Frustration with NHS not understanding menopause

[LadyKinbote]

I feel like I’m going mad here. I went to my GP to ask about HRT a year ago - I’ve had irregular periods for years now but now also have hot flushes, mood swings, difficulty sleeping etc.
The issue seems to be that I’ve had migraines since I was a teenager. My GP has admitted she doesn’t know much about HRT and migraine and has referred me to a specialist at my local hospital. I was really pleased at first but unfortunately the specialist isn’t listening to me at all. She’s insisting that my only options are a mirena coil (which I don’t want) and that she will only fit one if I have a hysteroscopy first (which I don’t need). Everything I look at online tells me that there are more HRT options for patients with migraine than the coil and that hysteroscopies are only needed if women have worrying symptoms which I absolutely don’t have.
I don’t know where to turn to next. I’ve gone back to my GP but she’s saying that she has to follow the advice of the specialist.
I’m going round in circles with this and feel like giving up. I really don’t want a coil or a hysteroscopy. I had awful experiences not being listened to when giving birth which resulted in extremely painful deliveries and I just feel like I’m back there again.

That's awful. Do you think you know what you need? Or want advice?

Can you afford to see/speak to the Newson clinic? They’re amazing.

I was resistant to a mirena coil but it has been honestly life-changing. Had it fitted when I was 50 with local anaesthetic. No pain, no more heavy periods, no more fibroids. I would seriously consider it

I think there are legitimate reasons for a woman to feel concerned about having any foreign body inserted in her person that isn’t necessary to preserve life eg a pacemaker.

Although many women benefit from and have no problems with coils, there are significant complications in a sizeable number, particularly post menopause. There are class actions now in the USA and yes, they’ll sue for anything, but it does give you pause for thought following the vaginal mesh scandal.

I’d see a different GP at the practice or even privately if you can muster up the cash.

If you're looking for specific migraine related advice try the national migraine centre. They're a charity and you can make appointments to speak to a migraine specialist doctor. If you can wait a few months the appointment is free. You can get a really quick appointment which is expensive or a cheaper price if you can wait a little while. I was recommended them on here and they're brilliant. I hade a 45 minute call with a specialist who did a deep dive into my symptoms and history and recommendations for treatment and prevention. They then write a report for your GP (they can't directly prescribe themselves). It's well worth it.

Obviously they can't help with your HRT or menopause issues but they do take them into account in coming up with your plan. The doctor I saw was incredibly knowledgeable.

This is terrible. Sadly you have to push and be your own advocate.

The Migraine Trust has guidance on hrt and migraine. It's all online.
Print it off and take it to your GP.

In a nutshell, you can use hrt,
I've had migraine since I was about 11. I've also been on hrt for a long time (with a brilliant consultant gynaecologist, privately, but I was seeing them anyway before starting hrt.)

The consultant youve seen is talking nonsense. No need to any investigations before a Mirena coil as part of hrt.

You don't need a Mirena coil!
I don't understand why the dr said that.

The only guidance about type of hrt with migraine is it's best to be transdermal estrogen - so gel, patches or spray. and most women now use micronised progesterone as the progesterone part.

You've got 2 options- see another GP and challenge them. They don't HAVE to do what the nhs dr told them. (They both might like to do a course on HRT!!!)

Or you're going to have to pay to see someone privately. There are loads of options there, either gynaecologists at your local private hospitals, private GPs or private consultants who offer video consultations.

You shouldn't have to do this privately- it's a disgrace your GP is so ignorant- but it depends how much of a battle you want.

Thanks everyone. I think I’m going to write to my GP with my thoughts and what I would like to happen next and take it from there.

I’d see a different GP at the practice or even privately if you can muster up the cash
Also my advice.

I have a mirena, had no tests before, gp put it in and trouble free, wasn’t painful either

I have migraines and use patches. I tried for a while without and migraines were worse.

You should print off the advice from the Migraine Trust- it's sound advice.

I had migraines for decades pre menopause but I take hrt as patches and utrogestan. As far as I know only oestrogen tablets are contraindicated for migraines and patches are fine.
There is no reason why you cant take utrogestan/micronised progesterone if you have a history of migraines.

I had a mirena coil and it sent me absolutely crackers!
turns out I have a huge progesterone intolerance. So don’t just automatically go for the mirena. There are other ways of having progesterone…

I had 2 failed attempts to get HRT prescribed by my GP.. The first time he said I couldn't take it because I had {controlled} high blood pressure. A few years later I spoke to someone at a Women's health conference who assured me that simply wasn't true so I went back to my GP. Then he said there was no point in prescribing me HRT because if it wasn't started within a couple of years of menopause then it wouldn't be effective.

I suffered for 8 years with really bad hot flushes (every hour or so during the day, sometimes nearly passing out in shops etc. I ended up taking early retirement from my Senior management job because it was so difficult to manage)

In the end I saw a private GP 2 years ago when I was in my early 60s - I went because I had thrush and discovered I couldn't buy canestan over the counter after the age of 60. Couldn't get an appointment with my GP so I paid to see someone privately to get a prescription. While I was there I had a really bad hot flush. The private GP was horrified that I was living with it and she wrote me a prescription that day. My hot flushes stopped the first day I put on that patch.

Unfortunately i now have to pay for my HRT privately but at about £1/day I figure it's worth it. Makes me mad though that I've had to go through so much.

@99victoria I’ve wondered if I’ll end up going down that route too (although I really can’t afford it). Absolutely appalling.

@99victoria- have you asked if they’ll do a shared care agreement so you can get it in the nhs?

That's crazy. I have really awful chronic migraine on ++ drugs and under a neurologist. I'm also just on very standard HRT-oestrogen gel and Progesterone. My understanding is that the guidelines changed a while ago, the risk of stroke is slightly increased with migraine with aura but nothing like previously thought.