Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: sidse on March 27, 2018, 03:52:51 PM
-
Hi,
I had to have an emergency HRT review yesterday after being told that my prescription would not be issued without one. The GP that I saw was not my usual one and I have to say she had all the people skills of a cabbage. She basically said that as I had been on HRT for 2 and a half years that I needed to come off ( said in a very authoritarian way). I told her that I was going through a bad time mental health wise and that coming off HRT would be the worst thing that I could do at the moment. Sadly, I didn't get a compassionate response. I listened politely to her going through the risks, told her that as my mum has severe osteoporosis, it could be a good thing for me and finally, she issued a new prescription. Does everyone else have these reviews and how can I be more prepared for making an argument about being on HRT long term. She actually said 'you can't stay on it for life you know'. Obviously, I will try to ensure that I don't see this GP again. I left the surgery almost shaking.
-
The GP is obviously not up to date with the Nice guidelines!
-
Pfft !!!!
These attitudes make my blood boil
I recently had to change surgeries due to house move and once they'd got my notes and saw my medication they called me in. The gp didn't ask about my asthma pumps, epipens or amitriptyline for my back but the whole hour was taken up with why I need oestrogen and testosterone and ON TOP of ALL that why do I then need vagifem. He was quite obviously anti hrt and said I'll be off it by 60, and I told him I won't ! He prescribed one testosterone script and said no more until I see a gynae and hear what they think. I was fuming ! I've put myself on a private consultants waiting list to get it. I went in expecting a fight and got one alright. I think my arguments gave him something to think but he did keep repeating “NICE guidelines are JUST guidelines, they're not instructionsâ€
It's a shame because I think I'd quite like him if I needed to see him about something else
-
Does it actually say in the Nice guidelines that there is no time limit? Isn't it such a pity that we have to battle with people who are supposed to be helping us. I understand that the risks have to be pointed out but it was the way she handled the whole appointment that really upset me and made me angry.
-
Guidelines are that though and if GPs don't want to prescribe they won't. Maybe send his details to Dr Currie so that she can have a quiet word in his shell-like ............
Until she gets to know exactly how many GPs are ignorant or refusing to listen to ladies, this problem will continue. It's obvious that the Menopause whatever they R are simply not getting through!!!!
-
I would have been furious too. So many GPs just aren't up to prescribing HRT and seem to know very little about it or the new guidelines. My personal view is that all things menopause and HRT should be taken out of GPs' hands and women should attend menopause clinics where they can get proper, meaningful advice. As CLKD so rightly points out, the message is not getting through and too many women are getting poor menopause treatment from their GPs, it comes up on here all the time.
It's easy to advise women to wave the NICE guidelines in front of these individuals but they are guidelines, not gospel and they don't have to prescribe HRT if they don't want to.
You can stay on HRT for life if you want to, that is what I am going to do and there is only one person who will make that decision and that is me.
Going forward, if she cuts up rough again, you could find another doctor in that practice if you have the time and/or inclination but if you can afford it, I wouldn't bother, I would seek help privately and get some advice from someone who actually knows what they are talking about. In most cases, menopause specialists will write to your doctor with their recommended prescription and you should be able to get your prescription on the NHS thereafter. She will struggle to argue with someone who is more knowledgeable than herself. I know it means spending money but (as long as you can afford it) what else are you going to spend it on that is more important that your health?
-
Unfortunately a GP does not have to listen to a private specialist either and can choose to ignore their advice . Daisydot is having that trouble at the moment....
-
That is very true Dotty. Daisydot has had the most appalling treatment and as we know, it is still ongoing. I think it would be worth a try though because there are others on here who have managed to get their prescriptions via the NHS. If all else fails, at least sidse could pay for private prescriptions which is better than not getting HRT at all.
One thing's for sure, the system is broke and it does need fixing.
-
I was just about to say the same as Mary G about menopause clinics only to handle HRT.
It's clear that many GPs are too nervous to prescribe HRT, maybe because they're hormones rather than drugs and perhaps they feel at risk of being sued if the small risk of cancer arose. Some may also think women are taking them to look younger (an old fashioned view) and hence the ‘telling off' many women here seem to be getting as if they're naughty children!
If GPs are not happy prescribing then they should do an immediate referral to a meno clinic rather than saying no or causing so much distress to their patients due to their own ignorance.
-
You are so right ladies the anguish that these gps put us through is uncalled for it's just down to their own predjudicies and beliefs,they think their doing the right thing I suppose but in my mind I do question if it's a cost cutting exercise when they will not co operate with meno consultants advice and recommendations,they should actually be applauding us for trying to take charge of our own health,my practice makes a big thing about advertising this very thing online.
I've no idea why, maybe it's if as a result of my persistence,they are prescribing me oestriogel and vagifem now when I ask for it online,it's a different gp who authorises it but not a name I've ever seen when making appointments.Im due to go in for a chat re my dxa scan and brain scan whenever these blooming results come back,so I'm quite sure then I'll get my ear chewed again about hrt.if I do then that's me done with gps I'll go via a private menopause as Mary says we can't put a price on our health.I can't take the stress of confrontations every time I need some help bugger that.
-
I agree, it can certainly be stressful going to the GP about HRT. All luck of the draw depending who you get.
-
I don't know really what's wrong with all these gyns!
Fortunately at my country I don't need a prescription for hrt! The majority of gyn don't want to advice for hrt and let women suffering alone and in silence...
My first gyn refused hrt for me and I was only 41!
I make my decision to stay on hrt for life if everything is ok! My body doesn't produce estrogen at all and without estrogen I CANNOT survive!
I'm with you! :)
-
And I'm also wondering from where these conclusions come from regarding the duration of use!
I think that the use or not of hrt is an individual decision and has to do with a lot of parameters a gyn and a patient have to account.
-
Sadly, I don't think I would be able to go down the private route as money is really tight but having said that I have no idea how much it would cost. I am assuming that I am alright for another year and these reviews are annually.I will definitely see a different GP in the practice - the one that I think would be most sympathetic is very popular so is difficult to get to see. Better make the appointment now!
-
Sidse which hrt do you take?
-
I take Femseven conti - 3/4 of a patch after having a bleed on the full patch. I have only been on them for 2 1/2 years which compared to a lot of people on here, is a relatively short time. I am soon to be 56 and my periods stopped at around 53.
-
This is what scares me about moving practices. I moved house 18 months ago but haven't told my doctors as I have quite a few different medical issues that they understand and I'm not sure I want to go through it all with a new doctor and find they don't agree :-\
-
Hi sidse just to give you an incling I paid £195 for my consultation with Mr Parsons at Nuffield Coventry and he's really nice,doesn't pressure you for follow ups if your gp is happy to follow his recommendations.I had big problems with my gp right from the start but now between us we have resolved it.good luck though you may not need to go private hopefully.x
-
My lady in Spain, I think she's Swedish. Charges €120. For a full mot, smear scans etc. not mamogram but she does an exam. I can call reception any time & she will call back when she's free.
-
Daisy, that it is a little cheaper than I thought and I am in the East Midlands.Has your GP followed his recommendations? Suziq - that sounds very good value, shame that it is Spain ( for me obvs not for you!)
-
You can hone Nuffield health in Coventry and make an appointment to see him sidse I saw him within the week.i think he does Tuesday and Thursdays there you'll have a 45 mins consultation for that which is pretty good and if necessary he'll write you a private prescription then he'll write to your gp with his recommendations,I can't fault him for his support with a very tiring gp system.x
-
Sidse - you shouldn't need to go private for your hrt. Just see a different GP
-
Dotty is correct sidse so keep trying your own practice,I've changed practice and doctors several times which was why I went private in the first place as I was getting pretty desperate so hold out as long as you can before you do go down the private route,that has to be your descision good luck xx
-
I am hoping that I am good for a little while as the awful GP did put the prescription on my repeat schedule. I will try to stay in the NHS but it is useful to have something up my sleeve just in case.
-
I changed my GP purely because of problems getting the right HRT and the threat that I would have to come off it at 60. I researched the qualifications and interests of other gps locally and was very lucky to find a lady doc who has worked with Mr Parsons. She referred me straight to him and we've finally sorted my regeme. We have agreed that it is up to me how long I stay on the meds but we don't know how much longer the clinic will be open for so I will keep reminding the doc what the plan is.
-
Hi stillsearching do you mean Mr Parsons clinic at nuffield is closing.?(or is it his nhs clinic) and did he prescribe you testosterone
-
Both the very young female GPs at my practice are very sceptical about HRT, and outright refuse to even consider testosterone. This is despite them having 2 explicit letters from Prof Studd. Who the f*ck do they think they are?
Luckily I managed to see the young male GP who was perfectly happy to go with Prof Studd's regime. And he even took down Prof Studd's details for research in case he had other middle aged female patients presenting with inexplicable anxiety, depression and all the other peri symptoms.
-
Just wondered if Dr Currie has ever intervened in these situations? It was a young female GP that gave me such a hard time. I don't really understand how different Gps in the same practice can differ so much in their view of HRT either - you would think that there would be a 'practice policy' which followed the NICE guidelines. I am very impressed with researching all of your local GPs - stillsearching'. How did you go about that?
-
Hi Ladies
I moved from London to Dorset 6 months ago, never had any problems with my lovely GP in London regarding my HRT. As soon as I went to my new GP here I have had problems with them wanting to stop the HRT and put me on anti depressants. I wasn't depressed when I moved here but I am now, the new GP prescribed me 4 months worth so far, but I am dreading going back to see him. I am even considering moving back to London.
xx
-
It would be more worth your while Vicky to go to a private meno consultant and pay a couple of hundred quid to get this resolved for you rather than the upheaval and expense of a move again that's so unfair to make you think like that,don't let them dictate to you take someone in with you next time you go and stand your ground or put it all in a very nuce letter to your practice manager and ask for help to resolve this.so sorry it's still giving you this stress,good luck xx
-
I must confess that I hope both the female GPs at my practice suffer a dreadful peri menopause.
Another quite elderly male GP I also saw was surprisingly sympathetic and knowledgeable about hormones and menopause. Turned out his wife had had serious problems in this area.
-
vickypk, if you are happy with everything else move related then I would do as Daisydot suggested and seek help privately. You should not have to move because of your doctor. Most private menopause specialists do telephone consultations if that helps. They will then write to your GP with their recommended prescription so that you can get your HRT via the NHS. We now know this doesn't always work but it seems to more often than not. It must be worth a try?
-
Hi Daisydot and MaryG
Thanks for your replies they are very helpful. I think my depression is move related as well, and the GP isn't helping with it all. If I had a considerate doctor here, maybe that would help me. Just because I had a lovely GP in London it isn't a reason to move back. I didn't know I could do a phone consultation, I'll look into that. I know I have options to consider thanks. Hope you are both fine
Vicky x
-
Does it actually say in the Nice guidelines that there is no time limit? Isn't it such a pity that we have to battle with people who are supposed to be helping us. I understand that the risks have to be pointed out but it was the way she handled the whole appointment that really upset me and made me angry.
sidse I am so sorry to hear you have experienced inadequate treatment from your GP. As far as I can see there is no mention of time limit in the NICE Guidelines at all. If there was, it would be stated. This is all it says about starting and stopping HRT:
Starting and stopping HRT
1.4.22 Explain to women with a uterus that unscheduled vaginal bleeding is a common side effect of HRT within the first 3 months of treatment but should be reported at the 3-month review appointment, or promptly if it occurs after the first 3 months (see recommendations on endometrial cancer in the NICE guideline on suspected cancer).
1.4.23 Offer women who are stopping HRT a choice of gradually reducing or immediately stopping treatment.
1.4.24 Explain to women that:
gradually reducing HRT may limit recurrence of symptoms in the short term
gradually reducing or immediately stopping HRT makes no difference to their symptoms in the longer term.
The various menopause societies (eg BMS) have issued recommendations which do state that there should be no artbitrary time limit - and this is based on the most up to date evidence.
Also as far as I know Dr Currie does not intervene in individual cases - I mean what authority does she have in relation to a paricular GP and practice? To research the GPs you can either find the ifnormation online if your practice lists the docs and their qualifications ( mine does) and once you've done this and identified the ones that have the basic gynae qualification, you can also ask the receptionist (or in-house dispensary if there is one) which is most ysmpathetic to menopasue and readily prescribes HRT.
This is really something we have to work at as well as all the education and publicity that is going on. Going privately for those who can afford it is all very well but changes nothing. The NHS is there for us.
I presume you now have the medication on repeat? I always order mine online and althoyugh my reveiws are always overdue according to the prescription they never ask me in for one - I just make an appointment as I need to eg if I want to change something! I must be lucky!
Good luck...
Hurdity x
-
Hi Ladies
I moved from London to Dorset 6 months ago, never had any problems with my lovely GP in London regarding my HRT. As soon as I went to my new GP here I have had problems with them wanting to stop the HRT and put me on anti depressants. I wasn't depressed when I moved here but I am now, the new GP prescribed me 4 months worth so far, but I am dreading going back to see him. I am even considering moving back to London.
xx
See my post below to sidse. Please do your research into the practice and find a GP who is sympathetic to menopause and is happy to go along with the latest recommendations. This is quite wrong unless you are medically contra-indicated for HRT. I hope you didn't take the anti-depressants - they are absolutely not the right treatment for menopausal symptoms and you should be on HRT first and foremost if not depressed!
Re NICE recommendations - CLKD - if doctors do not choose to follow them then what exactly is the purpose of them? They are surely to enable doctros to make the best possible decision for thier patients based on the most up-to-date information with the knowledge of their pateint's particular medical history?
Any doctor who refues to do so is surely acting contrary to the NHS fundamental principles and should be brought to account. Here they are (for England anyway - but will be similar for rest of UK):
https://www.nhs.uk/NHSEngland/thenhs/about/Pages/nhscoreprinciples.aspx
A couple of them:
Principle 3
The NHS aspires to the highest standards of excellence and professionalism
• in the provision of high-quality care that is safe, effective and focused on patient experience
• in the people it employs, and in the support, education, training and development they receive
• in the leadership and management of its organisations
• and through its commitment to innovation and to the promotion, conduct and use of research to improve the current and future health and care of the population
Respect, dignity, compassion and care should be at the core of how patients and staff are treated – not only because that is the right thing to do, but because patient safety, experience and outcomes are all improved when staff are valued, empowered and supported.
Principle 4
The NHS aspires to put patients at the heart of everything it does
It should support individuals to promote and manage their own health. NHS services must reflect, and should be coordinated around and tailored to, the needs and preferences of patients, their families and their carers. Patients, with their families and carers where appropriate, will be involved in and consulted on all decisions about their care and treatment. The NHS will actively encourage feedback from the public, patients and staff, welcome it and use it to improve its services.
Hope this helps and do not despair - there is light at the end of the tunnel and we will encourage you all the way. Daisydot had great success with her local practice after writing lots of letters. Do you have someone who can support you while you fight this - friend/family?
Hurdity x
-
Thanks Hurdity. Yes, it is on repeat but I am sure that I am going to be in the same situation again at the next review although I will at least see a different GP. It was the refusal to issue a prescription until I had a review which was so stressful as I had ran out and coming off it so abruptly is definitely not good practice. You are lucky that they don't seem to be as strict with reviews at your practice.
-
Heavens - definitely not good practice. If you had run out and they refused to re-issue until a review then you should have had an emergency appointment surely - at least that same week? It's appalling that it is not seen as sufficiently important in some circles. Yes I do feel very lucky where I live and this particular practice and the particular female GP with gynae specialism who has been there for over 30 years and carries on one session a week because she enjoys it!
Hurdity x
-
I was lucky to be on the phone when a cancellation came through otherwise I was being told to go to the drop in clinic which would have been awful. It is not good at all is it.