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[Sarah2]

I can't see anything on that link which says anything negative per se about HRT over 60- only that the WHI trials etc included some older women who started HRT at an older age ( and they were generally overweight, had high BP and many had already had heart attacks. )

Based on the WHI study, which is what that link is about, his conclusion is that HRT is safe for younger women - but the adverse effects found in those aged 70 were probably due to their poor health and the use of conjugated oestrogen etc etc.

Also you can't go along with what just 1 consultant says. Studd's comments on his website are not perhaps what will happen with his own patients- his writing on his site is very general and 'academic'. He's not the only gynae who knows about menopause and not all consultants agree or work in the same way.
For example, he also advises mammograms every 12 months. My dr advises more frequently than the NHS ( every 18-24 months) but not every 12 months!

[CLKD]

What many people don't realise is that even when they pay to see a Private Consultant, he is likely to employed by the NHS in the same speciality.  If he/she chooses to work privately along-side the NHS, they can only be part-time in the NHS.

Unless we jump up and down before we require treatment by the time we are run down with symptoms we won't have the umph to press our case.  I have never discussed age with my GP - he knows how old I am and we have a good 'working' relationship - so far.  Pity GPs don't run meno clinics on a regular basis for open discussion!

I can't understand why, unless someone has been diagnosed with oestrogen dominant breast disease, that they need to undergo annual mammograms?  I had these yearly after I had undergone surgery ……… but have lapsed now …….. I go when the NHS calls me.

[Sarah2]

Not all consultants work in the NHS- mine doesn't except for a tiny percentage of the time.

The reason Studd will suggest more frequent mammos is because of the slightly higher risk of b cancer when on HRT. Not saying I agree with that, but that's why he will have it on his website.

[Ju Ju]

With the support of my GP, I have sought the help of a private gynaecologist as I have very low levels of oestrogen and testosterone. So I have started HRT at age 60. I have weighed up the risks as far as I can and have decided quality of life far outweighs quantity of life. I have had years of very low energy and libido ( what's that?) The gynaecologist says the risks are minimal and that I can take it for the rest of my life. I get the HRT via prescription from my GP. The testosterone is not available on the NHS and I have had to sign a disclaimer as it is not licensed for women in this country. I have not started testosterone therapy yet. If I ever have difficulty in getting NHS prescriptions for HRT I will be able get a private prescription. Not too expensive, though testosterone is approximately £ 50 for 2 months. I have had the energy to do more, eat a better diet and exercise. We are responsible for our own well being, though this difficult when you feel as I used to.

[coolatlast]

Private medicine is cashing in on the budget and drug restrictions - we have to put a certain amount aside  for my private consultant (another health problem) who currently charges £180 per half hour and I need to see him every 6 months.
Those of you who have had to go and see Dr Studd will have paid upwards of £300 I think? And I found out to my cost that private insurers (OH has one through work) won't pay for anything they deem chronic ie more than 6 treatments. And definitely nothing to do with "menopause".

I think those fees are very high. I don't know what Studd's fees are but clearly there is a range.   (It's not a case of private medicine cashing in- there has always been the option to have private treatment for anything.)

I see a very good consultant in Harley St and his fees are less than you pay your consultant.

You will sometimes find that drs have 2 rates (speaking generally not personally) one if you self-fund and another if it's paid by insurers. Bit the same as garages with cars!

Private insurance will pay for menopause symptoms - but clearly not if you say you are having flushes or sweats etc!
A close friend of mine has had her consultations paid for  by insurance because the consultation was for 'heavy and painful periods' ( not menopause, though that turned out to be the cause along with a fibroid) but insurers will not pay once it becomes 'routine' and they like a resolution of the condition. They paid for my initial scans for various things but once they become routine ( if ever) they start to draw the line.

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I suspect it would cost too much if we were to stay on it too long after the age of 60.   
These things usually boil down to cost (often cleverly disguised and hidden beneath layers of concern for our health. )

[Dandelion]

This is a very controversial view, but maybe, they are trying to bring the population down.
They are always going on about how there are going to be so many OAP's and how they haven't got the resources top cope with them...

[Sarah2]

cool- which bit of that quote are you referring to?

I don't understand your point.

Insurers won't pay for any condition long term.
They won't pay for HRT consultations anyway unless HRT is being given as part of a bigger picture of health, or another condition of some kind.
I pay for my own appts every 6 months. Insurance won't pay for drugs for any condition, if you are an outpatient.

[coolatlast]

Sarah, I think I quoted the wrong bit! 

I was just trying to say, that I think a lot of the reluctance to keep women on HRT over the age of 60 - (NHS especially), has to do with keeping costs down.

They don't mind treating us for X amount of years, but don't want to treat us indefinitely!

[coolatlast]

Dandelion, that's quite funny!
(get rid of all us old gits - that would solve their problem lol)

[Sarah2]

I can't see how it's got anything to do with cost- 1:3 women has osteoporosis- many more die from it than breast cancer. HRT would prevent a huge number of fractures and admissions to hospital.

No the reason it's sometimes hard to get it is because most GPs have not moved out of the time warp they are still in, when they read the WHI trials and decided HRT was a Bad Thing.

Money is not a factor is you see a dr privately because you pay for your own HRT.

[Dandelion]

Dandelion, that's quite funny!
(get rid of all us old gits - that would solve their problem lol)

I think it's something that is worth looking at.
I think the welfare reforms are also another thing that has possibly been put in place to bring down the number of 'useless eaters', what with all this hate propeganda in the media convincing us that benefit claimants are all scroungers.
Bill Gates was talking about it in some video I once watched.

Also, it's a good job we have the NHS in our country, what with insurers refusing to pay for long term treatment and outpatients, because if it was all private, people with long term conditions or outpatients who cannot afford private health care would be stuffed.

Having said that, maybe we will end up being all private in the UK as the government is doing a grand job of dismantling the NHS.

Also, maybe NHS cut backs are the reason why our doctors fob us off when we consult with them about illnesses/problems, and maybe this is why they usher us out of the consultation only after a few minutes, cutting the consultation short before we have finished what we want to say.

[CLKD]

HRT is not for an illness which is why PP don't pay - mental health issues don't get much cover by Companies either  ……. however:  Sarah2 - you're private consultant unless full time in Harley Street will be working in the NHS  …. one of the Consultants I worked for used his off duty time to run a small holding  ……… his wife dabbled in antiques and they had a great life-style.

Because lots of private consultants use NHS services, i.e. nursing staff, lab/physio facilities ……….. or have rooms in private hospitals.  However, what I didn't realise was that when in a private hospital, there isn't emergency cover in the same way as when in an NHS hospital 

GPs now manage their own funding so have to justify costs to the Government  ………. one can book a double appt if we think that we need more than the regular 10 mins..

[Sarah2]

Sorry CLKD- that's not the reason why HRT isn't covered. They cover for illness - acute conditions.
That's not the same as 'HRT is not for an illness'. You may be given HRT as part of treatment ie for osteoporosis as an example. They don't pay for menopause treatment, once diagnosed as menopause.

[Dandelion]

If insurers will hardly cover anything, it makes me wonder why people take out private insurance, other than to avoid waiting lists.
I know some americans who end up bankrupt because of unpaid health costs, costs that are so high, they can make people homeless and penniless, literally.
I don't think I want the NHS to be privatised, more social cleansing, get rid of the poor people, as well as the old.

[tiger74]

Everyone has the choice about whether to let her/himself be "bossed about" by any medical staff.

I don't let it happen to me, even in my absolutely grottiest moments when undergoing chemo I still engaged in the system, asked plenty of questions, considered options, acted on recommendations and challenged the doctors if I wanted more information or felt that there were other options. 

If patients opt to take another approach that's their choice.