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[Claire MM]

Hi Everyone,

I'm having difficulty right now getting my prescription for HRT through my GP surgery. I am on a higher than licensed dose of estrogen. I spoke with a consultant at the menopause clinic in October for the first time and she felt going on my bloods that I was not absorbing well and did not cut estrogen, she had also prescribed cyclogest as I had problems with utrogestan.

In January I had a follow up with a nurse from the meno clinic she said due to the statement by the BMS in December that basically I had to strip back my estrogen, that I was not to stay on cyclogest but that I should be on testosterone, she wrote to my GP. She also was pushing me to have a hysteroscopy and Mirena. I did so and that went horribly wrong (as discussed here) and I am not well recovered. I also have underlying ME/CFS.

It has come to my attention that I cannot reorder any of my HRT from the GP despite not being in need of a review. I was passed a message via the receptionist that I can either do what the meno clinic nurse said or go private for my HRT prescriptions. I have been under a private meno clinic in the past for advice as I could originally get no help from GP but have always had GP prescriptions, I am a single parent on a low income. And aside from anything else I would really like my blood levels checked with the GP, I just want to be on the right dose for me. They have said I have to get this sorted out with the meno clinic and I contacted PALS who have put my concerns through as a complaint. I really am not in a fit state for the stress of conflict over my medical care. I do finally have an appointment to speak to my own GP on 10th of May and tomorrow I am seeing a duty doctor as I cried when seeing a nurse for swabs to check if coil infection had gone.

I had also asked about intra rosa pessaries previously (due to a lot of VA symptoms) but was told that they could not order them that they are not available. I have also contacted the BMS who are prepared to contact the GP surgery on my behalf (not about intra rosa about cutting all GP prescriptions).

I wondered if anyone has any experience in dealing with this kind of situation, any advice etc, I thought I had read on here that intra rosa pessaries were available through GPs. It has been hard enough going through the hormonal issues and dealing with shortages through the pharmacies etc now I just feel absolutely alone with this scenario and like I am coming up against various institutions when I just want to have the right hormonal balance and healthcare for me. I genuinely do not know what level of estrogen I should be on but my last blood test which was last May was low for the level I was on as was the testosterone.

I don't know if anyone has any further insight or suggestions beyond what I am already doing,

Many Thanks for reading,

Claire xx

[CLKD]

GPs don't have to prescribe from a private or menopause clinic as costs come out of surgery monies. 

What does your local pharmacy suggest u may be able to find out who will prescribe what medication?  I don't think that the menopause nurse is 'right'.  That's why we have specific clininc, could you see the Consultant again or get a telephone appt. to discuss?

Too many people suggesting too many pathways for treatments without many being on the same page 

Would they deny those with diabetes medication 

 

[Claire MM]

Thanks CLKD, I never thought of asking the pharmacist. It's so weird because NHS meno clinic expect GP to prescribe under shared prescribing guidelines but the GP want them to do it, even though they are out of county and I have only spoken to them twice. It is ridiculous. Thanks for the info that they do not have to prescribe, I thought that with private clinic but not NHS one. I'm just so fatigued at the moment. I have a number of times come up against an attitude that female sex hormones are kind of a luxury item not essential for health and given that I only have one ovary and have probably been low for many years it's really kind of scary how it's not really considered important or they don't seem prepared to make sure you are on the right dose etc, thanks for replying xx

[CLKD]

Ah if it's an NHS Clinic that should be different in that they advise the GP about treatment plans.  What ever the condition.

However: I recently read an article by a GP that although they refer patients to the specialist required, the Consultant now asks the GP Surgery to do all the investigations  i..e 'this patient requires a chest X-ray/these blood tests/this medication'.  When I was at work the Consultant arranged all the X-rays and other investigations, saw the patient at least 3 more times B4 referring back to the GP.  If surgical intervention was required, a letter would be sent: I know I typed hundreds  : to update the GP.  At discharge a letter was sent to the Surgery so that the GP was up to date.

No wonder GP Surgeries can't afford to employ more staff 

U R meeting problems that really shouldn't become problems.  Do U have a Plan?

[sheila99]

I wonder if this is as a consequence of reduced prescription charges for hrt. I'm not sure if it'll get you anywhere but can you complain about the meno nurse as she is the one who has overturned the advice of the specialist? I've just reordered via the Derbyshire wide phone line and been told they won't do it unless you have less than 7 days worth left. No answer to what happens when it takes the pharmacy over a month to fulfil the prescription.
I'm not convinced the gp can ignore the advice of an NHS specialist, it wouldn't cross their mind to withhold heart or cancer drugs.

[CLKD]

I thought about this in the early hours  and wonder whether that Nurse was acting on instructions from the GP or Practice Manager?  If so, you should have had the chance to discuss the why's and where4s. 

Let us know how you get on! 

[Claire MM]

Sorry to confuse things - the menopause nurse was from the NHS menopause clinic on the phone. I have made a complaint to them.

I tried to talk it over with GP today. GP said they had been instructed not to prescribe any HRT off license at all by their prescribing trust. So that includes higher than licensed estradiol, cyclogest and testosterone gel. They tried to look at instruction from meno clinic but did not seem to have any (the meno clinic previous to nurses phonecall supported all 3 aspects of my HRT prescription but expected the GP under the shared prescribing guidelines to actually prescribe, also as we all know probably I have had to keep getting in touch with the surgery to piece together my HRT based on what is actually available in pharmacies so getting a prescription sent out of county by post isn't really doable and the meno clinic don't do that), so the GP said today they would write to meno clinic asking them to review me. Seems a bit dodgy when they are supposedly writing an official response to the complaint which I didn't want to make.

I have contacted BMS also and updated them on this info, they were going to try to contact my GP about it but there doesn't seem to be any point. I think it is to do with the press and the BMS statement in December but when I spoke to the BMS they said these were guidelines. I don't know re prescription charges but it certainly seems to be pushing any women who are a bit complicated out of NHS care. I thought it was noteworthy that the weekend the reduced prescription charges were made available there were also articles criticising Newson's by name for prescribing higher than licensed doses. It seems to me unecessairily political, it is hard enough dealing with the actual symptoms and experiences without this level of complexity and stress as an individual. Sorry I am venting a bit!

I just have this image in my head of what would be great, which would be a 'well woman' clinic, run by women experienced in this field where you could turn to for advice and support, as part of the NHS. I'm sure this used to be a thing. xx

[Claire MM]

Sheila99, It's just ridiculous 7 days?! The last thing women need going through peri/menopause is stress, it makes everything worse. Honestly there must be a campaign for this?! It's half the population who will go through this! Xx

[sheila99]

Sheila99, It's just ridiculous 7 days?! The last thing women need going through peri/menopause is stress, it makes everything worse. Honestly there must be a campaign for this?! It's half the population who will go through this! Xx

Might have been the odd porkie pie - patches (oesteodot which cling on like limpets) for some reason keep coming off early  . There's no way I'm going to trust them.
Worrying about the 'nothing off licence', it means no one will get testosterone without paying a fortune for it.

[CLKD]

Perhaps it's the 'end of the year' scenario ..........

[Marchlove]

That’s so true CLKD!

I believe the “end of year” is last day of April for the NHS.
Money has run out but couple of weeks and funds will be available again.

Phew 😥

M x

[Claire MM]

Jeez Louise, maybe it is the 'end of year'?! And not the end of days.......xx

[Claire MM]

Shelia99 the thing is they are not only saying you have to go elsewhere to get testosterone but they claimed that it's all one thing HRT therefore if they are not prescribing one part of it they won't prescribe any of it, apart from the vagifem presumably. It took the meno clinic about 4 letters to the gp to get them to continue prescribing testosterone (which the GP had prescribed for over two years because my testosterone was coming back as zero in my bloods) but now they are saying keep prescribing the testosterone (GP won't) even though it's off license but stop prescribing cyclogest because that is off license (leaving me with no progesterone part of HRT?! surely less effective than cyclogest) and I can 'think about' taking my estrogen down but GP has decided think about means cut it immediately or go private. I just want to function again, trying to navigate this feels like a lot of work. I do hope things pick up soon in this situation or I will have to go private and it's not something I can afford to do :-( xx

[sheila99]

Can you tell them you'll have oestrogen with utro or provera so you still get the oestrogen part of it? Then go elsewhere for cyclogest.

[CLKD]

Claire - I would be sending a PM to Dr Currie, explaining who the Clinic is and the advice given to you.  Heather may be able to clarify the issue.