You want HRT? Not so fast! You want the pill? Here you go!

[EarthSight]

Just a rant really.

I have challenged about 2 GPs and 2 gynaecologists with the following long question (which I may create a separate post about) -

Why is is that every day in this country, women are freely provided with the contraceptive pill? It's not difficult to get and it is often suggested for a variety of ailments by GPs. The hormones they are prescribed are synthetic versions that are not risk free to take. They also completely stop ovulation. This includes prescriptions to teenage girls who haven't even stopped growing yet. There could be a brief chat about it, but unless you have a serious condition, it will be treated as no big deal.

Yet, women who are adamant that they are in peri-menopause, or even in menopause are treated as if they have asked for radioactive material when they ask to try HRT. Like the pill, HRT is also hormones . However, you can get regulated bio-identical hormones which are a closer match or identical to a woman's own hormones (unlike the contraceptive stuff). HRT is used in many cases to simply top-up a woman's existing hormones, not completely replace them and stop ovulation all together as in the pill.

You know what? All of them got a bit flustered when I asked them that and could not give me a decent answer. I was like they didn't like that I had asked.

The reason is likely because the government wants to stop unwanted pregnancy, which is related to women's wellbeing of course, but has more to do with economics and savings to the public purse.

HRT......well......no one seems to really give a fuck about older women, who apparently have lost their minds when they too ask for hormones.

I understand that some GPs are reluctant to prescribe because of some studies (some of them are worth looking into) linking HRT to increased risks of breast cancer.....but, the pill apparently lowers the risk of some cancers but raises others and things like deep vein thrombosis, and GPs seem only too pleased to recommend the pill as treatment for everything from acne to migraines.

I think the only reason doctors are hesitant is that they know it can be hard to get hold of. None of the women I know have had any problems with being prescribed hrt.

If only.

@EarthSight It appears to be a sods law thing. You want it and can't get it.

I don't want it because I can't have hrt due to another issue and so every doctor and consultant tries to prescribe it to me!

Well no, its true.

I fully appreciate others might have more difficulty but certainly me and my friends have not.

I also do not think the pill is easily available because the government don't want women to.have babies. In fact, do a little research and tou will find that the government actually wants MORE babies (they just don't want to help pay for these babies. Typical Tories).

Agree OP. The fight I had to have to get HRT was maddening and utterly illogical.

And now the menopause certificate to get them for a year for not very much

I'll point out that I'd been offered the coil far too many times.

Because women's holistic health is of no interest to society. Controlling women's fertility is.

I’ve wondered about this too given that the pill is far more ‘dangerous’ than HRT and you can just get the pill from the pharmacy now. And then I wonder, well what’s in it for men in these 2 scenarios?

With the former they can have sex freely with otherwise fertile women without the risk of having to pay for offspring whilst also enjoying maximum sensation. And with HRT, what’s in it for men?

Add me to the list of women who struggled to get hrt. My GPs attempted solution was anti-depressants, which are another thing they seem happy to hand out like candies, despite being far from complication free themselves.

Anti depressants, yes. My consultant says lots of women are prescribed them in peri if they present with mood issues when they should be prescribed HRT for hormone issues.

Ironically, due to progesterone shortages and supply issues I’ve been prescribed the pill as a backup.

Totally agree.

I think it's a bit too easy to get the pill tbh.

I was also offered anti depressants when I went looking for hrt. I said "why? I'm not depressed"
I was doubly cross as gp in question is a woman (albeit younger) so I expected her to know better. I got the hrt after a barrage of blood tests.

I have had no trouble being prescribed HRT. But my friend was only given it after she said her lack of libido was making her husband dissatisfied with their sex life and it was undermining their marriage.

Have not tried to get HRT (yet) but whenever I had contact with GP or specialists for gynaecological problems the Mirena coil was presented as the solution to all problems.
Never mind investigating properly, just take the coil.

I agree with this and am super suspicious of the unpublished side effects of the pill.

I think 'evening out' your natural menstrual cycle has significant impact on your behaviour as a woman, right down to the men you attract!

It’s the allopathic education of doctors coupled with the misogynistic nature of medical gaslighting.

Young women with any menstrual/hormonal issues = contraceptive pill to mask all the symptoms instead of treating holistically.

Older women = menopause is a “natural” process and doesn’t need to be medicated.

This is what they learn! Remember that doctors are diagnosticians that must match a diagnosis to the right pharmaceutical product.

Aaaaannd then there's oestrogen positive breast cancer!!! :-/

To be fair, the Mirena does do a fabulous job for many women. And I speak as one who should have listened to advice and had one at least a decade before I went ahead.

Just to counter this the HCP couldn’t have been faster to prescribe HRT

Over the phone, hardly any questions

GPs are not automatically trained in menopause. It's an elective extra, optional which amazes me.

The NICE pathway dictates they have to ask if you want antidepressant's according to my lovely GP who sighed when she asked if I want them because she was obliged to.

But I have had no issues getting it prescribed and actually I went back and asked after 9months how do you know it's an effective dose. My GP did a blood test and said my testosterone was on the floor so got referred to the clinic for that too.

Yea you have to be a bit pushy, you definitely shouldn't have to.

I had the complete opposite. I was forever being told to "give it a try" when ever I declined it.

OP I asked for HRT for years (and was offered ADs) before I spoke (about something unrelated) to a locum who couldn't understand why I hadn't been helped and referred me.

Afaik the only way you can get a scrip for testosterone on the NHS is to say your libido is suffering.

When they ask about bleeding during/after sex and I say I don't have penetrative sex, they're also flustered by that.

Yes, "whats in it for men".

Ooof....IUDs and coils are so invasive. Definitely not risk free either.

Testosterone tests are not as reliable as tests for other hormones. I understand why they use them to bolster their reasons for prescribing, and in your case it was a strong indicator that prescribing was a good idea, but I take issue with blood tests being used to deny women HRT when they are experiencing classic symptoms.

For example, one woman's testosterone levels could be 1.5 (I think is might be measured n/mol but could be wrong). Now that's a respectable testosterone result, but if the woman's body is used to having 2.5, and that it makes a certain amount of estrogen out of that, then it would make sense that she starts having symptoms if she experiences a drop that big, despite being within normal range. Yes, national averages are important, but women are not routineyly tested to establish what is normal for them

This is another thing I challenged them on -

My estrogen is within the bottom of what normal range is, but still within normal range and it means they can't easily precribe me estrogen at my current level (apparently).

However, I've read a number of NHS prescribing guidelines for different hospitals which state that if a woman presenting menopausal typical symptoms, they can prescribe the woman estrogen to my current level, or exceed my current level that until those symptoms cease.

Now that that means, is that the NHS has established some sort of base line with which to measure when a woman can expect to experience symptoms due to low estrogen. I am actually just under that baseline.

Why then, if I am under that base line, was I not allowed even to trial a teeny tiny amount by my GP (mainly because of my younger age), when NHS guidelines are telling GPs they can prescribe estrogen until a woman even exceeds my level of estrogen?? They actually specify an estrogen level that is higher than mine as the minimum optimum level they should aim for to begin with to try and stop symptoms. So if I come to the GP and my estogen is below that minimum level, then should it not be obvious that if some of my symptoms are typical peri, that the cause of this are those lower estrogen levels, and that at least trailing estrogen HRT might be good idea???