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[LittleClaire]

Morning everyone,

I just wanted to ask, if I purchase estriol cream from an online pharmacy, can my GP then refuse to prescribe it to me in the future and possibly stop my HRT?

Basically, I am on Evorel sequi patches at the minute which have been great for most of my symptoms apart from VA, which I feel is getting worse over the months.

I’ve got a HRT review on 11th March as this is the soonest they can get me in but I wanted to try ordering some cream online in the mean time to see if it helps, then if it does ask my GP to add it to my pre paid prescription. Or will it affect me negatively? Just worried they say well if you’ve gone private we can’t help you anymore etc.

Thanks in advance

[CLKD]

It will help: so phone your Surgery on Monday and ask for a prescription for VA treatment.  Explain that you understand from MM Forum that it works so would like to try, prior to your next Consult.  Gina is available over the counter for ladies over 55.

[LittleClaire]

Thank you,

I wasn’t sure if they’d give me anything before my appointment on 11th March without seeing me. Also I am 37 so I don’t think I’ll be able to have anything that’s for over 55s and I am still having regular periods

[Ayesha]

As you are only 37 you would have to lie about your age to obtain Estriol from an online pharmacy.
Your GP doesn't have to know as its your business and won't affect what you are entitled to on the NHS.

This document will help you now and in the future
https://bssm.org.uk/wp-content/uploads/2023/02/GSM-BSSM.pdf

[LittleClaire]

Thank you,

The only reason I was asking was the website wouldn’t let me go any further on the page without entering my GP details for them to inform them of the medication they were supplying me, so I presumed they had to be informed. The site didn’t ask for my age though. Shocking that you have to be over 55 to get this stuff.

Do you think my GP would prescribe something like this with me only being 37?

Thanks

[CLKD]

Morning.  And don't let any1 suggest that you are 'too young'!  there is also the Daisy website for 'early' menopause.

Some find that keeping a mood/food/symptom diary of use to chart progress and discuss with their medical advisor, i.e. GP or Nurse Practitioner.

[bombsh3ll]

You should be under the care of a specialist menopause clinic at the age of 37.

I would phone your GP practice when they open and ask for an urgent call back, tell them you have POI and that you are in severe discomfort due to symptoms of vaginal atrophy and are requesting a prescription for vaginal estrogen as per the NICE guidelines.

You shouldn't have to pay for it but if you do buy it online you don't need to worry at all about your GP's response. They are far to busy and overstretched to bat an eyelid even if they get a notification from the pharmacy. It will simply be filed under "no action required". This will not jeopardize your NHS care in any way.

However you may be asked for proof of age so it might be best to get your mum or another older relative or friend to order it on your behalf.

What I would say though is that if your systemic treatment is so low that you have vaginal atrophy at 37, this should prompt a review of your dose, ideally by a menopause specialist, because women who have normal ovarian function at your age don't have VA and with POI it is critical that you achieve a systemic level that is protective of your future bone and cardiometabolic health.

[Ayesha]

You are only 37, GSM symptoms only get worse and will prevent you from having penetrative sex, that I am sure will be good enough for your GP, Nurse Practitioner to give you what is required to lead a normal life.

You need to be assertive at your appointment, let us know how it goes   

[LittleClaire]

Thank you all for your replies and advice. I’ll have a look at Superdrug online to see if I can get it there instead if it doesn’t require them letting my GP know or ask my age (which I can lie about if needed).

Bloody annoying I know, I had to convince my gp in the first place to give me patches as in their eyes I was “too young”. Well actually no I wasn’t because the patches have eased a lot of my symptoms hence me being correct in the first place. I’ll give them a call on Monday also to ask about adding it to my already pre paid prescription so at least I won’t have to pay any extra than I already have.

Thank you x

[CLKD]

I would add that if U meet with resistance from your GP then ask for a referral to a dedicate menopause clinic - there are waiting lists both on the NHS and in the private sector. If once an appt arrives U can cancel if symptoms are improved.

[bombsh3ll]

You should be seen by a menopause specialist anyway as you are under 40. There are special considerations in this age group.

GSM will prevent you from having penetrative sex, that I am sure will be good enough for your GP

For sure, if they think it might stop you from putting out they will send it over to your house in a blue light ambulance

[LittleClaire]

How do you see a menopause specialist? Does your GP refer you on a waiting list? I could possibly go private through our work healthcare scheme as they pay towards it but I’d need to check.

[Ayesha]

You can refer yourself to a private menopause clinic, like any other private clinic.

[Ayesha]

GSM will prevent you from having penetrative sex, that I am sure will be good enough for your GP

For sure, if they think it might stop you from putting out they will send it over to your house in a blue light ambulance

"putting out" ?

[bombsh3ll]

You could ask your GP to refer you to the local NHS menopause clinic. This is standard for premature ovarian insufficiency (under 40) and you could signpost them to the relevant section of the NICE guidelines.

It sounds as if they are a bit out of their comfort zone treating you anyway and they may well be relieved to have some expert oversight.

The wait for this can be lengthy however and if you have insurance that covers this it would definitely be worth taking advantage of it.

Frequently it is the same consultant as you would have seen on the NHS anyway, and they can then sometimes feed you into the NHS system for ongoing care including DEXA scan if indicated.

If you are able to pay out of pocket you can self refer to a private menopause clinic but do make sure you research the provider thoroughly to ensure they can meet your needs as a POI patient.

I hate that this is the case but increasingly people are having to self fund to get appropriate and timely care, not just in menopause but all kinds of conditions.