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.

@RunningAllDay Thankyou for taking the trouble to do that. I had a very long bleed in November 2021 I started Mini Pill the previous month

Apart from three breakthrough bleeds last year ..............nothing and nothing this year

In early Oct 21 i was waiting for my period to start so i could start the MP That period never arrived so just had to start taking it

But every woman goes through the menopause, regardless of lifestyle. My GP is one of those who recommends every woman takes HRT, because it is still beneficial in so many other ways. She is a menopause specialist as well as a GP

P.s. Being slightly overweight as you age is actually a good thing for health and longevity.

@Jongleterre I think that's sensible, but unless symptoms are on the mild side, and the woman has obvious factors contributing to her ill health (like being overweight), then these are no match for HRT.

Hrt helped me hugely but I had to push for it as I was 43-44.

18 months later I'm unfortunately one of those women who have hormone positive breast cancer. I don't believe it's been caused by the hrt, I think it's as likely to be having a baby in my 40s and I was very likely to get what I have anyway as it's so common.

I'm passionate about women accessing hrt. However I really do think it must be in conjunction with rest, exercise, diet etc (sugar doesn't cause cancer but it does mess up sugar control and I do think makes meno symptoms worse, including alcohol.)

I'm actually feeling a lot better for dropping the hrt so far. My thinking is clearer somehow?! Though I know I may feel much worse in 3 months! I did start exercising a few months ago, nothing huge, just a lot more walking and early in the morning.

I have to go on hormone blockers (tamoxifen) so the only way I can see to cope is exercise programmes.

I also think sleep is extremely important.

Stress also definitely had a huge impact on my peri symptoms. Although i think antidepressants are not as good as hrt for this, if they help sleep and ease panic that is good.

Some are used by women in my position to help manage meno symptoms such as flashes and sleep issues too alongside the hormone blockers. Tamoxifen apparently helps bones if you're in peri.

(I've also read oestrogen matters - there are a lot of different claims about all this on both sides.)

Personally I just think there should be more screening.

My point in posting (and I'm a regular on fwr just name changed) is that unfortunately I think there's still not quite enough research for a wider discussion about a range of options for women dealing with this.

Not enough understanding, among the general public, certainly.

Not enough info for younger women in order to prepare; I think I would have focused more on strength training from a younger age for example, and maybe not delayed having my children so late (though that wasn't completely my choice!)

I'm going to have to deal with full menopause this year through the drugs, however, I feel more empowered and supported that I did before, I'm going to have to build muscle with zero oestrogen, and I'm a skinny type.

It's a massive feminist issue and I do agree with the OP. As actually, the hormone contraceptives I have avoided all my life would have brought this on more quickly in me. (I'm unlucky)

(Have to say Liz O Riordan who was in this boat after being a breast surgeon has thoroughly inspired me and given me hope! Plus a few friends who are also on the tamoxifen train.)

@Ikeameatballlunch the very best to you .

My story is learning to manage the aftermath of BSO TH - surgical removal of ovaries, fallopian tubes, uterus and cervix, and my GP surgery suddenly pulling my HRT safety net from out under me without consultation with my hospital consultant or me.

It's been one bloody stressful fight after another. I think I'm sorted now (had to go private for a while) but it genuinely gave me and my family the rage for a time! I am also trying to preserve some muscle tone which is hard as I have a arthritis (both sorts), but I tell myself that every little helps. I think I'm lucky that I was very fit and muscular in my 20s and 30s.

Agree OP. I had to push a bit for HRT but it wasn't the struggle that lots of women seem to have. I think it's part of a bigger picture of women's health, bodies, and issues being ignored. Same goes for slow progress in finding good treatments for painful/heavy periods, PMS, PMDD, persistent UTIs, endometriosis... The list goes on. Think of the vaginal mesh and symphesiotomy scandals. I honestly think things would be different if these were conditions affecting men.

I also had to push. And push.

A female GP told me I could only have a patch or pill despite having her finger on the Oestrogel entry in the BNF.

A female gynaecologist told me that older women only wanted HRT to make themselves more attractive to younger men.

WTF? I can only hope both suffer a long and miserable menopause. I'd heard from other women living locally who'd been told the same by the same doctors.

I'm always more disappointed when I hear of women treating other women in this way.

Good luck to all those searching for help during their meno journeys.

Having read the thread what astounds me is how it seems to be complete luck of the draw on whether you get a doctor who will prescribe or not.

Like I said earlier I can't have HRT and yet get it constantly pushed on me. Now that may be because there's a note on my file saying I can't have anti depressants so that's removed as a potential fix or because I've been under the care of a gynacology department for the last thirty years. Or because my GP practice seems to be very female heavy (and all in the memenopausal age range) with regards the doctors in the practice

But I do think those that get a no from their doctors regarding HRT need to get angry. See a different doctor in the practice, complain to the practice manager they aren't listening to their patients etc. Whatever it takes.

I can't see any reason not to prescribe an initial course to women of the right age who ask to try it. of course it may well be because anti depressants are cheaper and always in stock in pharmacies that push the doctors to prescribe. There may be a practice policy to not prescribe certain drugs (I've had that happen in my GP practice which was hard to fight but ultimately they caved) But honestly as a patient that's their problems and not yours.

If you do get a no it may be worth enquiring with your practice what their policies are in prescribing certain medications? Check whether they have a well women's clinic and see if that elicits different results?

What is obvious from reading everyone else's posts is there is no national standard for this, and if there actually is then it's not being followed.

Definitely agree with a lot of what's been said here that access to HRT should be more consistent and reliable across the country and between medical practices.

I do wonder whether access to HRT for menopausal women has been affected by the fear-mongering about HRT for trans people. Gender-affirming treatments for trans folks are often demonised as "unnatural", even though a lot of the procedures are used by cis invididuals as well, often on a larger scale and over a longer period of history (e.g. HRT, mastectomies, puberty blockers etc.). Glorifying the "natural" experience glosses over the fact that for cis women what is "natural" is often far more painful or otherwise unpleasant than necessary. But sadly glossing over the experiences of women has long been a part of medical practice.

Transgender men do not take HRT - they take cross-sex hormones.

Yes. And please don’t refer to me as ‘cis’. It offends me in the context of discussion of female menopause (and hysterectomy) and HRT.

This thread is about the issues faced by females in getting access to to HRT. The dismissive attitudes towards women's symptoms and understanding of their own bodies pre-date anything to do with the modern trans discourse.

Please do not treat this thread and discussion as a 1-2-3 back-to-me opportunity to shoe horn in discussion about trans issues.

@FriendlyNeighbourhoodTrans See above.

@Florissante @AutumnCrow Yep sorry, meant to say "...fear-mongering about hormone treatment for trans people".

@EarthSight I won't post anything else on this thread if that's your wish and I certainly have no intention to move the conversation away from hormone access for menopausal women - was just musing as to whether one form of medical prejudice was feeding into the other. I hope your continued efforts to get the treatment you deserve bear fruit!

Btw I was going to add to the thread that eventually I found that the GP surgery's pharmacy lead was much more sensible to talk to about HRT than my GP or any of the locums. She did my last medication review and we were able to talk in real depth over 30 minutes not 5-7 minutes. She was excellent.

Yep - kudos to all the GPs out there. They have a stressful, high stakes job, but I have found pharmacists and pharmacy leads to be more usefuly and knoedlegebl than GP. Could be that they have more time to think and consider you as a patient.

knowledgeable*

Dear oh dear - the typos!

Also see - I'd like a breast reduction please after lugging these around for 40 odd years, giving me back pain, horrible rashes, problems buying clothes, inability to excercise properly and confidence issues - sure, no problem, that's 10 grand please as we don't do that on the NHS -versus - I'm a teenage girl and last week I decided I must be trans because my best friend at school has changed her pronouns and everyone on tiktok is doing it, sure, let's get you booked in for a free double mastectomy next month after a quick one off consultation at this clinic.

It's insane isn't it.