Menopause Matters Forum

Menopause Discussion => All things menopause => Topic started by: anartistatheart on June 01, 2020, 05:21:31 PM

Title: Has the nurse got this wrong?
Post by: anartistatheart on June 01, 2020, 05:21:31 PM
Hi, Im a newbie here and I've only just received 6 months of HRT today.  I have been given Kliofem 2mg/1mg but Im wondering whether this is a mistake?
I am most definitely in perimenopause with my last period only in January and again 4 months prior to that. Understandably, due to the current situation, my consultation wasnt with a GP, It was rushed and I didnt really have the option to ask any questions.

The question I have now is this - Have I been given this HRT (specifically for post menopausal women) because of a shortage, or is it a mistake? OR despite the patient leaflet, is it sometimes given to perimenopausal women anyway? and if not, why not?

Sorry, much more than one question! If anyone could help me with this, I'd really appreciate it as I really dont want to start with something that isnt advised.
Many thanks
:)
Title: Re: Has the nurse got this wrong?
Post by: Taz2 on June 01, 2020, 05:57:02 PM
Hi Anartistatheart. You can ask as many questions as you like. There's always someone here to help and answer as much as we can.   :)

You are right in thinking you have been prescribed the wrong HRT type. This happens far too often we've found! You need to get the prescription changed to a sequential HRT which should give you a monthly bleed and keep your womb lining healthy. Have a look at all of the HRT options available by clicking on the menu button at the top of the screen so you are ready should your GP practice query it.

Keep posting and let us know how you get on.

Taz x   :welcomemm:
Title: Re: Has the nurse got this wrong?
Post by: anartistatheart on June 01, 2020, 07:29:13 PM
Thank you so much! Im going to try and get back in touch with the surgery tomorrow although its proving very difficult to actually speak to a GP. Ive had an appointment with a pharmacist and a nurse to get to this point. Its left me with little confidence in the decisions made on my behalf! I'll let you know how I get on :)
Title: Re: Has the nurse got this wrong?
Post by: Taz2 on June 01, 2020, 08:02:40 PM
Glad it helped. Do you have e-consult at your surgery if you don't manage to speak to a GP?

Taz x
Title: Re: Has the nurse got this wrong?
Post by: anartistatheart on June 01, 2020, 08:24:19 PM
Taz I had to get through the receptionist who i asked if i could have an appt. with my GP. she made the appt. with a healthcare professional. (Pharmacist). I then was given an appt. with a nurse over the phone who asked me to go into the surgery for blood pressure check and handed me a prescription. It was all very strange and without a GP involved. Im told they're only available for more serious cases, which i obviously accepted as the new norm.
Im hoping im going to be able to actually speak to a GP but ill have to go through the receptionist again  :-\
Title: Re: Has the nurse got this wrong?
Post by: CLKD on June 01, 2020, 08:30:39 PM
That's the new normal.  The GP would have been involved in order to prescripe HRT but it doesn't seem like he/she knows much about HRT!

I suggest that you put the product name into the search box here and see the threads that pop up: make notes ;-)

 :welcomemm:
Title: Re: Has the nurse got this wrong?
Post by: anartistatheart on June 01, 2020, 08:46:32 PM
Thanks so much. The nurse just took the prescription for signing to a gp... she was gone for literally 3 seconds. Ive been having a good look through the posts. this is such a helpful place to be! Wish I'd found you all sooner   :-)
Thanks for the great welcome  :-*
Title: Re: Has the nurse got this wrong?
Post by: CLKD on June 01, 2020, 08:49:16 PM
Browse round.  Ask ...... nowt is too much info on here ;-)
Title: Re: Has the nurse got this wrong?
Post by: sheila99 on June 01, 2020, 09:34:54 PM
Ring them up and tell them the prescription is wrong. This happened to me too. The gp rang back the same day and issued a new prescription.
Title: Re: Has the nurse got this wrong?
Post by: anartistatheart on June 02, 2020, 05:59:35 PM
I did a hell of a lot of research lastnight before I rang the surgery this morning and suggested that perhaps they had my prescription wrong. A pharmacist called me back (one of the list of healthcare professionals allocated to take calls) and said he would contact the prescribing nurse - anyhow, to cut a long story short and after several conversations with them both I have now been given Evorel 50 and Desogestrl 75mcg. THe Evorel sequi is still out of stock so this is to replace that. I feel much happier going forward with this combo even if it is a bit messy so to speak!

thanks everyone for your input and giving my the impetus to call them back. It was a very tough and long considered decision to try HRT so any barrier would have made me back off. add to that that one of the symptoms I have is that I just give up. At everything  - especially if it involves even the smallest battle. I probably wouldnt have called them back if I hadnt of found this forum. :)

Ill post how  get on with it :)
Title: Re: Has the nurse got this wrong?
Post by: Taz2 on June 02, 2020, 07:15:08 PM
That's great news! Good luck with the HRT and I hope it soon begins to make you feel better. The general advice is that it takes up to three months before you can really tell whether it is the right one for you. Your withdrawal bleeds for the first couple of months might be a bit painful or heavier than usual but, in my experience, this soon settles down.

It is very worrying that women are still being given the wrong HRT when it can have such a detrimental effect on their health. It just shows how important it is to read up on the medications etc. we are given and not just take what we are told is right for us actually IS right.

Taz x  :foryou:
Title: Re: Has the nurse got this wrong?
Post by: CLKD on June 02, 2020, 07:30:47 PM
It makes me wild that GPs still don't know how to prescribe HRT  >:(

Let us know how you get on anartistaheart !
Title: Re: Has the nurse got this wrong?
Post by: Annabanana on June 02, 2020, 08:04:07 PM
Hi,

Sorry to jump on this post but it's like you've described my own first experience. I've been prescribed indivina but had a period in January. Spoke on the phone to the nurse today, she Insists this is okay despite leaflet saying its post menopause. I'm so confused and don't know what to do. Not sure about the difference in hrt with post and peri aaargh  :'( :'(
Title: Re: Has the nurse got this wrong?
Post by: sheila99 on June 02, 2020, 08:14:45 PM
The nurse is wrong, the patient information leaflet clearly says for menopausal women (no bleed for a year) so if you're peri you shouldn't take it. You need a sequi regime which will give you a bleed. It's important you have the right one, if your lining builds up you're at greater risk of cancer. I would tell the receptionist you've been prescribed incorrectly and you need to speak to a gp. The nurse knows less than the manufacturer.
Title: Re: Has the nurse got this wrong?
Post by: anartistatheart on June 02, 2020, 08:25:39 PM
Hi,

Sorry to jump on this post but it's like you've described my own first experience. I've been prescribed indivina but had a period in January. Spoke on the phone to the nurse today, she Insists this is okay despite leaflet saying its post menopause. I'm so confused and don't know what to do. Not sure about the difference in hrt with post and peri aaargh  :'( :'(

I dont know much but I do know that the GP and nurses cant be a specialist in everything so they can and do get these things wrong. I plucked up the courage to challenge the prescription (in the gentlest way possible) And then the discussion we should of had took place. I explained that i was very nervous about taking hrt and i wanted to play it by the book and by the NHS prescribing charts....seemed to help open a discussion.  Im so grateful to this group that they gave me the courage to do this. Maybe you could ask the nurse to explain to you.... if he/she can, then they know their stuff, if not, then they'll need to learn and will probably change their mind (as mine did!)
Title: Re: Has the nurse got this wrong?
Post by: anartistatheart on June 02, 2020, 08:28:04 PM
That's great news! Good luck with the HRT and I hope it soon begins to make you feel better. The general advice is that it takes up to three months before you can really tell whether it is the right one for you. Your withdrawal bleeds for the first couple of months might be a bit painful or heavier than usual but, in my experience, this soon settles down.

It is very worrying that women are still being given the wrong HRT when it can have such a detrimental effect on their health. It just shows how important it is to read up on the medications etc. we are given and not just take what we are told is right for us actually IS right.

Taz x  :foryou:

Thanks Taz  ;)
Title: Re: Has the nurse got this wrong?
Post by: Hurdity on June 03, 2020, 08:41:04 AM
Hi anartistatheart

Good to hear your persistence has paid off, but if you are in UK then with reference to the title of your thread they have still got it wrong, in that the pharmacist and nurse have prescribed you an off-licence regime. Desogestrel is the active ingredient of the mini pill cerazette and is not available as part of hRT nor has it been tested in this respect. Rather, the only study I could find (quick look only!) was from 1993 where a trial investigated using Desogestrel separately with oestrogen as part of hRT but at twice the concentration.

As far as I know there have been no recent trials using this or at least it is not licesned, nor even recommended to be used off-licnece although I know one member who was prescribed two mini pills ( giving 150 mcg) as she was already on Cerazette.

The problem is that this may not be sufficient to protect your endometrium so if the prescribing nurse and pharmacist came up with this one - well there are other licensed progestogens available which are listed on this website here: https://www.menopausematters.co.uk/to_progestogens.php and which they should know about. These are Provera, Utrogestan or the Mirena coil, (occasionally norethsterone on its own as it is already part of some combi HRT types). Do you know if there was a particular reason why they chose a) this particular one as opposed to the licensed ones) b) this dose?

Sorry for dampening your enthusiasm but it is important to be given the right products in order to protect your womb lining. If there is a god reason for this combo then fine - otherwise it's wrong again!

Hurdity x
Title: Re: Has the nurse got this wrong?
Post by: anartistatheart on June 03, 2020, 01:13:09 PM
Hi anartistatheart

Good to hear your persistence has paid off, but if you are in UK then with reference to the title of your thread they have still got it wrong, in that the pharmacist and nurse have prescribed you an off-licence regime. Desogestrel is the active ingredient of the mini pill cerazette and is not available as part of hRT nor has it been tested in this respect. Rather, the only study I could find (quick look only!) was from 1993 where a trial investigated using Desogestrel separately with oestrogen as part of hRT but at twice the concentration.

As far as I know there have been no recent trials using this or at least it is not licesned, nor even recommended to be used off-licnece although I know one member who was prescribed two mini pills ( giving 150 mcg) as she was already on Cerazette.

The problem is that this may not be sufficient to protect your endometrium so if the prescribing nurse and pharmacist came up with this one - well there are other licensed progestogens available which are listed on this website here: https://www.menopausematters.co.uk/to_progestogens.php and which they should know about. These are Provera, Utrogestan or the Mirena coil, (occasionally norethsterone on its own as it is already part of some combi HRT types). Do you know if there was a particular reason why they chose a) this particular one as opposed to the licensed ones) b) this dose?

Sorry for dampening your enthusiasm but it is important to be given the right products in order to protect your womb lining. If there is a god reason for this combo then fine - otherwise it's wrong again!

Hurdity x

thanks Hurdity, yes I have since noted that and did a bit of research myself - I did find a few references to it being used such as the one below
https://link.springer.com/chapter/10.1007/978-1-4899-1268-8_50
but Im not convinced that their decision hwas made from a well considered and knowledgable point of view or the complete opposite.
Im conflicted now as to whatt to do. I have been given a 3 month supply, so I am considering taking it for the 3 months and then raising the issue after the review in August. Its either that or move GP surgeries. I have been with this surgery for 22 years and this is the first time I have been so bitterly disappointed by the seemingly lack of specialist knowledge. I have lost confidence in them I have to say but during these times I think its might be wise to stay where I am.
Title: Re: Has the nurse got this wrong?
Post by: Dotty on June 03, 2020, 01:34:17 PM
Hi .. I agree with Hurdity that you have been given an incorrect prescription again . There is not enough progesterone in what you have been prescribed to be used in HRT.

I would advise you to contact yr GP surgery and ask for Utrogestan or a Sequi HRT tablet .... Evorel Sequi or Femoston x
Title: Re: Has the nurse got this wrong?
Post by: Kathleen on June 03, 2020, 03:37:17 PM
Hello anartistatheart and welcome to the forum.

I'm pleased to see that you have been helped with your query.

 I  wanted to add that when you have been dealing with medics as long as some of us here you lose all fear of them lol. Obviously it's important to be polite and respectful but you will soon get the hang of asserting yourself so that you can obtain the right treatment.

Wishing you well.

K.
Title: Re: Has the nurse got this wrong?
Post by: anartistatheart on June 03, 2020, 06:38:18 PM
Im losing the will on this one now. I have evorel 50 and im supposed to take the progesterone pill daily.
If i go back again I need to be just telling them what i expect to receive.... if i stick to the evorel 50 patch, what strength, type and regime should I be on for the progesterone?

Thank you everyone...im just so tired and its taken so long for me to pluck up the courage to go get hrt in the first place.  :'(
Title: Re: Has the nurse got this wrong?
Post by: Taz2 on June 03, 2020, 07:31:49 PM
There are quite a few members on here using Utrogestan mentioned in Hurditys post or some go for the Merina coil.

Don't give up! I'm sorry I didn't notice the one you've been given wasn't string enough to protect your uterus by the way  :(

Taz x
Title: Re: Has the nurse got this wrong?
Post by: anartistatheart on June 03, 2020, 07:58:27 PM
There are quite a few members on here using Utrogestan mentioned in Hurditys post or some go for the Merina coil.

Don't give up! I'm sorry I didn't notice the one you've been given wasn't string enough to protect your uterus by the way  :(

Taz x

Hey Taz, you shouldnt been apologising... this group is a godsend and you have been nothing but helpful.
The surgery that im dealing with isnt easy. Getting past reception is hard enough, then the first line of defence is a pharmacist who doesnt seem to really know what hes doing, he then passes me to the nurse who seems to be trying very very hard but just isnt getting it right. She then defers to the gp who obviously isnt getting it right either. In the current situation I am feeling worn down by it because its taking so much effort and time when working full time too..... so I've looked online and I can buy the utrogestan via oxford pharmacy. Have you heard of this place? X
Title: Re: Has the nurse got this wrong?
Post by: Taz2 on June 03, 2020, 08:03:37 PM
No I haven't but others may have. You really shouldn't have to do this though.  :-\

Taz x  :hug:
Title: Re: Has the nurse got this wrong?
Post by: anartistatheart on June 03, 2020, 08:09:37 PM
I know I shouldn't but just dont feel I have the fight in me this week to sort it out.  Its really not my usual personality! Ill sleep on it... maybe if i get a good nights sleep I'll feel different in the morning. Fingers crossed. X
Title: Re: Has the nurse got this wrong?
Post by: anartistatheart on June 04, 2020, 08:34:41 PM
No I haven't but others may have. You really shouldn't have to do this though.  :-\

Taz x  :hug:

I had these words ringing in my ears all night and woke up with determination!  ;D ;D ;D i spoke to the pharmacy first and checked that they had the standard stuff in stock and gauged her opinion on the prescription. She said it wasnt right basically, pointed me to this site  ;D ;D ;D and she advised to call the surgery back ...exactly what I was hoping for. The conversation felt a bit easier then because I started it with "your pharmacist has concerns and pointed me to...". Its still been a farce and not yet sorted. Apparently a doctor is going to call me in the morning. Still..... progress!  :thankyou:
Title: Re: Has the nurse got this wrong?
Post by: Taz2 on June 05, 2020, 12:33:15 AM
That's good news! Well done! Waiting to hear the next instalment  ;D

Taz x  :foryou:
Title: Re: Has the nurse got this wrong?
Post by: anartistatheart on June 05, 2020, 10:47:21 AM
Maybe this saga has come to an end! There has obviously been some frantic reading up being done in the surgery since yesterday - they all suddely seem to know what I should be on now! ::). I now have the correct regime with the Utrogestan added for 12 days at 200mg. The pharmacist has now completed his CPD in HRT  ;D ;D

I will be eternally grateful for everyone who has helped me with this - I really just felt like giving up and despite losing my confidence in the specialists in my surgery, I feel well equipped now to be assertive with the medics as Kathleen said.

thank you for the expert advice and hand holding everyone :) :hug: :thankyou:
Title: Re: Has the nurse got this wrong?
Post by: Taz2 on June 05, 2020, 03:17:29 PM
That's great news and will also help other women who approach your doctor's surgery with the same problem!

Looking forward to hearing how you are getting on with the HRT.

Taz x  :)
Title: Re: Has the nurse got this wrong?
Post by: CLKD on June 05, 2020, 03:29:48 PM
Well done  :medal:  tell your Pharmacist your result too.

Maybe he would like to run a menopause group ;-).  Or the Nurse Practitioner at your Surgery, it's a learning curve but we shouldn't be educating the medical profession.  Sadly though .......

Do read the threads on vaginal atrophy and bladder issues   ;)
Title: Re: Has the nurse got this wrong?
Post by: anartistatheart on June 05, 2020, 03:41:03 PM
Well done  :medal:  tell your Pharmacist your result too.

Maybe he would like to run a menopause group ;-).  Or the Nurse Practitioner at your Surgery, it's a learning curve but we shouldn't be educating the medical profession.  Sadly though .......

Do read the threads on vaginal atrophy and bladder issues   ;)

will do and thank you :)
Title: Re: Has the nurse got this wrong?
Post by: anartistatheart on June 05, 2020, 03:43:59 PM
That's great news and will also help other women who approach your doctor's surgery with the same problem!

Looking forward to hearing how you are getting on with the HRT.

Taz x  :)

I hope it does help in some small way. I have found this very difficult to deal with whereas usually it wouldnt bother me at all. I am a hormornal mess and if other women are feeling as I do they might find it difficult to persist. Day 3 of the patch and I feel fine so far :)
Title: Re: Has the nurse got this wrong?
Post by: Dotty on June 05, 2020, 03:56:40 PM
Good news 👍🏻👍🏻👍🏻
Title: Re: Has the nurse got this wrong?
Post by: CLKD on June 05, 2020, 06:10:46 PM
Usually the body doesn't get where it is suddenly so we need to allow the body to take up the HRT - same with anti-depressant medication.  When I got medication I wanted it to work immediately  ::)
Title: Re: Has the nurse got this wrong?
Post by: Hurdity on June 06, 2020, 07:41:05 AM
Maybe this saga has come to an end! There has obviously been some frantic reading up being done in the surgery since yesterday - they all suddely seem to know what I should be on now! ::). I now have the correct regime with the Utrogestan added for 12 days at 200mg. The pharmacist has now completed his CPD in HRT  ;D ;D

I will be eternally grateful for everyone who has helped me with this - I really just felt like giving up and despite losing my confidence in the specialists in my surgery, I feel well equipped now to be assertive with the medics as Kathleen said.

thank you for the expert advice and hand holding everyone :) :hug: :thankyou:

That's brilliant news anartistatheart! So pleased we could all be of some help!

Glad too that so far you are feeling fine so far on the patch and long may it last. Here's to feeling better and better. :)

Hurdity x

Title: Re: Has the nurse got this wrong?
Post by: anartistatheart on June 07, 2020, 08:41:44 PM
Maybe this saga has come to an end! There has obviously been some frantic reading up being done in the surgery since yesterday - they all suddely seem to know what I should be on now! ::). I now have the correct regime with the Utrogestan added for 12 days at 200mg. The pharmacist has now completed his CPD in HRT  ;D ;D

I will be eternally grateful for everyone who has helped me with this - I really just felt like giving up and despite losing my confidence in the specialists in my surgery, I feel well equipped now to be assertive with the medics as Kathleen said.

thank you for the expert advice and hand holding everyone :) :hug: :thankyou:

That's brilliant news anartistatheart! So pleased we could all be of some help!

Glad too that so far you are feeling fine so far on the patch and long may it last. Here's to feeling better and better. :)

Hurdity x

Thank you... still feeling ok apart from itchy eyes!