Have you found NHS hrt sufficient or

[Pavementworrier]

Did you have to go private?

I'm not on anything yet but I want the full shebang (so to speak) and no corners cut

Did you get everything you needed from your GP?

Eventually! I got great advice on this board and quoted NICE guidelines at them.

I’m actually due a review of my HRT at my GP surgery so here we go again …

There is no difference between the HRT you can get on the NHS or privately. The only difference may be if you want / need testosterone which may only be given by some NHS trusts. I don't understand that completely as I'm not using it. (But many women are.)

But the HRT meds are the same.

Going privately, you get more time to talk through your symptoms and the doctor should be up to speed with doses and types.

Not all private doctors are the same though. Some are GPs with a bit of extra meno training who have set up privately, some are top consultant gynaecologists who have special training in menopause, who also train other doctors. There is a huge range of experience.

If you start with your GP but don't feel happy with the experience, maybe think again about seeing a different dr, but cross that bridge it it comes?

In the meanwhile, read all you can about different types of HRT and what you might like.

I had a useless NHS GP who wasn't following current guidelines. I was very fortunate to be able to ditch her and book an appointment with Newson Health. They are private menopause specialists and I couldn't recommend them enough. They got me started on HRT and had my dose tweaked at a review 4 months later

I've since registered with a different NHS GP and I now get everything I need from her. Last month she agreed to prescribe me testosterone and vaginal oestrogen as well. She listens to me, and checks guidelines if she's not sure of the answer so I trust her

Very much agree with the advice to do some reading of your own before you see an NHS GP - some are great, some are clueless. The NICE guidelines for perimenopause care are available online and the Newson Health website is a v useful resource too

Just to add I've used a private consultant gynaecologist for almost 20 years. I saw them initially for a non-meno issue and stayed with them for HRT.

Having said that, if a GP is up to speed that's great.

But almost daily there are posts on here about GPs mis-prescribing (usually not knowing the difference between peri and post meno HRT doses) which is shocking for all kinds of reasons. But also because there is guidance out there for them , easily accessible.

Am I right in thinking a private Dr can support a woman using cyclical hrt to extend the amount of time between progesterone phases?

@NeonSigns If you have HRT privately, you may be able to access off-license , individualised ways of using it because the consultant takes responsibility for it. (And some GPs will too.) But you'd need a medical reason to ask for this and the dr would have to agree. It's not just a 'demand' that they will automatically agree to.

Using HRT on a longer cycle means being aware of the slightly higher risks of hyperplasia and accepting you may need to pay for a scan annually, or more often, to check all was ok.

There is.... I get estrodot which is not available in my local nhs and also cyclogest which is off label
I also have testo gel

All private

@Pavementworrier Going back to your first post, there are good and not-so good doctors both NHS and privately.

Privately you will get more time (often 45 mins for the first appt.)
But not all private drs are good and not all GPs are bad!

If you do choose to see someone privately, check out their websites for their experience and also ask around for recommendations if you think you need to.

Cyclogest ought to be available as it's in the BMS guidance on types of progesterone available on the NHS.

Likewise Estradot- I know someone who's been on it many years on the NHS.
The issue with that seems to be a supply issue.

I am lucky that my GP has a special interest in women's health. She took her time and talked through all options with me and even called me a month or so after to see how I was getting on. Shame that this isn't standard practise isn't it?

Yes cyclogest is available but not at that dose for HRT, it's used to treat PMS and to prevent miscarriages

Do you think this varies across the UK?

The same applies to Utrogestan 200mgs which is for fertility, yet there are women posting here who get it on the NHS as HRT.

Could be.

Certainly, Estrodot is not available in my local NHS pharmacies because my GP confirmed there are supply issues. Solid I wanted a patch I'd have to have Evorel