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?

@Foxhasbigsocks this time last year I was in Spain on holiday and bought 6 boxes direct from a pharmacy no questions asked. Unfortunately this year we’re not going to Spain!!

I’m on patches and have had dosage changes., very straightforward. Can all usually be dealt with by the practice pharmacist. Annoyingly they will only prescribe 3 months at a time and will not accept my repeat prescription request until 2 weeks before my supply runs out. Has caused problems if the pharmacist has any delays with ordering in supplies. Apart from that I have a yearly telephone appointment with the practice pharmacist for a medication review, at which they try to persuade me to stop taking it and I tell them they will have to prise it out of my cold dead hands as I intend to take it for life due to previous osteopenia. They then say OK then .

Did you just walk into a pharmacy and buy them? Interested as I am in Spain at the moment!

I did a telephone consult with a GP, who suggested I have a Mirena and gel, which she said was “gold standard HRT”. The idea of the coil freaked me out, so I asked for patches, which fell off, and a few months down the line I asked to be referred for a Mirena. This had to be done at a sexual health clinic, and by a doctor who specialises in menopause - she was great and it turns out is chair of the regional women’s health services or similar. I found the fitting horrible, but four years on and it’s great not having to faff around with patches or tablets. She also prescribed vaginal oestrogen. I have gel and pessaries on repeat and am called in to get weighed and BP annually. I was 49 when I started, 53 now.

That's very poor. Both me and my best friend (different areas of the country) have been prescribed hrt on symptoms alone at the age of 42, it's not supposed to be dependent on the outcome of hormone tests anymore as these are not a reliable measure. Get a second opinion.

God I'd hate the mirena absolutely would never have that, I hope there are readily available alternatives.

I have a Mirena for the progesterone as I kept getting breakthrough bleeding with Utrogestan tablets. Have had no problems with the coil and no further bleeding for two years now. It’s been a great help.

Yeah but I have body horror feelings about it (I have a friend who had to have a hysterectomy after hers went awry and while I know it is incredibly rare it just confirmed my instinct about the whole thing). Nothing I can't remove myself pls.

Of course there are, your GP will talk you through what’s available and you can choose what you think will suit best. If what you choose doesn’t suit, you can try something else (I think they generally recommend you give it three to six months.)

The Mirena’s a good option for some people because it’s one and done, lasts five years, and also provides contraception. Mine was agony being fitted, but settled really quickly and I just don’t even think about it now. I’d had awful periods since the age of 12 and as I started in peri they were coming every 20 days or so, and the Mirena totally kiboshed that. Result!

I had my initial prescription through a private appointment and then was able to transfer the prescription over to my GP. When it came to renewing the prescription they were absolutely fine apart from the testosterone and for that I was referred to a specialist GP who has a clinic locally one day a week ( took me about 6 months to be able to see her). I have to say she was an absolute wizz and reviewed everything and prescribed everything ( adapting all my doses and adding a couple of things ). I have an annual HRT certificate ( whatever it’s called ) and I’m supposed to be paying for my Testosterone as it’s not supposed to be covered but the pharmacy at Boots don’t seem to know that.

I had a Mirena (for ages) but it’s synethic progesterone and my first menopause symptoms were splitting headaches - from low progesterone. So no I have utrogestan as well as the Mirena.

My initial prescription was valid for repeats for 5 years and I just order online every 3 months. At my recent check up it was renewed only for 18months, not sure why.

It’s been really straight-forward for me, and I’ve been on it for 5 years now. I have Oestrogel, a Mirena (which has worked well for me), plus testosterone & vaginal oestrogen. I don’t take the T any more as it gave me acne, but everything else has been fine. I have to check in each year with them to confirm all is still ok, BP etc, and that the HRT is managing my symptoms. And it doesn’t cost me anything.

Another q - did you feel younger once you were at the right dose or just a healthier version of your age?

How are you feeling now @CurdinHenry ?
What symptoms are you having?
Are they affecting you day to day, a lot?

HRT isn't about 'feeling younger' and that's really hard to quantify as we all get older! I've used HRT for years and I honestly can't say I feel younger, because I don't know how young or old I'd feel without it.

Are you thinking of having a chat with your GP about HRT and giving it a trial?

This version of myself on HRT is the version in which Im not miserable and about to bite everyone’s head off.

I'm going through a stressful time (hospital stuff for dh). Just started new hrt combination with continuous micronised progesterone. It is helping me sleep - thank goodness! A definite plus at the moment.

Vaginal and eye dryness and my skin is starting to look slack. I used to feel uncomfortably hot at night but now I take a sage tablet and that seems to have gone. Sage is amazing!

Anyway nothing that bad but I feel less "juicy" and want to take action preemptively if possible (I'm mid 40s)

You only need vaginal estrogen for that.

It's called estradiol and if you're over 50 you can buy it OTC- brand name Ovesse otherwise from your GP.
Dry eye- drops from the pharmacy.

You won't get HRT for skin etc so expecting it as a 'beauty' treatment isn't going to cut it with a doctor. (Not being harsh just stating facts!)

From what you say you don't need HRT yet.

Sage might work but it's hit and miss. In peri symptoms can come and go, especially as ovulation doesn't happen each month. Many women find when they miss a period their peri symptoms are worse but when they ovulate it all seems to settle down. And sometimes women mistake the improvement on herbs as them being effective when it's just normal fluctuations of their cycle.

Well I am obviously more worried about the bones issue so if I have any symptoms I'll expect to be treated for them to avoid that.

I pay a load of tax (Scotland) and fund all my healthcare privately (free prescriptions being a bit of a cruel joke for working people) so I don't expect to sit quietly crumbling

Initial 3 month check and now can just request repeats as and when. I think I might have had a text (SMS) based questionnaire a year or so back to check I was still doing ok on it. But I don’t have testosterone or any underlying medical issues.

I have an annual review with a practice nurse for Oestrogel. She asks if I'm still happy on it and whether the dosage is still working or needs adjusting. If I need to speak to someone in between times or get my Mirena coil changed I just contact the surgery. When I wanted to add in vaginal oestrogen (recommended by gynae consultant) I contacted the practice and they sent the prescription straight through to my nominated pharmacy - I didn't even need to speak to anyone. I'm not on testosterone so I can't answer that part.

@CurdinHenry you sound really cross about the idea of HRT/the idea your GP might decline it.

Have you already had a negative experience?

Is there a reason you think the NHS HRT is any less effective than private?

Private and NHS use the same preparations. The only difference is that some NHS GPs won't give testosterone - mine did happily.

I’m in Scotland and see the hrt nurse every 3’months. I’m recently started. Once my doses is sorted it will ovento once every 6 months