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[Nitchb]

Hi,
I'm after some advice please.....

I had IVF drugs at 35 years old which unfortunately came with a side effect of an early menopause. Extreme symptoms within a few months -  so bad that I was fainting at work with tiredness. I went to see my GP who immediately put me on Elleste duet (I think it was 2mg). It was immediately brilliant and I was happily on this for about 14 years.

About 3 and half years ago my blood pressure reading at my HRT 6 monthly review was slightly high - so they wanted to take me off the HRT. However my blood pressure reading at home was always okay. I couldn't convince GP that I didn't have a blood pressure problem but had a 'white coat' problem instead.

So she took me of the HRT - I immediately had exactly the same symptoms. It took a visit with my husband (for support) to the GP to convince them that I was soaked to the skin all day and completely knackered and that something needed to be done. I am now a childminder - I need to work and and I need to be on my top game to do a good job.

So the GP convinced me to go onto a lower dose HRT patch (I can't remember what it was) and anti-depressants (she said a side effect would help reduce my blood pressure). I was so ill with symptoms I agreed to this. I wasn't depressed though - just a really fed up - there's a difference!

So I stuck with this for about 3 years - but the HRT patch was nowhere as effective as my previous and I was still soaked to the skin all day but as I was able to sleep I put up with this.

Last year, unconvinced that the anti-depressants were doing anything I weened myself off them (my blood pressure stayed okay).

Then I had an HRT review with the nurse practitioner who actually asked me how I was on the HRT (no-one has ever asked that!). Dripping with sweat I said 'well it's better than nothing but look at me'. She disappeared off to speak to a GP and came back with a suggestion of changing to a different patch - Evoril.

They are great - although I am allergic to them so itching most of the time - to be honest I can live with that as I have got my life back. I can wear clothes again!

I thinks that's roughly where I am at this point. Itchy patches but no sweats and a good quality of life - able to do my job.

So - what's the problem?
On Friday I have my HRT review but this time with an unknown GP as the nurse practitioner doesn't do the HRT reviews anymore. I had mentioned to the nurse (at an unrelated appointment) that I was allergic to the patches and she said that the problem I have is that if I ask to try something else they will probably push for me to come off HRT anyway.  She then said that I should be aware that because of my age they will be pressing to get me off HRT (I'm 53). I am terrified of this.

Does anyone know how I should approach this? Can I ask to see a specialist - either via the NHS or if not, then privately? Will the GP go with what a specialist says - how does this work? What if the GP won't agree to refer me? And also - if I can get a referral - where can I find someone good?
So many questions - but I am dreading Friday. I know my blood pressure will be through the roof - even though it's fine at home.

Thanks for any advice and help.
 

[hellen]

Hi, i doubt i can help very much... but i do know how you get a private referral. just tell the doc when you see him, you would liked to be referred to a private gyne, you pick the private hospital yourself, and the doc will send them a letter, or fax it, and your off x. i did just that..  i didnt want to wait to see the nhs gyne which would have been a month, and i was fed up being fobbed off by my local doctors.. i do think that every doctor or gyne i see, seems to have there own opinion.. today i was told that i should have been on patches as soon i hit the menapause, and i would be better now, so on that theory there doesnt seem a reason, why you should be taken of your patch.. i used them for a short while and they left an itchy red mark for me to.. it didnt bother me though.. 

[Nitchb]

Thanks Hellen. Feeling much better already - might be able to sleep now!! I've been so stressed that I don't have any say over this. I'm going to spend tomorrow night researching who I could get referred to. I would prefer to go down the NHS route but if they insist on taking me off (I just have a feeling about this!) then I will need to get it sorted quickly as the symptoms just come back with a couple of days.
Thanks also for such a prompt response - I really feel I'm not alone now I've made my first post!
Good night
xx

[Ju Ju]

I went to see a private gynaecologist, self referral, though I was fortunate to have the support of my GP. She suggested who to go and see and I get my prescriptions from my GP. However, I could buy prescriptions from the clinic. The reason I went was my age.

[Nitchb]

it's a new GP I'm seeing tomorrow so it may be that he/she will be supportive - I doubt it as it seems to be a practice policy. I will ask for a referral if they do take me off - it does seem to be just an age thing.

Now I'm looking for recommendations for a specialist. I'm in Bracknell. Children are just about to arrive so will have a google tonight. Recommendations anyone?

[Ju Ju]

Guildford isn't too far from you. The Surrey Park Clinic. Google them to see what you think. I'm so grateful for the help I have received there.

[Grumpymum]

Sorry to hear the doctors are giving you such a stressful time. We don't need that on top of the menopause problems. I haven't any advice to offer about specialists. But on your allergy problem, I also get an itchy rash under the patch. I started with Femseven (terribly itchy as it stayed on for a week). Moved on to Everol - still itchy. I'm now on a separate regime of Estradot patches and Utrogestan tablets for days 15-26. The estradot patches are much smaller and so the area of skin to be irritated is much smaller. A doctor has suggested I spray Beconase nasal spray on the skin, let it dry and then apply the patch as it calms the skin. It hasn't had much effect for me (except if I haven't let it dry sufficiently then the patch doesn't stick properly). It might work for you though.

Good luck with your GP appointment.

[Nitchb]

thank you - if I don't have to fight too much to stay on HRT tomorrow then I'll give the Beconase a try. I really want to stay on these patches as I've felt the best I've felt for a long time - since I was on my original HRT actually.

Thanks

[CLKD]

Why Beconase? 

How did you get on?  We should NOT have to fight GPs for treatment 

[marras]

Like JuJu I go to the Surrey Park Clinic and thoroughly recommend it. Also, as its in Guildford it's not far from you.

[Hurdity]

Hi Nitchb

 

Sorry to hear about this but you absolutely do not have to come off HRT!!!!!! You are only 53 - the age many women start HRT. I was a couple of months under 54 when I first started and still on it at 61! It is only when you reach 60 that you might have a bit more of a fight on your hands because there is so little research on women of this age and long term HRT - especially the bio-identical kind.

Look at the information on this site and take to your doctor: http://www.menopausematters.co.uk/balance.php According to this information if you are under 60 and still having symptoms then the benefits of taking HRT outweigh the risks. it is your right to have this hormone replacement if you want it and are prepared to accept the very small risk. Transdermal oestrogen ( pactehs or gel) is thought to be less risky for many conditions anyway.

I also agree with Grumpymum - I use Estradot and it is so small there is hardly any area to itch. I am also very careful when removing it - peel it off very slowly and don't try to remove the marks nor scratch the area itself ( just nearby if needed!) to avoid setting off a sensitive reaction. You would need a separate progestogen as Grumpy and I do - Utrogestan. I presume you are on Evorel sequi or conti at  the moment?

If your doctor will not agree to change your regime then ask to be referred to an NHS menopause clinic - although there are sometimes long waits if there isn't one near you. You can find them listed here:
http://www.menopausematters.co.uk/clinicfinder.php

Also - if the doc you saw today isn't sympathetic, can you ask to see another one in the practice and ask the receptionists which one is the best for HRT/menopausal symptoms?

Do let us know how you got on?

Hurdity x

[MrsMopp]

Hi Nitchb

I hope your appointment went well today.  I'm also thinking of self-referral elsewhere, or a change of GP practice.

[Nitchb]

Okay!!

Just been out with my girlie friends and have just a couple ('ish) of glasses of wine - so this maybe a little incoherent!

So the update. The new GP was a very young, not yet qualified GP, who had to video our appointment for review with his manager!! So I felt I had the upper hand for a change! I went in guns blazing with how great I feel on this new HRT and that I feel I have my life back. He was very pleased for me. My main problem is that my blood pressure is sometimes high when I see the gp so I told him this. He didn't take my blood pressure and accepted my readings (which are fine).

Bingo - he just gave me the prescription. I didn't push to change the patches even tho' I'm allergic as I am so happy with the overall affect that I can live with the itching. I'm going to try all the various suggestions for the itching though. He suggested a different anti-allergy tablet. This is the least of my worries. The main thing is being on HRT.

So, for the moment, all the stress about being taken off has gone. Sooooooo much stress. If only the GPs knew how they affect me. I've had a splitting headache through worry. BUT through this group I now know that I have some say in the matter. THANK YOU so much everybody. I am certain that the confidence that you all gave me today gave me the oooomph to go in today so that he didn't get much of a chance to query.

I'm gong to research the private clinics mentioned so that next time I'm up for review I am ready to say that I want a referral.

Thank you again

[Grumpymum]

Hi Nitchb, so pleased to hear you successfully managed to get through your HRT review. I mentioned before that I also have a problem with allergy to patches and made the suggestion of Beconase. I'm having problems with that as the patches do not seem to stick so well after applying it. Can I ask what your doctor suggested about the anti allergy tablet? I take an anti histamine (fexofenadine) but I'm not sure if your doctor was suggesting something different. x

[MrsMopp]

That's fantastic news Nitchb.  I'm so pleased for you.  Let's hear it for the rookie GP