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[Starfish]

Hi everyone,

Despite trying many different kinds of hrt for the last four years (started at age 42), I’ve had no luck. Mood swings are the worst offender! Now I’ve started to have new symptoms as well. I think I have symptoms of VA and prolapse of some kind, despite HRT. My skin has become very crepey and I feel like I look 55, rather than 46. I asked a few months ago to be referred to the hrt clinic and was told the waiting list was very long and instead the gp changed my medication.
Has anyone attended an nhs clinic? What was your experience. How long did a referral take? I’m based in Northern Ireland. Thanks

[bombsh3ll]

The GP didn't refer you because the waiting list is very long?!!!

That's a reason to refer someone sooner rather than delaying referral, especially when multiple primary care options have failed.

Have they examined you regarding the potential prolapse? That may require a separate referral to a surgical gynaecologist or pelvic floor physiotherapist.

I don't know about northern Ireland but here in Scotland the NHS menopause clinic wait list is around 2 years for an appointment however GPs can email them and get treatment advice in some cases.

I hate that I'm saying this but if it's at all an option, I would pay to see a private specialist, someone who really knows their stuff AND gives a damn, and get your quality of life back in the meantime.

Neither your face nor your vagina deserve to look and feel 10 years older than you are.

[Starfish]

Thanks for your reply Bombshell,

I may have to go down that route. If they had of referred me earlier when I went into an early menopause I could  have been seen by now. I’ve had some good GPs, some clueless, some condescending and sexist throughout these four years. I have a phone consult with my gp in two weeks. Earliest I could get!

[joziel]

If you can afford to go privately and see a menopause doctor online, I'd do that. Pretty sure all the UK clinics would be accessible in NI, including Newson Clinic...

[Starfish]

Thanks Joziel. I wish I didn’t have to resort to a private clinic but if I have no choice, I may have to.

[joziel]

I most definitely had no choice. If I'd stuck with the NHS, I'd never have got access to the dosages I needed to feel better. (Currently on 100mcg patch plus 12 pumps of gel, but aiming for 200mcg patch and 6 pumps of gel - and possibly upwards from patches there.)

That is just to get me into the not-incredibly-high range of 450-650pmol. I'm sure I am not the only woman who doesn't absorb very well transdermally but sadly the NHS is obsessed with how much we apply to our skin rather than how much our skin is able to absorb, so many women go severely under-treated. And they don't even realise it.

With me shaking through the night with inner tremors, hypnic jerks when I start to fall asleep and my heart beating hard and fast, I was just told by the NHS that 'at some point we just have to treat your symptoms' before they had even tried to get my estrogen up.... god knows how many prescription meds I'd be on by now if I'd let them do that.

If you go to a private clinic, they will write to your GP and tell them what to prescribe. So you don't need to get the meds privately as well, I could never afford that with the dosages I'm on. I do think there are some GPs who refuse to cooperate with the clinic letter but the majority are happy to if someone else is taking responsibility for off-licence doses.

[Starfish]

That’s awful Joziel. I feel kinda similar. Glad you got sorted. Was going private expensive? I spoke to a male dr about lack of absorption. I said I would like a blood test to check. He refused to do this and I was told blood tests are not used to check hormones. I eventually got a female gp who did the blood test and my oestrodiol was at 200 despite being on a 100mcg patch! She then gave me gel, I absorbed a bit better and with four pumps my levels were at 420.

[joziel]

400 isn’t bad, but if you aren’t fully menopausal, a lot of that can be your own estrogen… which then cuts out.

It’s best to test during your period when your own levels are lowest.

It’s £240 for a consult at Newson, & you need one a year to stay registered there. Bloods and meds you can usually get via your GP.

[Starfish]

Thanks Joziel. I had to stop the gel and go on estrdot as the mood swings and anxiety were worse on the gel. I obviously did absorb this. I don’t really get natural period as such. My periods were 4 months apart at 41, prior to this I was very regular. I get a two day bleed, very lightly, one week into the utrogeston cycle. I take it for 14 nights on, 14 nights off.

[Birdbrain]

I've been seen by a NHS meno clinic. First referral I waited about 3 months.

Didn't find them that helpful - specialist told me 'menopause is not a disease' and when I expressed concerns that dose might be too low, they just told me let's wait and see as I'd only been on it a few months (which is probably the standard approach).

Saw a different one recently after things went haywire, much more helpful. I think being specialists, they have more knowledge about different treatment options, possible causes of problems, and also of broader issues that relate (e.g. PMS/PMDD) than GPs. They can also prescribe things that GPs can't or are reluctant to prescribe.

Access is an issue though. Too many patients, not enough doctors/clinics. After my initial appointment, follow up was scheduled 6 months later. Meanwhile my hormones took a nosedive, but was told no appointments available for several months. Eventually they did find me one though after a few weeks of repeated contact.

If waiting times are too long and you can afford it, I would consider private. Your hormones are so important to your physical and mental health and if you can afford a few hundred pounds for a private appointment here and there, it's probably worth it.  For a working person it's probably the cost of a summer holiday, and I think it's worth giving that up for one summer if it means you get sanity and wellbeing for the rest of the year.Once you are on a regime, it's also possible that your GP can carry on prescribing what the private one did.

[AngelaH]

From my experience only, NHS meno clinics waiting time depends on area where you live. I was referred twice to my local meno clinic and waiting time in both cases was very reasonable for NHS services, I can’t complain about it at all, I have quite bad experience with private meno specialist, totally waste of my money and time, I would prefer to spend those money on something really useful.

[Starfish]

Thanks ladies!
It’s good to know what the nhs service is like and it’s probably dependent on area for waiting times. Birdbrain, your first experience with the nhs was pretty poor, that’s awful. I would feel bad waiting a long time for a sub-par experience.
 I will request a referral and research private clinics in Northern Ireland as well. Although waiting lists here are notoriously long for everything!
Does anyone else have any experience with menopause clinics, either NHS or private?

[joziel]

If you want a doctor recommendation for Newson, I see Dr Jane Robertson and she's very good. I've seen a couple of others there and sometimes I didn't feel 'seen' as an individual but like I was in some sausage factory HRT prescribing thing.... if that makes sense.

Once you get stable on a HRT dose you can actually see a nurse practitioner or a pharmacist at Newson Health and they are cheaper. But if you're still getting dosages right or there's anything complex going on, they will tell you that you need to see a doctor.

[Starfish]

That makes sense, I was kinda worried about that. Thanks for the recommendation