Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Berto77 on July 07, 2021, 05:18:26 PM
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I am 43 and suspect I may have been perimenopausal . My symptoms are fatigue, low motivation, increasing migraines (after years of them being well controlled), hair and nails getting worse, burning pain when I pee, itchy skin, palpatations, hot flushes, restless legs, insomnia, digestive issues, sweating, weight gain and changes to my menstrual cycle. There is literally always something going on with me physically, some days i feel like an alcoholic in withdrawal I feel so awful! Sometimes I feel ok for a week or two, I'll still be bothered by something but its not everwhelming but I'm always dreading things getting worse again.
My periods have been intermittently irregular either very close together or far apart for about 18 months now, sometimes they are normalish. I haven't had a period for 2 months now and for 6 weeks of that time I felt like death with back to back migraines, insomnia, restless legs and hot flushes. I have an appointment to see my GP about HRT this week but I am worried about a few things.
1. I have some contraindications to HRT, I suffer from migraines, I am very overweight and I'm not sure how my blood pressure will me, its been borderline in the past, I also have a small fibroid (2cm in my womb). On the plus side I am vegetarian, I've never drank alcohol or smoked. From what I have read being overweight, having migraines or high blood pressue should stop me having the more modern body identical forms of HRT or things like patches and that it might even help me but I'm worried that my GP will use these as a reason to not proscribe these for me.
2. I am still having periods somewhat regularly (at least until may) and when I spoke to my GP on the phone she said I was too young to be taking hrt, that it only delays the inevitable etc. Is she correct about this? Would using HRT now when my homone levels are so variable be harmful in anyway? Does taking HRT damage my bodies own hormone producing abilities? If I start younger is my risk of cancer increased? Will I be forced to come off HRT earlier than other women if I start young? My thinking is that it is better to be on HRT sooner rather than later to protect my bones, brain and heart and that hopefully I would be able to stay on it long term / forever as long as I had not major issues in future? I have no breast or uterine cancers in my family history.
3. I am in scotland and the nhs guidelines up here don't seem as up to date as in England. I believe that the body identical transdermal estrogen is available but the body identical progesterone is harder to get here. I also don't know about things like testosterone or topical estrogen for the vagina (which I might need). If anyone is in scotland can you let me know your experiance please?
4. How best do I approach the gp appointment so that I don't get fobbed off. All I want is a chance to try HRT to see if it helps me and my symptoms but appointments are short and it can be difficult to get everything across in that brief time. I know I don't want antidepressents which I am wondering if they will try and offer me as these do not get to the root of the issue and offer no long term protection but I've heard that currently trying to presuade doctors with the long term benefits is ineffective, they are only interested in symptoms, any advice on how to tackle the appointment would be great!
If you can offer any advice on any of these points that would be amazing! I do have loads more questions but will read around the fourm and perhaps as some later!
Thank you!
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Hi Berto I had lots of appointments with my GP re the various symptoms and was referred to menopause clinic Dundee but waited over a year for my first appt however GP corresponded with the clinic and had to try various options at their suggestion. . My BP was a little bit high but was still allowed to take HRT. I am on antidepressants, hrt patches, totesterone gel, BP tablets and recently started getting ovestin cream for sore vulva oh and had a mirena coil inserted 2 years ago!!! It's a long journey to find what suits a lot of trial and error but don't give up. Ask the practice manager which gp knows the most and start there. I wish I could say all is good but think I am entering a new phase as my flushes are back again. So will be asking my GP if I can increase my oestrogen. Good luck
Denise Didi
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Hi Berto77
I am in Scotland and eventually got a menopause clinic referral at 46. I'd been having symptoms for maybe 6 years but wasn't taken seriously until this year. I would say that your symptoms sound pretty conclusive so I reckon the GP should do a full blood count and thyroid check first, then if nothing shows up you should be offered hrt or referred to clinic. Do others agree?
I got a phone consultation very quickly with the meno clinic but I guess it just depends where you are. Good Luck xxxx
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1. High BP can be a contra indication for hrt but as long as it is controlled it should be OK. Depends on your gp if weight is an issue but if it is perhaps you could agree a weight loss program if she let's you have hrt?
2. Oh dear, another ignorant gp. Yes, you will benefit from hrt in peri though it can be harder as you have to deal with your own peaks and troughs. It won't make any difference to what you produce yourself.
3. Not in Scotland but I think the only problem is with utrogestan?
4. Get as educated as you can about it so you can argue your case and have a look at the NICE guidelines. Bad temper was one of my symptoms and my gp bore the brunt of it when she suggested ads instead of hrt. If you know you're right and she's talking through her backside tell her so (but make sure you're right).
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Hello Berto77! I am also in Scotland. Your GP is haverin'. You are not too young for HRT (my mother was on it from her early 40's back in the 1980's, and that was in Scotland!). Some GPs are just not clued up and there is absolutely no excuse. If they just read this forum plus Louise Newson's site they would be well on their way.
Being overweight should not automatically exclude you from HRT unless there is a particular health condition too? I suffered from migraine with aura, caused by hormone fluctuations, and HRT has helped that so far. So no automatic ban there either. Depends on what the origin of your migraines are and even then should be case by case.
Re. utrogestan, I have got it no bother at all in Glasgow and Aberdeen. They just don't like to offer it because it is not the recommended first line of supply. I had to get oestrogel ordered in, but the pharmacist was very happy to do so and it arrived within a day.
The key is to do your research, refer to good sources of information and be very specific about what you do and don't want. It can be tough being your own advocate. If no joy, I would recommend changing GP (looking for someone who specialises in women's health) otherwise bite the bullet and pay for a private appointment with a menopause specialist who can guide your GP to a more satisfactory position.
Let us know how you get on. X
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Hello Berto77, Utrogestan seems difficult to get from nhs Lothian. My GP wouldn’t prescribe and referred me to the Menopause clinic but there’s still no guarantee they will prescribe and it’s an eight month wait. I think I might need to go private. Seems a 2009 SMC report felt it wasn’t worth the extra cost even though it’s only £1-2 more.
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Hi Berto I had lots of appointments with my GP re the various symptoms and was referred to menopause clinic Dundee but waited over a year for my first appt however GP corresponded with the clinic and had to try various options at their suggestion. . My BP was a little bit high but was still allowed to take HRT. I am on antidepressants, hrt patches, totesterone gel, BP tablets and recently started getting ovestin cream for sore vulva oh and had a mirena coil inserted 2 years ago!!! It's a long journey to find what suits a lot of trial and error but don't give up. Ask the practice manager which gp knows the most and start there. I wish I could say all is good but think I am entering a new phase as my flushes are back again. So will be asking my GP if I can increase my oestrogen. Good luck
Denise Didi
Thank you for replying Denise, thats good to hear that you were able to get HRT with higher blood pressure, I am not sure what my gp will say but hopefully she will m try to see if it helps. Its quite overwhelming and worrying when you learn that gps are not up to speed on the new research but I will ask for a referral to a manopause clinic if need be, I think in Glasgow its the sandyford so not sure if that is any good. Thanks again and good luck with sorting out your flushes!
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Hi Berto77
I am in Scotland and eventually got a menopause clinic referral at 46. I'd been having symptoms for maybe 6 years but wasn't taken seriously until this year. I would say that your symptoms sound pretty conclusive so I reckon the GP should do a full blood count and thyroid check first, then if nothing shows up you should be offered hrt or referred to clinic. Do others agree?
I got a phone consultation very quickly with the meno clinic but I guess it just depends where you are. Good Luck xxxx
Hi Cookie, thanks for the feedback, I have an appointment with my GP tomorrow so not sure what she will say, I mentioned the menopause clinic at the sandyford to her but she wasn't sure if it is running at the moment due to the pandemic, but perhaps a phone based consultation is an option for me as well. I had hoped that my GP might just do a prescription for me and let me try hrt but it does seem like many don't quite know where what to do with us lot! Thanks again!
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Hi Shelia,
Thanks for the detailed reply! I am worried about my weight and blood pressure being an issue although I do think that some of the weight gain is down to me feeling to tired and unwell to exercise much over the past couple of years and eating for the energy to get through the day. I know I do need to tackle my weight for my overall health and well being into the future so I'd be open to a weight loss program as you suggest. Hopefully I'd start to feel a bit better on hrt to be able to do more exercise!
Yeah I was so dismayed when the gp spoke like that it was just such a rote answer! I'm hoping she will be more open minded in person and thats a relief to know that the supplemental estrogen won't affect my own natural hormones!
Everyhting I'm reading seems to suggest that the body identical, micronozed progesterone is better so that would mean utrogestan but it does seem to be a bit of a lottery as to if it gets prescribed here, but I will ask about it.
I am trying to get all my info straight but in scotland it seems all over the place I can find the nice guidence which is great but "sign" the scottish equivalent doesn't seem to have anything and I can't find anything for nhs glasgow which is where I am. I think I'll have to just go on the nice guidence, that is fairly up to date anyway!
Thanks again for the advice!
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Hello Berto77! I am also in Scotland. Your GP is haverin'. You are not too young for HRT (my mother was on it from her early 40's back in the 1980's, and that was in Scotland!). Some GPs are just not clued up and there is absolutely no excuse. If they just read this forum plus Louise Newson's site they would be well on their way.
Being overweight should not automatically exclude you from HRT unless there is a particular health condition too? I suffered from migraine with aura, caused by hormone fluctuations, and HRT has helped that so far. So no automatic ban there either. Depends on what the origin of your migraines are and even then should be case by case.
Re. utrogestan, I have got it no bother at all in Glasgow and Aberdeen. They just don't like to offer it because it is not the recommended first line of supply. I had to get oestrogel ordered in, but the pharmacist was very happy to do so and it arrived within a day.
The key is to do your research, refer to good sources of information and be very specific about what you do and don't want. It can be tough being your own advocate. If no joy, I would recommend changing GP (looking for someone who specialises in women's health) otherwise bite the bullet and pay for a private appointment with a menopause specialist who can guide your GP to a more satisfactory position.
Let us know how you get on. X
Hi Trust and Hope!
It is frustrating on the lack of knowledge gps have on this matter. I have been reading the Louise Newson website and listening to her podcast and I was think oh great things seem a lot better now then they did when my mum was going though all this 20 odd years ago but of course most gps aren't up on that sort of thing at all sadly.
I am over weight, I've had migraines since I was young and my new blood pressure monitor is saying my BP is on the high side. So it might be an issue. I do feel that my blood pressure is due to my weight / lack of exercise and that both my diet and exercise have been impacted by having perimenopausal symptoms such as migraines, insomnia and tiredness and that perhaps hrt would help with that but I don't know I might need to lose weight before I can start. It was good to hear that your migraines were improved with hrt, I do think mine are much worse (incontrolable really) when my estrogen levels drop.
That is great you managed to get the utrogestan in glasgow (I'm in the greater glasgow area), how did you manage to get it did you just ask for it? From my current research my preferance is for a continuous estrogen patch (which is supposed to be better for migraine) and the cyclical utrogestan. I will ask about that as a starting point.
Can I ask what sources you refered to when you went to your doctor? I'm having trouble finding scotland specific guidence, it it find to use UK or english based guidence like the nice guidence?
I will look into the option of a private menopause specialist if need be, I am concerned about costs but could potentially fund an initial appointment if that info could then be transfered over to my gp to go on with.
Anyway, thanks again for the brilliant info!
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Hello Berto77, Utrogestan seems difficult to get from nhs Lothian. My GP wouldn’t prescribe and referred me to the Menopause clinic but there’s still no guarantee they will prescribe and it’s an eight month wait. I think I might need to go private. Seems a 2009 SMC report felt it wasn’t worth the extra cost even though it’s only £1-2 more.
Hello SamEdin,
Sorry to hear that you have had trouble getting Utrogestan proscribed, I think I saw that report as well online when looking for info. It does seem like a lottery on if you can get it or not and it really is shocking how poor menopause treatment is, an 8 month wait is terrible! I'd prefer the utrogestan as its seems to have better safety and it is body identical but then I've also read that some women haven't felt great on it at all but perhaps that is more down to progesterone intolerance?
Good luck with it though!
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Hi! My GP in Glasgow gave me the patches straight off - her recommendation. This is because they are on the list (see below). Utrogestan 100mg is NOT on the Greater Glasgow and Clyde list, but I said I was not comfortable using anything else. The Evorel Sequi patches contain norethisterone and I know I react badly to it. You may be OK. The GP did roll her eyes when I mentioned Louise Newson, but wrote the prescription anyway. I now use oestrogel and utrogestan but you can also use evorel oestrogen-only patches and utrogestan, so both are body-identical. Interestingly, Lenzetto spray is on the list?
The list: https://ggcmedicines.org.uk/formulary/endocrine-system/sex-hormones/
I am positive that since Davina's Channel 4 programme there will be many women asking for a review of their HRT.
From past experience, if the GP will not prescribe something you know they could (e.g. oestrogel) it is worth paying the couple hundred pounds - if you can - to see a specialist. They will then write to the GP with a prescription recommendation, which often means you can access HRT not on the list. That's how I got oestrogel on prescription eventually. And, of course, it is free in Scotland.
If that doesn't work, you can obtain a private prescription from the specialist and pay for the prescription. I had to do this when moving cities and between GPs. Oestrogel and utrogestan together cost me £18 from Boots (they ordered in the oestrogel and said they could do that easily).
I wouldn't worry too much about being overweight. I am not overly skinny myself! Migraines might be a different matter but I would also see a menopause specialist rather than a GP to discuss that.
All the very best!
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Have just noticed that oestrogel is in fact on the list, but not as first line prescription.
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I haven't read all the responses but your GP is living in a Cave!
No one is too early for menopause: girls may have 1 peroid or non at all. So it can happen across the whole age range. GPs still tend to think that 52 is the age ....... Certainly, HRT will protect heart and bones in the main. As will brisk walking 10 mins several times a week. Eating well - mayB have a lookC at your over all diet?
A drop of oestrogen may well cause the skin to become dry: inside and out as well as muscles may become lax = aches and pains. Do read the 'bladder issues' and 'vaginal atrophy' threads.
What support is your GP offering regarding any weight loss regimes?
Browse round. Make notes ;-) Let us know how you get on.
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Hi Trust&Hope,
Thanks for getting back to me with all that information! I think I will ask for estrogen only patch and the utrogestan at least to start with. I will consider seeing a specialist privately if I need to but will see how I get on at the GP first. Thanks again!
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I haven't read all the responses but your GP is living in a Cave!
No one is too early for menopause: girls may have 1 peroid or non at all. So it can happen across the whole age range. GPs still tend to think that 52 is the age ....... Certainly, HRT will protect heart and bones in the main. As will brisk walking 10 mins several times a week. Eating well - mayB have a lookC at your over all diet?
A drop of oestrogen may well cause the skin to become dry: inside and out as well as muscles may become lax = aches and pains. Do read the 'bladder issues' and 'vaginal atrophy' threads.
What support is your GP offering regarding any weight loss regimes?
Browse round. Make notes ;-) Let us know how you get on.
Hi CKLD,
I know my GP is incorrect as my mum was menopausal in her late 30's but they seem to get so little training on menopause, its disgraceful really. I think the only way to know if hrt will help me is to try it but I'll need to wait and see what the GP says today. It seems that many women have to see a specialist privately then have their recommedations transfered accross to the GP!
I've spoke to my GP about my weight in the past and always been brushed off so I don't think they really do offer any support. I think you have to already be ill with hypertension, type 2 diabeties or heart disease before they offer any help, which is unfortunate. I do want to lose weight and think i could on my own if I were not so tired and unwell feeling all the time!
Ah well, wish me luck for today, sounds like I will need it ;D !
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GPs want to save money too >:( so every referral costs.
Take a list with you and push your point. You should not have to pay privately. I would ask directly for a referral to a menopause clinic, NOT a Gynae! Different speciality though many GPs seem unaware of the fact.
Let us know how you get on? MayB seek a dietician within the Group or perhaps join Weight Watchers for support? No one is too heavy or thin there, it's all about getting to a healthy, comfortable weight in your own time.
Because GPs get little or no up2date info on menopause, wouldn't you think by now that they would try to listen and not be defensive? U do of course, have Dr Currie in Glasgow who began this Forum ;-)
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I'm back form my appointment and it was a mixed experiance, the doctor was actually really nice and listened to me but obviously very busy. The main issue was my blood pressure which was high at the appointment 170/95 I think. I have to take my own readings for a week then get back to her. If my home readings are lower by then she has offered me EVOREL SEQUI patches which is combined estradiol hemihydrate and norethisterone acetate and an estradiol hemihydrate only patch for the non progesterone part of the sequence. I think if my blood presure remains high I'll need to have that under control before I start hrt.
I did ask for the estrogen only patches and the Utrogestan but she had never heard of it and it wasn't in her database. I did have some information from the british menopause society about migraine and hrt and blood pressure and hrt (from bloodpressure.co.uk) both suggesting that the micronosed progesterone in Utrogestan would be better for me but she said she didn't know enough about it to prescribe it. She did ask if I'd like to go to a menopause clinic given my issues and my requests for a more specific treatment which was good. However I think there is a long wait for appointments. She also said she could ask them (the meno clinic) for advice of what to do in the meantime, she did say she was not especially knowledgable about the menopause.
So I think the plan at the moment is to see how my blood pressure is then if that is ok start on Evoral Sequi while I wait for advice or an appointment from the menopause clinic. We didn't discuss topical estrogen at all unfortunately. I'd like to try it to see if it helps my urinary symptoms any but perhaps I need to give the patches a chance first? I have also seen that superdrug do private prescriptions of topical estrogen for about £55 so I could perhaps do that to see if it helps and then if it does see if my GP will prescribe it.
I'll also look into private menopause specialists in the glasgow area as a back up plan. I'll do a search or ask on here about who people recommend. How do I get to see Dr Currie, is she NHS or private?
I'm going to download the myfitness pal app to log my food and calories and work out a plan, perhaps do the 5:2 and then do walking (which I do anyway) and some strength training. My basic diet is good but i know where I go wrong and I have a good incentive to tackle it now!
Thanks for all the help and advise, I'll be back!
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I'm pretty sure Dr. Currie is in Dumfries&Galloway. You can send her an e-mail with your health issues by using the Contact option on the black bar along the top. She charges £30 for invaluable advice and recommendations to which the medical profession seems to pay great heed. Might be a positive next step with a positive outcome re your gp. Good luck!
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I'm pretty sure Dr. Currie is in Dumfries&Galloway. You can send her an e-mail with your health issues by using the Contact option on the black bar along the top. She charges £30 for invaluable advice and recommendations to which the medical profession seems to pay great heed. Might be a positive next step with a positive outcome re your gp. Good luck!
Thank you thats really good information! I will see how I got on over the next week with my blood pressure and GP then do the email to Dr Currie as that sounds like my GP would be more likely to listen to what she had to say!
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You can ask for 'vagifem' or 'ovestin' if you have vaginal atrophy or any dryness. It's classed as HRT but isn't really, other than to plump up the tissue which becomes thinner due to a drop in oestrogen levels. U can ring and ask as a separate issue. The sooner you begin treatment, the better your vaginal health will remain. We have threads about that too!
You could also suggest that your GP Surgery buys copies of Janes Lewis's book 'Me and My Menopausal Vagina' ;-). Written by a Member about her difficult journey to get appropriate treatment.
Let us know how you get on. This is an opportunity for your GP to be on a learning curve to, so that she can help the next women along. Also, make a double appt. if possible next time? Encourage her to speak to the menopause clinic too.
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I think it can be advantageous coming at it from a knowledgeable third party who is neutral, but more influential? Some doctors don't take kindly to patient recommendations. It depends on the relationship, how negotiable etc. You'll know best how that is in your case. Good luck!
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GPs still seem defensive in some areas when a patient makes suggestions :-\. In these difficult times, it should surely save time and energy on both sides of the couch ?
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Thanks Postmeno, I think it would probably sound better coming from another doctor than some upstart patient!
Thank you too CLKD, I would like to try something for my vaginal symptoms, thats been going on a while now and I was always putting it down to other things but with all my research I really think it could be menopausal related. Its can be quite painful and had been bad enough to put me off sex with my husband so I think I'd be justified in asking to try something topical. I think I should be able to try that even if systemic HRT is off the cards for the time being. That book sounds great I will definetly check it out and suggest it to my GP! Hopefully by trying to educate myself and being assertive in trying to get my needs met it will help to improve things, just imagine if all the suffering women went in demanding quality care, it would be a revolution!
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Va will only get worse so I would ask for local oestrogen at your next appointment. Some people are OK just with hrt, others need local oestrogen too so I'd suggest you start on it now and perhaps try to reduce when (if) you've been on hrt for a few weeks. My gp had trouble finding Utrogestan too, it only came up with the 200mg which is licensed for ivf but not for hrt, he shouldn't have prescribed it but he did. The 100mg that is licensed for hrt came under Micronised Progesterone not Utrogestan. This was 3 years ago so it may have changed but would be worth checking. Hrt is only contra indicated for high blood pressure, once your blood pressure is controlled hrt should be prescribed so you should be able to get it even if it takes a bit longer to get there. Good luck, hopefully your BP is OK when you're at home and you'll get hrt soon.
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Response from SMC if they are relooking at Utrogestan prescriptions in Scotland as prev. 2009 appears to have been economically driven :(
Although this study notes post-menopausal rather than peri-menopausal.
Still looking like a tough one to get prescribed even though final paragraph hints it’s not a total block? Consider requests?
Dear Ms Wright
Thank you for the enquiry concerning micronised progesterone (Utrogestan). I can confirm that in April 2009, following a full submission, SMC did not recommend micronised progesterone 100mg capsules (Utrogestan) for adjunctive use with oestrogen in post-menopausal women with an intact uterus (HRT) (SMC542/09). This advice remains valid.
As per SMC process, if the company has substantial new clinical and/or economic information then a resubmission may be made. SMC has not received a resubmission to date.
Please note that all NHS boards In Scotland have procedures in place to consider requests for the use of a medicine (which has not been recommended by SMC) in an individual patient when a doctor feels this would be appropriate.
I hope this answers your query.
Kind regards,
Jonathan
From: [email protected] <[email protected]>
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I'm in Scotland and been on hrt since I was 32!
Where in Scotland, I was in midlothian and now east lothian and was referred to the well woman clinic and they were amazing, most of the anyway and helped me a great deal at the time.
I'm now back with a local gp so we'll see how that goes 🤔🤪
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Have you been prescribed body identical progesterone - Utrogestan?
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Hi SamEdin I live in NHS Lothian area too and I've been unable to get a prescription for Utrogestan on the NHS and have had to go private. My GP liased with the Menopause clinic who said they do not prescribe it but gave no clear/consistent reason why; sometimes referring to the SMC guidance, other times saying it does not provide adequate uterine protection. So in May I put in an FOI request asking for; Any information on criteria for its prescription including the criteria fulfilled by the individuals who have been prescribed Utrogestan for the treatment of menopause symptoms in the NHS Lothian area.
• Any internal or external correspondence or other information relating to current guidance or practice in its prescription, reasons for not prescribing, or developments of such guidance and / or practice in the future (to include correspondence between NHS Lothian and GP practices on its prescription).
• Any analysis which has been undertaken on its prescription, including numbers, GP practices or other prescribers involved, costs, criteria and / or other analysis.
They replied to me last month but unfortunately they have not put their response on their web site yet so I can't post a link.
So bear with me while I try to summarise without turning this post into War and Peace! Basically they have not been able to prescribe it to anyone since 2019 following instructions from the Executive Medical Director in NHS Lothian. "Utrogestan is licensed for this indication, but it is not recommended by the SMC.
When it was considered in 2009, the SMC decided that there was not evidence of additional benefit over and above HRT combinations containing synthetic progestogens that were already approved for this indication. In the specialist Menopause Clinic at Chalmers, we used to recommend use of Utrogestan for women who had intolerable side effects with synthetic progestogens,but in 2019 we were reminded that individual PACS2 applications needed to be made to recommend this medication (I attach the correspondence from that time). Subsequent PACS2 application was rejected. We have therefore been unable to recommend Utrogestan for this indication in Lothian." The menopause Clinic have emailed the Executive Medical Director in June 2021 highlighting the fact that NHS Lothian is out on a limb in this approach and that they are receiving criticism from their peers and patients. "Lothian patients are requesting Utrogestan in their droves as a result of media coverage and the extensive online presence of private menopause specialists that advocates use of Utrogestan in HRT as standard, because, together
with transdermal estradiol “it is the safest option”. They have asked her to reconsider the current policy and align it with practice in other parts of the country. They say that they will inform GPs if there is any change in the policy.
So on a positive pester power seems to have had an impact at a clinical level and spurred them on to question their practice but who knows if that wil have any impact higher up the chain. I hope this makes sense.
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Thanks!
Even the SMC response I received indicated some flexibility in what doctors can prescribe, so it’s a shame NHS Lothian haven't reappraised their advice to GPs. But I’m hopeful from your info that the menopause clinic, patient etc. are pushing back to change their stance.
How many people need to go private? So frustrating
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Thanks all for the updates especially to Seahorse and SamEdin for posting all that information on the FOI and response. Very interesting reading and infuriating that in scotland so many women are being refused the bog standard treatment, safest treatment!
I've been given evoral sequi (which seems to be the go to at my GP's practice). I've only just started it in the past week (estrogen only patch) so its too early to say how effective its been. I've perhaps had a bit more energy and less breathlessness but not sure if that is related. I've also had a bit of nausea and headaches although I'm still on my period so headaches / migraines are the norm for me! I am worried about the switch to the combined patch as I head many women struggle with the synthetic progesterones like norethisterone acetate. I'd feel so much better about using a body identical progesterone and I will push for the chance to use it. I've been refered to the menopause clinic but I don't know how long I'll need to wait for that. My GP refused the local treatment for my vaginal and urinary symptoms and my poor vulva was in agony a week or so ago made worse by the fact that I'd had to see a gynocolagist to have my coil removed and a biopsy taken he tried to use a speculum the size of a jumbo jet I think and it was so painful I nearly passed out! He did then switch to a much smaller one but it was brutal and I ended up in tears which was embaressing. Things are feeling a bit better now but I am thinking of getting the Estriol Cream off the superdrug site (£55 though!) to see if it helps and then that might sway the doctor to give me a prescription for it. It shouldn't be this hard to access the treatment we need. I defintely think I will do a letter to my MSP to highlight the issue.
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You could try an email to Dr currie who runs this site, I believe it's £30. Perhaps your gp could be persuaded to prescribe va treatment for you if it's on her advice.
You may find you are fine on evorel, it seems to be the 'go to' hrt in many English surgeries too. Most women are absolutely fine on the first one they're prescribed so the chances are you will be too (I got on well with evorel until I developed an allergic reaction to it some months in). I hope it goes well for you.
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Thank you Sheila I might do that email as you suggest.
I'm prepared to give the evoral a fair trial as I know it might take a bit of getting used to and a while of the estrogen to build up to high enough levels to make a difference, so I think i need to give it at least 3 months. My GP has only given my a months supply so I'll need to check in with her and give blood pressure readings to get the prescription renewed so I'll ask her again about the cream if I'm still having problems then. Was it the patch or the hormones you developed an allergy to? I've heard that some people struggle with the patches but so far so good but I've only used two!
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I believe it's the glue in it. I switched to gel and have no problems with it. Also now on utro which gives me fatigue, I had no side effects from the prog in evorel so although utro is body identical and supposed to be the best it doesn't always turn out that way ???
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Ah I see well I think that you can develop allergies to that sort of thing through exposure. I am imagining utrogesten will be"holy grail" but I suppose it may not work out like that!
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Hi Berto77
What reason did your GP give for refusing vaginal oestrogen? It carries no risks and apparently can make a huge difference to vaginal atrophy and UTIs. Surely much better than repeated GP appointments, antibiotics and referrals to Specialists. Your experience with the gynecologist sounds horrific! Is there another GP in the practice you could see that might have more specific knowledge. I contacted my practice and told them about the free training that Louise Newson's Menocharity is providing and apparently one of the GPs is doing it. The HRT can help with UTIs and VA but some women do need additional localised oestrogen too. It really shouldn't be such a slog. I hope you see some improvements soon.
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https://www.heraldscotland.com/news/19541646.utrogestan-petition-women-cant-get-safest-hrt/
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Berto77 I am in Glasgow and my doctor prescribed Utrogestin, however your doctor sounds like my doctor I eventually got ovestin but she would not prescribe vagifem as her words it was to much estrogen, re weight loss i am following a lady on facebook PhalaB she is very good and there are exercise videos for menopausal woman that she does on youtube if you are interested give me a shout and i will send you the facebook address
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Hi, I’m in Inverness and I was offered Utrogestan and Lenzetto from my GP. I wasn’t aware about the SMC.
The info on this thread is great ladies.
I don’t expect GP’s to know everything but I’m surprised that a female GP admits to knowing very little if anything about the menopause.
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I attended a private clinic in the Lothian region today.
I now have an Utrogestan prescription.
The doctor was very sympathetic and aware of the current postcode lottery with this drug, esp nhs Lothian.
She did say the Edinburgh NHS menopause clinic have submitted information with SMC and nhs Lothian pharmacy board to try and change the situation.
Fingers crossed.