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[CLKD]

You may have to wait until there's been a meeting to get approval for you to join 

[Dana]

My experience, in Australia, is that doctors are quite positive about using HRT. I got a good response from my then GP when it became apparent that all my insomnia problems were being caused by menopause. She immediately gave me a prescription for HRT. However, I was the negative one because I had been fooled by all the media scaremongering, and was totally convinced that conventional HRT was going to kill me, so I threw the prescription out.

Instead I opted to go the compounded hormone cream route, and that was a total disaster. Then I thought going to a naturopath was a good idea – another complete disaster. Eventually I relented and actually started to do some proper research on conventional HRT and found that all the scaremongers and advocates of compounded hormones and alternative therapies are, IMO, people who love to play on women's insecurities so they can make money.

I went to a different GP and was put on to conventional HRT straight away. However, my problems weren't over because due to the 2 total disasters I went through I had become dependent on diazepam, and believe me coming off that is no picnic at all, because benzodiazepines and hormones, especially progestogens, do not play well together. I went through almost 2 years of tapering off diazepam, and it was horrible, but things are great now.

Incidentally, menopause may not be life threatening, but the fall out from it can be. During my trials I was definitely suicidal. Had I not eventually gotten things sorted out, I honestly have no idea what would have happened to me.

[GeordieGirl]

I went to a different GP and was put on to conventional HRT straight away. However, my problems weren't over because due to the 2 total disasters I went through I had become dependent on diazepam, and believe me coming off that is no picnic at all, because benzodiazepines and hormones, especially progestogens, do not play well together. I went through almost 2 years of tapering off diazepam, and it was horrible, but things are great now.

Incidentally, menopause may not be life threatening, but the fall out from it can be. During my trials I was definitely suicidal. Had I not eventually gotten things sorted out, I honestly have no idea what would have happened to me.

What on earth is a naturopath doing putting you on a drug like diazepam? A complete contradiction to what they should be doing.

Compounded hormones are actually no different in molecular structure to some of the bio identicals offered in a box - the drugs companies recognise there is a call for bio identicals (especially in mainland Europe) and there are a number of these on offer (some which are successfully used by many on here) Utrogestan for example, Oestrogel, Hormonin.  The only difference is the compounding is meant to tailor the treatment to the individual rather than use a standard approach - that usually means close monitoring and adapting the dose until it's right. The dosage is key - how many  threads on here discuss issues with one dose or drug but that changing completely when the dose is altered. Unfortunately though the hormone testing doesn't always follow within the UK NHS - a shame as I suspect it would give us so much information.

I've had a colonoscopy  this week and the hospital team were alarmed at my low heart rate - so much so they wouldn't proceed until they'd given me an ECG. I was then denied sedation on the back of it and left with a set of graphs to give my GP and a note about left ventricular action. Of course I've headed to Google (and some of the books I've amassed ) and have read in a clinical report that "epidemiological data shows that hypothyroidism may be the only cause of left ventricular diastolic function".  The symptoms of hypothyroidism match very closely those I discussed with my GP back in December, where I left with sleeping pills. (Though there are probably a number of hormones at play as oestrogen and progesterone feature largely too).  I well understand the dangers of reading too much on these things and putting 2 and 2 together to make 5 but in the absence of a GP team who pick up on these things I really feel I have no option but to research as much as I can so I won't be fobbed off.  I've a GP appointment this morning to discuss the ECG results, let's see where that leads. 

GG x

[CLKD]

My husband has a 'normal' low heart beat and his heart also skips and jumps around a bit  .  Once he lost the weight at least the holding his breath in the early hours stopped ……...

[GeordieGirl]

I've always had a low heart rate (doctors have often asked if I'm an athlete - ha, ha!) but it's now close to the red zone. To be honest I feel fit and healthy and don't think there's anything majorly wrong with me that the odd little hormone boost won't correct. I've printed off a whole load of stuff from a Thyroid charity to take with me to my appointment in support.

GG X

[Hurdity]

Geordiegirl - most of the oestrogens in HRT are bio-identical  (estradiol) or converted quickly to bio estradiol (such as estradiol valertae). It's only the PRE ones that aren't ie horse oestrogens.

All the progestogens licensed for HRT are synthetic except for utrogestan, but progesterone is also available as Crinone gel and Cyclogest - for fertility but sometimes prescribed off licence for hRT.

All the local oestrogens are bio-identical.

Hurdity x

[Dana]

I went to a different GP and was put on to conventional HRT straight away. However, my problems weren't over because due to the 2 total disasters I went through I had become dependent on diazepam, and believe me coming off that is no picnic at all, because benzodiazepines and hormones, especially progestogens, do not play well together. I went through almost 2 years of tapering off diazepam, and it was horrible, but things are great now.

Incidentally, menopause may not be life threatening, but the fall out from it can be. During my trials I was definitely suicidal. Had I not eventually gotten things sorted out, I honestly have no idea what would have happened to me.

What on earth is a naturopath doing putting you on a drug like diazepam? A complete contradiction to what they should be doing.

Compounded hormones are actually no different in molecular structure to some of the bio identicals offered in a box - the drugs companies recognise there is a call for bio identicals (especially in mainland Europe) and there are a number of these on offer (some which are successfully used by many on here) Utrogestan for example, Oestrogel, Hormonin.  The only difference is the compounding is meant to tailor the treatment to the individual rather than use a standard approach - that usually means close monitoring and adapting the dose until it's right. The dosage is key - how many  threads on here discuss issues with one dose or drug but that changing completely when the dose is altered. Unfortunately though the hormone testing doesn't always follow within the UK NHS - a shame as I suspect it would give us so much information.

I've had a colonoscopy  this week and the hospital team were alarmed at my low heart rate - so much so they wouldn't proceed until they'd given me an ECG. I was then denied sedation on the back of it and left with a set of graphs to give my GP and a note about left ventricular action. Of course I've headed to Google (and some of the books I've amassed ) and have read in a clinical report that "epidemiological data shows that hypothyroidism may be the only cause of left ventricular diastolic function".  The symptoms of hypothyroidism match very closely those I discussed with my GP back in December, where I left with sleeping pills. (Though there are probably a number of hormones at play as oestrogen and progesterone feature largely too).  I well understand the dangers of reading too much on these things and putting 2 and 2 together to make 5 but in the absence of a GP team who pick up on these things I really feel I have no option but to research as much as I can so I won't be fobbed off.  I've a GP appointment this morning to discuss the ECG results, let's see where that leads. 

GG x

It wasn't the naturopath who put me on diazepam. It was the idiot doctor who put me on compounded hormones. However, the naturopath also inflicted enough of a disaster on me all on her own.

We will obviously have to agree to disagree about compounded hormones. Saying that compounded hormones is the only way of "tailor" making hormone prescriptions, is just one more myth that those who advocate compounded hormones tell you. You can just as easily "tailor" make your own hormone doses by using conventional patches or gels, and many women already do that by tweaking their daily dose of (eg) estradiol gel.

Also, the base ingredients used by the compounders comes from - guess where - that's right - the pharma companies who also produce conventional HRT using estradiol and progesterone. So if they are using exactly the same base ingredients, what's the point? You are paying a lot more for them, there is no added advantage of "tailor" making your prescription, and there are no studies that have shown that using progesterone as a cream will protect the uterus. Numerous menopause societies around the world warn against using compounded hormones, and I have already posted some of those links.

"Bioidentical" is not a scientific word. It's become a buzz word used by the compounders. Compounding is no guarantee you are getting something better. In fact, you are at the mercy of one or perhaps two compounders (if that particular pharmacy has a check system in place, and there is no guarantee of that) that your prescription will be made correctly.

[GeordieGirl]

A bit of a tangent to where this threat started out but as we're here.....It seems like the term bio-identical can be contentious, when in fact as Hurdity points out, a lot of branded drugs are bio-identical too. The comprehensive list below is from the Surmeno site and is a good reference guide.

OESTROGEN:

Oral human-identicals:

    Biestrogen ("Bi-est")
    Estrace and its generics
    Femtrace
    Gynodiol
    Triestrogen ("Tri-est")

Oral synthetics:

    Cenestin
    Enjuvia
    Estinyl
    Estratab
    Menest
    Ogen
    Ortho-Est
    Premarin

Transbuccal human-identicals:

    compounded troches or oil drops
    Estrace and its generics

Transdermal human-identicals:

    Alora
    Climara
    Divigel
    Elestrin
    Esclim
    Estraderm
    Estrasorb
    EstroGel
    Evamist
    FemPatch
    Menostar
    Minivelle
    various compounded estrogens
    Vivelle
    Vivelle Dot

Transdermal synthetics:

    none

Vaginal human-identicals:

    Vagifem
    Estring
    Estrace cream
    Femring

Vaginal synthetics:

    Ogen cream
    Premarin cream


PROGESTERONE / PROGESTIN

Oral progestins (synthetic):

    Amen
    Aygestin
    Curretab
    Cycrin
    Megace
    Ortho-Micronor
    Nor-QD
    Provera

Oral progesterone (human-identical):

    Prometrium
    compounded capsule

Intrauterine progestin:

    Mirena

Transdermal/ Transbuccal Progesterone (human-identical):

    compounded cream/gel/troche
    Endometrin
    Prochieve (ex-Crinone)

Progestin injection (synthetic):

    Depo-provera

------------------------------------------------------------------------------

I suspect the list probably needs updating (I can't see Utrogestan on there) but it's useful all the same, more so than some medical sites.  My doctor refers to the GPNotebook site (a Univadis site) which is anything but comprehensive on this subject. In fact the most recent information showing on Univadia is a Lancet report from February with the title " Even short term HRT can cause ovarian cancer" (oestrogen plus progestogen -synthetic).  If our GPs are being bombarded with this information without having an in depth understanding of menopause and HRT it's little wonder so many women simply get fobbed off.

GG x

[Dancinggirl]

Geordiegirl - I'm afraid this is probably an American list as many of the names are different here in the UK e.g. Prometrium is called Utrogestan here in the UK - many of the things on that list are not available here.  DG x

[GeordieGirl]

Geordiegirl - I'm afraid this is probably an American list as many of the names are different here in the UK e.g. Prometrium is called Utrogestan here in the UK - many of the things on that list are not available here.  DG x

Aha, that's why Utrogestan wasn't on the list!  I did google a number of the others and found them on the NHS list but didn't  go through the list in its entirety.  It is however reassuring that such a wide number of preparations are available though from the pharmaceuticals and they don't just insist on their own patented drugs.

GG x

[Dancinggirl]

Going back to the question posed for this thread, I thought I'd tell you about an article I read in the Sunday Times today.  The trend for not giving specific appointments in advance at many GP practices is being widely rolled out to help many surgeries cope with the pressure. GP practises are adopting the strategy of telephone triage which means you receive a call from the GP and the GP will only ask you to come in that day if they feel they need to see you after discussing things on the phone. I can see the sense of this for certain occasions and  preventing the need for many patients to actually make the trip to the surgery but you may not get to see the same GP each time and if you have an ongoing issue you may not get the continuity of care. This system is basically turning GPs into casualty departments.  If you need to sit down to discuss things quietly with a doctor you know and trust it will be virtually impossible. The article did raise concerns about this strategy but I can see this being adopted quite readily as it whisks people through quickly. Apparently this approach can save a GP surgery around £30,00 a year!!!!! The notion that we can have a doctor or nurse in each practise to discuss our concerns around menopausal symptoms may well be a pipe dream. DG x

[honeybun]

It was also reported that some people have been taking up appointments with requests for toilet rolls on prescription, something to give them shiny hair before they went on holiday, asking why they had sore legs after wearing high heels. The list was endless and ridiculous.
Perhaps if that kind of person thought before taking an appointment from someone in genuine need.
You can hardly blame GPs from trying to weed out the idiotic ones.

It's the same with A&E departments.....a lot of the people that turn up could have waited to see a GP.
Maybe some education is required as to when a visit to a doctor is appropriate otherwise we all suffer.
Bet if they had to pay it wouldn't happen nearly as much.

Honeyb
x

[Dancinggirl]

honeybun - I personally think there is a good argument for introducing a fee for a GP appointment and I think many GPs would support this as well. I think many women don't see their GPs regarding problems with meno symptoms because they feel they shouldn't 'bother' the GP about something that is supposed to be 'natural' and just tolerated.  If we paid a small fee then we might feel we were being less of a bother. When I paid for the private consultation with a gynae it was so much easier because I felt I was entitled to the doctor's attention and time instead of taking up the time of an overworked NHS doctor that should be seeing someone with a more serious condition. DG x

[honeybun]

At one time you were asked by the receptionist what the appointment was for.....I didn't agree with that but perhaps a nurse who screened calls would be a good idea.
The older generation which I guess now includes us does not like to bother the doctor but some of the younger generation obviously does not see it like that.
The whole system needs changing.
Minor complaints, coughs colds sore throats could be dealt with by nurses leaving the GP to deal with more relevant things.

Honeyb
x

[CLKD]

It's exactly because treatment is 'free at point of delivery' that so many people end up asking for silly requests.  When Mum was a child a fee was paid to the visiting Doctor, one rarely saw a Doctor in the Surgery unless it was for ulcer care etc..  Then the NHS was developed, never knowing how far technology would jump in that short time nor realising how much the publics' need of cures etc. would be expected.

Our receptionist would ask why we wanted to see the GP, I would say 'the usual' and yes I need to see a GP ………. now we can make appts on line but I've forgotten my password