If you are on NHS hrt how much of a hassle is it?

[CurdinHenry]

1. How often do you have to interact with your GP?

1. How difficult are they about flexing dose or type and adding in things like testosterone?

I have an annual review but that is by phone. Super easy otherwise and now includes Androfeme so that saves me a fortune

Same here, but I'm 50. Wondering what else I should get tested for to see if I need HRT now.

I have an annual medication review with a nurse, this includes a thyroid and testosterone blood test and blood pressure check. I think if it was just estrogen and progesterone I wouldn’t need any blood tests. I had it before I was on HRT ie I think it’s compulsory with any long term medication and I take thyroxine.

They don’t need blood tests to prescribe, mine will based on symptoms only.
It’s the nurse practitioner at my practice who deals with HRT. Bloods can vary day to day also so are wholly unreliable

Far less hassle than suffering menopausal symptoms

PS there’s no blood test for menopause. Results would fluctuate from day to day as hormones fluctuate, meaning any results are meaningless.

During lockdown, I was about 50 but I had needed for a decad3 before but was continuously prescribed antidepressants instead. Finally went private and got what I needed

My GP is telling me that day 2/3 bloods I’ve had done are showing them I’m not even in peri. They did them once and because I knew they fluctuate I got them done privately for 4 months after and the results were almost identical and so they say that plus a regular 28 day cycle means I’m not perimenopausal. I have anxiety, I get too hot at night, exhausted, no libido, severe pmt every month now and brain fog. They won’t entertain the idea of me being perimenopausal and I just know I am 😭

Over 45 there are no tests, it should be prescribed on symptoms alone. Show your GP the NICE guidelines.

Guidance across the NHS is that any meds prescribed long term need an annual review.

Not all GPs get round to this but they are supposed to.

So it's not just HRT, it's any drug, long term.

it’s been ok for me so far, but very hands off, just agreed with what I asked for each time.

Called BP, had phone call, they prescribed what I wanted over phone (patches, utrogestan, vaginal estrogen) on repeat.

A year later called back, asked for estrogen to be increased which they agreed. Had a telephone review after 3 months and they added Yes VM to prescription.

I haven’t asked for testosterone.

i have had annual check ups and blood tests for a few years before HRT (I was on blood pressure meds before)

I text my BP to my GP about once a year and just order my repeat script of oestrogel, testosterone and vaginal oestrogen via the app as and when I need it. I have a Mirena for progesterone.

No hassle , mostly managed online I have a lovely NHS practice . I occasionally see a private menopause doctor for an hour long in depth wellbeing visit but that’s my choice and by no means essential

I have to go every 6 months to get my blood pressure checked before they will give me any estrogen. I don't have high blood pressure and never have so its a total pain and as far as I am aware unnecessary or applied more to old style oral HRT. If I increase my dose its a fight to get it and they make me come in repeatedly for more blood pressure testing before they give me a longer supply.

Maybe raise this? HRT if it's transdermal does not raise BP- many GPs seem to equate it to the Pill or the old data on HRT from 25 years ago.

I remember being 44 and feeling just like you and my tests also came back normal. I had to see a private consultant specialising in menopause who agreed to treat my symptoms with HRT after blood tests revealed nothing wrong. About six months after that, my tests came back showing no was peri, so I had symptoms before it showed up.

*showing I was peri

I haven't seen a GP regarding HRT in about 7 years. Submit bp/weight readings annually.
I just do an Econsult and request changes or increases.
I'm on testosterone too, no issue getting it.

No hassle at all, no blood tests required, I was put on combination tablets to start and I asked to go up to a higher dose after a bit. I have annual reviews, which can be just the surgery pharmacist ringing to ask if everything is OK. Once I knew a bit more about things, I swapped over to oestrogel and micronised progesterone with a review with GP and I asked to go onto continuous progesterone as I was over 53 and wanted rid of the withdrawal bleed. Given testosterone to try when I asked for it - we do have one female GP who is especially good, she's not my GP, but I just ask for her now when I want to talk menopause. I'm very happy.

Glad there is the HRT specific prepaid certificate now too!

I know this and I've told them this but they refuse to budge on it! Probably a waste of NHS time and money!

This is why the GP system fucking sucks. We should just be able to go to a health service run by the NHS and consistently providing care instead of gatekeeping private businesses.

@CurdinHenry Yep, it could be done so much better!

It's not the NHS as such- the training is out there but many GPs aren't motivated to take it up as they aren't interested in women's health.

The British Menopause Society runs very cheap online and in-person CPD courses throughout the year which cover prescribing, for GPs.

There are also guidelines produced by NICE which GPs can access.

I was on a low dose of oestrogen tablet for a few years (had my ovaries removed so surgical menopause) and it was prescribed on repeat, no problems. When I went onto patches instead (lowest dose) it's been much more difficult. They won't put it on repeat and every 3 months I have to go in to have my BP taken before they'll prescribe it. I also have an annual HRT review. I don't object to any of this, but it seems strange that these conditions come with the safer form of HRT. I asked the practice nurse if the prescribing policy had changed and she said it hadn't.

@TipsyLaird i have exactly the same issue and end up driving around to try to source the Estradot. For me they work brilliantly but the stress of trying to find them has been awful over the last year.