Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: westie on February 15, 2020, 09:05:19 AM
-
Morning ladies
Just need to get things off my chest about my menopause/HRT journey so far. I am in such a state today so forgive me if I appear to be rambling, I am not even sure what to say I can't seem to get my brain in gear.
So, long story short. Am 57 , 8 years post meno and started gel and utrogestan last July. Started on 2 pumps of and now upped to three , two in morning and one at night. Split the dose as I kept waking up with adrenaline surges and was thinking it might be a drop in oestrogen during the night. It has helped a little.
Utrogestan- I really think it is turning me into a mad woman. I take it vaginally on a cycle - 12 days 100mgs on advice from my gynae as have had an endometrial ablation and therefore although I still have a womb I have barely any womb lining. I get to day 4/5 and I have terrible panic attacks, severe anxiety about the most riidiculous things and the dreaded 4am adrenaline surges are back. This month I gave up at day ten as couldn't take anymore. Then I get really nasty withdrawal symptoms very similar to PMT. Oh and also tiny pimples on my face just to make me feel even lower😔
I used to get quite bad PMT during my reproductive years and had PND after my second son was born so I am thinking that my body really does not react well to progesterone. I cannot go on like this, I am even considering a hysterectomy to remove any need for the bloody stuff ( sorry to swear).
I have felt the benefit of the added oestrogen , it has helped my aches and pains and flushes but at the moment the downside of this HRT journey is by far outweighing the ups.
My doctor is one of those who thinks HRT is the devils work and won't even prescribe a 3 month supply of the gel without me making an appointment to have my blood pressure checked ( which has always been fine) and giving me a lecture about all the risks associated with it. It is all so demoralising.
I have been seen twice at Louise Newton's clinic who are great and am thinking of making another appt in next few weeks, although it is expensive and a two hour drive from my home.
I so want to feel better, not just on the odd day but preferably most of the time. I have tears rolling down my face as I type this, what a start to the weekend. I have a lovely understanding husband but I know this is as hard for him as it is for me.
Can someone give me some reassurance?
So sorry for the ramble.
W xx
-
You ramble away!
Make an appt to see Dr Newson. If you were travelling to a holiday, what's 2 hours ;-). Take a diary of how you are: symptoms, food intake etc.. Make it clear which is the symptom that you would like to ease first.
Hyestertcomy is major surgery and may cause it's own problems. Have you dropped into 'hyster-sisters' I think the site is called.
Also, change your GP? He/she sounds really out of date. They are there to support not lecture! :tulips2:
-
Hi westie
So sorry to hear you are struggling. Many of us feel like this on Utrogestan.
However - a very good alternative ( depending on how your bleeds are now) is to take it on a longer cycle like stellajane says, provided this does not make your bleeds heavier - and especially if you have had an endometrial ablation and your lining is very thin anyway.
By longer cycle I mean instead of the 28 day cycle (like when we're fertile) or monthly one that some women do, you extend it (gradually at first) to the length of time that means you shed your lining but doesn't cause any other issues re bleeding. This must be under medical supervision.
I have been on long cycle HRT for over 8 years (since September 2011) but I am on medium dose oestrogen. My cycle varies from 5 to 8 weeks depending on what I'm doing and when I'm going away. To achieve this I have taken 200 mg vaginally for 12 days. This means - like stellajane until recently - I continue to have a bleed even though I am mid 60's. Horrible I know but there is no palatable alternative ( stopping HRT, taking progesterone continuously are the alternatives). I endure both the progesterone and the withdrawal to give me those lovely weeks on oestrogen alone ::).
Stellajane's suggestions of shorter duration progesterone each cycle is another option favoured by some gynaes - again only under medical supervision. I have never tried this as I do prefer to take it for the full duration to enable proper shedding of the lining. Short duration regimes can lead to build up of the lining although after an ablation maybe this is less of an issue.
Your GP is a separate issue. You absolutely should not have to pay to see a private gynae however good they are - you have mentioned the expense and you really do not need to pay for this. (CLKD!!) and I would always encourage womane to try to get the treatment that is their right, through the NHS. Can you go to another doctor in your practice specifically to consult re menopause and HRT? I go to my gynae GP specialist (NHS) where I live just about all things gynae but my regular doctor about other stuff (or whoever is available at the time). The Newson Clinic should in any case have written to your GP so that care can be handed over locally.
Just another point re PMT and PND. PMS can be caused by any or all of 3 hormone situations and sensitivities: fall in oestrogen (at end of cycle); progesterone withdrawal (at end of cycle); progesterone intolerance (usually most of the seocnd half of the cycle). Hormonal PND is not due to progesterone intolerance because you do not produce progesterone post-natally - until fertility resumes with ovulation. PND if hormonal and prolonged, is thought (especially by John Studd) to be largely due to fall in oestrogen since this remains low until ovulation and cycles resume.
I hope you feel better as the day goes on - although the weather is not conducive to that!!!
Hurdity x
-
Hello Westie
So sorry that you are feeling rough and I completely sympathise.
HRT was never that great for me, possibly because I never got the oestrogen right but it was the progesterone that really worried me. I have been off all HRT for nearly eight months now and most physical symptoms have gone, even my VA is fine with only a small amount of YesVM twice daily. My moods however are still an issue and now I have hypothyroidism to contend with.
I'm sorry that I can't be of more help but perhaps Dr Newson will have a plan for you. There are plenty of us struggling with the same issues so the answer must be out there somewhere.
Wishing you well and sending hugs.
K.
-
westie, I really do sympathise, I've been there myself and it's horrible.
I'm not progesterone intolerant but I got to the stage where I just couldn't take Utrogestan anymore because it was throwing my hormones out of kilter and causing migraines. I was on the low dose 7 day 100mg Utrogestan regime for years but in the end I couldn't even handle that and I was also finding that periods were making me feel ill - I was 57 at the time. Like you, I considered a hysterectomy but I decided to have one last ditch effort to find an alternative.
I consulted my migraine specialist and long story short, it was decided I needed hormone stability and to avoid the seesawing hormones of a cycle. I now use bespoke 50mg progesterone every day and separate oestrogen and testosterone. I've been using this regime for nearly 18 months now and I'm pleased to say it's going extremely well with no side effects at all.
For me, Utrogestan was a case of wrong dose with the delivery system.
Obviously there is no guarantee this regime would work for you but it's worth considering. Even if you are progesterone intolerant, you would probably be able to tolerate 50mg every day.
The other alternative is a low dose coil like the Jaydess but I'm not sure if this is possible after an ablation.
If all else fails, I'm afraid a hysterectomy is the only option.
-
Reading the above/previous very carefully as I am in the same situation almost exactly. What worries me a bit is that no one mentioned the coil at any stage as this, in desperation, is my next attempt to limit the progesterone still further and do away with the horrible process of shoving Utrogestan up every night, getting the most hideous "periods" ever on the 3 day break I have been told to take, and having to wear pads to soak up the stuff that falls out once, presumably, the blessed pill has melted away and needs to shed the excess!
The doc I see - in the next city from me because there seems nothing available in mine - told me that as soon as she hits the meno she is going to have a coil fitted. She said it lets out a much lower dose of progesterone (I am not sure about that?) than the single pill I insert each night and you also avoid all the fuss, and any bleeds. This in conjunction with the two pumps (one on each arm) of oestrogen I already use. Guess what - there is a three month waiting list for coils here - but this seemed the most sensible next move - but as I say, no one mentioned it. Would be so grateful for thoughts - and it might help previous poster?
-
Sometimes as many ladies have found out, the way to get proper support regarding menopause requirements is to go privately.
If a GP 'thinks that HRT is the Devil's work' they shouldn't be in practice. It isn't up to a GP to tell a patient what they require, but to explain the whys and wherefores and refer accordingly. If the Practice is non-menopause treatment lead then what's a patient to do? Once seen by a menopause clinic or by a private specialist one can return to the GP with a prescription.
-
Westie,
So sorry you're having such a hard time. I'm pretty close to your age and post meno and it is so difficult getting a 'balance'.
I tried continuous Utrogestan both orally and vaginally initially when I switched to gel (Sandrena 1mg) and didn't feel 'right'. My gynaecologist OK'd me trying Utrogestan vaginally on alternate days because my uterine lining was very thin, and because I don't need higher oestrogen to control my symptoms. This has been the magic recipe for me (plus testosterone), for the past year.
It's really very surprising the reduction in side effects to almost zero by taking Utrogestan vaginally on alternate days compared to every day for me. I've also had no bleeding, besides spotting in the first 6m, which was expected and settled spontaneously.
I'm not sure whether your GP would be OK with you trying this regime, and you might need to drop your oestrogen to facilitate it, but it might be worth asking?
Incidentally I had adrenaline surges when I was taking Utrogestan every day and I've only had 1 in the past year (when I accidentally dosed on 2 consecutive days) so for me it's linked to the Utrogestan. I've not changed my dose of Sandrena at all since I switched to gel.
HTH,
S x
-
Starkitten, I did mention the Jaydess coil in my post.
Personally, this is what I would opt for rather than the higher dose Mirena coil which caused migraines for me once menopausal. A Jaydess is a good option for those who are progesterone intolerant or have a history of migraines.
It does mean having a yearly transvaginal uterine scan but so what? Surely it's less drastic than a hysterectomy and better than living with an HRT regime that is making your life a misery.
-
Hello again and thank you all so much for your replies.
So sorry you have had similar problems Stellajane, I hope life improves for you and you can find a way out of this minefield.
I haven't tried another progesterone as I like the idea of the body identical and am concerned that a more synthetic one could be worse! I can't have a coil because of the ablation ( scar tissue in womb so no room for anything else).
I have decided to book another appointment at the Newson Clinic. I take your point Hurdity about getting help via NHS and I agree with you however there is a three month waiting list in our area and I really don't want to feel like I do for that long. The reason my gynae doesn't like the idea of me taking progesterone continuously is because of the ablation ,there is apparently a small risk of my womb atrophying which has its own problems. On the plus side, and this is the only plus, I don't get a bleed at all as there is virtually no womb lining there. At my last visit to Newson Clinic my oestrogen levels were only at 198 which is why I upped from 2 pumps to 3. This has kept my symptoms under control and made me feel so much better until the flipping utrogestan kicks in and messes everything up! I will discuss the possibility of a longer cycle as you suggest not least because it is my husbands 60th Birthday-in a few weeks and I could do without feeling so rubbish.
Birdy, thank you for your advice re cortisol.that is definitely what seems to be happening to me so yes am another one of the unfortunate ones. Am so sorry you have also had such a horrible time, it feels so isolating doesn't it? Glad you have found a better way forward and hope you continue to improve.
On the exercise front, I walk my lovely dog each morning for an hour and follow up with half an hour of Pilates stretches. I also do a Pilates class once, sometimes twice a week'.i also like to ride my bike although lately with this weather it has been almost impossible! I love to cook and really watch my sugar intake, only have one coffee a day ( in the morning) and rarely drink alcohol these days as it really was a symptom trigger. I also take magnesium, Vit d and Vit k as well as a multi vitamin.So I am trying to do all the right things but sometimes it feels like I am wading through treacle.
Kathleen, sorry you now have hypothyroidism, it must feel like one thing after another! Hope you can get that settled soon.
Mary G do you mind me asking how you get your 50mg of progesterone? Is it a bespoke prescription?
Snooze, very reassuring to hear that your adrenaline surges have stopped by doing alternate days, hope that continues to be the solution for you.
CKLD my GP hasn,t actually said that HRT is the devils work, I can just tell by her attitude!
Anyway, sorry again for the long post but I really wanted to say thanks for all your responses and support, I really appreciate it.
I will let you know how it goes at my appointment.
W xx
-
AAAHh - making assumptions ::)
At least my GP is open. If he doesn't like something we discuss. I never feel rushed even though it's supposedly a 10min appts.
Let us know how you get on? It's worth getting an update from Dr Newson for peace of mind. I have no problems paying for health/dental care if it is quicker and more informative than waiting around.
-
westie, I get my bespoke (aka compounded) progesterone from a private clinic in London but if you Google it, you will find clinics that prescribe it near to where you live. The actual product costs ?1.00 per day, the initial consultation was ?300 and the annual follow up costs ?140 and they supply a prescription for the whole year. It's not cheap but in my case it's worth it to feel well and apart from a hysterectomy, I had no other option.
I don't think the Newson Clinic prescribe bespoke progesterone but you could ask.
I agree with CLKD, there's nothing wrong with seeking help privately, particularly when you have an unhelpful and anti HRT GP. Three months is a long time to wait for an appointment at a menopause clinic when you are feeling terrible.
-
Hi Westie
So sorry to hear how rubbish you are feeling, good advice from the lovely ladies in the forum.
My experience was that at 52, I was put on 2 pumps of gel/Utrogestan 100mg daily, combo last October, after a 4 month HRT break, and whilst the gel fixed the sleep, hot flushes and night sweats, the Utrogestan had a really bad effect on me. It made me feel very emotional all of the time, I was an absolute horror with my husband, and also made me paranoid. At the same time when I was not feeling out of control, I felt 'drugged? and sedated so could not concentrate on anything and was struggling at work, and on top of that I was retaining a lot of water so really sore joints - incredibly awful combination. Felt mega stressed and anxious all the time, with lots of crying. I tried for 3 months taking the Utrogestan orally, then switched to inserting for 2 months, which was slightly better with the above symptoms, but the tablets irritated my skin so I was then constantly sore down below. I know it's definitely the Utro as I stopped for a few weeks and carried on taking the gel and life improved dramatically. Unfortunately that could not continue as I need progesterone as I had a lining build up, and still have all of my bits and pieces. Coil has not been possible for me.
I saw the consultant last week, who reassured me that a number of ladies can't tolerate the utro, and I have now switched to Femonston conti tablets, combined with vagifem every night. Oral tablets are not ideal but patches are just not available in my area, and the consultant thought that the progesterone in the Femonston would be better, as previously I did very well on Femonston 2/10. I'm only 5 days in but feeling a positive difference already, I feel like I have had a major energy injection and for the first times in ages have clarity of thought and don't feel like an emotional basket case!
I have really struggled with the last few months, as the gel/Utrogestan combo suits so many ladies and it's meant to be the gold standard, so I desperately wanted it to work for me, and felt like a failure that it did not, but after 5 months have come to the conclusion that it's not for me.
In terms of your GP, I think you need to find another one, depending on where you live you should be able to join another practice and find a mature lady GP, ask around and look at their websites - it's quite a simple process and the new practice do the paper work so you don't have to have any awkward conversations. I got referred to the consultant via my GP, a long wait but worth it, and the meno consultant is not in gynaecology but in the sexual health dept.
Just remember you have the control in these things, although hard to remember that when you are feeling so rotten. Take care xx
-
Stellajane, thanks for being happy for me but I'm not sure why you are not convinced about compounded hormones. I've been using Oestrogel, testosterone along side bespoke 50mg progesterone - which is like using a 50mg dose of Utrogestan - for nearly 18 months with no bleeds, no side effects and uterine scans showing a womb lining measurement of 3.3mm. What's not to like apart from the cost?
Obviously I would never suggest bespoke hormones as a first port of call or to anyone who is happy with conventional HRT but what about the women on here who are at the end of the road with progesterone? What about all the women who end up ditching HRT altogether because they can't stand the progesterone phase and/or the bleeds any longer?
I honestly feel duty bound to put my regime out there as an option and some will be interested and some will dismiss it but I might just be able to help some women who are really struggling.
I was faced with a situation where I could never take Utrogestan again, all forms of synthetic progesterone (including the Mirena and Jaydess coil) were out of the question and my migraine specialist said I had to stop having a cycle and needed hormone stability. Apart from having a hysterectomy, what were my options?
The progesterone component of HRT is very definitely the Achilles heel of HRT and needs urgent attention.
-
Thank you nairnacat and Stella Jane for your replies.
Stelllajane i agree that if I am to continue on HRT, a long cycle has to be the way to go but I also need to sort out the type of progesterone and need to speak with someone who knows what they are on about. Clearly that person is not my GP! But I don't want to give up yet so i?ll persevere.
Nairncat I am so glad that you have hopefully found a way forward, I am hoping I can too. Am beginning to think that like you the gel/ utrogestan may not suit me as well as it does others. Maybe I am still not absorbing enough oestrogen and that is why I have such a bad reaction to the utrogestan. It is all about balance I know and what suits one person may not suit another. I definitely am a way off finding the right balance for me but I am determined to get there.
This forum is a godsend isn't it? Don't know where I would be without it.
Thanks again
W x
-
Hi Mary g
I completely understand your situation and agree it is important to share, that is after all what this forum is all about.
If I am honest, I have avoided private compounded HRT purely because it is not as well researched and tested as the conventional stuff. However, having read your experience which does seem very similar to my own I would be willing to explore the possibility especially if the only other alternative is hysterectomy.
I agree we should all be open to alternatives provided they are safe.
Thank you so much for sharing, much appreciated
Wxx
-
yea i feel like this- feeling v depressed having done the utro element of hrt and i'm not touching it again- been feeling suicidal- need a boody hysterectomy- getting second opinion re this in march and no not an answer! - so very bloody pissed ff with it all! i wish you well and you'e not alone
-
Hysterctomy is major surgery and can produce it's own problems :-\
-
Hi vintagefriend
So sorry you are feeling so bad, it is truly awful isn't it and can be so isolating which is why I am so appreciative of the help and support from the lovely ladies on here.
I think I have had it with utrogestan too, I cannot carry on when I feel so bad it really affects my whole life and quite frankly I find it scary. Only problem is that I feel so much better on the oestrogen so am not giving up yet as I can't go back to feeling literally suicidal as I was before I started the HRT.
CKLD well aware that hysterectomy is a major op and has its downsides, but for reasons stated above am willing to consider if all else fails.
W xx
-
With regards to the compounded pharmacies, it is quite a new return to traditional pharmacy methods (before mass production started) for the UK where its very common in some other countries like Australia. There you can go in with your prescription for 3 different drugs and they combine it into one or make something up for you that doesnt include a particular filler that you are allergic to.
it's all the same active ingredients, so the progesterone is micronised progesterone, just measured and delivered how you want it. I saw that one compounding pharmacy can make a timed release progesterone capsule so that you don't have any withdrawal symptoms. So many options and not just for HRT.
-
Thanks dangermouse that is really interesting and something I may well look at if I can't get to grips with any other regime on the flipping utrogestan.
W xx
-
The compounded one I know of is a wax like lozenge that you melt in your gums, so a bit like taking the Utrogestan vaginally so it's absorbed through the mucous membranes directly into the blood (and like how you can take aspirin).
I suspect it's the frequent dosage that makes all the difference so you aren't getting one big hit every 48 hours followed by a dip. With progesterone you want it to be as constant a dose as possible to avoid withdrawal effects. Hence why those who take it cyclically really suffer as they have to have a full withdrawal of their whole progesterone stores each month.
-
That's probably because your dose was too high, so it was too much prog which would make you feel awful too.
it's about balance so a lower dose could make you feel just right.
-
All your replies are so helpful ladies thank you!
I have an appt with Dr Newsons clinic this weds so I shall report back.
W xx
-
Hi MaryG - What I don't quite understand is why a compounded 50mg progesterone dose works so much better than using Utrogestan 100mg every other day.
Is it the carrier ingredient in Utrogestan that causes so many of us such problems perhaps? Or method of delivery? If its all micronized progesterone then it has to be something like that surely? I could quite understand it if that was the case because I have to take antihistamine daily and tolerate one particular 'brand' a lot better than other brands, and some give me very unpleasant side effects.
What is the compounded tablet like?
Stellajane, I did try 100mg Utrogestan every other day but it caused silent migraines almost immediately. I persevered for a while but the migraines persisted so it was obviously very unstable and causing oestrogen spikes.
When the clinic prescribed the continuous bespoke progesterone at my first consultation I was terrified. I have had such a bad experience with Utrogestan (which is designed for pregnancy) and synthetic progesterone I really did not believe that bespoke 50mg progesterone would be any different. I voiced my extreme concerns to the doctor and she assured me that my experience would be different this time because the dose is lower and the progesterone is absorbed buccally ie between the lip and the gum. She pointed out that when progesterone is absorbed buccally it behaves differently and more like the progesterone you used to produce yourself and it actually complements oestrogen. Very importantly, it prevents oestrogen spikes and acts like a hormone stabiliser.
The doctor was 100% right (in my case at least) and believe me, if the progesterone was destabilising my hormones I would know about it because I would be plagued with migraines and I would probably have breakthrough bleeding. I desperately needed hormone stability and I have finally achieved it.
Good luck with your appointment westie and please keep us posted.
-
Mary G
Your situations is s9 8nteresting to me as we seem quite similar in our reaction to utrogestan.
After nine months I really do feel I have given it a good go and 8 really can't carry on on my current regime, clearly my hormones are all out of balance and they way I have felt since stopping the utrogestan last week is nothing short of terrifying! This continuing hormone imbalance is causing* absolute chaos.
I wont give up yet though , am determined to find a solution one way or another.
Will of course let you know how I get on.
thanks again
W xx
-
When the clinic prescribed the continuous bespoke progesterone at my first consultation I was terrified. I have had such a bad experience with Utrogestan (which is designed for pregnancy) and synthetic progesterone I really did not believe that bespoke 50mg progesterone would be any different. I voiced my extreme concerns to the doctor and she assured me that my experience would be different this time because the dose is lower and the progesterone is absorbed buccally ie between the lip and the gum. She pointed out that when progesterone is absorbed buccally it behaves differently and more like the progesterone you used to produce yourself and it actually complements oestrogen. Very importantly, it prevents oestrogen spikes and acts like a hormone stabiliser.
The information in bold is exactly the sort of misinformation - or rather misleading comments by doctors at these specialist clinics that led to the medical establishment and menopause societies voicing such concern not so long ago about BHRT.
The point is the doctor is comparing buccal with oral administration - and therefore what she is saying is indeed true (they behave differently), but any method that absorbs progesterone directly into the bloodstream is getting it into your body so that it behaves like our own progesterone ie vaginal also. These clinics are conning women (because they are private and expensive!) if they state otherwise (not you Mary G as you are knowledgeable) - but it is not necessary to have buccal administration to be able to have bio- or body-identical progesterone.
Moreover, actually, even though the liver first pass effect is avoided through buccal or vaginal dosing (progesterone is absorbed straight into the bloodstream), I imagine buccal delivery is still less effective at a given dose for example than vaginal delivery ( but better than oral ingestion) because systemic concentrations must still be high enough for sufficient to reach the endometrium. With vaginal delivery (in my view the best option currently available) the progesterone is transported and absorbed directly through the cervix to the uterine tissues. One paper I read suggested it was ?held? there for longer than any other method. Buccal delivery also produces a rapid rise in serum concentration within about 80 mins (according to paper I read) which might be unacceptable for some women even though the dose is lower.
Also - a 50 mg dose even used vaginally would only be beneficial for women on low doses of oestrogen due to the need for endometrial protection. Studies show that the current licensed doses work best at low and medium oestrogen doses - and tend to cause more bleeding at higher oestrogen doses (can't recall the papers that looked at higher doses).
Sustained release would definitely be brilliant - if such a vaginal capsule could be produced but failing that using the current capsules vaginally are the best we can get at the moment.
Hi MaryG - What I don't quite understand is why a compounded 50mg progesterone dose works so much better than using Utrogestan 100mg every other day.
Is it the carrier ingredient in Utrogestan that causes so many of us such problems perhaps? Or method of delivery? If its all micronized progesterone then it has to be something like that surely? I could quite understand it if that was the case because I have to take antihistamine daily and tolerate one particular 'brand' a lot better than other brands, and some give me very unpleasant side effects.
What is the compounded tablet like?
Stellajane when used orally it is the metabolic by-products (after going through the liver) that causes most of the negative side effects, but additionally these same compounds as well as progesterone itself directly cause the side effects - the pronounced sedative effect for example - is a property of progesterone. Nothing to do with the carrier ingredients. Remember when you were pregnant - the fatigue and exhaustion especially during the first trimester?!
Personally I would not want to take progesterone daily at any dose - because there are still question marks about its effect on the breast, so being a long term HRT user I would rather put up with the bleed and the effects of the prog, unpalatable though these are.
Hurdity x
-
Bottom line, it works.
I don't have any side effects, I have balanced my hormones and no longer have oestrogen spikes, I no longer have migraines, I don't have any breakthrough bleeding, no breast pain, I have a consistent womb lining measurement of 3.3mm and a consistent blood oestrogen reading of 271 pmol from only pump of Oestrogel.
To reiterate, I can't take Utrogestan ever again because it causes migraines, I can't take any form of synthetic progesterone including both the Mirena and the Jaydess coil and the migraine specialist (probably the most well known and respected hormonal migraine specialist in the UK) completely ruled out a cycle and confirmed my particular type of migraine is caused by oestrogen spikes.
Re progesterone and breast cancer, this is from CRUK. Obviously it is only one study but it is interesting:
https://scienceblog.cancerresearchuk.org/2015/07/08/solving-a-breast-cancer-mystery-why-do-double-positive-women-do-better/
It's worth noting that women on the NHS licenced dose of Utrogestan (200mg for 12 days each month on a cyclical regime) are taking approximately 10,550 mg per year more than I am.
It's taken me literally years to find a regime that works and does not cause migraines so I'm going to stick with it. After all, it's not as if anyone has any better ideas.
-
Ive read that the site of absorption is irrelevant as the blood stream is the blood stream. When I used Ovestin (a vaginal cream) I would get a dry mouth an hour later.
As MaryG just pointed out, 50mg every day adds up to more progesterone protection than those who take higher doses for 7 days or so. As you may remember with the pill, progesterone builds up in the blood. Having an even but low dose means you get less side effects and no withdrawal. If I was taking HRT I would do it like this as I now how sensitive I am. However, if you are ok with Utrogestan then that's all good as this advice is for those who can't make it work and are considering drastic options like surgery. Paying to see a hormone specialist, real life actual doctors in the UK, is a small price to feel good versus holidays and other stuff we might waste our money on.
Progesterone can reduce fibrocystic breasts but a well respected biologist has informed me that both oestrogen and progesterone can feed breast cancer depending on the specific receptors present in that single cell where the growth begins, so both are an equal, albeit low, risk.
I also believe we have a duty to inform women about all options on this site and not just the one size that doesn't always fit all. If it also means taking a tiny bit of pressure off the NHS then what's not to like?
-
Hi dangermouse - the point is that vaginal absorption is unique because (more) progesterone goes straight to the uterus (as well as being absorbed systemically into the bloodstream) whereas all the other methods have to go into the bloodstream BEFORE they are transported to the uterus hence higher doses are needed.
Mary G "Bottom line it works" - for you yes and that's great! It doesn't mean it will do so for everyone else and you are also now on a much lower dose of oestrogen than you used to be - you used to speak of very high levels, and such low doses of progesterone just would not be likely work for anyone on higher doses of oestrogen.
dangermouse - I don't think we have any duty at all to inform women of expensive private treatments! When women (including westie) talk about expense and time to get to some of these clinics - the inequitability begins to become apparent and the last thing i would want anyone to feel is that the only treatment that works is beyond their reach due to cost or distance. Personally I feel it is our duty to do our best to encourage all women to be able to get the best treatment they can on NHS ( and I would never use that argument about pressure to justify private treatment = two tier...) through education, encouragement and also to encourage flexibility.
No-one EVER said one size fits all least of all me (I'm on a non-standard regime after all - but on NHS with approval of my doc) - we're always talking about off-licence regimes on here - but under freely available medical supervision where possible.
The effects of progesterone and oestrogen on the breast are complex but so far the negative effects of progesterone are the ones that concern me most - while acknowledging of course that should a cancer develop for whatever reason, an oestrogen positive one will grow quicker in the presence of oestrogen.
Sorry westie this is somewhat off topic! Good luck with your appointment and hopefully you might be able to be prescribed something like a long cycle - especially as you are a special case having had an ablation.
Hurdity x
-
I was never told if my breast lump - non sinister until it got to histology - was reactive to hormones, simply as I was discharged from oncology the Consultant muttered "No HRT for you young lady". I had no idea that breast disease might be hormone charged. I don't suppose my slides would be still available ......... I wasn't allowed to see them after surgery either. Which annoyed me ::)
The Change does what it says on the tin. Alters how our bodies work, each 1 individually. Which is why it may be difficult to find a regime as well as a care provider, to offer up the regime willingly.
My paternal gran had a lump removed from her chest in about 1969 which we thought via the Aunty grapevine was a TB Tubercle, again nowt was said - it simply wasn't talked about. Not something that I have worried about but any information shared can increase over-all knowledge in any sphere.
westie - keep posting!
-
The one size fits all is referring to the Utrogestan (which doesn't actually fit anyone as it wasn't designed for use as HRT).
Hopefully the NHS will offer more flexible doses of natural progesterone soon.
-
I made it quite clear in my post further up that my regime works for me but will not necessarily work for everyone. No HRT regime works for everyone like Utrogestan or a long cycle for example.
I don't think westie should feel uncomfortable about seeking help privately. If someone is opposed to private health care on ideological grounds that is fine, but does that mean nobody can ever discuss the private health sector?
I agree with dangermouse, if this is a free and open forum, all types of HRT should be freely debated. If indeed there is a problem with members discussing private menopause clinics and their HRT regimes, then there should be a directive from one moderators setting out forum protocol ie only NHS clinics and HRT regime may be discussed. I don't think this is a decision for individual members.
Nobody should be made to feel uncomfortable if they are happy on a standard HRT regime, I wish I could have a standard regime but that has not been possible. Equally, I feel this should be an open forum and all individual experiences should have equal value be they NHS or private.
-
Morning everyone
For what it's worth I have really appreciated the feedback I have had from everyone who has kindly responded to my post.
In an ideal world of course we would all like to have the treatment we need on the NHS but, as in my case and in many others I am sure,there are often very long waiting lists to see an expert on these matters and , I cannot waste my life feeling so rubbish so will consider other options in my quest to feel better.
It is also good to hear the variety of ways that others have found a solution. I think it is all about being informed by gathering information from others who have struggled. I agree it is important to ensure the safety of what we chose to use but I still think this forum should be able to discuss the many options available.
Thanks again everyone I shall report back later in the week.
W xx
-
In an ideal World we would sail through menopause >:( ::) ..........
Let us know how you get on westie. Good Luck!
-
Dangermouse ? I've just said that Utrogestan is not necessarily prescribed as one size fits all ? there are various different regimes which can be prescribed off-licence even on NHS provided women are monitored. What we do need is greater official flexibility and licensing to enable these regimes to be more widely available (even with the limited trial information we already have). The problem with progesterone is not especially Utrogestan ? it's nothing to do with what it was designed for ? it comes in two doses and like I said the lowest doses (100 mg and 200 mg) are for menopausal women not fertility (600 mg). There are also other (unlicensed) progesterone formulations - but they allo have the same problem - large doses needed due to the properties of progesterone itself). The problem is as we have discussed many times before ? is that progesterone is unstable in the body and has to be given in large doses in order for sufficient to reach the endometrium (and also that there should be trials on lower dose formulations or even modes of delivery). This is why synthetic progestogens were developed and are more effective ? however many prefer only to take the bio- = body-identical preparation. HRT is but a crude way to mimic ovarian production of progesterone during the menstrual cycle which pumps it out in small pulses. Even if we did have a slow release product available I still wouldn't want to have anything pumping extra progesterone into my body all the time ? not without long term trials showing it is low risk.
Mary G ? westie has spoken for herself and values all our contributions. What I and others try to encourage is for women to pursue the regime and help they are seeking through existing channels to obviate the need to seek private treatment. Of course I understand what westie is doing and I have wished her well. However she is being driven to use expensive private treatment that should be offered through menopause clinics on NHS, due to ignorance on the part of her docs ? this is what we all hope should be available. The Newson clinic will likely offer an individualised treatment based on westie's circumstances using existing products.
Of course it's a free and open forum and no-one has said anything about what can or cannot be discussed and no-one is criticising you Mary G or westie. However don't be surprised at strong views being expressed about your treatment, especially when the treatment that works for you Mary G (and as I've already said I am pleased for you) is not only non-standard re the products and lacking proper evidence as to efficacy, but also beyond the reach of most women (financially and practically due to distance) so although interesting is of limited help in that only the privileged few who can afford it can try it (and be monitored).
Like I said the information on this site is based on scientific and medical evidence so it's not surprising that there are members on here who strongly argue from this point of view. Only this morning I got the weekly MM newsletter in my inbox which says in the first paragraph: ?Our aim is for all women, approaching and experiencing the menopause, to have clarity over the different treatment options available, based on sound, clinical evidence, meaning you can make up your own mind about what is the best option for you.?
Westie ? hopefully once you have been to the clinic you can ask the doctor to write to your GP recommending whatever regime you are prescribed so that you continue the treatment you need without extra expense?
Hurdity x
-
What's the real problem here :-\ ............ surely all experiences are valued, regardless of which part of the World they originate from? Surely it isn't necessary to keep repeating, repeating, repeating? Most Members are quite capable of reading experiences and working out what might be appropriate/not ..........
It is absolutely fine if the NHS won't listen to patients - what ever the complaint might be - to make the choice of paying for advice. It shouldn't be necessary to need to see a Consultant: private or otherwise: to get the necessary prescription : advice should be offered by a GP who are there to prescribe, not to judge .......... but it does seem that the message isn't getting through or this Forum wouldn't be necessary.
Regardless of what MM newsletter suggests [I haven't read mine yet] GPs are not giving clarity. Patients shouldn't have to research any evidence, that's what Practitioners are paid to do.
-
All of the private doctors will write to the patients GP to let them know what they have prescribed so that those medications available on the NHS can be prescribed by the GP.
When I last saw my specialist who is a BMA endocrinologist (London Hormone Clinic) she actually had on her desk Estrogel, Estradot patches, Utrogestan, along with lozenges and creams. They will try to use the products you can get on an NHS prescription first but the others are there if needed. They come from a compounded pharmacy in Northumberland so you get by post if you don't live close to Northumberland.
I was actually advised then that hormones may not help my current issues as, although hormone imbalance makes it worse, they believed it was not the cause of something I'm dealing with so I thought that was very honest of them.
Hurdity, I think the timed release option which was not from a UK compounding pharmacy (I found it googling) seems to be the same amount you'd have in one hit mixed with something that makes it slowly release into your system. So more like the Mirena coil or an implant.
-
:thankyou: dangermouse :tulips2:
-
Hello again
Thought i'd report back following my appointment at Newson Clinic on Wednesday.
We discussed my apparent intolerance of utogestan and the possibility of doing a longer cycle ( 6/8 weeks) with an annual scan to check womb lining. However, she also did a blood test to see if my oestrogen levels were up from last time (198) bearing in mind I have increased my gel to 3 pumps daily for last six months. Have just got blood results today and my oestrogen levels have actually dropped , now at 108!
So am guessing that my extreme reaction to the utogestan could be that 8 have barely enough oestrogen to balance it.
Luckily during the appointment we did discuss the possibility of insufficient oestrogen to balance the progesterone and she changed my prescription from gel to patch ( Estradot now back in stock). Am glad we agreed that as I am now about to stick my first patch on in the sincere hope that I absorb better . Let's hope so!
Am going with the patch only for 6 weeks than will add the utro and see how I react.
This HRT journey is by no means straight forward is it?
W xx
-
It's The Change - does what it says on the tin >:( ::)
Tnx for the update!
-
westie, thanks for the update and I'm glad the appointment went well.
Assuming this is pmol, that oestrogen level is very low for three pumps of gel and that is why blood tests are so important, you really do need to know how well you are absorbing oestrogen.
The variation from person to person is huge because I'm consistently getting levels of 271-300 pmol with just one pump of gel but I had very low blood levels with patches.
Perhaps you are not progesterone intolerant at all and you just have a hormone imbalance? Hopefully you will absorb the patches well and start to see an improvement quite quickly.
Good luck and keep us posted.
-
Mary g
Yes I agree it is important to get blood tests... it seems that the past 9 months in my case have been a bit of a waste in terms of oestrogen absorption and you?re right maybe I am not intolerant to progesterone just need to get some balance.
Really hope the patches work.., if they don't I'm giving up!
W xx
-
Hi Westie, having just seen this thread for the first time tonight I've just read all 4 pages (backwards(!!) as I got engrossed from the latest page). As someone who's had to give up on the "gold standard" Utrogestan after 4 trials (both oral & vaginal administration) proved it to be very much something my body hates & who still hasn't found the right HRT fit after nearly 3 years of trying with a long break in the middle, I understand your desperation.
Though not well off & currently not in paid employment, I've had help from both NHS & private healthcare providers & save for the latter, foregoing other things, as with more than one chronic health condition I really need as much help as I can get to get on top of the situation in order to have a life & don't want to waste more precious time waiting & hoping the NHS will eventually somehow be able to provide everything I need.
Whilst I believe in an ideal world we should be able to get the best healthcare from all specialties in a timely manner through the public system, this has become increasingly difficult with the growing burden on the NHS. I say that with a heavy heart as the NHS has been my only employer in the last 30 years & I'm passionate about it. So I say to anyone who feels they need for whatever reason to look outside the NHS for help, please do so - nothing is more precious than our health & if we can afford it, we are reducing the burden on the public sector for those who simply can't afford to go elsewhere.
I've also had to resort to a non-standard regimen, so completely understand why others do so & applaud the sharing of information & experience that may just broaden others' options. I likewise value the cautions expressed by those better equipped than me to interpret relevant scientific data.
So thank you to everyone who's contributed so thoughtfully & passionately to this thread. Wow ladies - what a lively, intelligent, caring & informative debate. Fab forum, fab contributors. :)
As a past Newson patient currently still juggling both NHS & private care from more than one specialty, I wish you all the very best with the next step Westie. Please do let us all know how you get on.
-
Thanks so much Wrensong for your post.
Yes it has been a lively and thought provoking thread hasn't it's? But it just goes to show that there isn't a one size fits all when it comes to HRT and we are all so different in the way we react to the varying types. I have really appreciated all the different views expressed, after all knowledge is power as they say.
I am very disappointed that that my current regime hasn't worked for me as well as it should but am determined to persevere, life is short and I want to get the most out of however many years I have remaining.
The help and support from from 'the sisterhood? on here has been invaluable to me and I hope to others too.
Thanks again everyone, i?ll Let you know how it goes
W xx
-
:thankyou:
Years ago my psychological sessions were ?75.00 an hour but it was never the full hour. By the time she had arrived and when she began to leave earlier each week :-\ - siting another client - they eventually got down to 35 mins.. She still charged ?75.00.
Our Solicitors charges ?250.00 per hour plus costs. It is the whole package: his time, his experience, his company car, the building maintenance - not simply the time that he charges to the client.
-
Hi Westie
Good that you are getting some answers. I just thought I would give you an update following my earlier post, and yes it's been a lively thread! I stopped the gel and 100mg utro daily and like Wrensong I was really gutted that the gold standard did not work for me- and feeling quite defeated that my HRT must be impossible to manage, and that there was no hope. However as soon as I stopped I started feeling better immediately, mentally and physically, but the hot flushes, night sweats and dryness returned so another prep had to be found. I now realise that I had turned into an emotional basket care on utro.
I'm now 10 days into Femonston conti (1mg higer dose) with daily vagifem, and I feel like a different person, and I can see the old me coming back -in fact it has made me realise how much the untro affected and isolated me. For the first time in 6 months I can think clearly, I'm interested in things and I'm contemplating exercise again. The massive water retention has gone, and I'm slowly feeling like my body is mine again. At first I felt I was a failure going back to oral HRT rather than gel or patches, but nothing is perfect. it's also a relief not to have to cart the gel and utro applicator around as I travel a lot for work. So, early days as yet but though I would share what is hopefully a little more positive. I was also helped by a wonderful NHS consultant so I've been lucky, but a challenging and long journey to get to that person. There is no one size fits all, and as you say everyone is different.
Good luck with your journey x
-
Thanks for the update westie. Glad you are hopefully on the road to feeling better and increasing your oestrogen levels. Yes the research trials show the huge variation in absorption both of patches and gel and indeed tablets. As you will have seen from this thread flexibility is key. Those of us on non-standard regimes (using different dosing and delivery regimes of the proprietary products available) are able to share these with others on this forum to their benefit (provided they consult with doctors.). Of course if a product is not available, such as some of the BHRT regimes and products mentioned on this thread - then will only be helpful to those few women who can afford and wish to go down this route. Personally I would always recommend - even for those seeking private treatment - that they go to specialists endorsed by the British Menopause Society and you will see that the link on this website to specialists goes straight to the BMS page.(Btw it says this on the front of thast page: "In particular, the BMS does not endorse the use of compounded bioidentical treatments"). The ultimate hope is that sometime in the future women will all have access through NHS to menopause clinics and get the time allocated for personalised individualised treatment based on accurate information and evidence that we all deserve.
westie - don't be downhearted that the regime you tried didn't work - many of us have tried several over the years and some are still tweaking ::). Good luck :)
Hurdity x
-
Agreed stellajane ! :thankyou:
-
Hi Nairn, so good to hear how much better you're feeling on the Femoston & that you had a wonderful NHS consultant. There are some very good ones out there - I've recently been lucky to be treated by an exemplary NHS medic whose care & that of his colleagues throughout the entire lengthy episode was beyond anything I could have wished for.
In contrast, I was very disappointed after 4 failed trials of Utrogestan with different doses & types of transdermal oestrogen, to find that the private meno clinic I went to last year for further advice merely told me to persevere with Utro, saying if I took enough oestrogen I should be able to tolerate it. The only alternative form of prog that doctor endorsed was Mirena, which I explained at 57 I didn't want fitted - both as I feared the difficulty of this as a childless woman with poorly managed VA who'd found her last hysteroscopy excruciating, and because my GP had told me if I opted for Mirena, another would not be fitted to replace it beyond age 60.
My HRT is now managed at another private hospital where my testimony that Utro really doesn't suit me is accepted without question & I'm treated, unhurriedly, like an equal partner in my care. That attitude & having adequate time for consultations are invaluable to me.
I also felt something of a failure for my reaction to the "gold standard" combination & had so wanted it to work as it worried me to have to consider other regimens considered potentially more risky. In fact I find it upsetting & disappointing that the only combination wholeheartedly endorsed these days by many authorities, seems to be the micronised prog with transdermal oestrogen, as I worry that that leaves many women feeling more at risk, apologetic & maybe even furtive about their HRT if their needs are for one of the alternative regimens.
Stellajane, like you, out of the progesterone variants I felt best on the Norethisterone in Evorel Conti, but only got poor absorption of oestradiol from it, insufficient for good symptom relief, so have had to persevere with finding an alternative. Currently that's Estradot with MPA, a prog I would have preferred to avoid, though I have read articles suggesting its demonised reputation may be unfounded. Needs must - bottom line is I'm worse without HRT than with & with other health conditions, need to do all I can to achieve best quality of life.
Another thing I meant to say in that earlier post, is that when we are very unwell & faced with struggle with the overburdened NHS to get the treatment we need, the stress of that can be considerable & at times enough to deter us from persevering, so we end up suffering needlessly with horrible symptoms & greatly reduced QOL, with all manner of potentially serious repercussions. Easier maybe to persevere with repeated too short consultations & resistant GPs at the start of peri if you're still physically & mentally robust, but many of us have been weakened by the sledgehammer of menopause & are not up to pushing continually for help. If there's no NHS menopause clinic with short enough wait or within reasonable reach, those seem very good reasons for considering a recommended private menopause specialist if we can afford it, where we go along knowing there's likely to be time to listen & an attitude in favour of HRT, both of which are sadly often lacking at GP level. I worry that many women can't afford that luxury & that the NHS is therefore letting them down.
-
To a certain degree the NHS is letting it's GPs down by not allowing 'time'. All these quotas for waiting lists, being seen in A&E within so many hours but fining Health Autnorities that don't reach targets is IMO, B****dy ridiculous >:(
-
Agreed CLKD - there is a lot of constraint in the system & insufficient flexibility. Those medics I know who've left the NHS & now work in private healthcare seem relieved that the environment is more conducive to treating patients as they'd wish. A sad state of affairs.
-
Such an interesting thread to read.
It is unfortunate that some women cannot access the private specialist consultants who are far more knowledgeable about menopause and HRT than GPs. Very often, even though GPs don't mind prescribing HRT 'off licence' they insist on instruction first from a consultant, purely to cover their backs.
This was very much my experience in the 3 years I went from pillar to post within the NHS and 2 separate NHS Menopause Clinics. Even these so called NHS specialists only wanted to really prescribe 'by the book' HRT regimes. However as soon as I had the authority of Prof Studd behind me, my hitherto very reluctant GP couldn't give me an NHS prescription for my specialised HRT fast enough!
My GP was even happy to prescribe me the testosterone part of HRT which he'd previously refused to even discuss. Prof Studd told me that testosterone is often the final magic key to making HRT properly work. And yet getting it via an NHS GP is nigh impossible.
I think we chatted about this a few years ago Hurdity, when you ended up having to go and see Dr Annie Evans at her private clinic in Bristol in order to get your testosterone. We compared notes on her at the time and what exactly did she mean by a 'pea sized blob'??? I still deeply regret that Annie Evans retired so soon after we went to see her, she was so lovely and compassionate.
-
Agreed GRL, a shame Dr Annie Evans retired. Imo she was a very knowledgeable advocate for women.
-
Yes, she really was. I seem to think that she had suffered with peri menopause depression/anxiety - so she genuinely understood how debilitating it was.
-
Sorry ladies bear with me - the first bit is off topic for the original post but follows on from Stella's last. Stella, at my routine dental check yesterday my new & very young dentist (they cannot seem to keep staff at that practice) was trying to sell me as something progressive, the idea that in his words they are a "prototype" for a new NHS system which he says is now going to only annual checkups for those patients with good oral hygiene. That includes me, he says. So, against my wishes, I have been relegated to only annual dental checks from now on with scale & polish midway. So only one of those a year too. I remember when we all got 6-monthly dental checks with scale & polish included. As we already pay for some of my essential healthcare privately & there is only one just about adequate household income & no private pensions ahead for either of us, we can't really afford go go private for dentistry as well.
I do understand some members' objections to compounded HRT but also believe strongly in informed choice, especially as we all know need for HRT can be great & the range of products to meet that need is inadequate in many cases. I think as grown adults it's our right to choose what we try. If those members who've posted they've felt compelled, under medical supervision, to try products not currently endorsed by mainstream menopause authorities (the compounded prog) are taking relevant precautions to safeguard their health - vigilance & regular endometrial scanning - then that's responsible imo & about as good as it gets in what seems an unsatisfactory situation of inadequate provision of a better range of approved HRT products. So I completely understand why you're tempted by the compounded prog Stella - I've seen your post elsewhere saying that you're again feeling rough without HRT.
We all make choices about what risks we're comfortable with - I decided to give up alcohol because of its association with increased breast risk which we're told exceeds that from HRT. Though I miss a glass of wine, I can live without it, but my QOL suffers too much without HRT so I choose to continue with that, taking other measures such as healthy eating & regular exercise in an overall "package" I feel is the best thing I can do for myself as an individual, with a unique health profile & set of circumstances. I think that's the best any of us can do.
Having exhausted other options, I've also reluctantly ended up on a non-standard regimen as mentioned elsewhere, with very low dose prog for just 7 nights a cycle, the prog being of a type often demonised (MPA) & @ only 1/4 the standard dose for sequi. This would perhaps be considered unwise by some, but was prescribed by a very experienced Endo with my informed agreement. After nearly a year on this regimen I was scanned yesterday & pleased to be told my lining is "nice & thin", only 1-2mm, at the end of my oestrogen phase for this cycle, i.e. having not taken any prog for past 3 weeks. As an unexpected bonus I'd had no bleeds at all on this sequi regimen for the first 9 months, when a very scant bleed a few weeks ago took me by surprise & was the reason I scheduled the scan before the full year was up. It's unlikely I'd have been entitled to this scan on the NHS as my HRT is overseen privately & the bleed was to be expected on sequi, though the absence of them for all those months beforehand, was not - so that was why it unnerved me a little! I now have to decide whether to ask my GP for an internal exam, wrt the so far one-off bleed, my smear not being due this year & the bleed not a consequence of sexual activity.
The point is it all gets both expensive & complicated when we feel obliged to go private & there may be worry associated with going off the beaten track with a non-standard regimen of whatever type, but it still feels worth it & to me this compromise comparable to those of you who put up with a substantial bleed in later years for the improved QOL you get the rest of the month and/or the protection we feel this affords us in terms of cardiovascular health, bones etc.
-
Quality of Life is important. Time medics began listening to patients? I am sure that it would save time eventuallY!?!
My polyp bled on contact. Gyane wanted me to have it removed [privately ::)] but I refused. At that time I wasn't mentally stable enough. He pushed for a date so I asked whether he was looking forwards to a holiday ;-). ::). I made the appt. 4 removal then cancelled it closer to the date. The polyp disappeared at peri..
We don't have expensive holidays nor life style. So we are happy to pay for health care that the NHS won't or is slow to provide. Good Dental care is so difficult to get that we have stuck with our Practice - we entered as NHS patients then they 'went private'. I LOVE my Dentist ;). Again, it isn't his expertise what is paid for but the over-all set up: Practice, Rates, Electricity, Equipment, Staff, Insurance. We have no dependants but would still pay if required. If we are both well it's less stressful over all ;)
I can't remember where I was going with this :-\ ;D
-
I agree your raising the dentistry was appropriate for this thread, as you say an example of exactly what we've been debating here. My OH has good health but for his teeth - so his need for dentistry has always been greater than mine, but he's been supportive of my need for private healthcare which has cost us a lot for expert endorsement of treatment I otherwise couldn't get on the NHS - the T3 situation ::) >:( So I completely understand your going private for your teeth - makes absolute sense.
Your low dose 7 day monthly regime seems to have worked out well for you. 1-2mm is very thin, mine was always 4-5mm. It hardly seems as though you need prog every month.
It helps Stellajane, but the 25mcg Estradot patch is unfortunately not enough to suppress night sweats completely though they are less intense & fewer. I already sleep badly due to pain so I need to try to get a better HRT fit if I can. More oestrogen will likely mean more horrible prog though ::) Incidentally, bloods have just shown I get nearly twice the oestrogen out of that tiny patch than I did on the 50mcg Evorel Conti!
You found what worked best for you - the long cycle, but I get that substantial bleeds into our 60's are tiresome to say the least. I remember you saying you got on well with Norethisterone - was that in Evorel Sequi/Conti or as separate tablets? If not the latter & you decide you want to go back on HRT, might the tablets be more tolerable with the gel than the Utro? It's said to be very powerful so might give you a far scantier bleed. Have you tried MPA? Comes in a range of strengths. Neither is body identical though, of course.
My oestradiol was unmeasurably low before starting HRT well postmenopause in 2015 & since then I've had BSO & being underweight I just can't seem to produce enough oestrogen to control symptoms without HRT. Now in my 15th year of them after a 15 month HRT break 2018-19. It just goes on! ::)
-
This thread has developed way beyond what the OP ? westie ? was expressing. It has developed into a general ?private vs NHS?? which really was not the actual issue. Also into justifying expensive and unregulated compounded BHRT - whaaaat?
I'm going to have to repeat myself yet again.
1 As far as I can recall ( though I am not re-reading this whole thread) no-one has criticised any individual for choosing their own treatment including monitoring, private or otherwise (even if it costs ?1000.)
2 For the umpteenth time compounded BHRT therapy is not recommended by the medical profession for all the reasons stated by the Menopause Societies. Dr Currie, Louise Newson and the rest. Of course any individual is free to choose to go down this non-standard route if they can afford it, including the associated monitoring to check their womb lining is protected - and marvellous for them if they have found something that works. The main point is that it is non-regulated re product safety and consistency and there are not enough trials using specific products.
Louise Newson - https://www.menopausedoctor.co.uk/menopause/body-identical-hormones
MM website: https://www.menopausematters.co.uk/otherpreps.php
https://www.menopausematters.co.uk/pdf/magArticle4.pdf
3 Like I've said so many times, most of these very individualised and non-standard compounded products are beyond the reach of most women (costwise) and therefore to promote it on here is of niche interest only for the privileged few (who are able to save up etc) and (I've already said this before) can make women feel frustrated and depressed if it is suggested (or implied) that such treatment is the only route to improving their health = due to cost. Most of the time anyway it is not necessary as an individualised approach using standard and regulated products should be available on NHS.
4 The issue raised by westie and the one I feel especially strongly about and which I said very early on in this thread ? was that her GP was anti HRT and she felt she had to go privately in spite of the expense and time involved because of this. My comment was that westie should not need to go privately to discuss issues with her regime and how to tweak it to suit her so that she feels well. The whole compounding thing and BHRT was raised by Mary G and consequently altered the course of this thread. I can't believe we are still discussing such treatments. No-one said there was anything wrong with seeking private treatment, rather that an individual should not feel obliged to seek such treatment due to inadequacies of their local practice, notwithstanding waiting times for menopause clinics.
And just to re-emphasise ? I (and I am sure others) have no issue with any individual who have themselves chosen for whatever reason to go privately for an individualised regime even including unregulated non-standardised BHRT . This thread is not (well was not...) about that. Nor is it about private dentistry!
And again to repeat ? we do urgently need more research and greater flexibility in progesterone preparations, doses and routes as more of us are remaining on HRT for longer, as well as an expansion in menopause services and education for GPs so that women can receive the best and individualised treatment (including monitoring) from the products currently available.
wesite - I hope you are already feeling better on your new regime and if it works ( did Dr Newson suggest a longer cycle mght be OK in view of your ablation?), that she will write to your GP who can continue the prescrption. If your GP still refuses then time to change GP! It is your right to have appropriate treatment to your circumstances on NHS using products currently licensed!
Hurdity x
-
Why repeat :-\ ...........
Most threads meander ::)
So what's the British Menopause Society doing about education? GPs don't seem to be getting the message ..........
-
I think that so many GPs are part-time. Or Locums so will be moving on. Or don't have any interest in womens' health or are too young to even consider menopause as a speciality? At least my male GP recognised my vaginal atrophy symptoms but hey! he's my age and has a wife ;) ; and listens :)
We should never feel at 'wits end' with any medical problem. It is time that GPs had as much time as necessary to listen to patients. Less people would then be inclined to go to A&E with 'simple' problems which would free up time and beds for the really urgent cases. I have to say that I never feel rushed in my GP appts..
-
Surely stimulating debate does develop, Hurdity? I'm sorry you felt that meant you had to repeat yourself if it was tiresome for you. I do find it difficult not to engage when interesting points are raised in a thread, much as we would if we were all sitting together in a room. Tangential issues would naturally develop there & to me that's part of the value of the forum - we learn from a range of views that arise spontaneously.
Like I've said so many times, most of these very individualised and non-standard compounded products are beyond the reach of most women (costwise) and therefore to promote it on here is of niche interest only for the privileged few (who are able to save up etc)
I cannot agree with the statement that informing the forum of all options available is somehow inappropriate. I come from a very working class background where being financially comfortable has never featured, so I know only too well that many reading will unfortunately be unable to afford private healthcare. I also worked for the NHS for years & feel passionately about it. But as stated earlier, I believe strongly in the right to choose for ourselves how we manage our own precious health & that the exchange of information here about all that's available out there empowers women to do just that. I don't mean to be disrespectful to your view, which in this case differs from mine, but also feel I have the right to express my opinions in response to points others have raised whether or not the thread has meandered from the original topic.
You have my absolute admiration Hurdity, for your tireless efforts to help so many women on this forum. Your knowledge is mind-boggling & very valuable to the forum & that you obviously care so much about equality in healthcare is touching, but some of us come here very unwell, desperate & at our wits' end & in such circumstances I think knowledge & experience of all options available should be welcomed.
I apologise to the OP and anyone else reading this thread if responding to Hurdity's post has continued to take it in a direction that is not of interest to others & to you Hurdity if I have misunderstood the way a forum should work. This is my first & I am still learning how it should operate.
Wx
-
I also feel that we are 'sitting in the Pub. discussing, meandering, returning to the topic ...... '
The written word is static. It's about filtering what is offered up as experiences, using what might be appropriate today and shelving the rest for later use.
-
Stella, yes all patches it seems are not created equal! I'm sorry about the prog situation - I thought you had probably been through the lot. We so need more options.
Wx
-
Morning everyone
Gosh! I never thought my post would cause so much interesting discussion!
Hurdity in answer to your question yes the Newson Clinic did suggest a longer cycle and that is what I am going to do. I really hope I absorb better from a patch than the gel and that then the Utrogestan won't be quite so unbearable. Who knows? Trial and error. Have just completed my second week and can't say I feel better/different to how I was on the gel but will be interested to see the outcome.
Am planning on asking my GP for a blood test to check oestrogen levels ( hopefully she will do this once she has received the letter from Newson Clinic). However, if this regime doesn't work and I am still struggling I may have the hassle of finding an alternative GP who is willing to help or make another trip to Stratford on Avon.
Sadly, given the intense pressure the NHS is under especially at the present time, I think our hopes of a fully comprehensive, knowledgeable and individualised Menopause care is still a long way off.
W xx
-
.......... and Good Luck from me. :tulips2:
-
Good morning Westie,
Gosh! I never thought my post would cause so much interesting discussion!
Same happened to me a few years ago - I started a thread with what I thought was an innocent question about whether anyone had found Testosterone improved their sleep & came back a couple of days later to check for replies, only to find the thread had been shut down! :o ;D
Glad to know you've found the discussion here interesting & don't object to it having gone off topic in places.
Very pleased to know Newson Health were able to suggest a way forward & were able to endorse trying a non-standard approach that many GPs would not be comfortable with. I hope your GP supports this when you see him/her & if not, that you manage to find one who will, to avoid the long trip back to Newson & the expense of having to continue with private treatment.
Not sure what patch brand you are trying, but I've just had bloods that showed very good absorption from 25mcg Estradot, as mentioned earlier. Hopefully when your oestrogen has had time to build on the patches, you will feel much better on the dreaded Utro if you prefer to stick with that for the prog part. Can I ask whether any other form of prog was suggested as an alternative at Newson?
Sadly, given the intense pressure the NHS is under especially at the present time, I think our hopes of a fully comprehensive, knowledgeable and individualised Menopause care is still a long way off.
I agree, which is what a lot of the debate on this thread has been about.
I think the Newson consultation was a choice you were wise to make given your situation. Everything crossed for you that you will feel so much better on the patches & that the long cycle works well for you.
Wx
-
Thanks for the replies everyone.
Stella jane she has suggested 6/8 week cycles or 3 months ( obvs Under supervision but as have had ablation less chance of substantial womb build up).
Am thinking i?ll do eight weeks to let the patch try and load me up with oestrogen ( Estradot 50mgs) and then try and persuade my GP to do a blood test to see where i?m at. Def taking Utro vaginally to lessen side effects ( haha).
Wrensong yes other forms of progesterone were suggested but to be honest it is me who wants to try and persevere with the utro as a more body identical option. If that fails though I will consider others before taking the drastic step of hysterectomy.
Will keep you posted . Thanks again girls for all your support
W xx
-
westie, that sounds like a very good plan. Because you have had an ablation (something I considered myself) and you are having regular uterine scans, you can afford to be very flexible and in your situation I would push for the longest possible cycle, preferably three months.
My gynaecologist tried to get me onto a three monthly cycle but my womb lining breaks away voluntarily at about 8mm so I only every got to about six weeks before breakthrough bleeding but obviously this will not be a problem for you.
I would definitely recommend blood tests after a few weeks because it's vital to establish how well you are absorbing the oestrogen.
Keep us posted.
-
Surely any conversation tends to ebb and flow and go off at tangents? If we were all in a pub, chatting away, surely no one would rap their knuckles on the table and announce 'No, no we were talking about ABC so we cannot start discussing XYZ now'. That's not how conversation or even debate works - and I speak as someone who was the star of her debate team at school <polishes medal>
I am fortunate that we can afford private healthcare if necessary, and God knows it was going private that finally rescued me from the confusion & ignorance displayed by the well meaning, but uninformed, NHS. I'm sorry, but I wasn't going to risk my mental health any further just because another suffering woman elsewhere couldn't afford private medicine. But, in recompense I was very happy to pass on all the valuable advice and knowledge that Dr Annie Evans and Prof John Studd gave to me in their consultations. As I recall it was thanks to reading MaryG's posts that I was even made aware of the work of Prof Studd, for which I was incredibly grateful.
To avail yourself of private medicine and treatment, to only then keep its secrets to yourself could be deemed elitist? But to avail yourself of private treatment and then pass on that knowledge to as many others as possible is surely altruistic.
-
Completely agree Gypsy RoseLee
As I've said before knowledge is power and why shouldn't we all have access to that knowledge so we can make the right, well informed decisions about our own health.
W xx
-
:thankyou: GRL! :tulips2:
Also - by going to a Private Clinic and opting for a private prescription and/or surgery, it takes that person out of the waiting list for the NHS, gets people back to work quicker .........
-
That's s very good point CLKD. By moving over to the private sector, because my issues were obviously too convoluted for the NHS, I also removed myself from any NHS Menopause Clinic register (tried 2 of them). So obviously I freed up a place for another woman with more straight forward needs.
-
Very well said GRL, I think this is becoming ridiculous now.
A forum is supposed to be about shared experiences and exchanged views and it is not for one member to decide whether or not private health care is allowed to be discussed. We are supposed to opening up debate, not closing it down because we don't agree with it.
I'm pleased that my posts on the Professor Studd regime helped you GRL. That's the whole point of this forum isn't it? His regime worked well for me for a number of years until I finally hit the buffers on the dreaded Utrogestan.
If women like myself are unable to find solutions via the NHS then why not find a solution in the private sector? I appreciate that not everyone can afford to do this but not everyone can afford holidays either so do we close down the holiday thread on here? Where do you draw the line?
Women join this forum desperate for solutions - let's not forget, westie's thread was entitled 'At my wits end with all this - and it is only right that all experiences, both NHS and private, are made available. We are not children that need to be protected from ourselves.
For the minority who may be interested, I'm starting a new thread on compounded hormones (aka bespoke hormones) in the Alternatives section subject to the approval of the regulars on there!
-
It's a Forum. Maybe remember what that stands for ;-)
I would put out health first, if necessary paying for treatment even though we are no longer covered by Company Insurance: B4 thinking of booking a holiday etc.. If we both feel well we can relax even if it means staying at home. Which I love. My ponds and bathroom give me daily pleasure.
Also, very often private treatment isn't as expensive as people fear it might be!
-
Well, quite...MaryG. Plenty of women on cannot even access NHS Menopause Clinics because they can't get a referral, or they simply don't have the means to travel to one. Doesn't mean we shouldn't discuss them on here though, surely?
-
forum
Public medium (such as a newspaper column) or place used for debates in which anyone can participate.
In Roman times it meant a public place at the center of a market or town where open discussions on judicial, political, and other issues were held.
-
Thank you GRL, Westie, Sparkle, CLKD, Mary G & Stellajane. Seems the majority view is that this thread has been interesting & worthwhile, which is reassuring.
:thankyou:
-
It's a good idea to share ;-) "It's Good To Talk" ? BT many years ago.
-
I feel exactly the same Wrensong. This website is such a valuable treasure trove of information and knowledge about the menopause. And we have members from all over the globe, many for whom private medicine is their only available option anyway.
-
I wonder how many browse from the Middle East, India, China etc. :-\. Some places womens' health is not valued as highly as men.
-
CLKD, both times I visited Prof Studd's consulting rooms there were women in the waiting room who had flown in from the far East and the USA! And you could hear the receptionist talking on the phone in Spanish.
-
Why block bold though - that's shouting :-\
No one needs to seek private treatment but many of us choose to or have to because we are unable to source what is appropriate for us personally. I had private treatment for breast surgery because I had paid insurance to do so via my Company, of course this was taxed also as a perk. It took me out of the NHS which left space for patients, as well as getting me back to work quicker. I remained in the private sector for 3 years until both my Consultants retired ;D. I don't think they left because it was anything that I had said :-X
How else is one to proceed when one feels ill, tired, frustrated, alone - because the GP Practice can-not/will-not give what patients require? Even if this is due to Government restraints on time etc., until GPs take a stand and tell the Government a firm "No, 10 mins is not enough so I will see patients at my rate" this idiotic situation will continue. GPs I know don't stick to the 10 min rule anyway ........... as an aside not many Trainees are opting to become GPs so there will be even more of a shortage of practitioners :-\
What many people are unaware of is that Consultants who also work privately, have to be part-time in the NHS. They cannot work full-time. If they weren't offering private clinics on their days off, they would be away tending their Jacob sheep, running, orienteering and yep: I worked with Consultants that did all 3, as they wanted a complete break on their time off from providing medical assistance.
-
Very well said GRL, I think this is becoming ridiculous now.
A forum is supposed to be about shared experiences and exchanged views and it is not for one member to decide whether or not private health care is allowed to be discussed. We are supposed to opening up debate, not closing it down because we don't agree with it.
I'm pleased that my posts on the Professor Studd regime helped you GRL. That's the whole point of this forum isn't it? His regime worked well for me for a number of years until I finally hit the buffers on the dreaded Utrogestan.
If women like myself are unable to find solutions via the NHS then why not find a solution in the private sector? I appreciate that not everyone can afford to do this but not everyone can afford holidays either so do we close down the holiday thread on here? Where do you draw the line?
Women join this forum desperate for solutions - let's not forget, westie's thread was entitled 'At my wits end with all this - and it is only right that all experiences, both NHS and private, are made available. We are not children that need to be protected from ourselves.
For the minority who may be interested, I'm starting a new thread on compounded hormones (aka bespoke hormones) in the Alternatives section subject to the approval of the regulars on there!
What is becoming ridiculous Mary G?
Although you never mention me by name, I know of course you are referring to me with this comment: "A forum is supposed to be about shared experiences and exchanged views and it is not for one member to decide whether or not private health care is allowed to be discussed. We are supposed to opening up debate, not closing it down because we don't agree with it."
I strongly object to your casting me in such a false and negative light which is so very far from what has occurred and you know it. Please stop attributing views and actions to me that are untrue. Anyone reading this thread in detail can see that this is not what occurred. No-one has decided anything about the discussion of private health care ie whether it should or should not be discussed. Read my posts again and please stop misrepresenting my views which you also did earlier on in the thread here:
I made it quite clear in my post further up that my regime works for me but will not necessarily work for everyone. No HRT regime works for everyone like Utrogestan or a long cycle for example.
I don't think westie should feel uncomfortable about seeking help privately. If someone is opposed to private health care on ideological grounds that is fine, but does that mean nobody can ever discuss the private health sector?
I agree with dangermouse, if this is a free and open forum, all types of HRT should be freely debated. If indeed there is a problem with members discussing private menopause clinics and their HRT regimes, then there should be a directive from one moderators setting out forum protocol ie only NHS clinics and HRT regime may be discussed. I don't think this is a decision for individual members.
Nobody should be made to feel uncomfortable if they are happy on a standard HRT regime, I wish I could have a standard regime but that has not been possible. Equally, I feel this should be an open forum and all individual experiences should have equal value be they NHS or private.
Westie was not made to feel uncomfortable about seeking help privately - as you will see if you go back to my original post. I feel saddened that such negative comments have led to such a polarisation of views and seem to have encouraged discord with people I regard as friends on this forum.
This started out as a civilised discussion and could have continued as such. If you read my posts you will see it is the promotion of private bespoke BHRT regimes that I disagree(d) with and not private health care per se (in this context anyway) and make no apology for doing so, even though anyone is free to discuss them.
Hurdity x
-
Hurdity - IMO that's taking the issue too far. A bit like being in the playground? No names nor pack drill ........... either that or paranoia has crept in :-\
-
Surely any conversation tends to ebb and flow and go off at tangents? If we were all in a pub, chatting away, surely no one would rap their knuckles on the table and announce 'No, no we were talking about ABC so we cannot start discussing XYZ now'. That's not how conversation or even debate works - and I speak as someone who was the star of her debate team at school <polishes medal>
I am fortunate that we can afford private healthcare if necessary, and God knows it was going private that finally rescued me from the confusion & ignorance displayed by the well meaning, but uninformed, NHS. I'm sorry, but I wasn't going to risk my mental health any further just because another suffering woman elsewhere couldn't afford private medicine. But, in recompense I was very happy to pass on all the valuable advice and knowledge that Dr Annie Evans and Prof John Studd gave to me in their consultations. As I recall it was thanks to reading MaryG's posts that I was even made aware of the work of Prof Studd, for which I was incredibly grateful.
To avail yourself of private medicine and treatment, to only then keep its secrets to yourself could be deemed elitist? But to avail yourself of private treatment and then pass on that knowledge to as many others as possible is surely altruistic.
Hiya GypsyRosLee - you know I have always supported you and tried to help you on this forum and of course I think and have often said on here - that it is wonderful that you (and others) are sharing your (private and individualised) treatments with others so that they can benefit - who could possibly think otherwise? Likewise others who have done the same. I have never ever suggested otherwise and I don't think anyone else has either. Your last sentence says it all and everyone is grateful to you and others who share in this way!
I'm not sure if you have read the whole thread but in case not, no-one has said at any point that women should not seek private treatment nor that it should not be discussed. However what I was talking about, and you and most women are talking about are individualised regimes using existing regulated products (I've already said this on the thread but my views seem to have been misunderstood or lost on the way).
There is a world of difference between sharing these so that we can take the ideas to our GPs (along with research showing their efficacy), or experiment under medical supervision, vs the promotion of private but non-regulated regimes and products (BHRT) that we cannot get hold of and which are not regulated and tested. That is and always has been my objection. Of course members can and do discuss the treatments - no-one has suggested otherwise, but my view is that we shouldn't be promoting them.
In addition my frustration which I expressed and was shared by others too earlier in the thread - was that westie (and of course other women) should not feel the need to seek private treatment solely due to the inadequacies of their local GP practice.
If you read the first few pages of this thread, everything was being discussed amicably and in a friendly manner until emotive language started to creep in, which resulted in polarising the arguments!
Anyway I wanted to respond because you know I agree with you and along with other members, have walked with you for some years in your quest for better health and I have always understood where you're coming from.
Hurdity x
-
What's happening here - I read the above on the other page ;D - now I might be menopausal but I ain't stupid - yet :-X
-
CLKD I swapped my posts round but unfortunately you managed to post while I removed one, added the other and then re-added the first so you're not going gaga yet!!!
Bold is not shouting - it is emphasis so that the important parts or the distinction between them stands out. I wanted to clarify exactly what I was referring to because there issues have been conflated ie NHS vs private, and private BHRT (compounded) vs private using regulated products and I felt my views had been misrepresented hence the attempted clarification.
Hurdity x
-
Hi Hurdity
I do agree with you that women should be very wary of unregulated potions and lotions for the menopause. God knows I wasted enough time and ????? trying many alternative practitioners who were neither use nor ornament, frankly.
But, as I understand it, the BHRT discussed is being prescribed by NHS trained specialists, at respected clinics (for which, yes unfortunately we do so often need to pay). I certainly wouldn't advocate randomly buying BHRT off eBay! But the knowledge that progesterone is available in smaller 50mg doses is remarkable. You and I have both cited how ridiculous that Utrogestan dosage seem to only be in a one size fits all regime in only 100mg or 200mg. I really, really hope that we all see the day when progesterone can be individualized to the extent that gel or patches can be.
Like you, I don't want women to ever think they can only access gold standard HRT from private consultants, because that would be a tragedy. But if you're at your 'wits end' as Westie is, then the slog of trying to source decent HRT through another GP practice, or waiting months for a NHS Menopause Clinic referral - it can just seem insurmountable, it really can.
So, if you can afford it why not smooth your way as much as possible, as fast as possible? Then, as tends to happen, once you have a private consultant inside your GP will be much more inclined to write you a NHS script for the HRT you need. It also frees up your 'slot' in the endless queue for NHS menopause resources. And maybe, just maybe, receiving an instruction letter from a private specialist might encourage GPs to educate themselves more about the latest developments in HRT (yeah, well we can all hope...).
But, we don't need to waste energy bickering over semantics on here. We all have a valuable contribution to make, and you more than most Hurdity! We need to pick our battles and use our energy where it's most necessary - spreading the word as far and wide as possible, and amassing as much information and knowledge as humanely possible.
Here endeth the lesson...x
-
Nice one GypsyRoseLee :thankyou:
By the way I do agree with you re the private consultations if absoutely necessary and if the usual channels have proved fruitless although I would still push for improvement at local level at the same time otherwise the staus quo will continue. My first post on this thread was expressing frustration on westie's behalf that she felt the need to seek private treatment because of the appalling and outdated treatment from her GP - especially if this does provide a way into prescription on NHS. After all as you said I did this myself ( and made no secret of this) re testosterone - but this was in early 2015 before the NICE Guidelines so there was no NHS option at all - at least there is now - if only off-licence, and it is using regulated products (albeit desoigned for men but at least it is the same stuff!). Even so I always advocate caution here too.
However I wasn't aware of any NHS trained specialists in compounded BHRT in respected clinics (whatever they are?) - I understood that that was the whole point - there is no standardisation and no regulation in terms of dosage or efficacy - even in very famous very expensive clinics attended by celebrities ::).
Yes a 50 mg progesterone dose delivered at a known dosage would be fantastic - we are always suggesting this - but at the moment this is only available as a bespoke product without any knowledge as to uterus protection, or standardisation of dosing. ift here were published trials in that particular fomrulation of that particular product and some sort of CE mark or whatever - quality assurance - then that would be different. I stand corrected if there is - but if there was then the menopause societies would endorse it?
I still think there is quite a lot of flexibility with the current prog we have available even though only 100 or 200 mg - ie vaginal or oral or combination and differences in cycle length or internittent dosing - all of which could be provided on NHS and could make many women's lives so much easier...
Anyway - thanks for your post. I don't agree with absolutely everything you've said but hey - I've had enough?! Also currently fogged with prog... ::)
Hurdity x
-
Oh God, prog fog is just evil.
I know what you mean about the status quo will never change unless we get the NHS to fully listen and change their stance on HRT. But when you're in that dreadful hormone hole I truly believe you shouldn't waste time and energy trying to change the NHS from within, for the greater good. I believe the reason I became so very ill is that I stuck within a system that couldn't help me for far too long. Three years at the mercy of the NHS who just didn't know what they were dealing with in me. I was one of the few very unfortunates for whom getting the right, helping HRT was a matter of life or death. I had become suicidal. Unless you have been there, you simply cannot imagine what it's like.
If I had found Prof Studd months/years earlier then I would never have sunk so low. So my warning siren always goes off when I see posts like Westie's titled 'At my wit's end'.
As for specialists prescribing BHRT I'm thinking of the Marion Gluck clinics and that place down South, called something Park (??) where they take a holistic approach? Obviously they employ genuine pharmacists to compound the prescriptions. It's not like the consultant is cobbling it together in their own kitchen, thankfully.