HRT through private providers

[TheGoodEnoughWife]

Hi, I am 53 not had HRT before or know much about it. I have an email from Voy about menopause and have just had a consultation which was interesting.

The nurse said she would recommend the Conti patches (think it was this!). They can provide and there is a cost - obviously.

Does anyone have some advice for me about whether paying privately is a good or bad thing please? I don’t know how easy it would be to get HRT from my doctor and struggle to get an appointment or to make contact with them however I get prescriptions for free and so HRT would be free from the doctor? Any input welcome!

As a side note if I have the progesterone and oestrogen patches will I get periods again? I really do not want that!

There have been news stories about private providers prescribing too high (unhealthy too high) doses. That would be my main thing to watch out for.

Ah, okay. Thank you. Not sure what dose she is going to recommend at the moment but hopefully will soon.

Before you do anything learn about HRT. You will find navigating the system considerably easier if you know what you’re talking about, what you want, and why.

I sense from this board that UK GPs have got better at prescribing HRT, probably because of increased media coverage and higher demand. Not all will be, but worth reading up on HRT and trying your GP first. You might be surprised and find it very straightforward.

Hi, thank you. I am normally pretty good at finding things out but am just starting out after having some private blood tests where I found my testosterone level is high. That led me to being told HRT would potentially help with that and other symptoms I have.
I do need to find the time to go to GP but it is tricky!

I wouldn't bother with getting HRT privately if your situation is pretty straightforward. Your GP ought to be able to sort this for you.
As a PP says spend a week or two reading all you can about the different types and go to your GP with some preferences in mind.
Dr Newson's Balance site is a good place to start to find out about all the types of HRT.

Prescriptions are not free- only for the over-60s unless you're on benefits for some other reasons. However, there is now a pre-payment HRT certificate for around £19 for a year.

I started with HRT using a private clinic but eventually got fed up of the endless charges. Everything was an added extra and in the end I wasn't even particularly convinced that I was receiving good advice - the only recommendation for any issues I was having was to keep upping the Oestrogel dose. When I eventually saw my GP I was pleasantly surprised by how clued up and supportive he was and I'm saving a fortune!

Hi, thank you for your reply. I get prescriptions for free as I have an under active thyroid and am on thyroxine. Weird old regulations!

Conti patches are a straightforward thing. Google it and see if you would be happy with these.
If so, approach your own GP, get their advice/input and hopefully you will come out with something you are happy with and will be free.

GPs are better than they used to be. Mine is excellent, although she did say I need to come off HRT at 60, so I'll need to see someone else when I get to that stage.

I’m younger than you with a useless GP, but they managed to progress everything for me in 24 hours. A lot of the negative noise about hrt is thankfully going away but note that patches are less effective and only really required if there’s a medical need. You shouldn’t just be choosing them because you read somewhere that hrt causes cancer / clots. It doesn’t cause either of those problems in healthy people.

My understanding is from posts here that both Boots and Superdrug do menopause consultations (free) and will prescribe.

I'm not sure how that works with getting hold of the drugs long term (ie via a GP or not.)

If you simply want patches and have no questions or any other issues, it's worth thinking about those if your GP is busy.

but note that patches are less effective and only really required if there’s a medical need.

Not sure what you mean by this @pottylolly
Transdermal HRT is considered safer re. blood clots, so personal and family history needs to be discussed.

patches are not less effective than tablets as a lot of the hormones in tablets are lost in digestion.

Just speak to your GP, don't waste your money paying privately. I was prescribed over the phone, never even saw my GP in person and I was only 44 when I was given HRT. I had seen the practice nurse and she told me to go away, work out what I want and just ask them. So that's what I did.

Thank you for replies. It does sound like the GP will sort. If I can remember to contact them!

The Voy recommendations work out as £100 a month and I am not prepared to spend that much.

I have completed a consult with Boots asking for the same as Voy recommend (patches and a vaginal tablet) which is much cheaper. If they agree to prescription I will try those and then contact GP for ongoing if I find it is helping.

Where did you hear/read that about patches being less effective?
Less effective than what?

In view of your other medical issues I think your GP needs to know what medications you are taking, so go through them.

Just make a GP appointment instead of wasting time / effort with private consultations.

And transdermal is considered the 'best' form of delivery in terms of risk / side effects & effectiveness, no idea why a PP states otherwise.

May be cheaper but you don’t need to pay privately at all.

No need to pay more than a standard prescription charge per item (or free in your case) or the specific HRT prepayment certificate at c£19 a year will cover both oestrogen and progesterone in various forms eg patches, and also covers Vagifem (which is probably the vaginal tablet you mention).

That’s great - thank you. I think I have accepted paying for things as I pay for Wegovy so seems ‘normal’ to me!

Go to your gp, you are entitled to these and can use the menopause prepayment thingy.

Do not use these money grabbing vultures.

It’s considered safer for overweight women, those with high blood pressure, and a history of cancer / clots to take patches & if the problem is just symptoms but it has not yet been proven that they are as equal to tablets & many menopause specialists think not because they don’t improve cardiac health / bone profiles to the level tablets do.

This is why it’s a good idea to get regularly referred to a decent NHS menopause clinic because the advice has materially changed.

It’s considered safer for overweight women, those with high blood pressure, and a history of cancer / clots to take patches & if the problem is just symptoms but it has not yet been proven that they are as equal to tablets & many menopause specialists think not because they don’t improve cardiac health / bone profiles to the level tablets do.

This is why it’s a good idea to get regularly referred to a decent NHS menopause clinic because the advice has materially changed.

I used the BUPA menopause service and I recommend they aren’t in it to sell anything. Once they prescribed HRT my GP did the repeats. I’d stay away from company that is prescribing AND selling.

There are very few NHS menopause clinics. They are only there for women with complicated health issues who want HRT. Not for run of the mill prescribing.

You said patches were less effective- they aren't.

Transdermal estrogen is now the preferred route for safety around clots. Yes, there are women who have no risk factors and if it's their preference they can use tablets. But who knows if they may be at a higher risk anyway? Not without a full range of blood tests which the NHS can't afford to do for every women wanting HRT. So that is why most women are offered transdermal.

There is another disadvantage to tablets though- they only come as 1mg and 2mgs doses. Patches and gel can be changed in smaller /larger doses.

Just of note I have been advised against any oral form as I am on Wegovy

I get it privately. GP was worse than useless, refused to believe I could be peri (at 45 with all the symptoms) and gave me sertraline instead which I had a terrible reaction to. Private clinic sorted it. Yes it’s expensive and no I don’t care, because I feel so much better.