Anyone know an online pharmacy for HRT?

[KarlaKK]

Hi, my doctor wants to take me off Trisequens for no apparent reason. I'm happy to stay on it and I've had a blood test that hasn't raised any problems. I've been offered gel or a patch rather than Trisequens, which is a tablet. I want to stick with tablets. The doctor has put a fair amount of pressure on me, which has upset me. I'm wondering if it is due to cost.

Anyway, I've decided I want to buy Trisequens via an online pharmacy that won't inform my doctor. I only want 3 months' worth while I decide what to do. I think I might go private for HRT, get a full assessment and get the right thing for me, rather than a one-size-fits-all approach by my current doctor.

Does anyone know of an online pharmacy that will supply Trisequens and not require me telling them who my GP is?

Thanks in advance.

Sorry I can't help with buying them as I'm in another country. I was also on Trisequence and the reason for my change is that this is sequential (so you still get a period as not full time progesterone) and I moved over to continuous. Could this be why the dr is suggesting a change?

Would you not need a prescription from a dr for the online pharmacy?

Thanks isthismylifenow. I need to look into sequential and continuous as I don't know the difference. I don't mind changing but felt bullied by the GP and asked for some time to think about it.

You don't need a prescription from a Dr for an online pharmacy, true, but some ask if they can see your summary care record or inform your Dr. And won't give it to you if you say no. I want an online pharmacy that doesn't contact my Dr.

my doctor wants to take me off Trisequens for no apparent reason.

How did the conversation go with your GP?
If they want to change your meds, there has to be a reason.
Surely they've just not said 'You can't have this any more'.

The reasons that they may have discussed would be-

1 The current advice which is to offer all women transdermal HRT where appropriate. This reduces the risks of blood clots and is relevant for women over 60.

2 That it's a 3-monthly cycle and again, there is advice that women who are post menopause should consider combined continuous, no-bleed HRT. This is not mandatory and there are pros and cons. The 3-monthly cycle is used mainly for women who are younger and in peri, because it mimics the irregular periods they may have anyway.

The pros are it almost eliminates completely the risks of endometrial hyperplasia. The cons are that it increases the risk of breast cancer compared to sequential HRT by around 1%.

You really need a proper discussion rather than being 'told' what to do without any insight into why.

If your GP is unwilling to engage in that, maybe you do need to see a private consultant. Not sure if you know the costs but the minimum is around £200 (for either a private GP offering HRT ) or up to £350 for a top consultant. You need an annual review at least although some GPs will accept a consultant's advice and prescribe.

All of the above is info I've learned over a long time on HRT from a consultant.

At an online pharmacy you still need someone to prescribe. And that person needs to be competent in prescribing HRT.

What you are describing is a private menopause consultation together with a private prescription. Not just the cost of the meds from an online pharmacy.

I could be wrong here, but my impression from women posting here is that they use online pharmacies in 2 ways -

to fill a gap if there is a shortage of HRT products in their area, and online pharmacies can source it.

to have a consultation and get a prescription (I've read that Boots and Superdrug do this.)

I have no idea if either of those require you to tick a box saying the info is sent to a GP.

The problem here for the OP is that she is already on HRT so getting more of the same when it's already being prescribed (or was) is not what online pharmacies do unless there is a stock issue.

Have a read up, but @JinglingSpringbells has written a nice summary.

I was on the tablet form, both when on sequential and on continuous, but i have changed to the twice a week patch now. Although I too was hesitant, as I was just really used to my routine, I much prefer the patch to the tablets now.

Why not ask the gp for 3 months prescription and then it gives you time to research the other options.

Hi Jingling - I'm under 60 (aged 57). There was definite pressure - no discussion. I did ask for 3 months leeway while I did some research and was told no. I don't mind changing prescription but give me the chance to do some of my own research. Another 3 months on Trisequens won't make any difference.

Perhaps I'll have to go private with this.

isthismylifenow - I did ask the GP for one last prescription but she said no. She was very inflexible. I've a lot on my plate right now - I've just moved and trying to sort out a boiler and a leak in the roof so just wanted to get that all done then sort out the HRT. I'm open to what they said but I won't be dealing with this particular GP again.

Can you go back and discuss with her?

It's not acceptable to be told you have to stop one product and not be given a reason.

I'm really shocked that any GP can behave like this and not expect to be asked why! Surely she knows that you have a right to be informed of her reasons?

Nice guidance makes it very clear that the choices over HRT have to be done as a discussion.

https://thebms.org.uk/wp-content/uploads/2022/12/09-BMS-TfC-NICE-Menopause-Diagnosis-and-Management-from-Guideline-to-Practice-Guideline-Summary-NOV2022-A.pdf

See 1- individualised, taking women's preferences into account.

You should make another appt and ask why she's suggesting this.

That is ridiculous, I don't blame you for being upset about this. This is your journey and you should be able to have your say, or at the very least, have reasons explained to you.

I am very fortunate to have a very different health care system where I live, I just cannot imagine being told what to do rather than having a discussion about the new/best/available options.

If you are in a position to, I would look into the private option.

I know that Trisequence was often out of stock, and then the next one I went onto (Climen) was discontinued completely. I also managed to stock up on a few months supply so that I wasn't under pressure to change there and then.

We are having a massive shortage again here on the patches, currently Evorel Conti is no where to be found. The one I am on was also completely out earlier this year. So I fully understand the wanting to have a backup supply as a change is not always straight forward.

Do you have a friend in an EU country that can just buy it OTC in a pharmacy and send it to you?

Having said all of what I have, you would be 'sensible' to consider transdermal HRT as it is safer than tablets. But this doesn't mean your GP has behaved correctly at all.

If you do seek a private consultant, they should take time (anything up to 45 mins) to discuss all the pros and cons and take your own preferences into account.

There is much more variation than GPs know about or are qualified to prescribe. The best way I can describe it is it's the difference between ordering food off set lunch menu, or choosing various options from the a la carte!

Patches are fine so why can you not take them instead?
I had to stop my newly prescribed hrt patches to go on a tablet form which I have to partly pay for, usually fully funded because of the hrt worldwide shortage.
Other meds have been changed to generic cheaper ones, is this supply issues for yours i wonder.
I would not be leaving feeling as you do but trying a patch is actually easier i found.

isthismylifenow - thanks for understanding. I already had to go on to Trisequens as the one I was on was discontinued too or very difficult to get hold of (can't remember exactly). It is stressful. I just wanted a bit of understanding from the Dr about having a lot on my plate right now. I do feel it her awkwardness was personal to me. I was new to that surgery and they use a booking system called Anima Health, which is really horrible and impersonal and also its terms & conditions concerned me (it talked about sending your health data to third-party data management people (one of which has already been hacked) and it "might" transfer your data abroad sometime, but it'll let you know. Anima Health is approved by the government but there was a recent hacking of people's health data - the Synnovus cyber attack - which a friend of mine in Southwark was affected by. With the amount on my plate I've reached peak tech as well at the moment plus my smartphone can't seem to handle apps. This Dr basically told me if I don't use Anima Health I won't be able to access healthcare. I've now switched to another GP but worried I'm going to get the same attitude even though, thankfully, they don't use Anima Health. This is why I thought if I can get three months' worth I can sort out the things with the house then the HRT. I just want some breathing space.

BlackStrayCat - I don't. I did manage to buy it in Portugal last year and am thinking I might go over and get more.

Jingling - I think the private option sounds good. As you say, it'll be more tailored to me, which can't be bad. Yes, it is an expense but I think it would be worth it. Again, though, if I could get three months' worth of Trisequens it would give me time to research the private option.

Inspireme - I do prefer the tablet - you take it and forget about it. Patches I see as a faff. I've switched HRT a few times for various reasons (supply etc) and I've found it takes time to find the right one. I just don't want to have to deal with it right now with so much on.

Jingling - I forgot to say I found the Nice guidelines after this Dr spoke to me and she definitely didn't follow them. I wish I'd thought to look at them beforehand. There was no discussion. She spoke at me. At one point I went to say something and she said "Listen to me!". I was listening but wanted to say something too. She was horrible. I won't be going back. I've now switched GP practice. I didn't think asking for three months' prescription was unreasonable so give me some space while I've so much on (Trisequens comes in packs of three months).

No, not unreasonable at all.

Personally, I prefer the gel as it is the safest but it can be a faff.

Either way, your choice. Well done for changing GP.

Boots Online sell Trisequens (84 for £26). There will be an online consultation.