Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Dandelion on October 14, 2014, 09:22:43 AM
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Hi Ladies :)
Hope you are all ok today. It's been pouring with rain here for two days, but I like rain so I don't mind.
I just got back from a GP appointment, and what a palava that was.
I went, armed with some emails from Dr Currie saying I would be allowed patches and utrogestan.
The doctor has only given me one months supply, because she is not sure whether Utrogestan is allowed to be prescribed in our area.
I've been given estradot and utrogestan. The chemists are ordering it in. I think I have been given the lowest dose estradot.
When I told her other ladies from the UK were being prescribed it on the NHS she said that it differs from area to area, what they are allowed to prescribe.
When I tried to explain bio-identical hormones to the doctor, she asked me what I understood about bio identical and I said the molecule mimics our own prog molecules.
The doctor got confused between natural hormones and bio identical hormones. I told her I had tried the natural route and it didn't work.
The doctor wasn't happy that I was not wiling to try other options. I said I just want the hrt that I have asked for, that Dr Curry agreed.
Dr Curry said the doctors can email her, but this GP did not seem interested in that.
She was also not too fussed about me 'going on the internet' even though I told her lots of GP's refer their patients to this site.
She would not take seriously the fact that I 'spoke to' lots of UK women on here, and I said this site is not some random website.
I said I paid Dr currie, £50 for two questions, and I asked, why, when other women get what they want, am I having all this hassle getting what I want.
I have another appoinntment in a months time with her, and I hope she has found out by then whether I can take utrogestan other wise, if oestradot and utrogestan work for me, I may have to buy them privately, cos once I am on a HRT that works, I wont want to come off.
What do you guys on here think about my GP appointment?
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Dandelion,
It may be Ultrogestan is not in the CCG Prescribing Formulary. This advises GP what to prescribe and is decided locally. GP's can still prescribe it if it is not in the local Prescribing Formulary however it would be at a GP's discretion.
Any hassle I would just ask for a private prescription for it. It is not that expensive.
What dose of Estradot have you got? Surely you need an equivalent dose to the 2/10 Femston?
It sounds like you have an extremely uninformed GP.
Ellie
Ps Dandelion I have Oestrogel for NON menopause related reasons I will not have any medication in patch form at all. The patches will be the same as Oestrogel it is just a different for slapping them on your body!!!
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Dandelion,
Do a Freedom of Information Request to your CCG to find out if Utrogestan is in their Prescribing Formulary.
I am happy to do it for you if you want to message me. I do NHS FOIAs all the time. I bet it is in the Formaulary. This would really make your GP squirm!
Ellie
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Dandelion,
Do a Freedom of Information Request to your CCG to find out if Utrogestan is in their Prescribing Formulary.
I am happy to do it for you if you want to message me. I do NHS FOIAs all the time. I bet it is in the Formaulary. This would really make your GP squirm!
Ellie
Hi Ellie thanks, i will pm you.
I don't wanna alienate the gp but I do want utrogestan.
I think im on the lowest dose oestrogen, I wasn't absorbing the pills at all, cos I have ibs.
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Hi Dandelion
I had a conversation yesterday with my Pharmacist regarding Utrogeston. He advised me the due to cost GP's prefer not to prescribe this and therefore go for a cheaper option.
He did say if you ask for a private prescription (£8:30) the GP would agree to this.
Hope the above helps ;)
W
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Hmmm it is quite cheap compared to a lot of drugs. Plus if it has less side effects there will be less waste as patients will not be asking to have their script changed. http://www.menopausematters.co.uk/to_progestogens.php
At that price I cannot see how the NHS can deny on cost grounds.
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I only got 1 month of Utrogestan the first time too as my GP wanted to make sure it suited me.
Perhaps try the month and then contact your GP to confirm it is suiting you (which hopefully it will!). Then you'll have more ammunition to argue your case (which hopefully you won't need to do) if the Utro suits you.
Good luck - when are you planning on starting the patches/Utro?
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Most GPs only give a month to start with, in case it is unsuitable. There are no guarantees that a particular HRT will suit everyone as we're all very different.
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Dandelion,
It may be Ultrogestan is not in the CCG Prescribing Formulary. This advises GP what to prescribe and is decided locally. GP's can still prescribe it if it is not in the local Prescribing Formulary however it would be at a GP's discretion.
Any hassle I would just ask for a private prescription for it. It is not that expensive.
What dose of Estradot have you got? Surely you need an equivalent dose to the 2/10 Femston?
It sounds like you have an extremely uninformed GP.
Ellie
Ps Dandelion I have Oestrogel for NON menopause related reasons I will not have any medication in patch form at all. The patches will be the same as Oestrogel it is just a different for slapping them on your body!!!
gp
Ive been so unlucky with all female GP's at the moment, it might be that i have tio go private, even though i disagree witj private health care, mney should not equal health, healthare should be available to alll, but we live in a topsy turvy world full of loads of obstacles and needs must migjht come into it if he refuses.
My GP today, not usual one, didn't like it when i suggested she email Dr Currie, like Dr currie suggested in her email.
I think she resented me doing my homework and I could not be ar$ed to explain the difference between bioidentical and natural phyto oestogens.
I had to remember to try and keep my cool, cos I was so pissed off with all these doctors amy surgery, seeming to put obstacles in my way, cos theydon't like it when their patients dig a bit deeper on issues that affect their quality of life.
If when I see the doc next month, and she refuses my oestrogen and utrogestan, can I always ask for a private prescription?
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Hi Dandelion
I had a conversation yesterday with my Pharmacist regarding Utrogeston. He advised me the due to cost GP's prefer not to prescribe this and therefore go for a cheaper option.
He did say if you ask for a private prescription (£8:30) the GP would agree to this.
Hope the above helps ;)
W
Aww thanks, you answered my question in the post before this.
Yeah it's worth paying to feel good.
I never absorbed 1/10 or 2/10, got flushes throughout, plus sweats, totally random but often in bed, or coming indoors after being outside.
I dunno how far through perimeno I am.
I've had loads of medical stuff lately, psych nurse appointment, psychologist referral appointment, COPD newly diagnosed caused by smoking, I love smoking but its like this, carry on smoking and damage lungs more.
Back to hrt, I had a little feeling that doctors might be avoiding prescribing utrogestan cos of price, but isn't utrogestan cheap anyway?
http://www.chemistdirect.co.uk/utrogestan-capsule-200mg/prd-mf6
I went on netdoctor.co.uk and looked at the bumph on estradot.
How depressing that it emphaasises the risks, based on this faulty research that caused loads of women to come off hrt.
Sometimes I think the powers that be want us to be crazy hormonal wrecks. They make it so hard to get hrt, grrrrrr frustrating, that doctor could tell I was pissed off.
I suspect that my digestive system is disrupted due to lack of oestrogen, so I am hoping that this different delivery method will take away the ibs and digestive problems and of course, the flushes and sweats.
It's been a year of hard work with hrt, I admit, I procrastinated doing anythig for months, even though I knew my femoston was not working.
I suspected I wasnt absorbinhg it and I think I may have posted about that, Dr Curry confirmed my suspicions, that some women just don't absorb oral tablet hrt.
I listen to my body and have a good command of what it is telling me, even though i smoke (for now) and drink, I know when something is wrong and usually what to do about it, and my own GP doesnt seem to like me researching my own health and in formation that affects or can affect my life.
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Hi Dandelion - when are you planning on starting with your patches then? Hope they work for you.
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Hi Dandelion - when are you planning on starting with your patches then? Hope they work for you.
Hi
I've just started the progesterone phase of my femoston, so I have to finish that before starting the estradot.
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Ah, I see. Good luck with it! I'm just finishing off the last 3 patches then going to try the Oestrogel. The Utrogestan suits me very well, though.
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Dandelion - sorry to hear about all your issues with the doctors. However the most important thing you can do for your health and especially as you enter menopause is to start the process to try to give up smoking, and limit alcohol (if it is over the recommended limits). HRT is not a panacea and especially as you have other health problems including those caused by smoking.
I do hope this HRT suits you - and I presume you have been given 50 mcg Estradot patch? Once you have found out if it suits you then you can tackle the issues of the docs not prescribing it. I am not familiar with any of this (ie prescribing formulary) I understood that we were entitled to be prescribed any generally licensed product needed for our health. In the case of progesterone, there is no other alternative to Utrogestan, as there is no other product on the market licensed for use as HRT, only progestins (ie synthetic progestogens). If you are adamant you do not want progestins then surely they have to comply? Anyway even it sounds like even if they (the powers that be) have decided to advise docs not to prescribe Utrogestan on cost grounds - this surely is only advisory, because the product is licensed by NICE and available?
Hurdity x
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Dandelion - sorry to hear about all your issues with the doctors. However the most important thing you can do for your health and especially as you enter menopause is to start the process to try to give up smoking, and limit alcohol (if it is over the recommended limits). HRT is not a panacea and especially as you have other health problems including those caused by smoking.
I do hope this HRT suits you - and I presume you have been given 50 mcg Estradot patch? Once you have found out if it suits you then you can tackle the issues of the docs not prescribing it. I am not familiar with any of this (ie prescribing formulary) I understood that we were entitled to be prescribed any generally licensed product needed for our health. In the case of progesterone, there is no other alternative to Utrogestan, as there is no other product on the market licensed for use as HRT, only progestins (ie synthetic progestogens). If you are adamant you do not want progestins then surely they have to comply? Anyway even it sounds like even if they (the powers that be) have decided to advise docs not to prescribe Utrogestan on cost grounds - this surely is only advisory, because the product is licensed by NICE and available?
Hurdity x
Hi Hurdity
I hear you on the cigarettes and alcohol thing, you are right.
I think they have given me estradot 25mg. She was on about giving me the lowest dose I think.
It might be enough - I told her I was in peri and she said it didn't matter. A couple of you on here said Estradot 50 and I am now worrying she has not given me a high enough dose.
EDIT,- aww damn, I just checked and the dose she gave me is only 25mcg, so probably not enough.
Two of you have said you assume I am getting estradot 50mcg.
I don't wanna waste anymore time, my meno based anxiety is just getting worse and worse, so I wanna go straight onto the fifty micrograms.
Can anyone tell me how I can buy estradot 50mcg please privately.
I'm really starting to despair now, I have had enough of this hassle, and it's getting me down.
thanks
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Dandelion,
Whoops I have had several thoughts and suggestions. I have sent you 3 messages let me know when you get them as I do not want to bombard you but I will then message you my email address as it may be easier.
Ellie
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I really think all these different thoughts and ideas may be confusing and cause panic.
Dandelion emailed and payed for Dr Curries advice and has been prescribed exactly what she wanted.
Surely much better to start with the months course and see how it goes.
There is no need to complain and rock a boat that does not need rocking.
She has not been refused.....She has been given a month's course which is what a lot of doctor's do.
What is the problem as I just don't get it anymore.
Honeyb
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There are 2 issues:
1. Dandelion has only been prescribed 25mcg of Estradot not what seems to be the standard 50mcg.
2. The GP is trying to use the CCG Prescribing Formulary as an excuse not to prescribe Utrogestan even though GP's can use their discretion and prescribe outside it.
I strongly suspect Dandelion has a rubbish GP!
Ellie
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Surely best to start low and minimize side effects as more will be absorbed by using patches and Dandelion is in peri.
The GP has given Dandelion what Dr Currie prescribed.
I still think she should start with what has been prescribed and start from there....she has not been refused the HRT she requested.
Dandelion ....Sorry....also worries a lot and this really can't be helping.
Honeyb
x
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I still think Dandelion is right this needs to be sorted out once and for all. A patient needs to know an long term prescription is actually correct. The uncertainty is quite appalling. It is very bad practice to use the CCG Prescribing Formulary as an excuse.
The other point is the GP should have the CCG Formulary in front of them on the computer my GP does! It is a standard document.
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But it's not a long term prescription....It's for a month and then a review.
Once that's sorted then presumably then it will be a three month prescription and then a further review.
That's pretty standard for HRT. This time there has been no excuse....the prescription has been given for the type of HRT she asked for.
Surely it's wasteful to give someone a long term prescription for something that may not suit.
When I tried Dandelions combination I was given one month. It was sequi and I hated it so after the month was up I was given another prescription for a month's conti. Again it did not suit. There was no waste of medication and my GP was happy to prescribe something else.
It's tried and tested prescribing.
I again don't see the issue. Dandelion. has wanted this for so long.....She has got it....at least just try without over thinking things again.
Honeyb
x
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Honeyb,
The issue is it may be stopped after the month with the GP using the CCG Formulary excuse.
This is not a normal try it and we will review prescription. The GP has already said to Dandelion she may not be able to prescribe Utrogestan after the first month due the CCG Formulary.
Ellie
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That would be unfortunate, so in that case she could ask for a private prescription. I guess if it's down to an areas budget then that's it. Maybe some areas have a bigger budget than others
Still don't know if this mix will work but hopefully it will and she can take it from there. At least get settled before worrying again.
Honeyb
x
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I've never heard such issues as not getting a prescription because of the reasons given >:(. GPs will prescribe what is required by the patient and if it means a cheaper option then so be it - it's the basic ingredient that makes the medication work and most Companies use the basic ingredient!
As stated: the GP has been given the details from Dr Curry and is giving a month's supply to see if it works - if it does then I expect a repeat prescription will be recommended with reviews. I've never heard of a patient requiring a private prescription: pets yes, because one can get medications cheaper directly from the Companies: but not an NHS patient unless they go totally private to a consultant for long-term treatment: i.e. it cost me a tenner for removal of a stitch >:( ::)
Take the medication and don't expect over-night miracles?
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One of my prescriptions (not HRT) I pay for privately as the CCG does not like it on cost grounds and their alternative is rubbish. The alternative is a drug I use to work with in clinical trials in the pharmaceutical industry. It really is a rubbish alternative >:(
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Surely best to start low and minimize side effects as more will be absorbed by using patches and Dandelion is in peri.
The GP has given Dandelion what Dr Currie prescribed.
I still think she should start with what has been prescribed and start from there....she has not been refused the HRT she requested.
Dandelion ....Sorry....also worries a lot and this really can't be helping.
Honeyb
x
Of course I am worrying, I have severe perimenon anxiety.
I've seen three female GP's all rubbish.
I dunno why they are all hostile instead of giving me the utrogestan and sufficient oestrogen I need.
I cannot see what their problem is, they treat me like I am asking for opiates or some other controlled abusable drug, not a hormone.
They are putting pointless obstacles in my way.
I might have to just ask for private prescription, cos I cannot be aresed fighting with egocentric doctors who are too arrogant to even consider dr curries advice.
The last doctor scowled and said its really complicated, and she thought I was confusing bioidenticals with phytooestrogens.
I just dont have the energy to explain cos I cannot see why they are all begrudging me what I need. Maybe they are just stubborn and immature.
if femo 2/10 not enough thrn what good is 25mcg oestrogen gonna do.
Ellie seems to get me, I do need sorting out once and for all.
Maybe the doctors play ego games and prescribe based on strength of character, a bit like clicky school or cliquey work.
I cant be arsed with it, just gimme sufficient so I can get on with the rest of my life in good health. I know what I need and I am not getting it.
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Hi Dandelion
Thinking about it, I do agree with honeybun, good to start low and get your body used to this different method of deliver ie transdermal. You don't know how much oestrogen your body was absorbing from the tablets especially because of your IBS.
Start this new treatment with a positive outlook rather than dwelling on your unhelpful doctors at this point - and hopefully you will begin to feel better ...and don't forget to ask for help with the smoking and alcohol if you need it :)
Hurdity x
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HI Dandelion - hope the new HRT regime helps you. Just to let you know that I've only been prescribed one month's Oestrogel to start with...... (GP wants to make sure it suits me and will then prescribe 3 months hopefully), so I don't think that's unusual to just be prescribed 1 month initially.
Hopefully, once you tell the GP that the Utrogestan suits you, they'll prescribe it for you. I'd take it one step at a time and see how you go on the first month. Good luck!
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HI Dandelion - hope the new HRT regime helps you. Just to let you know that I've only been prescribed one month's Oestrogel to start with...... (GP wants to make sure it suits me and will then prescribe 3 months hopefully), so I don't think that's unusual to just be prescribed 1 month initially.
Hopefully, once you tell the GP that the Utrogestan suits you, they'll prescribe it for you. I'd take it one step at a time and see how you go on the first month. Good luck!
Hi Liz, thanks, yeah one month does seem to be standard when starting on new hrt, but my doctor has only given me half the standard dose.
I know Hurdity has addressed this above though.
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Have you found anyone to help on the Daisy site yet.
Although that is for really early meno you might get some better info. Did your periods stop completely when you were in your early 40s ?
Honeyb
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Have you found anyone to help on the Daisy site yet.
Although that is for really early meno you might get some better info. Did your periods stop completely when you were in your early 40s ?
Honeyb
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No, they have been on two-six week cycles since my early thirties, but the first time I noticed flushing in my upper body and night sweats was in the summer of 2009.
There isn't a lot of activity on the daisy site, so I am not holding my breath.
I'm a bit dissappointed though, cos I seem to be spending more money on this menopause, when my derelict flat needs renovating and making comfortable and worth living in.
I know that if I hadn't of written to Dr Currie though, I probably would have been refused again.
I have just been unlucky with negative experiences of the last three GP's.
Once is happen-stance, dunno why but hrt-negative GP's seem really common on here.
Twice is co-incidence, have another go with a different GP, maybe this one will be more compassionate and empathic.
Thrice, well, you have gotta be pretty unlucky.
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So you were peri at a fairly standard age and still having periods then.
My periods just stopped at 47, then came and went for a couple of years. I think that's quite standard and not really all that early to be honest. My mother had an early meno at 40.
Sorry you are not getting much luck from the Daisy site. I honestly think it's perhaps for younger people. Maybe someone will eventually reply.
Fingers crossed.
Honeyb
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So you were peri at a fairly standard age and still having periods then.
My periods just stopped at 47, then came and went for a couple of years. I think that's quite standard and not really all that early to be honest. My mother had an early meno at 40.
Sorry you are not getting much luck from the Daisy site. I honestly think it's perhaps for younger people. Maybe someone will eventually reply.
Fingers crossed.
Honeyb
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I started peri at 42 years of age, so I would say, pretty earlier than the standard.
It's got steadily worse and worse.
I think I am classed as early peri.
I've been lacking oestrogen for five and a half years.
I hope I haven't wasted £20, cos I need all the money I can get to stay warm this winter, as I have rubbish windows which are too awkwardly shaped to and high risk of damaged plaster due to condensation.
My gas ch is very inefficient, again, I need a new one, but I am busy spending money on this men0 boll0cks when I should be getting more support offline.
It's become more of a saga than necessary.
My GP intimidated me last year which is why I gave up for a year, and put up with symptoms I neednt have
EDITed to add, the dentist and receptionist were more sympathetic as they saw me flushing really hot today, the doc has seen this also, but is being pointlessley difficult and wasting my time.