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[zen]

I have posted before about a new GP who has sent me to a menopause clinic as she is not happy with Proff Studd's regime.  I am currently using 2.5 pumps of estorgel and 200mg of cycolgest for a week every too months and testosterone.  I have to say it wasn't really working as I still have bad anxiety and depression which I never had before the menopause.  My GP wasn't at all happy with what I'm taking and even less so when I said I wanted to increase the estrogel to 4 pumps as Proff Studd suggested.

The menopause clinic suggested I tried Premarin and 5mg provera everyday as they are also not happy with Proff Stud's regime.  I told my GP I wasn't happy with taking Premarin so now the menopause clinic said I can take sandrena gel instead(not sure what strength) with the 5m of provera every day.  I am also worried about taking provera everyday as I pretty much progesterone intolerant.

The GP I saw has also refused to prescribe one of my thyroid medications (T3) I have been on for years so I am not happy!

I am feeling even more low and anxious about all these changes. Has anyone tried sandrena gel and provera? I guess the other option would be a mirena coil?

Any comments would be really appreciated. Many thanks.

zen




Any suggestion would

[dahliagirl]

Have you tried any other sorts of HRT before you saw Professor Stud?

[zen]

Thanks for your reply.

Yes! I've tried evorel coni which made me depressed and estrolel with Cronine pessaries and also Angelique.

Nothing has worked!  I used to be so upbeat but nothing has helped since I started the menopause 9 years ago.  That seem to be the beginning of an underactive thyroid which I feel has been very badly managed.

zen

[Ladybt28]

Oh Dear Zen - it sounds awful - I don't really know what to say.  Firstly a GP taking away your thyroid meds? What on earth are they basing that on if you have been on them for years.  Secondly a GP querying a specialist menopause consultant on his recommended treatment? 

Sandrena is similar to oestrogel I believe.  I can only tell you about my experience and I say before I start everyone is different  - you are not me but I was prescribed a Premarin/Provera on a continuous regime eg progesterone everyday back in August and you will find a post on here listed as "screaming inside".  It was a very dangerous and unpleasant experience because I too am progesterone intolerant.  On the advice I got here I dropped my progesterone immediately after 4 weeks and then went back to my GP and went onto oestrogel 4 pumps and utrogestan 12 days only on a cycle with a bleed because I couldn't cope on the Premarin Provera.  I don't have a problem with Premarin at all in principle or in taking - in fact I have an underlying thought that out of the oestrogen I have had in the past it might be quite a good one for me but I went for the oestrogel/Utrogestan because they are both supposed to be "kinder" versions of hrt on the body and talked about a lot on here.

I had severe anxiety/panic attacks, insomnia, brain fog, sweats etc until I started on the oestrogel/Utrogestan regime.  Those have all now gone but I still have problems with libido and motivation but am much better generally than I was (still a way to go though).

I find it weird that you meno clinic was unhappy with Studds regime - I know he can be controversial and there are plenty of disagreements on his approach on the forum but he is one of the oldest leading menopause consultants in the country and has written numerous papers in medical journals on the subject of menopause, hormonal depression, etc and womens gynea health in general.  Its tough enough when your GP wont play ball but when a meno clinic starts joining in and overiding an eminent consultant I really dont know what to suggest?

[sheila99]

If it was me I would change GP, I would be very suspicious of a GP who thinks they know more than a specialist. It appears to me she is trying to reduce costs. Was the thyroid med prescribed by a consultant? You could ask for a referral to get their opinion.
 If you're worried about a daily dose of prog why not use it as a sequi regime? My surgery doesn't seem to watch how frequently I get my repeat prescription, it may be possible to increase oestrogen a bit without them noticing.

Ladybt28 - have you tried testosterone?

[zen]

Hi Ladybt and sheila

Thanks so much for your replies. It is awful! I know re the thyroid med (T3).  I am sure it is because of the cost! The GP I saw said to order it from the internet! It ridiculous...….Unfortunately the Dr who said I needed it has now passed away.

Re the hormones- am really sorry Ladybt that you had such a bad experience with the provera. How awful. How often do you use the utrogestan? - is it 12 days every month? I tried utrogestan and it made me pretty depressed.  Mind you so does cyclogest!  I know re the menopause clinic disagreeing with Proff Studds regime:-(( That just added fuel to the fire:-( .  I think I am going to change my GP practice as I am feeling like I've been really srtuggling for soo long-about 9 years since the menopause and underactive thyroid and just seem to be going round in circles. I think I'll have to contact Studds and get a private prescription and I will try and up the estrogel to 4 pumps to see if that helps.

Thanks again

zen

[CLKD]

Ring Prof Studd?

Also have a talk with a local Pharmacist, not one aligned with your Surgery, and discuss the refusal to prescribe thyroid medication. 

[zen]

Thanks everyone for your kind replies.

Yes I do think I have been very badly let down all round for a long time. I spoke to Studds office to a Dr Watson.  He said I need to get blood tests to see what my hormone levels are as I may not be absorbing the gels.  I did say my GP wouldn't be receptive to that since she doesn't want me on the regime but he said he would write anyway. Like you say Stellajoe there are not lots of tales of woes about Proff Studds regime and he does really know his stuff and he does say 4 pumps are necessary for hormonal anxiety and depression.


That's interesting that HRT can alter your bodies requirement for thyroid med.  I didn't know that and I am sure my GP surgery doesn't know that.  I did ask a local pharmacist about the GP'S refusal to prescribe T3 and he said I would have to discuss it with the GP.  I said to her before that I really need the T3 and I would have to buy it of the internet if she wouldn't prescribe it and she said 'well buy it off the internet then'! Sorry I should have made the context more clear! I am going to change my GP practice on Monday.  I've really had enough of my surgery.

Hope you are all having more luck with your HRT, your GP and your health.

Thanks again

zen

[GypsyRoseLee]

What an arrogant, ignorant GP you have. It's astounding they would think they know better than such a respected professor of gynaecolgy.

I suffered terribly with sudden onset anxiety and depression when my periods suddenly got a lot lighter and shorter. No one knew what was wrong with me. One GP did agree to try me on a couple of brands of HRT but the progesterone phase made me feel suicidal, and I don't say that lightly.

I finally found my way to Prof Studd who explained that some women need high levels of oestrogen to alleviate hormonal depression and anxiety. For the last 2.5 years I have been on 4 pumps + 100mg of Utrogestan for 7 days a month + pea sized blob of testosterone gel every day.

I won't lie, it took a long time for this regime to fully kick in and even now I occasionally get a mood dip, but they're relatively mild and only last about a week.

Please think about changing your GP for someone with more empathy.

[CLKD]

Again - arrogant GPs who simply don't listen to what patients require.  I truly believe that if patients were listened to initially then treated correctly, the NHS would save K£ - as it is patients have to return over and over which takes up time etc.. 

[Katejo]

Thanks everyone for your kind replies.

Yes I do think I have been very badly let down all round for a long time. I spoke to Studds office to a Dr Watson.  He said I need to get blood tests to see what my hormone levels are as I may not be absorbing the gels.  I did say my GP wouldn't be receptive to that since she doesn't want me on the regime but he said he would write anyway. Like you say Stellajoe there are not lots of tales of woes about Proff Studds regime and he does really know his stuff and he does say 4 pumps are necessary for hormonal anxiety and depression.


That's interesting that HRT can alter your bodies requirement for thyroid med.  I didn't know that and I am sure my GP surgery doesn't know that.  I did ask a local pharmacist about the GP'S refusal to prescribe T3 and he said I would have to discuss it with the GP.  I said to her before that I really need the T3 and I would have to buy it of the internet if she wouldn't prescribe it and she said 'well buy it off the internet then'! Sorry I should have made the context more clear! I am going to change my GP practice on Monday.  I've really had enough of my surgery.

Hope you are all having more luck with your HRT, your GP and your health.

Thanks again

zen

A new member asked about the interaction between thyroid medication and HRT last week. I asked about it myself in Boots because I am considering asking my GP for systemic HRT and I also have underactive thyroid. I have never taken T3 and have never been offered it. I have heard that GP's here are very reluctant to provide it because of the cost. I only get Levothyroxine (T4). The pharmacist told me what I had predicted. There is no contra indication but HRT may reduce the effectiveness of the thyroxine medication so a higher dose may be needed. A GP needs to monitor this.

[CLKD]

   would it be wise to see, would it be an endochrinologist?

[vickypk]

Hi Zen.
I really feel for you. It must be difficult trying different  HRT regimes and still not feeling right. I saw Prof Studd about 4 years ago and the regime he prescribed for you, that's the same HRT he put me on. I couldn't tolerate that at all and just felt much worse. It wasn't a good time for me with bad anxiety at that time. I'm on evorel conti now, better on that. I do a lot of running every day, I think that helps with my mental health. I still get days when I don't feel right. It's not easy with the menopause. I had thyroiditis a few years ago, a virus of the thyroid. I hadn't heard of that before, it happened at the time of the menopause, it went back to normal after a few months. Hope you get things sorted and you feel better soon. I went through some really bad times. Xx

[SueLW]

Hi

Actually I think you are talking about the HRT/Thyroid the wrong way around.  Good levels of oestrogen are required for thyroid hormone to work properly.  Not the other way around.  It's one of the cofactors for thyroid meds like good iron levels and top of the range B12, Vitamin D. 

Menopause, with the lowering of oestrogen, seems to bring out hypothyroid conditions.

[SueLW]

I said to her before that I really need the T3 and I would have to buy it of the internet if she wouldn't prescribe it and she said 'well buy it off the internet then'! Sorry I should have made the context more clear! I am going to change my GP practice on Monday.  I've really had enough of my surgery.

Many do have to buy T3 over the Internet because the NHS has backed themselves into a stupid corner with it and now tells everyone not to prescribe it unless absolutely necessary.  BUT the guidelines do say that patients already on T3 should not be removed from it. 

If you want specific help with this, what to say and do re your GP and/or a new practice regarding T3, join the thyroid board on the Health Unlocked forum.  You will get great help there, with links to guidelines etc if you tell your story there. 

It's getting harder and harder to source T3 abroad and with Brexit looming we have no clear idea if it will even be possible after March.  You don't want to go down that route unless you have no other option.