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Menopause

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Finally feel like I'm at the right dose of HRT but GP is telling me that I need to consider stopping soon?

38 replies

moderdy · 08/03/2026 14:08

I am 48 now. I've been on HRT since 43. I started on a 50mcg estradiol patch and 200mg progesterone (utrogestan) capsules 12 nights a month. After a few years when my symptoms returned I had to fight to get moved up to 75 mcg estradiol and then again to 100mcg. Prior to each increase I felt like hell, I wasn't sleeping, I had terrible joint pain, hot flashes, the worst brain fog and low mood, crippling migraines and there were times I seriously contemplated ending my life because it just wasn't worth living like that. I've just had my first review with my GP after starting the 100mcg (she has me in to do my blood pressure, weight and blood sugar, cholesterol every 6 months while I'm on HRT) and my blood pressure is down, cholesterol and blood sugar are now in the healthy range when previously they had been creeping up high. Its not all perfect but I was telling her how much better I was feeling and sleeping, that I was exercising more, doing strength training, losing weight and back working again. She said that was great but then reiterated how "you can't stay on HRT forever" and that in the next year or so we'd need to have a conversation about my reducing the dose and then stopping essentially as soon as possible as I have already been on it now for 5 years.

I just can't face the possibility of stopping at any point or not for a long time. I'm not even 50 year so still have almost two decades where I will need to be working and earning and I just have no quality of life without the HRT being at the right dose. I'd love to try the testosterone and be prescribed some vaginal estrogen but it feels like any mention of additional hormones is met with such resistance from my GP.

I was searching online about this and found the UK GP subreddit where it looked like a lot of GP's were saying the same kind of things that HRT was too risky and that demand for it had got out of hand, that is should only be for hot flashes and was over prescribed and demanded for mental health and sleep issues now. This was in a post after a high profile HRT advocate was diagnosed with breast cancer.

I do want to stay on HRT long term, I looked at the nice guidance and the British menopause society and both say there is no longer any defined deadline to stop HRT and that staying on longer term is a choice to be made between the patient and doctor taking individual risk factors into account. Why are GP's ignoring the guidance like this and how can I stay on HRT long term, for me my life was hardly worth living without it.

OP posts:
Nofeckingway · 08/03/2026 15:15

I am not originally from UK so have a different view of healthcare . I have been on HRT for years and I am never coming off it . In fact I recently got it increased . My US friends are thriving on it . I have no other breast cancer risk and I consider the cardiac low risk . There is risk in everything but there is even more risk that I will become seriously mentally unbalanced without it. Not worth it to me . I have a female doctor who has decided that she has discussed the risk with me and it's my choice .

I wonder if there is a money aspect to this is the NHS not willing to fund it .

remort · 08/03/2026 15:16

HostaCentral · 08/03/2026 14:50

It always blows my mind that some GP's are so conservative when it comes to HRT, in direct contrast to how keen they are on prescribing contraceptive hormones for any female related issues. Why the difference?

Anyway, my GP says we will reassess in my 70's, I am not yet 60 😁

Yep
”headache? Period problems? Mood swings? Here have the pill”
menopause “alter your natural hormones?! Oh no, can’t do that”

newornotnew · 08/03/2026 15:22

Isn't there another GP in the practice you can see?

Lottapianos · 08/03/2026 16:27

'Your GP is out of date which I think is shameful especially as she is a woman treating other women.'

It's shameful whether the GP is a man or a woman

Charliede1182 · 08/03/2026 17:23

I would print out the relevant section of the NICE and BMS guidelines, highlight the areas concerning age based cut offs being inappropriate, and hand them to your GP.

Be respectful but firm, and say that if continuing your prescription, either at all or at a therapeutic dose, is outwith their scope of practice then could you please be referred to the local NHS menopause clinic.

The menopause clinic is likely to just write back to the GP and say of course you should continue to be able to receive treatment and that a clinic visit is not required.

Or you may just find they back down when they realise they are dealing with someone knowledgeable who is able to advocate for themselves.

Many patients probably just meekly accept the loss of their prescription and never challenge the GP.

JinglingSpringbells · 08/03/2026 19:22

Charliede1182 · 08/03/2026 17:23

I would print out the relevant section of the NICE and BMS guidelines, highlight the areas concerning age based cut offs being inappropriate, and hand them to your GP.

Be respectful but firm, and say that if continuing your prescription, either at all or at a therapeutic dose, is outwith their scope of practice then could you please be referred to the local NHS menopause clinic.

The menopause clinic is likely to just write back to the GP and say of course you should continue to be able to receive treatment and that a clinic visit is not required.

Or you may just find they back down when they realise they are dealing with someone knowledgeable who is able to advocate for themselves.

Many patients probably just meekly accept the loss of their prescription and never challenge the GP.

There are very few menopause clinics in England and they are for very complicated cases where there may be possible contraindications to HRT that need specialist input.

The waiting time can be months according to posts here.

So- that's not going to do the trick!

I agree that printing off the guidance and expressing that you want to carry on is the best way forwards.

OddBoots · 08/03/2026 19:32

EnjoythemoneyJane · 08/03/2026 15:09

Same. She’s 84 and looking bloody good on it.

I’m sure GPs must be under some financial pressure to ease people off repeat prescriptions after a certain amount of time. With the big push in the last decade to finally get menopausal women the care and treatment they deserve, and with the prepayment certificate meaning the cost to the individual is negligible, I’m guessing the bill for HRT provision is steep and constantly increasing.

Which should never be the reason to stop prescribing it, but we see these kinds of decisions being made across the NHS all the time. I’ve been on it for 6 years (not yet 60) and have zero plans to stop any time soon.

I guess prescriptions come from a different budget but having proper menopause care will save the NHS money in the long run by reducing osteoporosis, UTIs and heart disease.

That's before we look at the number of women that no longer need psychiatric care due to major menopause symptoms and the increased tax revenue when women can remain in the workforce rather than being forced out by symptoms.

Girlwithavibe · 08/03/2026 19:53

This happened to me when a Dr lady ! Rang me COVID times for repeat prescription I was on everol sequi at the time and i.felt so good she said Mmmm might have to get u off of it at some point !
I just spoke up and said No I won't come off it because it's got rid of my symtoms why wud u even suggest that it doesn't make sense?
She didn't have an answer but I never spoke to her again the Lady Dr at our surgery different one is super good she did Change me over to continuous hrt after 5 years !
So my advise speak up and don't be pushed into coming off glad u feeling good thou x

Sorrytimes · 09/03/2026 00:20

JinglingSpringbells · 08/03/2026 19:22

There are very few menopause clinics in England and they are for very complicated cases where there may be possible contraindications to HRT that need specialist input.

The waiting time can be months according to posts here.

So- that's not going to do the trick!

I agree that printing off the guidance and expressing that you want to carry on is the best way forwards.

Respectfully I disagree with this. Yes Menopause clinics should be reserved purely for complex cases but in some areas, like mine, only Menopause Clinics can prescribe testosterone not GP’s.

@moderdy I would advise you to ask your GP directly to be referred to one because ONLY HRT is alleviating your symptoms, you need vaginal estrogen for GSM & you want to try testosterone - but only say you want it for libido purposes & nothing else. Not even menopause. It’s ridiculous but it’s the only way to be given a chance. I tried to say look I’m obviously wanting to try it for my chronic meno related insomnia, fatigue & the other health benefits as well as libido & this was enough to put them off.

The point being however that some areas operate this way. I too had been told by a GP to come off my HRT altogether because I was concerned I may be getting progesterone intolerance & had asked if I could trial a different form of progesterone, per the BMS guidance. (I mean poor OP wasn’t even complaining or presenting her GP with a “problem” with her HRT) As the GP was clearly completely inexperienced in suggesting alternate options, she made up some reason why I shouldn’t even be on HRT at all, due to “risks”” as a solution to the matter.

I suffer extreme anxiety, ADHD dysregulation, even worse insomnia, severe mood disturbance - when not on HRT. It has been the only thing, that like you OP that keeps me going. For me (& I appreciate my difficulties have been more severe p’haos in this regard) HRT has literally been life saving for me due to suicidality experienced for many long years without it (& years of begging for it as I felt there was a hormonal basis to my depression & anxiety. It has worked in ways unlike any antidepressant possibly could & literally transformed how I was feeling).

So someone suggesting I simply come off it because they couldn’t cope with not being the expert in the room & do the sensible thing & refer me to someone that knew more, was not going to wash with me.

I trialled myself taking progesterone on a strictly empty stomach & my intolerance symptoms subsided. I then saw a different GP & explained how much of an impact being taken off HRT would have on my mental & emotional health, & that I wanted a second opinion about this from a specialist who understands Menopause.

Thank god the GP agreed & referred me. In my case, it was only because Testosterone could not be prescribed by the GP, that enabled her to refer me to the Menopause Clinic. Because I was also asking to trial this too.

It’s crazy that specialist services should be not only organised in this way, but also used like this. But if it’s the only way to be able to get treatment you’re entitled to then I would strongly advise you to take it.

It’s clear that GP’s themselves don’t want to clog up specialist services with people who should be seen & treated in primary care, hence why they also try to fob you off and say all the horrific & damaging tripes about menopause like testosterone won’t work, it will make you grow hairs like a man (what I was told) etc etc to deter you from even trying it.

It really is a disgrace. Please advocate for yourself OP. You won’t be causing a fuss. Bit simply asking for what you need.

Sorrytimes · 09/03/2026 00:24

And by tripes I mean tropes! But actually tripe is actually probably a more accurate description!

Negroany · 09/03/2026 17:59

The gynae registrar told me to ask for a referral to the menopause clinic for complex cases (I don't think I'm a complex case), though my GP is the menopause expert for the area and runs one of the clinics anyway.

The registrar then told me I should be on SSRIs for anxiety, not using HRT for it (the latter works). I firmly reminded her that not what the NICE guidelines say, that they say if you are the right age with symptoms start with HRT and if it helps, stay on it. She looked a bit taken aback that I should know such a thing (I wasn't even expecting her to comment on my HRT at all!).

Pretty unimpressed with her tbh.

onelumporthree · 09/03/2026 18:08

I had this nonsense from my GP after I'd been on it about 8 years or so, having started taking it at 40 due to premature menopause. I pointed out to the doctor that all my HRT was doing was replacing the hormones that most people my age were still producing naturally. If other people my age would only now be starting to take it, what was the problem? To my surprise the doctor agreed that maybe I had a point there, and let me carry on having it.

ilovebrie8 · 09/03/2026 18:27

My doctor won’t prescribe testosterone just won’t hear of it.

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