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[MIS71MUM]

Hello
I have been reading a couple of articles that suggest transdermal HRT is best for moods. Is this right?  If so, can anyone suggest a good one to try as I need to come off Femoston 1/10 due to my increased risk of blood clots.  I'm 44 and in peri! I don't like the progesterone phase of the F 1/10. I am currently suffering with anxiety and depression.
Thank you.

[Mary G]

Transdermal HRT is definitely far more effective which would explain why it is better for moods and yes, it could help with your anxiety and depression.  I use the oestrogen gel and would recommend it without any hesitation - you can easily adjust the dose too which is helpful.  I didn't find the oral oestrogel to be very effective at all and looking back, it didn't really do anything for me.

I am intolerant to all types of synthetic progestins and it is worth noting that the risk element of HRT is with those and not the oestrogen.  They also undermine the good work that the oestrogen does.  I would recommend you switch to Utrogestan which is a bio identical/micronised progesterone and used vaginally, carries fewer side effects like painful breasts.  I don't particularly get on with Utrogestan either but it is the lesser of two evils. 

[MIS71MUM]

Thank you - that gives me some information to speak to my GP about.  Hope it also improves my mood.

[Taz2]

I found that Evorel patches led to PMT symptoms due, possibly, to them containing norethisterone but FemSeven was much kinder with no mood swings. They are a bit tricky to get to stick for the whole week sometimes though. I've never tried utrogestan as I have a soya allergy and the capsule is soya based.

Taz x

[MIS71MUM]

Another wasted GP appointment! I mentioned that I needed to switch to oestrogel and utestegan because of my sticky blood syndrome. My young lady GP looked blank and said she had no idea as to what to prescribe and told me to go back to my gynaecologist as she was unsure about my requirements! What a waste of time!

[GypsyRoseLee]

When I was first on HRT I was okay using Utrogestan. I hit a problem when I stopped taking it at the end of the 12 days. My patch just wasn't strong enough though to improve and balance my mood. I too suffered very much with depression and anxiety on a cyclical basis.

I then spent 4.5 months trying 2 brands of BCP. But the first (Microgynon) caused constant spotting. And the second (Marvelon) was great for the first 3 weeks, but then the anxiety and depression came back with a vengence! I persevered for 2 weeks feeling dreadful but stopped taking it 2 days ago, and instead applied a 75mg latch. Within 6 hours I felt so much better. Today feel much better again.

I think I can't tolerate synthetic progesterone. Years ago I had the Mirena coil fitted and it sent my PMS through the stratosphere. So I guess I should have guessed I wouldn't tolerate synthetic progesterone this time either. But my anxiety and depression were much, much more severe this time.

[Mary G]

Mis71Mum, frankly, that is dreadful.  It's frightening to think that your GP has such a limited understanding of HRT and it begs the question, what other types of medication does she not understand?  At least your doctor admitted that she didn't understand it, mine frantically started googling but failed miserably, told me she could not prescribe it and then stood up and terminated the appointment.  I have never been back since.

Can you get an appointment with your gynaecologist quickly?  Can the gynae. give you a prescription to save you having to go back to the GP? 

[GypsyRoseLee]

I agree MaryG. It's a f*%&ing joke. If a GP realises they don't know enough about HRT then it is incumbent in them to LEARN more about it. Hundreds of thousands of women take it/need HRT. A GP can't just sweep their lack of knowledge under the carpet and pass the buck like that.

[MIS71MUM]

I must admit, I was surprised when she went onto Google too, then starred at me blankly! I've called the Gynaecologist who I saw this time last week but he only goes to the private hospital when he has a patient, so the receptionist didn't know when he's next in. Anyway she's emailed him to call me. But my GP said she'd need a formal letter rather than me coming back with the name of something. Is there any wonder when there are so many of us suffering unnecessarily due to ill informed GP's. Sorry to rant/vent, I will not knock the NHS as it has saved my husbands life, but I do think the menopause deserves more attention/care.  Surely there should be a set of guidelines / decision tree that you can follow to ascertain the best effective treatment for each individual patient?

[Mary G]

Mis71Mum, oh buddha, so your doctor googled too, I despair.

Have you considered seeing a specialist like Professor John Studd?  He would write a letter to your doctor to enable you to get a prescription.  It will cost you about £300 and a trip to London (don't know how far that is from you) but it would be well worth it - he takes credit cards by the way.  He knows what he is doing and could give you a personal service and might also suggest testosterone. 

Please don't waste too much time waiting, it's your life, not theirs. 

GypsyRoseLee, I couldn't have put that better myself.

[MIS71MUM]

Hi Maryg - I may look into the Prof Studd thing, will google it🙄🙄🙄!  You can get to London in 2 hours on the train.  Will keep you posted.

[Hurdity]

.....and especially as the NICE Guidelines have just come out!!!! Yes there are decision trees and all sorts of help out there for doctors to follow - some of them produced by Dr Currie eg Guidelines in practice website:
http://www.guidelines.co.uk/obstetrics_gynaecology_urology_mm_hrt#.VlOG979y3NU

They can get the info on the different types from this website - I mean heavens above we all can and we are not medics!

Some NHS Trusts produce their own too - I came across one such yesterday but won't be able to find it again!

If the doc does not know they should admit it and to save time should note what you are requesting and then say they will get back to you - and then look it up when they are not having a surgery, and get back to you by phone if necessary.  There must be protocols about this sort of thing surely?

The whole point of the NICE Guidelines is that all this should be available on NHS so don't give up yet. Also Studdles is more expensive than some others....

Hurdity  x

[Briony]

I too have had the Googling doctor experience 

Ironically, it was the best thing that's happened to me in this hormonal nightmare, as it was the kick I needed to switch GP. New practice is lovely, all Dr Cog trained and recommend this site ! X

[MIS71MUM]

It is a bit disappointing when we don't have a menopause clinic as such in Sheffield. So are relying fully on our GP's.

When I mentioned the utrogestran, she said that was for getting pregnant/pregnancy, so said I'd got it wrong. I feel rather failed....what if I didn't have my private healthcare?

[Emma]

Sheffield Menopause Clinic
http://www.menopausematters.co.uk/clinicdetails.php?id=90