Menopause Matters Forum
General Discussion => New Members => Topic started by: Freckles on March 16, 2016, 05:52:42 PM
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Thank you for letting join this web site.
I'll admit to being overwhelmed by the great range of the information and I'm clearly not as knowledgeable as some of you!
So apologies in advance if I am intellectually challenged on the subject
I've made an appointment to see John Studd in a couple of weeks and saw there seemed to be differing views on his regime.
I'm 55 years old and been on Femoston 1/10 for 5/6 years.
Originally went on Femoston as I had no physical symptoms but psychological problems (generalised anxiety, depression, feeling de-personalised, etc)
It was effective but I've noticed an increase in the past 18 months of generalised anxiety, depressive episodes etc, along with noticeable thinning head hair, increased facial hair, very dry skin, etc. I thought that indicated I needed more oestrogen?
I went recently to my GP who was about 12 years of age and less than helpful.
She said I should be "weaned off" HRT due to my age (!) that the menopause was "natural" (it might be, but depression and anxiety isn't) and prescribed me liquid fluoxetine (AD) which paradoxically made me feel more anxious, so I stopped that.
Still taking Femoston.
I asked and finally got my blood tests back today and I have:
serum FSH level of 49 iul
LH level of 40.6 iul
and testosterone of 0.65 nmol/L.
All of these I was told were in the "normal" range.
Am I right in thinking these are "normal" for a post menopausal woman who is NOT on HRT?
Also am I right in thinking my oestrogen levels have dipped?
I know everyone is different but there seems to be varying opinions of Studd and wondered if any one else had similar symptoms to myself and found him helpful?
Any advice appreciated and apologies for not being as aware of some of you re HRT issues!
Thanks!
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Freckles, welcome to MM!
I am a patient of Professor Studd and I think he is fantastic, he changed my life.
Your "suck it up" doctor sounds utterly clueless not to mention completely out of date. She doesn't know what she is talking about and is giving you dangerously bad advice.
Professor Studd despairs of doctors who wrongly diagnose women with depression when they desperately need oestrogen therapy and you are a case in point.
Firstly, oral HRT is nowhere near as effective and transdermal HRT because much of it gets lost in your digestive system and the dose you are on is way too low. That is why your symptoms have come back because you have (probably) stopped producing any oestrogen of your own - it would appear that you have gone on to develop new symptoms as well, all of which indicate low oestrogen. When I was taking 1mg orally, it was so ineffectual, I might as well not have bothering taking it at all. In a nutshell, you are on the wrong medication.
I am in no doubt that Professor Studd will prescribe Oestrogel (2-3 pumps everyday) together with Utrogestan (best used vaginally) and possibly testosterone. Believe me, the Oestrogel is life changing stuff and it was only when I started using it that I got back to normal.
Have no fear, he will understand your problems and get you onto the right medication.
Hope that helps.
PS Sorry if I am being dim but I can't see your oestrogen blood levels.
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Thanks Mary G for the reassurance!
Really appreciated!
My GP is newly qualified, knows sweet Fanny Adams about the menopause and HRT and thinks AD's are the way to go for woman with depressive menopausal symptoms.
I'm a bit overweight (too low in mood to get active) and still smoke (I know) but would risk a stroke in 10 years than spend the next 10 years being a bearded, semi bald woman, and felling like life just isn't worth living.
I'm seeing Prof Studd in three weeks so really hoping he can help.
You aren't being dim - they only tested for my FSH level, LH level and testosterone, but for some reason omitted a test for oestrogen - good old NHS! I despair sometimes.
I've also got Hashimoto's disease (which is an autoimmune disease resulting in low thyroxine levels) which I take prescribed thyroxine , so don't think that helps with oestrogen production from what I read.
Anyway thanks for the reply Mary G- really appreciated.
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Glad to be of help. Why on earth didn't they test your oestrogen levels? I despair.
You may be interested to know that once I started using the Oestrogel, my thyroid function improved so this regime might have a positive impact on your condition. My cholesterol levels also returned to normal.
Good luck with Professor Studd and please let us know how you get on.
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Thanks Mary G. God only knows what they didn't check my oestrogen - really despair of the NHS sometimes. Seems a no brainer to me.
Getting my hormone levels checked was a battle in itself but may go back and ask for them to be done- might save a few £'s re the appointment with Prof Studd re bloo tests.
I will post again once I've seen him.
Still trying get to get grips with the forum mechanics thought I'd checked the necessary boxes asking to be notified when I get a response to posts but it's not working.
Of course I may be a numpty at all that!
Thanks again Mary G. much appreciated
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Still trying get to get grips with the forum mechanics thought I'd checked the necessary boxes asking to be notified when I get a response to posts but it's not working.
Of course I may be a numpty at all that!
Not sure, perhaps you won't be notified till you're a member (10 posts I think) rather than first flush.
Don't fret, you're not a numpty!
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Hi Freckles
Just wanted to let you know that I ve been on Prof Studd s regime for just over a month now and can honestly say it has changed my life. I hope you get the same great results that I ve had, please keep us posted. GOOD LUCK ;D
Panda
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Thanks Panda, Limpy and StellaJane
Think I have sorted out the notification problems, so not as much as a numpty as I thought I was!
Thanks too for the positive replies.
I'm not as anxious as I was about spending hard earnt money on seeing John Studd after reading them.
I chose him as I read some variable reviews about the Marion Gluck clinic, plus MG was a lot more expensive
I've been back to the GP and asked if my oestrogen levels could be checked (God knows they didn't but did standard FSH and LH tests, which is useless), so hoping for once they don't get arsey with their "suck it up attitude" and it may save money on private blood tests (?)
Thanks again everyone- really appreciated and I will let you know how I get on!
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I m no expert on hormone tests but in my experience they are a waste of time especially if done using blood or urine testing. All the many hormone checks I ve had over the years at the GP s surgery showed "normal" readings when in fact things were far from normal! I m not sure if the tests Prof Studd does are done differently from the GP ones or if he just knows how to read them properly but in my experience they are useless. My GP has admitted that she knows next to nothing about how to treat women going through the menopause and has been very interested by the information I have passed on to her about Prof Studds regime as she is coming up to menopause herself!
Panda
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Hi Freckles
I went to see professor Studd in February as of yet I'm still not 100%
I had all my bloods done before I went and they were worth doing! I was made to have a bone scan at studds which wasn't too pleased about but my own doc's wouldn't do one as I was low risk. I have been contacted by several ladies all with different views on Studd and his regime some agreeing and some not. It's def better for me cos of side effects but as yet has not been effective enough as oral hrt in combating sleep and VA problems this I have been told will take longer. Due to start utrogestan so that will be interesting? I have tried to speak to him twice since going and he is in my opinion not great on after care unless you paying. Luckily for me my doctor has offered me full after care with scan and no problem getting testosterone etc. She also said I can get a referral to Chelsea and Westminster hospital to see Nick Panay if I want he is the other guy mentioned on here that you can also go see private. Similar prices. Take care x
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Thanks Kate50.
Hopefully I will be one of the women who find Studd helpful.
Bit worrying re your comment about his after care though
My GP is less than helpful, compared to yours- she specialises in "women's issues" but bizarrely thinks HRT is for physical problems only and advocates liquid AD's to treat anything else! I despair.
Will see how I get on with Studd, as I can't afford to pay for two private consultations and it's unlikely my GP would refer me to anyone.
I am still trying to get a NHS blood test to get my oestrogen checked.
Will let you know how I get on with Studd.
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Freckles
You are allowed to be referred to anyone in the UK if NHS registered that's the law! And you need to tell your Dr you got a private appointment and you need oestrogen progesterone testosterone FSH and LH bloods done! I did and that's what I got done at my local hospital instead of waiting for a 3 week appt at doctor's for bloods. It's your right! It's not a case of whether your Dr will? ? Once you been to see Studd Dr will have to take notice or you can report them. They are not God! That's Simon Cowell job oh no it isn't its noel Fitzpatrick Supervet job now! Lol
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Kate50, how right you are, they are not God and need to remember that. Far too many people are in awe of doctors which is why they get away with so much. Other public sector workers have to face far more criticism and scruntiny and doctors should not be exempted from this. They are over protected like football referees.
I should have mentioned that Professor Studd is always happy to write to GPs detailing his prescription and they should prescribe it for you but there is no guarantee they will.
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Kate50- my GP is one of the most arrogant I have come across. I'm hoping to go back on Monday and see if she has agreed to my oestrogen blood test being taken- all the others were done except that.
I very rarely visit my GP, maybe once a year for my thyroxine blood test to be done but that's about it. I really have to bite my tongue when I do see her in case I get in touch with my inner bitch ;)
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Maybe you need to put her on the spot and say what you want and if she doesn't agree ask her is she saying you can't have them? The consultant you are seeing has asked for them. She absolutely cannot refuse you
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I'm not that well versed in the joys of the NHS and GP's- Kate50, are you sure she can't refuse if I am going for a private consultation?
I can see her telling me if I am going privately I can pay for a private blood test!
It seems bizarre to me they did all the other hormone tests but neglected oestrogen.
Sorry, I get a bit anxious around medics! They are so subjective and often so arrogant.
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Yeah I know how you feel. Maybe play to her feeling side? ? My docs are always mortified if you have had to go private. Go for the sob story route. Words like suffering help! Makes no difference if you pay for consultation they still are required to follow it that's why they are GPs that need the specialist advice. If she had referred you she would be following it then it makes no difference. I know it's scary but we shouldn't be afraid to ask for what we want. If you really wasn't happy with her you could tell her in a nice way and say you are going to have to put in a complaint. It's not what you say but how you say it. Have a Google of your rights when dealing with this sort of thing.
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Professor Studd should write to your GP and will hopefully give instructions to them about what to prescribe.
Kate50 is right - if you go and see your GP and explain that you were getting desperate so feel you need to find the money to seek advice from a top specialist, this basically puts the GP into a corner as they really should have referred you if you were feeling that bad. If you explain that to save money you would like to have bloods done, in advance of the visit to Studd, then this is quite a reasonable request. I would really stress that it is going to be difficult for you to afford treatment with Studd.
My private gynae, wrote and insisted my GP do blood tests etc. - however I am seeing a lovely lady GP who was actually relieved I was prepared to pay to see someone privately for advice as I was already 59 so she was unsure whether HRT was the right thing for me to use at this age, if I had seen any of the other male GPs in the practise I think it would have been a different story.
Sadly GPs do not have to be fully clued up about everything and every referral costs money so they are under pressure to avoid referrals where possible. Many GPs still deem the menopause as simply a natural process that has to be gone through with minimal medication and they rarely understand the true negative impact for some women. By paying for a private consultation you are saving the NHS money, so don't forget that.
DG x
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Freckles, a lot of doctors get off on the power it gives them i.e. sitting behind a desk telling people how it is. When my GP refused to prescribe HRT I simply said "oh well, I will buy it myself without a prescription" thus transferring the power away from her and back to me.
If all else fails, you could always refuse to leave the her office until you get some decent service. They will then have to call in the Practice Manager and that will cause a stir!
Remember, be assertive.
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Thanks DG, Kate50 and Mary G for the advice.
Going back tomorrow to enquire about getting my oestrogen being checked, especially as they did all the other hormone tests except that one, which is illogical.
I still find it amazing in this day and age that GP's have such a negative attitude to the adverse affects of the menopause on women and just dismiss it as being 'natural' and therefore inconsequential.
Will let you know how I get on!
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Yay! I've been 'allowed' to have my blood test done tomorrow for my oestrogen levels.
Minor victory with my GP surgery
Hopefully I will get the results back in a few days.
Can anyone point in the direction where I can check the results against what is 'normal' for someone on Femoston 1/10 and post menopausal?
I can't tell you how pleased I am to have found this forum and such helpful, supportive replies.
Thanks all - really appreciated.
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Nice one Freckles!
I was really surprised when my results came they Were really explanatory and showed comparisons of levels and told you if you were in menopause. I had been on oestrogen for 5 months and the levels of oestrogen I thought were high but the guide range it gave you showed they were in the middle. When Studd saw them he said they should be higher having been on oestrogen for 5 months? ? I haven't got a copy at moment but gonna go in and get one as I see a lot of ladies ask this.
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Hi Freckles - the reference range is here:
http://www.gpnotebook.co.uk/simplepage.cfm?ID=570818627
pmol/L
50-200 males
70-510 females: early fol. phase (day 5)
390-1480 females: preovulatory peak
70-600 females: luteal phase
< 130 post-menopausal
If you are post-menopausal and on HRT you want it to be at least 200 pmol/l - mine is probably something not much more than that - and for me that's fine as I have no symptoms of flushes and sweats. Some women earlier in menopause or who are used to a high level - need to continue at a high level otherwise they experience symptoms. Personally I am pleased that my levels are not extremely high because it means I can have a long cycle HRT and only take progesterone every two months and don't have a huge bleed - quite a consideration at 62! It's all a compromise between the dose of oestrogen that you would like to feel at your best, or one that minimises symptoms - and one that means you don't have to have too much progesterone!
Hurdity x
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Thanks Hurdity, that is really helpful.
Had my blood test today so hoping I get the test results back next week.
Freckles x
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Got my oestrogen results back today - 72 pmol/L AND I'm on Femoston 1/10!
I am relieved as at least I know my symptoms aren't in my imagination but result from barely there oestrogen levels!
Also can I say a huge thanks for those of you who replied to this post and your advice- really appreciated!
I didn't even notice my oestrogen blood test had been omitted last time I have my hormones blood tests done.
I am so pleased to have found this forum- thanks so much again.
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:-*
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Freckles - I have a learned so much from this site - there should be a big poster in every GP surgery about MM - I think every GP should study the forum on MM to see how women suffer.
You are now armed with good info when you see Studd - good luck. Dg x
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Freckles, that is extremely low and that is about what mine was when I found out I was post menopause. No wonder you have been having problems. I knew that oral HRT was not as good as the transdermal varieties but even I am surprised at how little oestrogen it is delivering.
Good luck with your appointment and let us know how you get on.
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I agree DG, It's shocking how little my GP knows or cares about HRT and the menopause.
Her "suck it up" attitude and going on anti-depressants for the rest of your life is appalling when some simple blood tests and discussion of the options and risks would have been more helpful.
Thanks too Mary G. At least I know now my instincts were right about lacking any oestrogen and my symptoms were related.
Seems most men have about a similar level of oestrogen!!
I am so pleased I found MM and all the advice and knowledge you clever lot offer!
Now looking forward to seeing John Studd and waving my test results at him!
Hopefully on his regime I will able to stop shaving my face, losing my hair, and more importantly, stop feeling so low and anxious.
Thanks again - you are stars x
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Hello All,
I promised to update every one after my original post as a Newbie here and have been to see Prof. Studd today.
Had a bone scan done and found I had osteopenia (i.e. lower than normal bone density in my left hip bone, but not so low for a diagnosis of osteoporosis) in my left hip, which may account for the joint pain I get there sometimes. And which my **** junior GP said was 'normal' at my age and told me to find a private osteopath, with no other further investigations by her.
Anyway, I have been prescribed and collected the following 3 months supply today on a private prescription:
Estrogel gel - 3 pumps daily;
Testim 1% (testosterone) gel, single (pea size) small amount daily;
Utrogestan (progesterone) 100mg capsules for 7 days at the beginning of each month and
Vitamin D 1000 iu.
Prof Studd is writing to my GP to advise her to prescribe my HRT on the NHS.
I'm keeping my fingers crossed the regime works.
A couple of quick questions for the knowledgeable women on this forum:
1. Do I stop taking my other hormones (Estrogel and Testim gels) when I take the Utrogestan caps for 7 days or continue as usual? (I forgot to ask today, as I get anxious around medics)
2. If my GP gets arsey about prescribing the above meds in the NHS, is there any recourse I take or are they allowed to do that?
Finally, can I say how pleased I am to have found this forum and for all the helpful advice offered to me- I wouldn't have known my oestrogen levels had been omitted in my blood tests, that they were incredibly low, to get my hormones checked on the NHS (which saved me £250.00 for the private consultation today) and for all the advice and support- SO appreciated. xx
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Yes you do take then along side. I got all these from my gp but I know some gps won't prescribe testim cos not licenced to use on women! ?
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Hi Freckles
I have been following this thread and would love to hear how you get on with the Utrogestan. I m on the same regime (minus the testim) and find the Utrogestan makes me very anxious and depressed but I seem to be severely intolerant even to my own progesterone so it's not surprising. I hope it all goes well for you though.
Panda xxx
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Freckles, hello from me too. What a very interesting post and I pray you start to feel better soon.
My female gp is around the same age as me (51) and is absolutely clueless about all things menopause related.
I had my thyroid removed 3 years ago as I had hashimoto's and was having horrendous symptoms. When they came back 3 weeks after I was told it must be something else. My own research led me to this site and that was when I realised everything I had been suffering from was hormone related. Even the letter from the rheumatologist describing my symptoms makes it plain to see. All results were normal but no one put 2 and 2 together and made 4!
After 5 years of horrible symptoms, 2 years of hrt and a very recent change from estradot to estrogel I'm praying things settle as I'm struggling to cope with the fluctuations at the moment.
My estradiol level was 383 pmol on 75 edtradot at day 26 but I was still symptomatic.
Lets hope we all get back to the people we were. Sending you my very best wishes x
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Freckles, thanks for the update and glad it went well with Professor Studd. Sorry to hear that you have osteopenia, thank goodness you have taken the necessary action to start HRT now and stop it getting any worse.
You do need to take the gel and Testim everyday as others have said and try taking the Utrogestan vaginally, it works better that way and has fewer side effects.
I hope you manage to get your GP to prescribe his recommended regime. I can't think why they wouldn't particularly as Professor Studd is so well respected in the medical profession.
Good luck and please let us know how you progress.
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Thank you all for the replies- really appreciated, especially for the advice to continue with the other meds when I take the progesterone (Ultrogestan) for 7 days, as I didn't ask at the time.
I'm really hoping the regime will make a positive difference, not only for my chronic low mood and general anxiety, but the physical symptoms of thinning head hair, dry crappy skin and very brittle nails (which also add to low mood when I inadvertently look in a mirror!) I really feel I've aged in the last two years. The Femoston 1/10, which I've neen on for six years, in the past two years didn't do anything for me at all.
But at least I know my psychological problems are hormone related, my 12 year old GP knows bugger all, and my recent x-ray done on my hips on the NHS which said everything was 'normal' was also crap ( albeit I know it's not the same as a bone density scan).
I am hoping my GP will prescribe all the HRT meds- if they don't, does anyone know if I have a right of appeal? Or do I have to bite the bullet and pay for it all privately for the next few years (which will be a big stretch for me financially)?
Interestingly, John Studd said I should try and see a male GP as he thought that they were more helpful with menopause problems than female GP's!
I'm pleased that at least I know I have a bit of osteopenia, so can treat that, and that all my symptoms are 'not in my mind', that I don't have to go on anti-depressants for ever (which I don't want to take) and despite low mood and lack of motivation and energy for most daily activities, I still managed to get off my backside, find this site and see John Studd.
I'm pleased I have found someone who takes me seriously Even if my HRT meds need altering in the future, at least I'm finally in the right range of oestrogen that I have known I've needed for a couple of years.
Another numpty question MaryG- how can I take Ultrogestan vaginally when it's tablets? I'm guessing I'd need to ask for vaginal pessaries from Prof Studd?
EllaM, I too have Hashimoto's disease (but still have my thyroid) and have always been sensitive to hormone changes (PMS for years, etc) so hoping I will feel better in about a month. I know Hashimoto's is linked to hormonal issues and low mood etc. Hope you start to feel better on Estrogel soon. I was advised at Studd's clinic I should feel better in about three weeks and notice a positive difference in about 6-8 weeks.
Again, a HUGE thanks for all the replies and advice- you have all been incredibly helpful and supportive and I can't tell how much I appreciate that.
But I am so pleased I saw John Studd- praying the huge increase in oestrogen levels works for me
Will let you know how I get on with Studd's regime and any battles with my crap GP re a NHS prescription. xxx
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Freckles, it's not a silly question, the Utrogestan capsules can be used both orally and vaginally, you don't need to ask for a different type to use it vaginally. For no logical reason whatsoever, the UK does not licence Utrogestan to be used vaginally but practically everywhere else in the world does. I have never seen a UK box of Utrogestan because I buy all my stuff over the counter in Spain (it's much cheaper and you don't need a prescription for any HRT medication) so I imagine your box does not mention vaginal use but all the foreign Utrogestan packages do.
Regarding your useless GP, you could try printing out the new NICE guidelines and insisting she prescribes it. If she refuses, you can then refuse to leave the surgery until you see the practice manager and then insist they give you the prescription. Give them a hard time!
I really don't see why you should have to pay for it but if all else fails, you will have to buy it yourself but I always buy mine in Spain where it is much cheaper but obviously this is only a good option if you happen to go on holiday there. The Oestrogel costs about £8.00 in the UK and the Spanish gel costs about €4.00 so it is quite a difference. Utrogestan is around €4.00 per box.
I think you will start to feel better very soon (probably in a week) on this new regime, it really is the best on the market. The HRT you were on before was far too weak and oral HRT is nowhere near as effective as the Oestrogel.
Interesting what Studd said about female GPs. I wonder if they are in denial because they fear what is coming their way very soon. If only they would learn about the menopause and HRT properly, they would realise that much of the pain and misery can be avoided by getting onto the right type of medication at the right time.
I'm looking forward to hearing how you get on!
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Thanks MaryG. I have looked at the leaflet for Utrogestan and you are right, it doesn't mention you can use it vaginally.
Thanks for the heads up re buying it in Spain. It would be worth a weekend away in Spain just to stock up!
Fingers crossed my GP does prescribe the HRT for me. I need to refresh my memory on the NICE guidelines just in case I have the wave them at my GP.
Will let you know how I get on the regime. Thanks again.
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One more quick question- I saw that a lot of forum members are on the Estrogel/Utrogestan regime but not many on that regime with Testim (testosterone) gel. I have been prescribed a daily amount of 1/8th (pea sized) of a 50mg size tube.
I know what testosterone does for men, but just unclear why I have been prescribed it?
Studd did ask about my libido, which has been on holiday for a few years, as a) I'm not currently in a relationship and b) been too low in mood and looking crap to even think about dating. He did ask if I "flew solo" (his phrase!) regarding my sex drive even though I wasn't in a relationship, and I told him I didn't.
I was wondering if I've been prescribed it for that?
And if anyone had experienced any side effects on a similar dose?
I guess I am a bit concerned about possible side effects such as even more facial hair etc.
Any experiences or advice really appreciated! Thanks in advance. xx
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Freckles, I'm on Testim too, prescribed by Professor Studd. I use a very small bead everyday and I haven't had any adverse side effects. Professor Studd nearly always prescribes testosterone as well and the Oestrogel and Utrogestan. I'm not sure how much difference it has made to me but I take it anyway and my testosterone blood levels are back up to what they should be. I would say take it anyway and see if it makes a difference, I doubt you will have any adverse effects on that small dose.
I don't think many women get Testim on the NHS, it's usually Oestrogel and Utrogestan if you are lucky!
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There was an article quoting Prof Studd in 2-day's Telegraph supplement. Seemed a bit disjointed to me ::).
No question is silly on here ………..
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Thanks Mary G- much appreciated! That was reassuring to read. I'll see how I get on- got to anticipate an argument with my rubbish GP prescribing all or any of the regime.
Thanks too CLKD- will see if I can find a link to the article.
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Freckles - just be calm yet firm with your GP. He/She should get a letter from Studd and they are supposed to carry out his instructions. Good luck DG x
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Thanks Dancing Girl- my GP practice seems to be a law unto themselves sometimes, where common sense and effective medical care have gone on holiday!
Will let you know how I get on.
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Apologies in advance if I should have posted this on another thread- if so please let me know and I will copy and post it there.
I don't want to upset anyone!
I am getting anxious about seeing my GP to ask to have the Estrogel gel, Utrogestan 100 mg and the Testim from my crap GP.
I know Prof. Studd has written to my 12 year old GP to ask that I'm prescribed the regime on the NHS (and I realise that Testim isn't licensed for women in the UK). The bone scan at Studd's clinic showed I had osteopenia in my left hip (which a few months ago my crap GP when I complained of years of left hip pain just advised me to see to a private osteopath and prescribed nothing!).
Given my GP says she likes to "wean you ladies off HRT" as she was advised by the senior female GP at the surgery and prescribed me liquid AD, which I don't want, I am hoping for the best but preparing for the worst!
I've looked at some other forums and some folk say the GP is within their right to not prescribe Studd's regime if it's not within their budget? Or that they might say if I paid privately to see Studd they don't have to agree to his advice and prescribe on the NHS? Is that right? Seems that the regime is not that more expensive than standard HRT patches.
Basically I am looking for any advice to counteract any potential arguments my patronising GP (they all seem to be rubbish at my surgery) may have to decline prescribing the HRT? Can they refuse me? Would I get anywhere if I made a complaint if they do?
Any specific advice or suggestions from you knowledgeable posters would be very appreciated.
Freckles x
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Reading the guidelines issued by the Mid Essex clinical trust in 2013 for an example, it does seem to suggest that your GP is not obliged to prescribe what a private consultant has prescribed if you weren't referred by them, if the drug isn't one that they would normally prescribe or is contrary to their usual clinical practice. It is all about clinical responsibility and your GP could argue that as you have had a private consultation that for this " episode of care" it is Studd who is is the person responsible for your prescriptions and you are responsible for funding them. If the GP agrees with the prescription I think they can issue one, but then they become responsible for being the prescriber and you'd run into whether they are prepared to do this if they a) don't know enough about it b) don't approve of HRT and so on x
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Thanks StellaJane and Coldethyl. I am always polite and non confrontational I just get annoyed about things afterwards!
I referred myself to Studd so my GP may take this into account.
Doesn't sound too hopeful given StellaJanes's advice.
Will see what they say and let you know.
Thanks again.
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"has written to my 12 year old GP " ;) -
However: A Consultant should never see a patient privately without a referral from the GP. It is simply un-ethical! The patient may not tell everything that the Consultant requires to know about their past medical history, the patient may be evasive when questioned. (Have seen this happening in Clinical situations).
It really does depend on the Consultant too. I have been seen privately when referred by my GP, was referred back to the NHS with advice. But some GPs think that if a patient begins to self-refer: to any Speciality: then why should the Surgery pick up the tab, in fact the patient should return to the Private Practice and continue paying. If a patient by-passes the Surgery they can be struck off. Quite honestly, it an insult not to include the GP. Also, who is ultimately responsible if a problem with the medication occurs, the GP or the referring Consultant?
One GP I was registered with didn't agree with PP but didn't not refer me when I asked! He was a believer that the NHS should look after it's own but by going privately, I left a space in the NHS.
Wondering Freckles - why did you self refer to Prof Studd? Did he give you the impression that your GP would prescribe what he recommended?
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Freckles, your GP sounds extremely patronising. Saying she likes to "wean you ladies off HRT" is pretty sad not to mention hopelessly out of date.
If she refuses to precribe Professor Studd's regime, you could complain to the practice manager. At the very least, you should insist on having a good explanation as to why they will not prescribe it. The annoying this is, these surgeries are still prescribing ineffectual and outdated forms of HRT that are much more harmful than Professor Studd's regime and you might want to point that out. It is the synthetic progestin component of HRT that can cause breast cancer although even then it is extremely rare. Nonetheless, if there is any risk attached to HRT at all, that is where the risk lies, not in the transdermal, bio identical forms of oestrogen or micronised progesterone.
When is your appointment?
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However Mary G - as stated above, Consultants should not see potential patients without a GP referral letter. Why should a Practice prescribe from the NHS when a patient has self referred to a private practice? :-\. Without a GP referral letter, then the Private Consultant should take on prescribing, any problems that might result from that prescription - it should not come out of the NHS!
I have no problem with either system having used both myself, but it is polite to ask the GP for advice - that's what they are there for. One shouldn't expect the NHS to pick up the tab on a suggestion from a Private Practice which the GP probably had no aware that their patient was considering. Doesn't matter which Specialitiy either. That is not what the NHS is about.
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CLKD, I was forced to go to Professor Studd because my GP refused to prescribe HRT full stop. I didn't have the luxury of choice, it was forced upon me because I had to do something, I was having debilitating silent migraines that I just couldn't live with and my GP was not prepared to help me. Also, she admitted she knew very little about HRT so how could she possibly advise me? I doubt the NHS would refer anyone to Professor Studd anyway, I have certainly never heard of anyone being referred to him from their GP but I stand to be corrected.
The new guidelines do state that GPs should be using HRT as the first line of defence for the menopause and prescribing the Professor Studd regime so there is no reason why Freckles should not be able to get it. Of course they can refuse to prescribe this regime to Freckles if they wish but how much will she cost the NHS in the future if she goes on to contract the numerous ailments caused by oestrogen deprivation?
As it happens, I have never gone back to my GP and buy my own HRT (apart from the testosterone) over the counter and without a prescription in Spain so I am saving them money I suppose.
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I asked my GP for a referral within the NHS the first was our local hospital I was told the only thing on offer for VA was steroid cream? ? I tried fir a serving refferal abs I never got one it went missing? ?? Went back to tell them I wanted to go see Studd. They wrote a letter which I took but he didn't read it? They said I could see who I liked. Luckily my GP has prescribed everything but says she will look to ongoing care through NHS and will then follow that? ? Make of that what you can.
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I saw the receptionist at my GP and asked what the process was re getting the HRT regime prescribed.
She seemed to think it was just a case of letting the GP seeing the letter and getting the HRT added to my prescription.
I find out on Tuesday- I may hear in the interim if there is a problem and/or if I need to see a GP, but wasn't advised today I need to discuss with them.
Fingers crossed ...
CLKD, I understand your argument.
However, I'm in same position as Mary G's reply - my young GP like to "wean you ladies off HRT" and offers liquid antidepressants instead. I knew my many problems were due to virtually no oestrogen despite being on a synthetic HRT. AD's aren't often effective and they don't work for me. So my GP's "advice" was flawed and contrary to NICE guidelines, which when I mentioned NICE recommendations, she had to Google it in front of me and tell me menopause (and presumably my chronic hormonal symptoms) were " natural ageing process".
So I had no option other than to go privately or not bother and continue to suffer. My GP certainly wouldn't have referred me to Prof Studd or anyone else.
GP's are just that - general practitioners- and I wanted to see an expert in the field, which Studd certainly is.
I had to provide a comprehensive medical history and recent blood test results, which is far more information than many GP's send in their referral letters (I have to review GP records as part of my work and the referral letters are usually very brief).
Without the bone scan done at Studd's clinic, I wouldn't have known my hip had osteopenia (low bone density and a precursor to osteoporosis) .
I rarely go to the GP and when I saw her about getting increased HRT and then mentioned the years of pain in my hip, she declined to do any tests/x-rays and told me to find my own private osteopath, telling me to look in the local Yellow Pages for one!
Was also told a really horrible skin condition I have on my feet and legs that I have wouldn't be funded on the NHS for treatment and she Googled a private skin clinic and told me to make an appointment with them (again without NHS assessment or the need for a formal referral).
So she seems ok about telling me to see a private osteopath and a private skin clinic without referring me.
I guess I am saying that the idea the GP has to be the gatekeeper to refer to specialist services doesn't always apply.
I have saved the NHS money by going privately, and as Mary G suggests, potentially saving even more money by preventing a numerous medical conditions that absence of oestrogen provides.
I guess I'll have to agree to disagree with your opinion CLKD. ;)
I think the days of relying on a NHS GP to provide effective, up to date care, and appropriate referrals are historic nowadays. Especially for hormonal conditions.
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Yay! :)
Went to my GP surgery today to ask about my HRT as prescribed by John Studd in his letter to them, and anticipating being refused some or all of them.
Was informed by the receptionist that they had been added to my prescription list and were all waiting for me at the local chemist!
So now have a month's supply of Estragol, Utrogestan, Vit D AND Testim (although someone made an error and instead of 4 tubes of Testim, I was given 30 tubes!)
So no discussion/consultation with a GP needed and simply added to my prescription list. Plus the receptionist said they would test my hormones levels on the NHS and provide a printout before I see Studd for review in July this year, which will save me £250!
Well chuffed!!!
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Freckles - great news!! :old: Dg x
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Thanks DG- I'm very chuffed!! ;D
Plus feeling better after only 10 days on Estrogel and Testim than I have done for months/years.
So pleased that I went to John Studd!
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Hey Freckles that's amazing!
I think you must be one of the first on here who has been prescribed testosterone on NHS after being prescribed it privately and who still has a womb!
I have yet to test the system in this regard and probably won't have to for a while as I got another prescription from Annie Evans by e-mailing the secretary and they will send it to me in the post ( hopefully 30 tubes as well - a year's supply!).
Glad you are feeling better and long may it last :)
Hurdity x
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Thanks very much Hurdity. I was astonished!
I'm keeping quiet about the over prescription of the Testim gel as I'm prescribed by Studd an 1/8th of a tube a day, so 30 tubes will last about 9 months or so. May be due to my rubbish GP in reading Studd's letter properly advising my prescription but I'm not complaining.
At least if I am prescribed the regime on the NHS it will make it more difficult for my 12 year old GP to then later decline to prescribe it ;) I have a medical exemption certificate for NHS prescriptions as I have an auto immune disease (Hashimoto's syndrome) which results in low thyroxine levels so I have prescribed thyroxine medication.
I'm honestly feeling a bit better re a reduction in my depression and anxiety symptoms and some improvement in energy and motivation levels. Not quite all singing and all dancing as yet, but I certainly feel better than I have done for such a long time.
I know posters can vary on this forum regarding their views on Studd and his regime but although I have yet to go through the 7 day progesterone stage, so far, so good! So pleased I paid out my hard earned money to see him and got off my depressed backside to make the appointment.
Thanks again for all the helpful, informative, and positive replies I've had to my original post- really appreciated. So pleased I found this forum- you are stars! xx
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:thankyou: Girls. It shouldn't be so though should it :-\ that people have to pay privately unless they want to. It isn't up to a GP to 'wean you ladies off HRT' - that would be a letter to the GMC if that had happened to me. Particular in view of the recent Guidelines to GPs stating that ADs should not be the first route in order to treat menopausal symptoms. As for it being 'natural ageing processes' well so is OA, late onset diabetes, some cancers ……… :-\
Would this GP 'wean' patients off diabetic treatment, heart medication etc.? Sounds like they have budget constraints. However, her Time Will Come >:(
I suppose by telling a patient to contact a Private Practitioner without a referral letter saves the Practice money too.
Thanks for the update Freckles - well done!
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Well done Freckles, that's brilliant news! Hopefully this will encourage others to press their GPs for this regime and who knows, perhaps Professor Studd's message is finally coming through and/or some GPs are reading this forum and taking note.
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Thanks Mary G and CLKD- I agree with both replies. You shouldn't have to pay privately to get decent treatment on the NHS for menopausal symptoms that really negatively impact on your quality of everyday life. Anti-depressants may work for some women but I know from my reading of the research that are only effective for about 30%, 30% feel no different and 30% feel worse
Nor should women have to put up with being prescribed NHS poor quality HRT regimes that have little nor no effect on their symptoms by GP's who haven't a clue.
Mary G - I truly hope women read this and press their GP to prescribe the bio identical gels - I have read the NICE guidelines and related research and transdermal gels are the most effective and safest form of HRT treatment, with progesterone used at low dosages for a few days each month.
Like many women I did (initially) feel confused and overwhelmed by the information about HRT but after some time reading on the PC and the helpful posts on this forum , feel far more clued up than I did before.
I'm hoping the current improvements for me continue- so pleased with my prescription outcome! At least the last third of my life might be spent more productively and be happier than it has for the last two years. Yay! So chuffed still!
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Little steps ;)
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I got testim from my GP ok and 30 tubes from Studd. Utrogestan been shit though! Sorry! Not look in forward to taking it again.
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Oh no Kate50! Do you take it vaginally or orally? Some people recommend taking it vaginally as it has less side effects? I've yet to start my first cycle of it.
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Orally tried it vaginally it made me wee all day! Will try again though as orally gave me shocking headaches
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I'm going to try it vaginally as many poster seem to suggest that's the best method. Fingers crossed ....
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Hello again
Just to update folk, I've just done the first 7 days at 100mg a night on progesterone (Utrogestan) on the Studd regime.
Apart from really bizarre and vivid dreams, can't say I've had any side effects.
Starting to feel so much better after a month on his treatment regime, as compared to the poor affect I got with Femeston 1/10 and the 12 year old GP for the past 5 years ... .
Hope it continues.
I picked up some printed articles at Studd's clinic for patients that he wrote on the benefits of HRT and other similar HRT issues.
They don't advocate seeing him- just the benefits of HRT per se.
Is it ok to scan and attachment them here, just for information for other MM users?
I think they be helpful.
I don't want to infringe any MM rules.
Freckles x
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Freckles - I'd check with Emma - you can email her. Studd's website actually gives a lot of this info so is available for all to see so have a look and see if what you have is the same or not.
Studd has done some groundbreaking research which is undoubtably significant. My worry is that his treatments are quite specific and do require regular monitoring which the NHS generally cannot provide due to cost.
I think we all hope that once the true benefits of a tailored approach to treating the menopause gradually trickles down to the GPs, things will improve. One mustn't loose sight of the fact that most women do extremely well on the standard HRTs that are routinely available on the NHS - it tends to be the small number of more sensitive ladies who need a tailored HRT. DG x
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Thanks DG. Seems it's not appropriate.
No worries! - It was just a suggestion in case it might be helpful x
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Hi Freckles - if it was possible to attach articles then I'm sure it would be fine - but this facility is not available. It looks like it might have been planned at one time but not implemented. I presume because moderating the attachments as well as the posts would be even more time-consuming?!
However you can link to articles that are helpful - as Dancinggirl says there is a lot of information on Studd's website so if there are any of the articles on there you feel would be helpful to others please do link to them - because it will save members reading all of the site!!
If you felt fine on the 7 days utrogestan - perhaps you could try a few more days next month to be on the safe side - unless you are having regular scans? I can't remember what dose of oestrogel you are on?
Glad you are feeling better - long may it last :)
Hurdity x
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Thanks Hurdity.
Seems it's deemed inappropriate to link articles from Studd or his web site and as I don't want to contravene posting rules, I won't.
Thanks for the advice re the Utrogestan (progesterone) 100mg daily for 7 days cycle but I think I will continue with Studd's regime for the time being and until my review with him in 2 months time.
Seems plenty of experts, including Dr Currie, concur with that unless the individual woman has specific problems.
I want to have enough progesterone to induce a healthy womb lining bleed each month but not enough to cause physical and/or emotional side effects.
I am currently on 3 pumps of Oestrogel daily, plus a very small dose of Testim (testosterone) gel daily and although it's only been a month or so, I do feel so much better than I have for years.
I'm going to pay privately for a uterine scan each year, just for peace of mind, as it seems it's not available on the NHS, unfortunately, unless there is suggestion you have abnormal uterine problems. IU'd rather pre-empt that.
But thanks, I am feeling so much better compared to what I was previously prescribed on the NHS.
So pleased I finally decided to take the issue of my health in my own hands and to not accept ill informed advice from my GP .
Hope the positive effects continues!
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Freckles, I am so pleased that you are feeling better and that you are getting on well with the Professor Studd regime. I would stick with it because it is a tried and tested formula that has fewer side effects.
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Thanks for the update. Let us know how you get on! R U keeping a mood/food diary too?
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Hi again - I'm not sure why you think it's not appropriate to refer to Studd's website? This doesn't contravene posting rules as I understand them and many of us have referred members to his site before including me.
The only rules are about advertising products and especially with links straight to them and especially to do with menopause. If you go to the Forum Guide and the threads Information for Members and Registration agreement you will see the info there.
I can see there is a fine line re private practitioners ie someone could come on here pushing one particular gynae so maybe this could be seen as advertising, but there are such practitioners (private) listed under specialists on this site. No-one has ever been pulled up for linking to a gynae that I know of - as long it's not one of these that is also trying to sell a load of products as well!
Hurdity x
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Hurdity I was told by the moderator it was "inappropriate" to link any articles on HRT by Studd so am abiding by that. It wasn't linked to advertising in any way; it was just information that I thought some might find helpful. CKLD- I'm not keeping a mood/food diary as I don't have (never had) significant mood swings or food cravings. MaryG - thanks. I am feeling so much better than I have for years, even though it's only been a month. I am definitely sticking with Studd's regime. Just wish I'd known about his regime years ago and then I wouldn't have to put up with the ineffectual treatment I got from my patronising GP for the past three years. I guess better late than never! Hope the positive improvements continues over time. I'm starting to feel I've got myself and my life back.
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Hello
I'm 45 and been suffering with bad anxiety depression, headaches etc lI saw Dr Studd on Wednesday. Had bloods haven't had results yet. Bone scan which was good. I said I had post natal depression ongoing anxiety and depression with a few good days a month. Headaches also and no libido. He prescribed oestrogel and testim and a tablet to take in a few months. Even though I'm day 9 of cycle ( cycle being 17-21 days) I'm still anxious with really bad headaches. So not sure if I'm a candidate for this regime as isn't this suppose to be when I should be having good days!!! :'( thank you for reading xxxx
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If you are only saw Studd on Wednesday and it's only day 9 of your cycle, maybe it's far too soon to expect any difference?
I saw Studd about six weeks ago for the first time and I was advised to expect to notice a small difference after a few weeks and to expect to notice a significant difference after about three month on the regime.
I started to notice a difference after 2 or 3 weeks, which has gradually improved over time.
If you are concerned though, maybe telephone or email Studd's clinic for advice and/or reassurance?
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Louloufell, I agree with Freckles, it's far too soon to know whether or not it is working. What has caused you to doubt this regime after such a short period of time i.e. 2 days? Also, what kind of tablet has he given you? I also agree that you should consider ringing his office if you have any worries.
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Hi Louloufell
:welcomemm:
When you say you have been suffering from post-natal depression - have you had a baby fairly recently then - or were you talking about the past?
Also re your cycle of 17-21 days - has it always been like this ie short cycles or has this developed fairly recently? I ask because the last phase of our reproductive years just before the peri-menopausal transition is characterised by shorter cycles. Some hormonal changes occur at this time and many women notice much worsening pms due to the extreme fluctuations in hormones - as your oestrogen swings from very high to very low and progesterone rises and falls.
Hopefully in your case the treatment you have been prescribed will work for you to help even out your moods, but as the others have said you need to give it time - although our cycle causes changes to our moods within hours, when oestrogen is replaced from outside - it can take longer so you will need to try it for several weeks! Chi chi is another member who has tried out similar prescription in the past for similar reasons so you could look up her posts.
Good luck with it and hope you see an improvement soon :)
Hurdity x
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Thank you everyone I just got so worried it wouldn't work for me. I knew the treatment wouldn't work instantly. I did speak to a nurse today who was great. Also I received my blood tests I have low testosterone on the blood test it was unmeasurable so think this explains a lot.
My last baby will be five in August. It was severe post natal depression after him i suffered. I have to relax be kind to myself and keep on rubbing the gel in. It will take 6-8 weeks. Xxx
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Hi Freckles
Just wondering how you are getting on with the Studd regime?
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Hi Freckles
I haven't seen any posts from you for a while and I wonder too how you are getting along. I hope all is well with you, do give us an update, when you're able to.
All good wishes. x
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Hi Panda and Elizabethrose
Thanks for the posts.
I'm doing really well on the Studd regime thanks. So pleased I went to see him.
The regime is far better (for me) than the Femoston I was taking.
I had loads of Femoston tablets left over that I recently found. I stuck them in the soil of my house plants and they have really perked up- so at least put them to good use!
Haven't posted at all lately as I have been horribly busy in real life with work and family problems, and not been able to spend time on the PC- but no doubt I will be back soon! xx
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Hahaha, that absolutely cracked me up! Perhaps you should contact Monty Don and give him your hot gardening tip! ;D
Lovely to hear from you and so glad your regime is still working well. Hope that all calms for you soon and that you're not having to deal with anything too traumatic.
All good wishes to you x
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Unlike me, my house plants have really perked up since being on the pills!
Can honestly recommend Femoston as a gardening tip ;)
Thanks for the kind wishes- hope to be back posting soon! xx
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;D It's the best use for Femoston I've found! x
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Freckles, I hope you don't mind but I've just been talking about you on another thread in the 'All Things Menopause' section! I was referring to the blood tests you had before your consultation with Professor Studd and how it save you money.
I am so pleased to hear that you are continuing to do well and please come back when you are less busy.
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No problem at all Mary G mentioning me!
It was you who originally suggested to me getting blood tests on the NHS and it was an excellent idea!
Hadn't occurred to me at all, and the basic blood tests for hormones done on the NHS are accepted by Studd's clinic
I am very grateful, as I saved £250-£300 getting that done (although I understand Studd's clinic does do a far more all singing, all dancing, analysis than the NHS- vitamin levels, iron, cholesterol, hormones, and anything else that can be tested).
I'll be posting again soon.
Just realised I've mentioned Studd by name- apologies if that has distressed (some) folk as it seemed to have done in the past.
I'll revert back to calling him "He Who Shall Not Be Named" when I start posting again :)
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Hi,.
Just read your message regarding appointment with Prof Studd. I hope you are feeling better.
I'm in a bit if a quandary at the moment and wondered if you could help and advice.
I went to see a nurse who had been trained by Dr Marian Gluck. Paid ?500.00 for initial consultation and blood tests
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Got test results back and needed DHEA, Progesterone and Testosterone . Got copy of results and copy of prescription.
The problem is that the clinic in questioned stated in their costs for cBHRT ?60.00 per month (and still do.)
However, when I contacted the compounded Pharmacy that they use ( same has Marian Gluck) the cost was double this amount . ?115.00 per month..which I can't really afford .
The question I'm asking is whether going to see Prof Studd might be cheaper as I have the blood tests results already
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Not sure though whether I could get acth , progesterone and testosterone from my GP.
Kind Regards,
Booblet
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Hey, they seem to be treating you for perimenopause high oestrogen by subduing with progesterone. Studd would likely treat that differently with high dose oestrogen to suppress your own oestrogen spikes. A GP may be able to do the same though.
That price sounds about normal for one compounded product but it usually lasts for 3 months. Are you sure it's per month? If not I would question the clinic on why they have quoted much lower, which is very misleading.