cancer which could be fatal.

Change your gp. Simple as that. She sounds very unhelpful.

Yeah unfortunately I think I need to change my GP.

I don’t intend to ever stop using HRT unless I absolutely need to so it can delay indefinitely as far as I’m concerned. Adding Vaginal HRT to systemic HRT doesn’t increase any cancer risk. Any increased risk from Systemic HRT is a very small increase on an already small risk. HRT protects against heart disease and osteoporosis two huge killers of women and is likely beneficial against bowel cancer and dementia as well as slowing own aging in general boosting energy and making life worth living.

I also crunched the numbers and found the benefits far outweighed the risks.

For what is worth, like with every other type of medical advice, ask for a second opinion! I agree, change GPs; you shouldn't have to get medicine privately.
OP, only you understand what you are going through so do what is right for you.

HRT doesn't delay the menopause, you're still going to go through it regardless ... HRT helps you manage the symptoms - thank goodness for it I say I'm 56 & have merina/evorel 50 patch combo
Definitely change your doctor they sound hopeless!

There is a small increase in breast cancer risk with combined HRT (much less than the increase from being overweight or inactive) but overall there's a reduced risk of dying. HRT has been shown to reduce the risk of osteoporosis which can make minor falls fatal or disabling. Its always good to mske lifestyle changes first but you sound like you have that covered, particularly if your exercise includes strength training.

The vaginal estrogen point is really annoying, the dose is so tiny in comparison that it's very safe. I think at 50 you should be able to get it at a pharmacy without prescription.

She says ALL of those things? I'm amazed you can get an appointment long enough!

The vaginal estrogen point is really annoying, the dose is so tiny in comparison that it's very safe. I think at 50 you should be able to get it at a pharmacy without prescription

You can. It's available over the counter.

These are pretty much direct quotes from several appointments both face to face and over the phone.

You need her to change her notes on your drinking and smoking habits then.

She's not up to date with her learning and her advice isn't useful at all.

Try and get an appointment with another doctor. Either another one who's more experienced in menopause (you can ask who their specialist is on that subject on the phone when you're making the appointment) or even one that's covering your GP if you can find out if she's on holiday soon!

Failing those options can you go to a sexual health clinic or whatever other options you have in your area?

Failing that you can go private but it's dear. Just don't give up. You're right.

Defo do something. She's wrong.

I’ve told her more than once that I don’t drink and never have except for a couple of times as a teenager and that I have never smoked. She knows this whether she believes me or not I don’t know I think doctors have said in the media before that their patients lie about drinking and smoking. To be honest she isn’t even checking my notes I don’t think she’s just giving me her standard anti-hrt chat.

Hi Op, I'm 41 and my doctor prescribed HRT pills 3 months ago and vaginal estrogen last week. Very understandable and sympathetic while also talking through the risks.

I think you should ask to see another doctor.

Good luck.

Interesting, I found the same. The male GPs I dealt with were far less subjective.

I wrote to the practice manager referring them to the NICE guidelines in the end,and a prescription was forthcoming. (My GP thought lots of blood tests were required!)

Could be both some people think hrt is an automatic thing at the first sign of a hot flush they are down at the gps demanding 'I want my hrt and I want it now' or you could have a bad doctor, you could try asking another doctor

@Summerhillsquare I'm post menopausal and have been suffering with my joints since. Asked the female doctor about oestrogens as I was worried about my bone density. The female doctor had no clue what I was talking about. . When I had a survey from the surgery I suggested they have a doctor who specialised in the menopause. Actually had a call from the nurse who explained my hormone levels and was very understanding. Better training needed for doctors I think

Change your GP!

Don't let her patronise you and she also seems badly informed when it comes to menopause and HRT so you want someone who actually knows what they are talking about...

Tbf my bone specialist said HRT won't hurt but isn't that helpful for bone loss.

@Austensource that's incredible. I'm a 61 year old retired GP and on HRT and vagifem and have been for about 7 years now. Her comments are so out of date to be laughable. I was 54 when I started HRT and having stopped my periods at 48 I thought I was going to be one of those ladies who didn't need it but the difference when I started was amazing. Maybe post her a copy of the NICE guidelines!