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[Freckles]

Petra and DedivaAnn
Do search and also check out posts on here  and read other internet forums.
Knowledge is power- and at least you can make an informed decision on what treatment options are offered to you, what is more effective and safer, what may be better than you are currently receiving as meds, etc. 
I was pretty clueless back in March  this year and this forum and the helpful posts from some  posters was incredibly helpful.
I had spent a few hours researching treatment options in the UK for HRT and as my GP was so unhelpful, eventually decided to see Professor Studd as he seemed the best option due to his considerable clinical experience. Ironically I found that tough to do, as I was so low in mood I struggled to be motivated to do anything,  despite being on oral HRT at the time!

As I said, I couldn't really afford it but figured that it if helped me feeling so awful, it would be worth it.
It was and it has been. Best £300 I have ever spent.

Sounds bit dramatic I know, but his treatment regime has changed my life. It's only looking back I realise how rubbish I felt, getting worse slowly over a period of a few years. 
I am a devotee of the gel treatments for daily  Oestrogel, Testim, and the short term treatment for Utrogestan (progesterone) especially. It's safer, more effective and does help re future problems such as heart problems, osteoporosis
I do realise some other women get on fine with oral (tablet) forms of HRT.I didn't at all. 
I just don't agree with the "one size fits all" approach of the NHS, whether from GP's or NHS Menopause Clinics, as evidenced by bad experiences from so many posters on MM. 
I think they often do more harm than good, prescribing inappropriate treatment that make many women feel so awful that they then give up and then suffer for years.
That shouldn't be the case.
Sorry, on a roll here!
I don't think any GP (or other medical doctor) is omnipotent.
It's about taking control of your life and your hormonal symptoms by getting appropriate diagnosis and treatment.
If you feel you have crap service from your GP, then reading up on all  the information, then thinking about getting more informed advice and treatment from an appropriate specialist would be sensible?

Life is truly too short, too uncertain and certainly not worth the last third of it spending it as an extra in a B rated version of the  "Twilight Zone" feeling an anxious, depressed, sexually numb zombie as I was feeling, with inadequate health care.
Sorry for the long post and rant but I feel so strongly about women's hormonal issues being generally mistreated, diminished, and/or disregarded.
Good luck and let us all know how you get on? xx

[Greenfields]

So good to read the comments on here as when the news came out I went "oh no!"  The thing that struck me is how few alternatives are offered for severe menopausal symptoms ... for e.g. I've found acupuncture helpful but I've yet to see it publicly funded!  Until more alternatives are offered, then unless a woman finds other things that work to reduce the symptoms to a manageable level (and can afford them - which is a whole other social justice issue), HRT is, in the interim, the most helpful and effective thing. As someone else said, it's quality of life that matters too. I couldn't function properly before I was put on it and while things have been a bit rocky the last 6 months (I actually had a breast lump in May this year - fortunately non-malignant), I've not regretted going on it.  I found it very hard to function with clinical depression and as a single person responsible for supporting myself, HRT enables me to function and live life.  At some point we're all going to die ... it's just the manner in which we will go that varies.  Personally I would rather have my mental health intact over the possibility of some physical ailment that may kill me in the future.   

[Maryjane]

As Freckles says , if necessary use a credit card to see Studd or whoever privately we shouldn't have to but ??

I saw Dr Annie Evans who has now retired , and will now be seeing Nick Panay in November all on Credit card.

Feels like I have done my " bit" raised three children, all pay there taxes etc and I have been sent to the back of the cave and ignored by the medical profession.

If I was overweight , with diabetes etc there would be far more help.

Need to put in my next three month scrip of HRT next week , see if it gets a response . I have three months extra that I bought privately , in case there was ever an issue and I would be left without anything .

Thank you Dr Currie and all the other informed posts , to help those ( me ) who felt like rolling over and giving up what I saw this on the news yesterday.

[Liz]

This news worried me yesterday, I must admit.  Currently on Oestrogel and Utrogestan days 15-26 per month which I take orally.  Would it be worth trying the Utrogestan vaginally instead?  Would this lead to a lesser risk, I wonder?  Frankly, I've considered giving up on HRT many times because of the Progesterone phase....... makes me feel sedated and miserable when I'm taking it.  Just a bit concerned as I do suffer with thrush, so using it vaginally could set that off.........

[Hurdity]

While this study reported today is good for an observational study, it is still an observational study and hence has biases. The overall information does not tell us anything new and nothing that was not included in the NICE guideline.
Some important points to consider:
1. The associated risk returned back to baseline within 1 to 2 years after stopping HRT, confirming the view that HRT does not CAUSE breast cancer, but that it may promote the growth of cancer cells which are already present in some women--it can act as a promoter, not an initiator. This is a really important message since many women fear that HRT causes breast cancer.
2. The NICE guideline did in fact take into account the fact that previous observational studies may have underestimated the risk so NICE recommendations are still very relevant.
3. There is evidence that different progestogens may be associated with a different risk, types increasingly used today were not the main types used in this study.
4. While trebling of risk sounds very alarming, the actual figures are still very small and for many women, the benefits will continue to outweigh the risks.
5. Statement from British Menopause Society and Royal College of Obstetricians and Gynaecologists will be placed in our news section later today.
I hope this is helpful.
In summary, no major changes in advice or recommendations.
Best wishes
Heather

Thanks so much Dr Currie for taking the time personally to let us know your comments on the recent study and confirming that Guidelines on HRT remain unchanged as a consequence.

Hurdity

[Hurdity]

I've read this study and it seems rather full of holes. The main one being that it talks of RELATIVE risk rather than absolute risk. If someone is better at statistics they may be able to calculate this for me as I am rubbish at stats.
I was also surprised that there was quite a few older women in the study.
The study also spoke of its limitations which should also have been taken more into account
They also seemed to have a high use of oral hormones rather than transdermal etc. The study was based on self-reporting by use of questionnaires so they could also have encountered bias there - if someone's drinking a couple of bottles of wine a night they are quite unlikely to state that on a questionnaire for example.

But I think the most important thing is that we have to remember that this is relative not absolute risk.

Here's a link to the study if anyone would like to see it

http://www.nature.com/bjc/journal/vaop/ncurrent/full/bjc2016231a.html

Personally I feel it is a case of the usual problem of journalists getting hold of a study and not having a clue what to do with what it really says.

Hope that helps!

Thanks for posting this link. I was in a hurry yesterday and going out again today - thought I read that it wasn't published yet so didn't look for it, assuming the press info came from a press release in advance of the date being published!

Here also is the link to the BMS/RCOG response:

https://thebms.org.uk/2016/08/bmsrcog-response-breast-cancer-now-generations-study-hrt-use-breast-cancer-risk/

From what I recall from a quick glance at the study, the combined HRT mainly used by the women were the Premique types and Elleste/Klio types - all containing norethisterone, Provera etc and the synthetic progestogens. As Dr Currie says different HRT types are used increasingly today and the study says nothing about the risk associated with progesterone itself. Therefore it does not confirm that progesterone itself is dangerous (or increases risk of BC) - and as I think I mentioned in my post yesterday morning there are studies showing no risk of breast cancer associated with progesterone itself (note to self - find these studies at some point - but v busy atm - maybe  someone else can do so?) - which has been described as "breast friendly".

Freckles you make some helpful comments, and so glad you have found an HRT to suit you, but you turn every discussion about HRT into a call for members to visit Prof Studd, and to promote the 7 day progesterone regime (not to mention travel costs). This isn't really relevant to the thread and I really hate to think of women feeling inadequate or that they have failed or causing themselves risk if they cannot afford this expensive consultation!!! it is not necessary (to see him to get that HRT)!!!!

I think we all need to get some perspective and carry on making the decision we need to make based on our circumstances, age and stage. Personally I would not use synthetic progestogens because I have been on HRT for more than 9 years and in my 60's, but someone in their 40's who wants to take HRT say for 5 years should not worry one jot. It is sensible if you have been taking it some time and over 60 perhaps to review what type you are using and weigh up the risks if any.

And of course if we need to - lose weight, stop smoking, reduce alcohol, take more exercise, eat a healthy diet - to minimise these risks to health/reduce risk of cancer, but continue with HRT if it enables us to function in today''s society! Off out now!!!

Hurdity x

[zelda]

Thank You Dr Currie its exactly what I was hoping to hear.

[Dancinggirl]

Thank you Dr Currie - so helpful to have a clear and balanced view on all this. 

Thank you again Hurdity - all your info and thoughts are so helpful.

What a terrible shame that, yet again, women will continue to suffer - many women in meno have health anxiety anyway and this latest study is really not helpful.  I also think the BBC together other news and media outlets have reported this irresponsibly - does no inspire us to trust anything else they report.

DG xxx

[Dediva Ann]

Hey Freckles Really loved your last long post - not ranty at all! Thanks Maryjane  too. I feel that 2016 has been a write off in every possible way for me and felt this was the shape of things to come.  I too was reading everything on here back in March and keen to see Prof Studd back then but when I phoned was told first consultation was X, follow up was Y and tests were Z etc and it all amounted to around £2000 and was definitively financially prohibitive big money for me. I lost heart and every day since has been a muddled depressing write off with me feeling like I've aged 20 years in six months.   I could defo muster up £300 though if the rest could be dealt with by NHS. Having reluctantly popped another Femoston 2mg I emailed lady GP this morning. Turns out she is on holiday.  Am just waiting for another GP to call. She's new so this could be the best or worst thing.  Will see how the call goes and then make contact with Prof Studd if there is no willingness to think outside the box. Thanks so much for your advice, moral support and inspiration via sharing your own story. So pleased things are far improved for you.   Will let you know how I get on xxx

[Dediva Ann]

Just spoken to the very rushed and unsympathetic new lady GP.  She was INSISTENT that it is oestrogen that causes increased breast cancer risk and not progesterone.  My understanding is that if we still have a womb we have to take progesterone to protect against endometrial cancer but that progesterone is not the reason for increased breast cancer risk.  I need a medical link I can refer her to if I am right.

She said the only alternative for me if I couldn't tolerate oral HRT (which she seemed doubtful of) was a coil with progesterone.  I said I felt the issue for me was synthetic progesterones and I wanted something more bio-identical. She said she had never heard of Utrogestan but I asked her to look it up.  She then reluctantly conceded (felt like I had to bully her as she kept trying to get off the phone) to prescribe Oestrogel and Utrogestan but she has to clear this with another GP who is in charge of costs (the same GP who refused me Testem.) I then asked her about Testen and she said the more hormones I introduced to my body the more risks.  I quote Freckles on the low risk versus significant benefit with Testem.  She then conceded I could have a blood test for my Testosterone level. 

I need to go and collect the blood test form and go to the hospital phlebotomists.  Am not sure what else (if anything) she may have included. I wonder if I should be asking for other tests so that I could use this info to potentially take to Prof Studd?

I have been so dangerously depressed and anxious this year, I have a long history of not getting on with antidepressants and mood stabilisers (including in hospital, have ECT too.) Aside from the standard oral HRT options the only thing my (male) GP was prepared to offer me was occasional use of steroids to give me a boost (and because I sometimes seem to have an autoimmune response to sex.) Without this forum and especially this post I would have just shut up and put up and am starting to feel really angry that whilst feeling very unwell I have to fight and make a fuss about something that could really give me a chance of a better quality of life. 

[Freckles]

DeDiva Ann
I'd ask for your blood tests to include oestrogen, progesterone, testosterone and FSH (follicle stimulating hormone) levels and a T4 for your thyroid, to rule out an underactive thyroid, which can cause depression.
Check out Studd's web site for an article on what he calls "reproductive depression" and how this is often wrongly diagnosed and treated with AD's, rather than hormone treatment.
Your GP sounds a nightmare!

[Vanessa1]

I've read this study and it seems rather full of holes. The main one being that it talks of RELATIVE risk rather than absolute risk. If someone is better at statistics they may be able to calculate this for me as I am rubbish at stats.
I was also surprised that there was quite a few older women in the study.
The study also spoke of its limitations which should also have been taken more into account
They also seemed to have a high use of oral hormones rather than transdermal etc. The study was based on self-reporting by use of questionnaires so they could also have encountered bias there - if someone's drinking a couple of bottles of wine a night they are quite unlikely to state that on a questionnaire for example.

But I think the most important thing is that we have to remember that this is relative not absolute risk.

Here's a link to the study if anyone would like to see it

http://www.nature.com/bjc/journal/vaop/ncurrent/full/bjc2016231a.html

Personally I feel it is a case of the usual problem of journalists getting hold of a study and not having a clue what to do with what it really says.

Hope that helps!

Thanks for posting this link. I was in a hurry yesterday and going out again today - thought I read that it wasn't published yet so didn't look for it, assuming the press info came from a press release in advance of the date being published!

Here also is the link to the BMS/RCOG response:

https://thebms.org.uk/2016/08/bmsrcog-response-breast-cancer-now-generations-study-hrt-use-breast-cancer-risk/

From what I recall from a quick glance at the study, the combined HRT mainly used by the women were the Premique types and Elleste/Klio types - all containing norethisterone, Provera etc and the synthetic progestogens. As Dr Currie says different HRT types are used increasingly today and the study says nothing about the risk associated with progesterone itself. Therefore it does not confirm that progesterone itself is dangerous (or increases risk of BC) - and as I think I mentioned in my post yesterday morning there are studies showing no risk of breast cancer associated with progesterone itself (note to self - find these studies at some point - but v busy atm - maybe  someone else can do so?) - which has been described as "breast friendly".

Freckles you make some helpful comments, and so glad you have found an HRT to suit you, but you turn every discussion about HRT into a call for members to visit Prof Studd, and to promote the 7 day progesterone regime (not to mention travel costs). This isn't really relevant to the thread and I really hate to think of women feeling inadequate or that they have failed or causing themselves risk if they cannot afford this expensive consultation!!! it is not necessary (to see him to get that HRT)!!!!

I think we all need to get some perspective and carry on making the decision we need to make based on our circumstances, age and stage. Personally I would not use synthetic progestogens because I have been on HRT for more than 9 years and in my 60's, but someone in their 40's who wants to take HRT say for 5 years should not worry one jot. It is sensible if you have been taking it some time and over 60 perhaps to review what type you are using and weigh up the risks if any.

And of course if we need to - lose weight, stop smoking, reduce alcohol, take more exercise, eat a healthy diet - to minimise these risks to health/reduce risk of cancer, but continue with HRT if it enables us to function in today''s society! Off out now!!!

Hurdity x

Well said Hurdity the voice of reason!

I'm sick to death of hearing about Prof Studd's regime and every post being turned on its head to promote it.

We're all different and we're all vulnerable and we don't have to spend money/credit on seeing him.

So frustrating, it's putting me off coming on to this forum.  If it wasn't for Hurdity and quite a few other balanced views I wouldn't bother!

[Nina]

Hear hear

[Maryjane]

For some of us myself included . I had no choice but to go private , I have / had severe VA .

Various " experts " I have seen wanted to do pudendal  nerve blocks / nerve blocks INTO my vagina / nerve blocks into my vestibule / Botox into my bladder. Potent steroid cream. A concoction of various drugs , with serious potential side effects.

I start d the potent steroid cream , at a time when I did as was told oh dear why a BIG mistake , I was told I had LS lichen Scerlosise.

My NHS gynae said you will want to be on HRT for a few months !!!!! a few months VA is for life.

I still see on here ladies being given short change, so yes it's good to be told there is help out there , if you are getting nowhere and where as desperate as I was.


So I then started researching ( at this point I was now suicidal ) I am 80% better it is VA. I kept saying to the experts is this VA , no your to young still having periods etc etc etc.

So yes the credit card has been my best friend , because unfortunately some of us do have to go private , and by passing on hat knowledge it may help someone else to not go through what I have , it wasn't just me but my husband / children also.


If a post " irritates" then look the other way.

[Dediva Ann]

Can I just say that further to Freckles support (which backed up what several other members said to me many months ago) I called Prof Studd's secretary again.  She was absolutely lovely and encouraged me to keep pestering my doctor until I found a regime that was right for me and that this was my right. So for now this is what I am going to do.  She helped empower me in the same way ladies on here have.

Hopefully there is room for us all on here with our multiple menopause experiences.  I tend to most tune in to those who are having similar experiences to me and some of these women have had a lot of success with Prof Studd and it's really good to know he is there along with a myriad of other options I am learning about via this site.