Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: da66 on September 04, 2016, 07:38:47 PM
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Hello all - I've just joined. I have been struggling with multiple symptoms for 2 years and finally went to the GP on Friday, an appointment I had waited 3 weeks for. She was billed as having a special interest in women's services. She was absolutely lovely and couldn't have been more sympathetic, but ... she didn't have a clue it seemed to me when it came to knowing what to prescribe! I asked her about bioidentical hormones having done a little bit of reading and she said she had never heard the word bioidentical before 😮. She gave me a prescription for elleste duet conti 2mg and said come back in a month to tell her how I am, and in the meantime for me to do some research on the bioidenticals and we could discuss it then. So after 3 days on the elleste I have raging thrush and awful weepy anxious crying fits. Have discovered since friday (having had my email question answered by Dr Currie) that what I had been given is fairly high dose and that she recommends starting lower dose. The GP thought my symptoms were severe which is why I think she went in high dose but I am obviously sensitive to what I have taken. To be honest I am just on here ranting. I can't believe a GP who is supposed to have a special interest in women's health has never heard of bioidentical hormones though I do stress she was delightful and so sympathieic. I feel gutted that I didn't do my research before last week's appointment so that I am now in the situation of having been give the wrong stuff and now will have to wait ages to see her again and get it put right. And I really feel the weight of responsibility for basically telling her what I need prescribed! Having made the very difficult decision to try HRT I now feel I have little confidence that my doctor is able to look after me properly. There is a menopause clinic here which has a 3 month waiting list so I think I maybe need to ask for referral to that and just sit tight. Bloody hell!!!
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:welcomemm: to the World of GPs who know not a lot! However, you and she could build up a working relationship which would benefit others, as well as the GP! You are both on a learning curve and at least she didn't advise ADs as a first treatment and is willing to listen to you. GPs do not always have time to search for info., many have to read on here and make notes to take to their GPS!
When I stopped taking The Pill I had thrush for the first time so expect your symptoms are hormone based. Buy yourself some LIVE Greek yoghurt and eat as much as you can, as well as putting plenty inside the vagina to ease the itching. Do keep pots separate though ;-).
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Oh thank you for replying CLKD - I feel a little less alone now 😊. Yes you are absolutely right about me and her being on a learning curve together. I am glad was was so sympathetic. I will feel guilty asking her for a referral to the menopause clinic but it seems daft not to given there is one where I live. I have decided to stop taking the elleste because I really can't cope with another day like the last 3 - I feel like I'm unhinged!
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Welcome, you're not alone
I had been on max dose elleste solo for 13 years after my hysterectomy and was then hit with a 2nd (natural) mrnopause
The young GP I saw said perhaps it's best to increase my dose and gave me THREE TIMES the maximum dose ! Another GP saw the mistake and called me to stop it immediately
Another GP prescribed me a patch that contained both oestrogen and progesterone (and because I have no uterus I don't need the progesterone), it left me with no trust in them
You'll learn loads here then you can go back to GP with good suggestions that will make you feel better
Annie x
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thank you Annie - do you not all feel terrified though, to basically be in charge of your own 'doctoring and prescribing?' I certainly do and I am very au fait with most things medical having come from a medical family though not a clinician myself. I am speechless that given 30% of the population are menopausal women that GPs can be so uneducated! I don't blame them personally for this of course and maybe the 'demonisation' of HRT has left a knowledge vacuum.
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thank you Annie - do you not all feel terrified though, to basically be in charge of your own 'doctoring and prescribing?' I certainly do and I am very au fait with most things medical having come from a medical family though not a clinician myself. I am speechless that given 30% of the population are menopausal women that GPs can be so uneducated! I don't blame them personally for this of course and maybe the 'demonisation' of HRT has left a knowledge vacuum.
I think I'm over the terrified feeling, maybe I'm too tired to be terrified but if I don't feel better soon I will look into the private sector as I'm nearly 50 and sick of feeling nearly 80
Keep asking questions and browse the search option with keywords, there's some very knowledgeable ladies and also so many whose personal experiences may help you
Annie x
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thank you annie I will do just that
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"Bioidentical" is generally a word that doctors don't use because it's not really a medical word. Worse even is that some doctors may think you are talking about compounded hormones.
If you want what is commonly known as "bioidentical" you just need to ask for estradiol and progesterone (as opposed to a progestin).
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thanks dana - yes it has taken me an entire weekend on google to twig the bioidentical thing and why the GP looked at me askance. and of course if all NHS prescribed oestrogen is oestrodiol which is bioidentical they would have no reason to think it was anything special I suppose. I think I suffered from having read too much american stuff at the beginning. this forum has been so helpful - I watched a great youtube video that was linked to that explained it and also prof john stubbs webpages have been helpful in explaining the bioidentical thing
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How did you get on?
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Yes good - GP said she will refer me to the menopause clinic and we had a long chat about an alternative prescription, discussing utrogestan and oestrogen gel. She said she would ask the meno specialist at the clinic what she should be prescribing for me. She had been reading up after my appointment with her last week which was very encouraging. I have stopped the elleste and am feeling better today. Am very lucky that she is so wiling to listen.
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Every day is a learning curve ;) and :thankyou: for the update.
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Thank YOU for all your support.
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Keep us up to date …… every experience shared is a possible solution ;-)
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da66, welcome to MM!
I'm not surprised you struggled with elleste duet conti because it contains norethisterone which is a synthetic progesterone notorious for causing side effects like breast pain, low mood and it undermines all the good work the oestrogen does.
You did well to read Professor Studd's website, I am one of his patients and I use his preferred regime of Oestrogen/Utrogestan/testosterone and have to say it is the best HRT regime I have used by a very long way. The key it its success is its flexibility and from my own personal experience, the more flexibility you have in your regime, the greater the chance of success i.e. you can easily change the amount of Oestrogel you use and it is very easy to split the dose and take it every 12 hours if you need to in order to keep your oestrogen levels stable.
Utrogestan is a micronised progesterone and again, this is a flexible product because you can reduce your dose if you are progesterone intolerant and also take it vaginally meaning fewer side effects like breast pain because it does not pass through your liver.
Anyone can prescribe this regime for you but in order for it to work properly, it is vital to use the right dosage.
I am currently using 2 pumps of Oestrogel everyday, a small bead of testosterone everyday and 7 x 100mg Utrogestan vaginally every 5 weeks - I am severely progesterone intolerant and this works well for me but you may need a different dose of each product.
I would say it is definitely worth a try.
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:thankyou: Mary!
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Hello all - I've just joined. I have been struggling with multiple symptoms for 2 years and finally went to the GP on Friday, an appointment I had waited 3 weeks for. She was billed as having a special interest in women's services. She was absolutely lovely and couldn't have been more sympathetic, but ... she didn't have a clue it seemed to me when it came to knowing what to prescribe! I asked her about bioidentical hormones having done a little bit of reading and she said she had never heard the word bioidentical before 😮. She gave me a prescription for elleste duet conti 2mg and said come back in a month to tell her how I am, and in the meantime for me to do some research on the bioidenticals and we could discuss it then. So after 3 days on the elleste I have raging thrush and awful weepy anxious crying fits. Have discovered since friday (having had my email question answered by Dr Currie) that what I had been given is fairly high dose and that she recommends starting lower dose. The GP thought my symptoms were severe which is why I think she went in high dose but I am obviously sensitive to what I have taken. To be honest I am just on here ranting. I can't believe a GP who is supposed to have a special interest in women's health has never heard of bioidentical hormones though I do stress she was delightful and so sympathieic. I feel gutted that I didn't do my research before last week's appointment so that I am now in the situation of having been give the wrong stuff and now will have to wait ages to see her again and get it put right. And I really feel the weight of responsibility for basically telling her what I need prescribed! Having made the very difficult decision to try HRT I now feel I have little confidence that my doctor is able to look after me properly. There is a menopause clinic here which has a 3 month waiting list so I think I maybe need to ask for referral to that and just sit tight. Bloody hell!!!
I quite agree da66 - it is absolutely appalling that this doctor who professes to have an interest in women's health does not know what HRT to prescribe, and has never heard of the term "bio-identical". This should be at the forefront of her knowledge - the confusion (the con) perpetrated by the compound bio-identical hormone therapy lobby! Great that she is sympathetic but no marks for knowledge. There really is no excuse for a women's doctor especially!
I agree no doctor should start you off on 2 mg dose and especially not a continous combined HRT with norethisterone in it. I have justed posted on another thread about "low-grade progestogenic side effects" which is what many women get on continuous combined HRT - even with progesterone ( Utrogestan).
If you have a menopause clinic then yes do ask for a referral but in the meantime do ask for oestrogen and progesterone from your GP. I have almost only ever used this type of HRT from when I started HRT in late peri-menopause. In contrast to Mary G I use oestrogen patches (estradot are really small) and progesterone vaginally on a longer cycle than 4 weeks (with the sanction of my well-informed women's health specialist GP!).
The licensed dose of utrogestan is 200 mg orally for 12 days per month if you take it cyclically and maybe start with this but be prepared to discuss changes to this with your GP ( or at the meno clinic) if you develop side effects. I use it vaginally too.
Women differ in how well they absorb the different types of oestrogen - ie pill patch or gel - so partly it is down to this and partly personal preference. Patches are changed usually twice weekly, and gel applied daily or twice daily - so it also depends on your life-style and circumstances too.
Here are all the different oestrogen types and doses:
http://www.menopausematters.co.uk/treatafter.php
and progestogens (including utrogestan - maybe in your doctor's book as micronised progesterone) here:
http://www.menopausematters.co.uk/to_progestogens.php
Do print off this information from the website and if your GP is doubtful - refer her to the British Menopause Society of which Dr Currie is currently chair!!
it is your right to have the medication you choose to treat your menopausal symptoms.
Good luck and let us know how you get on :)
Hurdity :welcomemm: x
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Hi Mary
I'm just about to change the utrogestan from orally to vaginally. I take 100mg. Am I right in saying it's the same round tablet that you can use orally or vaginally?
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Michelle46, yes, that's right, it is exactly the same and can be used orally or vaginally but the UK boxes don't state 'vaginal or oral use' like the Spanish boxes that I have. It's best to insert it last thing at night and try to place it next to your cervix, I use an old thrush applicator and it works well.
Good luck!
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Thankyou Mary x
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Welcome, da66!
Oh my goodness! I am spitting nails about how clueless GP's can be. Some obviously don't have even a basic knowledge of how powerful hormones are, and how it's absolutely not ok to 'hormone bomb' a woman. It just sets us up to fail, and then we get the blame for US not fitting the HRT, when the HRT should be carefully considered and monitored to fit our needs!
Annie0710, I am APPALLED by what you've had to endure!! Your experience is a clear case of negligence on the part of your GP. :steamed:
Just imagine if GP's adopted the same attitude with insulin dosages for diabetics! Yes, I know this is potentially deadly if mistakes are made, but we all know here who use HRT that ineffective or inappropriate doses of HRT can make women feel very unwell indeed.
:steamed: :steamed: :steamed:
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da66, I hope you are able to get some better help soon. The one positive thing is that your GP is willing to admit ignorance and work with you over this - my current GP is very similar and having previous experienced a GP who was both ignorant AND unwilling to listen/admit ignorance, I know which I prefer! Ideally, of course, we would both have GPs who were both knowledgeable and willing to listen, but they seem to be rarer than hen's teeth!
My GP admits to using the MM website as a resource to help her advise menopausal patients, so it might be worth encouraging yours to check it out too. Let us know how you get on.
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Do you all REALLY expect GPs to know everything!!!! :bang: :bang: :bang: how do we know that they aren't searching for info about other conditions? I would rather a GP admit that they are not au fait with conditions than prescribe something inappropriate. It is up to patients to build a working relationship with their Medical Practioners when ever possible. I told my GP when he arrived 35 years ago not to treat me as anyone else, 'cos I certainly ain't like anyone else …… bet he thought "She's a right one!" but we have worked together since. It does help that he's the same age as us and that we both have science backgrounds.
If a GP is young, newly qualified etc. how can they know everything? Maybe someone could explain how a GP could possibly be knowledgeable about every condition and possible treatment available World Wide?
It really is up to patients to take on a certain amount of responsibility.