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[MrsMitch]

Hello ladies, I wonder if you can help with regard to going to see a menopause privately? I've been on the waiting list for so long now to see one on the NHS and all I need is Estradiol prescribing at least x5 per week or, as I've seen some of you do on here, x7 per week. I've called the booking number and they say there is no appointment in sight and can't give me a date. My GP will not even consider increasing the dose even though I told her I've bought Gina from Boots but the cost is prohibitive long term plus each time I've bought it I have to be interviewed by the pharmacist as to why I need it.
So I see that Louise Newson has a clinic near me and I've enquired with them re fees.
So what I'm wondering is if I were to see her and get my prescription increased would that mean I could get her to let my GP know that's what she's recommended? Would my GP then issue NHS prescriptions or would I have to get an expensive private one each time? I also wonder if it will cause me issues with my GP? She will not accept I have VA as bad as I do, in fact I self diagnosed from this forum. The surgeon doing my hysteroscopy under GA said it was so bad it caused her problems. I've told my GP how much pain I'm in, how Dr Currie recommended to me in an email my dose should increase and that the damage to my body will never be reversed but she just keeps telling me there is nothing to be done until I see the specialist. 
However, I also don't want to have trouble in future if my GP may be even more obstructive because I went private.
I'd welcome yiur advice and experiences. Thank you.

[sheila99]

If your gp has already seen the advice from Dr Currie and ignored if I'm not sure I spend ££ on a different specialist on the expectation of a different outcome. Most gps will follow the advice of a specialist but some won't so perhaps it might be better to ask her first? Can you see a different gp who might examine you and see what the surgeon saw? You can buy a lot of Gina for the private of a private appointment.

[CLKD]

Change your GP and if possible, your Surgery.  In the mean time make an appt with the Practice Manager to discuss the e-mail from Dr Currie.  Is there a Nurse Practitioner with more knowledge about menopause? 

[MrsMitch]

Thank you both for your reply. I have called the surgery for my own GP email and forwarded her Dr Curries email recommending i need an increased dose. The other GP's have dismissed that in the past.  I have sent a gracious accompanying email explaining I'm criticising the practice in any way and that I cannot tollerate this level of pain any more. I just hope she accepts it. If not maybe I should email Dr Currie again and ask her how I can get them to prescribe what I need,  I just don't understand what the problem is.
I pointed out there are lots of ladies on here who have either x5 or x7 per week. I also mentioned that Dr Currie (I read somewhere on here) is trying to get the manufacturer to change the recommended dose, or something like that.
Why do I have to be in so much pain when there is something that can get rid of it?
BTW there isn't another surgery around here so I'm stuck.

[CLKD]

Let us know how you get on.

[Jules]

It's very  difficult when you are at the mercy of a doctor. I once had the same with one of my medications, every time I needed more I had to go through the same questioning. My doctor initially was making me take breaks with the vagifem but more recently I think they have caught up and she told me I could use it as I needed to. That said Im back to twice a week following a bleed and breast pain and that wasnt enough for me. I think when it comes to your health, you have to put yourself first because nobody else will, so do what you have to do and dont worry about putting anybody's nose out of joint. Remember we pay for the NHS. The staff sometimes forget that and behave as though we are after freebies.

[MrsMitch]

That's a good point, Jules. I've been told so often to tread carefully round doctors that it's become habit to do just that. But that's not good. I'm also not good at being firm when it comes to my own health, I think I need to be more assertive!

[Ayesha]

Have I missed something here, I know I am not around much anymore but why is this GP not helping a patient that is in so much pain when there is no need.
Why are women in this country allowed the correct dose of oestrogen to relieve symptoms and some are not, this is wrong on all levels.

I phoned my GP, I told her that the 2 a week Vagifem was having no effect, she immediately told me to use the pessary every day and changed my prescription which included Ovestin for the outside, she could not have been more helpful.

Reading stories like mine would have me marching down to the surgery and make myself heard, there was no way I could have lived with the dreadful symptoms of suffering VA.

[Jules]

It's the only way these days. You can do it without being rude. I think some of it goes back to the days when doctors etc were like god, the elite, and you didn't question, you were grateful. But many people now have greater knowledge and understanding and we're entitled to appropriate treatment,  it shouldn't be a lottery

[Ayesha]

This difference of opinion from GP's is causing unnecessary suffering and anxiety to patients. Topical oestrogen is safe to use in higher doses if needed, it wouldn't be available to buy over the counter if it wasn't. It shouldn't be a lottery, it isn't fair that some women can obtain what dose of topical oestrogen they need from their GP and some have to fight for it.
Buying Gina is very expensive if you need to use it every day which begs the question why, why are we forced to buy the more expensive treatment when there are cheaper pessaries available.   

[Jules]

This difference of opinion from GP's is causing unnecessary suffering and anxiety to patients. Topical oestrogen is safe to use in higher doses if needed, it wouldn't be available to buy over the counter if it wasn't. It shouldn't be a lottery, it isn't fair that some women can obtain what dose of topical oestrogen they need from their GP and some have to fight for it.
Buying Gina is very expensive if you need to use it every day which begs the question why, why are we forced to buy the more expensive treatment when there are cheaper pessaries available. 

When you buy it over the counter, what is the guidance about dose? Does it say you can use it every day? I've never bought it so don't know.  After my recent experience I don't feel its ok for everyone to use in higher doses,  I've had to reduce.

[Ayesha]

The Gina leaflet is exactly the same as the Vagifem leaflet, instructions say to keep doing a loading dose if symptoms are not improving, in other words keep trying until you get to the right dose for you.

The majority of women are ok using a higher dose but unfortunately some women will experience side effects using topical oestrogen, as I keep saying it wouldn't be available to buy over the counter if not safe.

[Jules]

Okay. Any drug we buy over the counter is only safe if it's used according to the instructions.  This is a difficult one. It clearly gets into the blood  stream and my radiographer mentioned it causing a lumpy cervical wall. There needs to be more concensus. I'm nervous of using it, I need more than twice a week but darent increase because if it causes another bleed I will have to ho through the same thing. We need Davina McCall on the job

[orrla]

I went through all that too. After last time I complained to female gp,  I walked out with a prescription for out of stock moisturiser. 4 weeks later had massive urine track infection. Third one in one year!

..so I went to Meno clinic and have now a ring installed. Only trouble it needs to be changed every quarter, by gino. Otherwise, wonderful. It works!

I recommend!

[MrsMitch]

It really is a lottery isn't it and it shouldn't be. My heart breaks for all the ladies who like me, can't get prescribed what they need or even diagnosed. I first had signs of VA about 15 years ago and had no idea what it could be - I was 40 then and hadn't even thought about menopause. Then about 10 - 12 years ago it flared up to level its back at now. No diagnosis from GP,  to GP to gynea all diagnosed other things I did not have. Finally I self diagnosed from information on this forum. The first GP I saw gave me pessaries and Ovestin straight away and the pain went from 10 - 2 in weeks. But when I saw her again once I was using twice a week because my symptoms were again getting worse, she then decided I needed further investigation into what I might have. She didn't tell me it could be VA in fact I'd never heard of that until I eventually came here. Then more misdiagnosis from other GP's and I saw a gynae who, when I mentioned the fact the pessaries helped at the loading dose, rejected the idea my problems could be hormonal. I asked if there were any menopausal symptoms I may have and she said "no". When I finally asked for local anesthetic cream to ease my pain, she reluctantly gave me it saying it wouldn't work as my pain was nerve pain. Next visit, I told her it worked, all be it temporarily,  and she looked me in the eye and said " There is nothing more I can do to help you so I will close your file down. You'll have to see your GP ".
Sorry if I'm repeating myself but I know you won't all have read my history in the past.
Why do we have to go through this? I cannot understand it.