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Author Topic: doc says I don't need progesterone?  (Read 4345 times)

grumpyjane

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doc says I don't need progesterone?
« on: March 03, 2016, 10:55:05 AM »

Not been on for a while. Was waiting for visit back to UK  and GP.  Have been taking hrt for 3 months - 2 pumps gel, vagifem and utro 200mg vaginally for 12 days a month. This was prescribed abroad, with the help of a lot of personal research. Hot flushes are definitely better, VA improved but not great. Still grumpy, irritable and tearful. (Although now I'm in UK without all the stresses at home this is much better ). Libido still zero, no, less than zero.

so.... finally had gp appointment yesterday as I wanted them to check what i was taking and hopefully recommend something for libido. She said I didn't need progesterone as I'm using gel externally and it wouldn't reach the endometrium so I didn't need to bleed. Excuse my language but WTF??? Is this correct?  :neutral: Everything I've read said you need it. I'm 58, 5 years post meno, everything intact. She suggested ADs, and when i asked about libido said they would definitely help. But now I'm reading the opposite.
 Sometimes i think when we get into those GPs surgeries there must be some brainwashing going on that erodes your self confidence. Or is it that we were brought up to assume the doctor is always right? She prescribed Fluoxetine, but I'm not at all sure..
Jane
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Hurdity

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Re: doc says I don't need progesterone?
« Reply #1 on: March 03, 2016, 11:16:15 AM »

Your doc is talking absolute rubbish! Of course you need progesterone and yes of course oestrogel is absorbed systemically. Sounds like she is getting confused! Vagifem needs no progestogen. Oh dear this is a very fundamental mistake. Is this a UK GP? You should complain because she could put other patients at risk.

Form what I've read reduced libido is a side effect of ADs thought can't say specifically about Fluoxetine. The HRT that is good for libido is the tablet Livial - but also Testosterone gel should help but you would need to go to a private consultant to get this prescribed.


Hurdity x
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grumpyjane

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Re: doc says I don't need progesterone?
« Reply #2 on: March 03, 2016, 11:28:44 AM »

Yes Hurdity, a UK GP. A young woman maybe 30. I feel like I totally wasted my time yesterday . I think I'll look at and maybe print the NICE guidelines and make another appointment. Grrrr  :hotflash:
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Annies

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Re: doc says I don't need progesterone?
« Reply #3 on: March 04, 2016, 02:18:46 PM »

Jane  I can't comment on any of the hormonal issues as only just about to (probably) embark on hrt myself but just thought I'd mention that I've been on fluoxetine a couple of times, mostly during my 20s, and found that it did make (ok I'm blushing slightly) it more difficult to have an orgasm but it did help to increase my inclination to actuslly do the deed-presumably given the positive serotonin & mood effect it had. Now peri and in my 40s however I too am in the same boat - b. all sex drive😕!
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dogdoc

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Re: doc says I don't need progesterone?
« Reply #4 on: March 04, 2016, 03:05:18 PM »

Your GP is not even remotely on the ball with regard to hormones or antidepressants. She's putting women at risk for CANCER giving this advice. You should contact her surgery to tell them so as well and find another GP.

Your gel is absolutely absorbed systemically...more efficiently in fact than taking it orally.

Antidepressants are absolutely terrible for sex drive. They absolutely do cause reduced sex drive, weight gain and reduced ability to orgasm. Maybe she thinks being less tearful might help with the libido ( but I highly doubt it).

Hurdity is right...estrogen may help with libido, but if you're already on it, then it's testosterone or DHEA.

Tara
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Trufflecat

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Re: doc says I don't need progesterone?
« Reply #5 on: March 04, 2016, 03:42:21 PM »

Would you contact the practice manager? You have the NICE guidelines to back you up. What she suggested is very risky and I hope she hasn't applied it to any other women
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grumpyjane

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Re: doc says I don't need progesterone?
« Reply #6 on: March 04, 2016, 05:13:09 PM »

I rang today to speak to the practice manager but she wasn't there. I've emailed her and asked that she rings me on Monday. Also that I want to speak to another DOCTOR about it, not just her. I was wondering today if the GP I saw misunderstood and thought I was putting the gel on my bits, but surely not.  :o I showed her what I was using and she recognised it.

Tara, what's DHEA? And thanks to you and Annies for your experience with ADs. I have never found it easy to orgasm so they're definitely not for me! I gather testosterone needs to be prescribed by a gynaecologist?

I've been on hrt 3 months now, so maybe I need to give it a bit longer to work properly.
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Trufflecat

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Re: doc says I don't need progesterone?
« Reply #7 on: March 04, 2016, 05:17:22 PM »

I am smiling at the thought of you slapping the gel on your ladybits 😀
Good luck seeing another doctor.
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CLKD

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Re: doc says I don't need progesterone?
« Reply #8 on: March 04, 2016, 05:18:21 PM »

I would go back to this GP and say "I think we're at cross purposes about …… and this is what the advice is from MM Forum/Pharmacist/Gynae Consultant.  Give the girl the chance! Maybe arrange an appt. with both the GP and the Practice Manager, Practice Nurse?  It's a Mine Field and this GP needs to know the correct procedures  ::). The Manager needs to be aware that this GP is giving poor/incorrect advice so a meeting would be beneficial for all concerned.

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Sunnydays

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Re: doc says I don't need progesterone?
« Reply #9 on: March 04, 2016, 05:25:49 PM »

Grumpyjane just to say that I have had only one 12 day course of Utrogestan and it completely annialated my libido! And for about 7/10 after.  Maybe this is why some ladies take testosterone with it. I have also heard that the Tibolone (livial) hrt is good for libido
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grumpyjane

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Re: doc says I don't need progesterone?
« Reply #10 on: March 04, 2016, 05:32:11 PM »

Well no, I don't want her struck off! But she needs to get up to date. I asked her specifically if ADs , specifically Fluoxetine (Prozac) would increase my sex drive and she said yes. Also, are you sure I don't need progesterone? No, it wont get to your endometrium. *sigh*
Well, let's see what happens on Monday. I may not have time for a face to face meeting as I'm only here another 2 weeks. And of course there are no appointments available now until the end of March! Ha ha
Jx
ps. Going to investigate Livial...
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grumpyjane

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Re: doc says I don't need progesterone?
« Reply #11 on: March 04, 2016, 05:33:54 PM »

By "it" I mean the oestrogen..
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blossom60

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Re: doc says I don't need progesterone?
« Reply #12 on: March 05, 2016, 01:39:35 PM »

To be honest Rockhopper, they always list possible side effects on patient information sheets.

I've been prescribed fluoxetine twice, and have not suffered any of the side effects you listed. 
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Cassie

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Re: doc says I don't need progesterone?
« Reply #13 on: March 05, 2016, 03:28:37 PM »

Yr GP needs a wake up call, how shocking that one in her position can be so clueless....even us laypeople know how the hormones work and that they are absorbed systemically....quite scary actually.... >:(
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dogdoc

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Re: doc says I don't need progesterone?
« Reply #14 on: March 05, 2016, 04:48:45 PM »

Grumpyjane

DHEA is produced in your adrenal glands throughout your life. It is a precursor only ( it has not direct actions itself), but is converted to both testosterone and estrogen, although taking DHEA as a supplement seems to favour increased production of testosterone over estrogen, and can results in side effects similar to testosterone particularly if you're not low. Many women have a relative high level of testosterone to estrogen at this point of life ( chin hairs anyone) although overall levels of testosterone and DHEA are lower and lower as you age.

There is also some research going on with regard to DHEA as a vaginal suppository for VA/dryness/sensation and libido.

It's interesting.
Tara
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