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[Katymac]

Apparently I can't have vagifem and evoral sequi

Says my gp

I think I can, and I have tried without and I do need both

So I am being rung tomorrow: do I start with after my conversation with the nurse yesterday I found the nice guidelines and goodness me they say I can have both or do I wait for her to say no then mention it?

I have a bit of white coat syndrome which is better by phone but not by much

Help?

[jillydoll]

Hi Katymac.

I'd wait for her to say no, then you can tell her what you've found on the nice guidelines, and ask them to explain why you can't have them....
Try not to worry, maybe she'll have to examine you first before she prescribes.
As for the everol sequi, maybe she's got to ask you a few questions first...like a health check
if you haven't had one...before she prescribes that too.
Good luck....xx
Let us know how you get on.....xx

[Katymac]

I started the vagifem 2 months ago (ish) and they really helped

I started the everol sequi last month and that's when she said I couldn't take the Vagifem too

I took the everol sequi and tried to do without the vagifem but the symptoms keep reappearing

I spoke to the nurse today who said the GP says I can't have both - she is getting the GP to ring me tomorrow

I feel so powerless when I speak to them

[Katejo]

Apparently I can't have vagifem and evoral sequi

Says my gp

I think I can, and I have tried without and I do need both

So I am being rung tomorrow: do I start with after my conversation with the nurse yesterday I found the nice guidelines and goodness me they say I can have both or do I wait for her to say no then mention it?

I have a bit of white coat syndrome which is better by phone but not by much

Help?

I tried telling a GP that the NICE guidelines allowed me to use Vagifem daily but she disagreed and said they weren't specific enough to do that.

[Katymac]

Yeah I know

But it seems fairly clear to me

Urogenital atrophy

1.4.9 Offer vaginal oestrogen to women with urogenital atrophy (including those on systemic HRT) and continue treatment for as long as needed to relieve symptoms.

1.4.10 Consider vaginal oestrogen for women with urogenital atrophy in whom systemic HRT is contraindicated, after seeking advice from a healthcare professional with expertise in menopause.

1.4.11 If vaginal oestrogen does not relieve symptoms of urogenital atrophy, consider increasing the dose after seeking advice from a healthcare professional with expertise in menopause.

1.4.12 Explain to women with urogenital atrophy that:

    symptoms often come back when treatment is stopped

    adverse effects from vaginal oestrogen are very rare

    they should report unscheduled vaginal bleeding to their GP.

1.4.13 Advise women with vaginal dryness that moisturisers and lubricants can be used alone or in addition to vaginal oestrogen.

1.4.14 Do not offer routine monitoring of endometrial thickness during treatment for urogenital atrophy.

[Katymac]

Oddly enough she said I could use it daily - as long as I took no other HRT

[Orangefoot]

Theres a difference between systemic estrogen and local estrogen and the NICE guidelines are clear in understanding that systemic estrogen might not completely fix atrophy and local treatment with vagifem will.

This doesn't ‘double' your systemic estrogen which may be what your GP thinks.

[Katymac]

That's a great explanation thanks orangefoot - I may start with that

[CLKD]

Go and have a chat with someone who actually knows what they are talking about.  Your local Pharmacist for example.

Also, see on the surgery web-site if there is a GP that has an interest in womens' health, they will have a set of letters after their name to say so!

Write to this particular GP and ask what the worst is that could happen if you took, as most ladies do, more than 1 type of HRT - atrophy is a totally different problem and therefore treated totally different to other symptoms.  Perhaps gift her a copy of "Me and My Menopausal Vagina"? 

It makes me HOPPING MAD  that GPs are still so thick. You could of course pay for advice from Dr Currie ;-)

[Katymac]

Apparently it went like this

Nurse 1: Katy wants HRT & vagifem
Doctor: No it's an overdose
Nurse 2 (passing through): actually you can I've been on a course

So the doctor said yes, but only 2 a week mind

So I'll carry on with 4 a week like I am MWF morning and Sat pm & I'll see what happens

[CLKD]

Make an appt. to see that Nurse?  Discuss tactics?  Why hasn't she had a meeting with the rest of the Staff and explained the ins and outs of correct prescribing  .

[Katymac]

Think that nurse is doing vaccinnations atm

[CLKD]

Shame that, particularly as across the UK a) less people are taking up the invitation for jabs and b) jabs are apparently in short supply 

Let us know how you feel!

[Katymac]

Thanks rockhopper I have another issue when I've decided what to do I like your letter and may well use it!