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Author Topic: HRT review  (Read 1004 times)

Tinkerbell

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HRT review
« on: September 02, 2025, 03:58:27 PM »

I had a HRT review with pharmacy practitioner last week, always had them before with GP with an interest in menopause before but receptionist at surgery said they are now done that way.

It did not go well, she said no woman in their 60's ( I am 62) needs systemic HRT and I need to reduce dose ( on 4 pumps) with the aim to be off it completely in 6 months time.  She said I was at risk of a stoke by being on it over 60. Also said two vagifem a week was sufficient and I did not need one every day and it would increase my cervical cancer risk, which I told her was rubbish!

Bit of background, I started at age 48 with horrendous VA that took me a year to get treatment as kept being told it was thrush and VA did not show up until 2 years post meno!  I ended up going private and got it all sorted with a regime of 4 pumps Oestrogel, Mirena for the progesterone plus Vagifem every night and Ovestin cream as needed. I have ticked along lovely since with just occassional flare up.

I have reduced my Oestrogel to 3 pumps this last week and now soreness is back.

I have googled and can't see any clear guidelines about systemic HRT over 60, can anyone point me in the right direction?

Obviously GP had no issue last year and said she was fine on me using all of it.

« Last Edit: September 02, 2025, 04:00:42 PM by Tinkerbell »
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bombsh3ll

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Re: HRT review
« Reply #1 on: September 02, 2025, 04:29:44 PM »

Make an appointment with your GP and take a copy of the relevant section of the NICE guidelines which discourage arbitrary age based withdrawal of hormone therapy.

If they are not willing to continue your treatment in accordance with the guidelines, ask for a referral to the local NHS menopause clinic.

I would feed back to them the educational needs of that pharmacist, who has probably had no specific menopause training and is operating outwith their scope of practice. It is particularly concerning that they think either systemic or vaginal estrogen causes cervical cancer - young women would all be riddled if it did.

Unfortunately in the worst case scenario you may be forced to self fund your treatment at least until specialist advice can be sought from someone sensible.
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Mary G

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Re: HRT review
« Reply #2 on: September 02, 2025, 05:25:05 PM »

Tinkerbell, this is very alarming. More and more women on here seem to be getting push back from GPs re HRT and now it's apparently spread to pharmacists.  What's going on?

The NICE guidelines clearly state there is no age limit or time limit for using HRT and that has been adhered to until recently.  Is this a new a directive from the NHS to keep costs down?  I take it you are on free prescriptions if you are over 60? 

I'm sure there are people on here who will know more than I do about the inner workings of the NHS but it sounds like a definite change of direction and an extremely damaging and ignorant one.

Definitely try to get what you need from the NHS but this probably means you will have to make an appointment with a GP which wastes your time and NHS time of course. Be prepared to buy it yourself or obtain it privately if you have to but don't let your health suffer because of it.

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bombsh3ll

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Re: HRT review
« Reply #3 on: September 02, 2025, 05:43:41 PM »

Absolutely, whilst we should be able to have our needs met in full by the NHS, there's no principle worth osteoporosis and a miserable, shortened life.

It bugs me that I have to pay for my pill, when I could get it free if I lived in England or Wales, but I would rather make economies elsewhere than with my health.

In the years following the WHI I actually remember some of the old guard within the NHS, who always thought it was bollox, really sticking up for women and prescribing liberal doses of estrogen and testosterone (granted there was a lot of provera meted out as well) that really helped their patients thrive, and it makes me sad that those they trained have now become so militantly anti HRT.

I think there's a real cultural dislike among some clinicians of women coming in more educated and advocating for their treatment, and they feel like patients need bringing down a peg or two and only being allowed the bare minimum.

There's also a really short sighted focus on costs, which I think ties in with other governmental failings and ass-backward priorities.
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sheila99

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Re: HRT review
« Reply #4 on: September 02, 2025, 05:45:23 PM »

I would make an appointment with your GP and also complain to the practice manager. If they want to use a pharmacy practitioner they need to choose one who's knowledge is more recent than 1990 and doesn't talk sh*t.
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Ayesha

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Re: HRT review
« Reply #5 on: September 02, 2025, 05:51:47 PM »

Awful, awful ill informed advice, for the sake of other women please gather all the information you can and hand in the facts to your surgery, don't let this pharmacist continue to give bad advice.

https://bssm.org.uk/wp-content/uploads/2023/02/GSM-BSSM.pdf

A post from Dr Currie on another thread recently

"Many years ago, we had a preparation Vagifem 25mcg--every night for 2 weeks then twice weekly. When it was taken off the market, we then used the lower dose Vagifem 10mcg (Vagirux is the same)--nightly for 2 weeks then twice weekly. So the maintenance dose of Vagifem 25 provided 50mcg of estradiol over a week, for which there was no concern about significant circulating absorption affecting the womb lining. Therefore, if needed, this can be achieved by using Vagifem 10 of Vagirux up to 5 times weekly. For many, twice weekly is enough and can be continued long term, for others using it 3 to 4 times weekly or maximum 5 times weekly works better.
If vulval and vaginal treatment needed, some find using the large volume estriol cream 0.01% applying half with a finger to the vulva and remainder into the vagina can be useful. However, other vulval conditions and sensitivity may need to be considered.
I hope that this is helpful"

 
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Clovie

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Re: HRT review
« Reply #6 on: September 02, 2025, 06:43:51 PM »

This just makes me cross reading this Tinkerbell!  >:(  I would definitely put in a complaint.
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Firebearer

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Re: HRT review
« Reply #7 on: September 23, 2025, 04:03:51 PM »

Sorry to hear this.  I had a similar experience with a private Dr who felt the need to tell me I was on too high a dose of gel (4 pumps). This was unsolicited advice as I wasn't seeing her for menopause/HRT reasons.  Sounds like your body was 'operating well' until you acted on the advice.  There is no age limit to taking HRT and it has long terms health benefits.  Hopefully you've seen your GP now and got some proper advice based on the most up to date data. 
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