Menopause Matters Forum
Forum Guide and News => Forum and Website News => Topic started by: Dr. Heather Currie on April 17, 2013, 06:15:37 AM
-
The National Institute for Health and Clinical Excellence (NICE) is developing a guideline on the menopause. This is a wonderful opportunity to push for better support for women and better education for healthcare professionals to give appropriate advice. I will be attending the first meeting in May, representing Menopause Matters. I would be very grateful for any feedback from yourselves on issues that you would like to be raised.
Many thanks
Best wishes
Heather
-
i hope the guidelines will cover surgical menopause and also early as i was 40 and mine due to surgery. without seeing a private gynae i would not have got vagifem nor been able to get enough oestrogel for month. gps even those who claim to have attended your seminars are very out of touch.
-
Anxiety.
When we asked on the forum what was one of the worst symptoms this seemed to be one of the top ones.
Honeyb
X
-
Hi Dr Currie
Thank you for this. I think it will be very useful for doctors to have NICE guidelines to refer to on the menopause, and I hope these will be developed to apply to GPs as well as hospital consultants, as GPs are often the first port of call for women in peri-menopause and menopause.
It seems to me from reading this forum that there is a lot of disparity over the prescribing of various treatments, and it would be good to have clearer guidance, for issues like the length of time recommended for taking HRT, and guidance for various doses, both for oral and local treatments. For example the recent Vagifem dose changes which just seem to have been imposed on women by the pharmaceutical company - without reference (it would seem) to guidance from doctors and health professionals about what individual patients with VA actually need. It seems that we are all different and have different health needs - so some flexibility in the guidelines would also be required ...maybe a big ask!.
Good luck with the meeting next month and please keep us up to date with the guideline developments on your excellent website.
Best wishes
English Rose
-
Crashing fatigue. I know that I have suffered with this in the past, along with many others, but when visiting GP, first thing they assume is that you are depressed.
Also would be nice ;) if GPs could sing from same song sheet over the menopause.
Good luck Dr Currie.
-
i hope the guidelines will cover surgical menopause and also early as i was 40 and mine due to surgery. without seeing a private gynae i would not have got vagifem nor been able to get enough oestrogel for month. gps even those who claim to have attended your seminars are very out of touch.
I would like to echo this. I've just gone through surgical menopause and quite frankly my GP is clueless. I'm having to go private to obtain topical oestrogen for VA as my GP thinks it could get better on its own. So many women seem to be let down by the very people who should be helping them.
-
Sounds like a very good move. I will put my thinking hat on.
-
As a patient really suffering at the moment from the recent change in the strength of Vagifem - suddenly reduced from 25mcg twice weekly to 10mcg twice weekly - I would ask that Vaginal Atrophy and the treatment of it be raised and that the profession be aware of all the issues of this distressing uro genital condition
My pharmacist informed me that it has been discovered (by a very small sample of ladies in the USA ) that the 10mcg is as effective as the 25mcg, so so be it. Please, that is no way to treat us.
-
I will continue to say it till Im BLACK in the face
Money Money Money the lowering of the dosage has lost 175m a pak yet paks about the same price
If it was strictly medical reasons it would be less liek a small pak of anythngs less than a latge one
But its not we are the first generation of baby boomers and Post baby boomers who need Vaginal HRT
We are also post baby boomers the ones who were less likely to have been given hrt in the 90s through
Early meno or sugical and over the years Atrophy has set in
So many think as Ive said before Atrophy is just painful sex its not its the least of the symptoms
The pain the burning the throbbing day after day month after month atrophy of the tissues disolving
Leaving me with hardly any inner labias at all and with almost no clitoral hood IM almost childlike down there now
AV affects your day to day life pain wise mental wise for me it was the never ending pain plus the peeing constantly
Vagifem 25 took the pain and suction throbbing away almost from the first dose it took a few months for the wee cos I didnt trust it even now if I have to odd day I freak
In December after nearly 3 years I did a 10day reload as I felt the symptoms coming back from the end of October
It worked after 5 nights of constant use it eased 95% by Xmas it was back to normal I did 3.500klms on a Motorbike
I have check up last Feb 2012 4 seperate internals even felt my Ovatires YUK smear the lot now 2015 next one
But if I had any funny feelings or odd symptoms Id go to GP ASAP_ Im still on 25 here in Ozz we are nromally the dumping gorund for drugs that have stopped being made or given in USA or EU or UK so Im stocking up got 8pks
End dat mid 2015 I will keep buying them and keep them in cool clean draws
ITS MONEY other wise there would have been a world wide test i prosses I wonder if the Patent is coming to an end?
-
Maybe there should be clearer guidelines for health professionals regarding irregular bleeding during the menopausal transition. My 45year old colleague had been suffering with heavy bleeding for a couple of years. In fact it was so bad, she had to wear incontinence pads. It was suggested by her GP that she that she should lose weight and have a mirena coil fitted. However, someone at work suggested she should have a smear done, so when she went in to have the coil inserted, she asked if she could have a smear done beforehand. It was then discovered she had cervix cancer. By the way she was still within the normal 3 year screening time, so I don't think there was concern because the last smear was ok. I think there is a tendency for some problems to be put down to 'time of life' which could be potentially more serious? Luckily she had a hysterectomy and did not require any further treatment.
-
I dont know if it is the same nationwide but since I turned 50 my smear tests are down to once every FIVE years. Is that sensible?
Agree re. VA and the reduction in the dosage of Vagifem. Cant help but feel we need a voice in all this.
-
Dr Currie will be our voice I think.
At least someone is listening.
Given the fact that all women go through meno you would think that in general practice there could be more emphasis on what is available.
It's very sad that we have to do our own research and tell our GPS what we want. I can't think of one other condition that this would be necessary.
Why are we being ignored.
Honeyb
X
-
Easy we arent visable anymore
We cant have children we arent considered productive for society except as NANS
The old ways still persist women except for Film stars anyone over 50 shouldnt want sex
Are considered by society as a whole as old and of no use
In shops we are the last to be served people barge in front of us when 10 years ago it would have been after you!
Very few of us command societys respect we arent Lawyers Doctors Surgeons Solicitors Architecs
Most wome even today have normal day to day jobs normal day to day lives with no big paycheck no smashing carrear
We are the back bone and the spine of society yet we are considerd less than a 16 year old sad but I think true
-
Dexa scans! We have a family history of osteoporosis. My sister wouldn't have had her scan unless I plushed her to do it, because both of them thought it was highly unlikely (herself and her GP), because of her very good health otherwise, hardly any menopausal symptoms and she walks to work each day, no fractures. She was very shocked to discovered she has this long-term condition but now on calcium supplements etc, so hopefully won't be as bad as mum and will prevent some of the problems when shes old.
-
Anxiety, panic attacks, fear of everything, growing old, dying suddenly, COPING - all of these don't seem to be taken into account - but they should be, especially if you knew you were fine before the Menopause started. If we didn't have this Forum - goodness knows how we would cope! Hats off to all the women before us who had nowt..............
-
Thank you Doctor Currie. I really hope that doctors could be better informed and more sympathetic. If they came to forums like this they would learn a thing or two. Some women seem to be more knowlegable than some of them. Nausea was something my doctor had never heard of in connection with menopause and I am with all of the other ladies on the fear/anxiety issue, there should be more help available and sadly not everyone can take HRT or even gets on with it but there should be more education about how it can be prescribed and possible alternatives. Menopause is a massive issue, it comes to all women and can have a huge impact on their lives and the lives of their nearest etc. I hope NICE is sympathetic because I associate NICE with budget cuts and sometimes we need prescription medication alongside other measures. At present many women are not getting the help they are crying out for. Good Luck.
Meg
-
Automatic referral to a knowledgable, qualified specialist for anyone who finds their GP isn't able to give adequate treatment - it astonishes me how many of the members here on this site are being poorly served by their GPs.
-
i hope the guidelines will cover surgical menopause and also early as i was 40 and mine due to surgery. without seeing a private gynae i would not have got vagifem nor been able to get enough oestrogel for month. gps even those who claim to have attended your seminars are very out of touch.
I would like to echo this. I've just gone through surgical menopause and quite frankly my GP is clueless. I'm having to go private to obtain topical oestrogen for VA as my GP thinks it could get better on its own. So many women seem to be let down by the very people who should be helping them.
These examples make my blood boil!! Seriously, these GPs need remedial CPD!!
-
As you may know from this thread, new national guidelines for diagnosis and management of menopause are being developed by the National Institute for Clinical Excellence (NICE). This will be a really significant development in women's health care.
NICE is now inviting comments on the draft scope, which sets out what the guidelines will cover http://guidance.nice.org.uk/CG/Wave0/639/ScopeConsultation. We will be responding to the guidelines as part of a network called Menopause UK and will publish our response at the end of June. Do leave comments and suggestions for us here. Our view is that the draft scope is a comprehensive and sympathetic document. We are especially pleased that it recognises the needs of women in early and or surgical menopause. We have some questions about the way the guidelines will address the needs of women who have had breast cancer or who are at higher risk of breast cancer, which we will raise as part of our response.
NICE are also recruiting members of the guideline development group. Do take this opportunity to encourage people you think should apply. The positions being advertised are: Consultant gynaecologists; Community gynaecologist; Specialist menopause nurse; GPs; Practice nurse/nurse practitioner; Physician (with a special interest in cardiovascular health); Physician (with a special interest in bone health); Lay members. The closing date for applications is 21 June 2013. The full advert for the positions can be found here http://www.nice.org.uk/getinvolved/joinnwc/MemberDiagnosisManagementMenopauseGDG.jsp and the lay members link is here
http://www.nice.org.uk/getinvolved/joinnwc/LayMemberDiagnosisManagementMenopauseGDG.jsp
We are founding members of a network called Menopause UK which is making sure that the guidelines benefit from being informed by the knowledge and insights of women affected by menopause. Other members of the Menopause UK network include: the Daisy Network, the Hysterectomy Association, and two social networking forums, Post-Op Hysterectomy for PMS/PMDD and Early Menopause UK Active].
-
Hi Dr Currie
It's fantastic that new NICE guidelines are being developed to give GPs up to date information on which to base treatment of women during and after menopause.
Some of what I want to say has already been said earlier in the threads but you asked for comments in relation to the draft scope so these are just some thoughts on the whole issue generally - sorry it's a bit late and also long!
I had a look at the draft scope and I wondered how far the review will recommend areas for future research and also what the relationship is between guideline development and drug companies?
The document says that recommendations will mainly base the review on licensed products and methods but only exceptionally otherwise, if supported by evidence.
Personally I feel that this is a very important area – and especially in relation to unequal treatment of women. Currently those women living in geographical areas where leading (research and practising) gynaecologists practise on the NHS, are able to access their (gynae) expertise and due to their knowledge are able to receive individualised treatment in a way that they cannot from most GPs. Similarly, those who can afford to do so, go to private gynaecologists at considerable cost for similar treatment and prescription. Also many areas are not served by NHS menopause clinics.
I would hope that the new guidelines would do something to try to lessen this inequality so that all women have access to the best possible treatment and with the latest knowledge and research.
In order to do this there are still a lot of areas where research is needed to provide the evidence on which to base treatments.
Topics that are discussed frequently on this forum include: long cycle HRT (other than Tridestra - the single proprietary brand currently available) – ie longer than monthly, and long term use of HRT particularly in the over 60's – with many still being asked to stop at 60 or before. I note the guidelines only refer to looking at the effectiveness of HRT and other treatments in the short term (5 years) but some of these can also be present long term eg urogenital symptoms and others. Many of us would like to stay on HRT for life if possible and this is an area where up to date studies and research are needed, and especially using what is thought to be lower risk transdermal bio-identical estradiol and progesterone.
A major area needing research and licensing in UK is evidence and dosing for using other forms of progesterone currently available in other countries or off licence here ie Cyclogest, Crinone gel and vaginal use of Utrogestan.
Other areas which seem to need more research are : long term vaginal use of local oestrogen; if possible a bit more precision in the dose of progestogen to oppose specific doses of oestrogen especially micronized progesterone, in preventing hyperplasia (at the moment often standard amounts are prescribed by GPs irrespective of oestrogen dose).
An area many of us know very little about but which urgently needs more research and proper treatment with hormones if necessary is reduced libido and treatment with appropriate women specific formulations of testosterone and the availability of testing and treatment for this on NHS rather than mainly privately as now.
I don't know how the drug companies relate to the Dept of Health but will it be possible to commission or recommend additional products eg re-introducing Vagifem 25 mcg for those for whom 10 mcg is not effective? The studies on which this was based were very small and as always based on a percentage of women and statistical significance – so what about the rest ie the percentage of women for whom that dose is ineffective?
For progesterone intolerant women – the need to re-introduce dydrogesterone as a separate product to enable better adjustment of dose in relation to bleeding – currently only available as combined tablet.
The need also to produce greater variety in dosage of progesterone eg lower strength vaginal gel, half strength micronized progesterone to enable splitting the dose daily ( eg 2 x 50 mg) and also to enable reduced dose for those on very low dose oestrogen (patches or gel).
These are just my thoughts as a menopausal woman based on my limited knowledge and experience – as I don't know what guides research and how the drug companies work.
Many thanks for consulting us and we look forward to hearing more in due course
Hurdity x
-
Hurdity, it strikes me that you should be encouraged to apply for a lay member's post on this commission mentioned in Dr C's last comment. Please do!
-
I read this thread with enthusiasm and hope, yet I cannot find treatment guidelines on NICE.org.uk.
Am I missing something? Looking in the wrong place?
Thanks
-
Hi Dandelion
I think this consultation process is still in progress - so no new NICE guidelines yet.
We all live in hope the results will be positive.
I think Hurdity and many of the others on this thread have brought up some very important points.
My view is there needs to be some major training of GPs to help the ever growing number of women reaching meno.
I'm sure this site will be one of the first places to see the new guidelines when they come out.
DG x
-
I have found that the GP's don't really know enough about menopause symptoms. Anytime i went to them with unexplained symptoms (thought i had some deadly disease) they almost rolled their eyes as if i was some kind of hypocondriac. One Dr eventually told me about this site and the rest is history. Once i was referred to the meno clinic, it all fell into place. The other problem i have found is that my surgery have not called me back at regular intervals to see if i still need the HRT, my understanding is you should be checked approx every 6 months and this has not happened. Considering every woman has to go through this horrid time, all i knew of meno symptoms was hot flushes. If we are told more about what we may experience, it would prevent a lot of women suffering needlessly.
-
Yes Dandelion you should need a review - but you will have to make the appointment. My prescription tells me when my review is due so I phone up and book a consultation with GP.
Re NICE guidelines. 2015 is the intended date - the development group is meeting regularly to reviw the literature, discuss with experts and come up with recommendations. I imagine there may also be a consultation process when the draft guidelines are produced too, and if so, Dr Currie will update us and ask for our opinion as she has done at the different stages in the process.
Hurdity x
-
More advice about treatment of older women -I am 76--who want to stay on HRT. Are the risks dose related and have there been any studies and conclusions in this age group. Having trie to come off many times and at last all is calm on Premarin one only three times a week, I have a special interest in this topic.
Very many thanks for your wonderful support.
-
Yes brilliant support Here and emailing Dr Currie was my lfe line, Unfortunately my doctors practice simply direct everyone to menopause matters website and I seriously doubt they have ever looked at it. My female doc said anxiety in menopause was rubbish and that ladies of a certain age get GERD because they enter the menopause overweight!!
I call for a menopause doctor/ nurse in all health centres and all the symtoms to be widely known.
Kellyx
-
I agree Kelly, there should be more NHS menopause clinics or like you say trained staff in health centres, GP practices. There is a private one where I live, but that's not an option for me I'm afraid.
-
Would like to see GPs not write women off for help with peri or meno symptoms just because they are not the 'average' age for treatment. I started having peri symptoms about 4-5 years ago, of course I was 41 then and couldn't possibly be in need of any help. I asked for a printout of my bloods and my FSH was high and estradiol was low...but doc said it was fine!!?? and that I just needed to sort out my lifestyle (!!??)
too many times leaving the surgery in tears...
and my ex MIL is in her 60s, desperately wants to get back on HRT, she is a vibrant amazing woman who feels like death but they won't help her.
Maybe the guidelines or whatever they use to determine who gets help need to be adjusted. Women are living longer...and for whatever reasons we are also entering meno earlier.
just my tuppence worth x
-
I just despair of doctors nowadays ! I had one hold open the door saying it was only a ten minute appointment while I sat crying in the chair!! They need to be a lot more aware of menopause symptons not just hot flushes!
Kellyxx
-
"Unfortunately my doctors practice simply direct everyone to menopause matters website and I seriously doubt they have ever looked at it"
Totally agree with this Kelly!
My own Doctor told me to go "look" - and then got all annoyed with me when it contradicted their "hallowed" opinion.
The Doc also tried to tell me that tridestra was for "post meno" also and that I wasn't allowed it - when I wanted to have a 3 month cycle not a monthly one.
I really think they use the "monthly" cycle to try and put us off using HRT when they first deem to allow us that HRT prescription. Especially ladies who are late peri and not used to the frequency anymore.
-
I totally agree peeweetip can you imagine the outcry if people were simply directed to a web site for any other problems! I have totally lost faith in doctors lately. I just feel they want you in and out as quickly as possible . They just can't give you the time you need nowadays.
They redirected me ages ago to first steps counselling for my anxiety and finally they are giving me a call sometime in August . Only a phone call mind I won't see -anyone yet!!!! Just can't believe the NHS lately!
Kelly
-
I've just read a rather anti HRT article in today's Guardian (Dr Luisa Dillner) in which she says that NICE guidelines are 2-3 years max on HRT.
Is this true? I've been on it longer but am a patient at a hospital meno clinic. Certainly the consultant doesn't believe in this restriction.
-
Hi oldsheep
Have a look at the very recent article on the Daily Mail website. There are contributions from leading professional women on HRT including Dr. Currie. It is advocating GPs should be prescribing HRT for women earlier in the peri stage. The current recommendation is to stop HRT by 60 but even this is not necessarily set in tablets of stone. Like most things there will always be arguments for and against.
The new official NICE guidelines will be through next year. Most of the alarming scares from the trials released back in 2002 have now been revised as it was a flawed trial. Maybe Dr. Dillner hasn't read the latest info about HRT or perhaps she is one of those who believe 'the natural way is the only way' - either way, she is perhaps too young to have experienced the meno herself or she has been one of the lucky ones to sail through meno with few if any symptoms.
I wouldn't worry. Dg x
-
Hi oldsheep
I haven't read all of the articles nor the sources but had a quick glance. As Dancinggirl says the new NICE guidelines are due out next year.
It is very important to note that the information out there does not recommend only using HRT for 2-3 years. The Clinical Knowledge Summaries (CKS) actually say this:
"For vasomotor symptoms, most women require 2–3 years of treatment, but some women may need longer. This judgement should be made on a case-by-case basis with regular attempts to discontinue treatment. Symptoms may recur for a short time after stopping HRT".
This is not a recommendation - but an observation! As always there are often assumptions and differential interpretations made.
This is what the same CKS says about stopping HRT:
Consider a trial withdrawal (if a woman is symptom-free) after 1–2 years.
Advise the woman that symptoms may recur for a short time once HRT is stopped.
Counsel the woman about the possible risks of HRT if she wishes to continue treatment, particularly if treatment is being used for longer than 5 years.
The crucial phrase here is: "..if she wishes to continue treatment"
Here is a link to the NICE CKS for anyone who wants to read it:
http://cks.nice.org.uk/menopause#!scenariorecommendation:9
http://cks.nice.org.uk/menopause#!management
The article Dr Dillner linked to is a Drug Safety Update publication and is also referring to this figure of 2-3 years. Here is the article - but it is actually from 2007 so it's out-of-date.
http://www.mhra.gov.uk/home/groups/pl-p/documents/websiteresources/con2032233.pdf
It is a pity that her article is only superficial but to most women appears as in depth and supported by the evidence, and in the Guardian too ;D
Yes the Daily Mail article is much better and up to date - even though it surprised me to say so !!
http://www.dailymail.co.uk/health/article-2800760/should-women-hrt-menopause-experts-say-s-best-way-ease-symptoms-avoid-long-term-health-problems.html
If the 2-3 year thing was a recommendation we'd all be in trouble!!!
Hurdity x
-
No wonder things are in such a mess. Talk about open to interpretation :o
Even the BMS have said in recent publications that "no arbitrary limit" should be placed on using HRT use.
2-3 years that would be nice if true however its almost always wrong :)
"with regular attempts to discontinue treatment" thats just verging on harrassment!
Perhaps we would all be healthier if docs we're so quick to remind people on other health issues.
"Symptoms may recur for a short time after stopping HRT" yeah right! perhaps whoever wrote that should read this site ::)
Or walk a mile in another persons shoes as the saying goes.
Its is our choice how long we should continue, never the doctors.
They can advise and cajole us all they like but if we wish to remain on HRT then there is nothing they can do.
If its doing good then continue. Simples :)
If you stop, in most cases the symptoms will return for a time that's going to be longer than most of us would want.
The suggestion of a trial period to withdraw seems almost stupid and verging on cruel (based on what we read on MM too).
-
peegeetip - I do agree. There is almost an obsession with many GPs to get women 'off this poison' (a women posted on this site that her GP actually said this to her!!).
There is a real need to educate both GPs and women about the menopause and get some real discussion about a sensible way forward. Hopefully the new guidelines next year will put some clarity into the muddied waters.
When i was advised to take a break from HRT last autumn I wasn't hopeful that my symptoms would subside quickly - I had a 3 year break from HRt before and they never subsided. What I hoped this time was that, as my life was a bit less stressful at the moment, I would cope better. The problem this time is my bladder a trophy are far worse - I can sort of cope with the lack of sleep and flushes but the burning pain and constant trips to the loo in the night are driving me nuts!!!!! Dg x
-
What I'd like to know is.. how do we educate menopause clinics to continue prescribing HRT once we reach age 60!
Taz x :-\
-
Let's hope the new guidelines next year gives us all a better quality of life.
If the NHS wants to reduce the amount of visits to the doctor and prevent many age related ailments, then better management of meno symptoms would be an easy way to start.
DG x
-
Its almost maddening when you here that the doctors are going to be paid £50 extra to diagnose certain complaints.
Perhaps they should be docked £50 every time they fail to identify and treat a problem or say something unprofessional (poison comment).
DG so your off HRT for over 1 year now, sorry to ask but how long did it take before bladder atrophy kicked back in?
Are you going to go back on.
As I mentioned yesterday that's one area I don't want to return to. Was out for a long drive recently and it was bliss not having to panic about when/where the next loo stop was, something that was not the case prior to starting HRT.
Taz, as for the meno clinics, not had any experience of them (yet), just local docs.
Either should respect your wishes then move on and prescribe what patient wants.
Same applies the other way if we wish not to have a treatment or operation, its our choice in the end.
I'm not trying to be funny, but it's almost like they are ensuring job creation for the docs.
Forcing a stop at 60 then having plenty of customers coming back regularly with post meno complaints due to lack of HRT.
At a time when they are trying to save money and doling out statins and ad's like no tomorrow.
They don't even have long term usage data on statins yet and the side effects are awful too (includes causing type 2 diabetes).
Just thought I'd also point out that statins cost more than HRT.
HRT = can be as low as £0.10 to £0.20 per day
Statins = £1.00 thru to £2.30+ per day
Imagine the outrage if diabetics got to 60 and they said "right better get you off that poison, no more insulin for you"!
No one would put up with that.
:o
-
It is understandable (but not excusable) that many GPs are out of date with current thinking and recommendations, but perplexing and more worrying if menopause clinics are also restricting prescription of HRT to the over 60's!
I think they are still using the data from that big study which is quoted on all HRT and which hasn't been superseded by a similar study - although there are small studies I understand eg Denmark etc.
The other annoying thing is that the recommendations are there hidden away eg in the NICE Clinical Knowledge Summaries I linked to below, and also in the most up to date papers of the British Menopause Society - where they do not say we should stop at 60, just that caution should be exercised if women start HRT over 60 (as far as I recall).
At least when the NICE guidelines are produced it should all be in one place - and hopefully clear.... no doubt there will be a draft produced for comment at some point so we need to look out for that if our views are sought!
Peegeetip - if diabetics did not have insulin they would die very quickly. Because illnesses exacerbated by menopausal oestrogen deficiency are long term - sadly it is not immediately obvious - but the paper published recently in Climacteric by the International Menopause Society to mark World Menopause Day (Prevention of Diseases After Menopause) goes some way to educate everyone about this.
Hurdity x
-
Hi Hurdity
my only point was that the insulin is just another hormone people can take to help us stay well in the long term.
It has drawbacks and side effects too.
Why the docs see HRT as some sort of poison or contraband is beyond me!
A better parallel would be if a doctor said to a diabetic "reduce" your usage, as they do with those on HRT.
A diabetic wouldn't die however their quality of life would go down hill fast.
They may also suffer from serious health problems in the longer term.
This is similar in ways to someone reducing/stopping HRT where their quality of life reduces quickly.
They may suffer unpleasant and difficult to treat serious problems in the longer term too.
In either case the doc would be just plain wrong.
???
-
peegeetip - I've had the burning atrophy start in my early 40s when I was already on full HRT but was probably into post meno by then and only using quite a low dose of HRT. Though I mentioned this to various doctors I saw, none of them suggested using extra local oestrogen which I now know might have helped. When I came off HRT last autumn the nurse suggested the local oestrogen and told me I should have started using it a long time ago - they were familiar with this problem as members of staff at this GP practise were suffering as well!!!
This is why I am seeing a gynae privately to hopefully get advice about how I can deal these problems long term. The local oestrogen is only giving me moderate relief - I still get some nasty episodes and it's generally far worse than when I was on full HRT. As for the nocturia - well, since having my babies I used to get up once a night, when on systemic HRT I got up 2-3 times per night and now it can be 4 or more times per night!!! Incidentally, I can go up to six hours without pee during the day - though I make sure I go at least every 4 hours to prevent any infection taking hold. If the gynae suggests I use systemic HRT alongside local oestrogen then I will probably take his advice.
I think there may come a day when they actually encourage women to use HRT to prevent the long term effects of osteoporosis, heart disease, bladder problems etc. - these things end up costing the NHS so much money. We don't hear much about the negative side effects of The Pill these days but the docs are very keen to get every young women onto some form of birth control medication to prevent unwanted pregnancies despite the risk these birth control hormones bring!!
The Pill enabled me to have a career (I suffered with terrible period pains) but I had many horrified people telling me the horrors that would befall me because I was taking these little hormone pills - the scares in the papers were awful at the time.
I think we all want some common sense to prevail.
DG xxx
-
Yesterday I had an amazing hysterectomy by Natalia Price at the Oxford Radcliffe women's centre. All women should have the benefit of Ms Price's attention to detail. I had my cervix left but womb, ovaries and tubes removed, I am 54. I am sure that having my cervix will be good for my sex life which is still very important to me and my husband. Take note GP's!
It took me a year to persuade my GP to prescribe bio identical HRT as he knew nothing about it and wanted to give me Premarin. I am very lucky that my GP was willing to listen to my concerns. Unfortunately, although I was taking oestrogen and utrogestan bleeding got out of control and was not helped by standard progesterone. I had biopsies to rule out endrometrial cancer and the surgery yesterday.
I came home at lunchtime today and feel really well with nothing more than period type pain which is easily controlled. I can now take bio identical oestrogen gel for as long as I like. As I intend working until I am 70 and the lack of oestrogen had a dramatic effect on my memory and cognitive function I am sure I will be able to continue now I'm sorted.
My main concern is that if I was not as determined to get help my life would have been greatly diminished. I have no doubt that I would have stopped my professional work due to lack of memory. Within three days of using the gel I saw a marked difference in my memory and no longer worried that I had early onset dementia.
I believe that many GPs are of the generation trained during the million women study which did so much damage to the idea of HRT. There is just two morning clinics for the menopause for all the women in Oxfordshire and this must be reflected across the uk. When did women over 50 become so insignificant! GP training is essential as is the message that if women need and want HRT it is likely to save costs to the NHS long term.
-
Happy New Year and it's great to hear that you have had such a positive hysterectomy experience Jolly. Do you know why your ovaries were removed as well as the womb? Just curious as usually hysterectomies due to bleeding problems result in the ovaries being conserved as they still secrete hormone even when post menopausal.
Now rest and take care of yourself as you have a lot of healing going on. Have you been on the Hysterectomy UK website? This was recommended to me by my gynae consultant and I found it helpful after my own hyster in July.
Taz x :)
-
BUMP! is this it Maryjane?
-
If any doctor tries to take my hrt off me, I willl point them to the NICE guidelines saying it's ok to continue hrt.
It's a shame lots of doctors are blocking quality of life for some women, my hrt raised my quality of life loads and any attempts to cut it have landed in misery.