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[Julietmaria]

I have been on HRT (evorel sequi) for about 5 years. I am 49 and due to early menopause asked/begged my GP for HRT 5 years ago.  My early menopause is hereditary and my mother now has terrible osteoporosis due to no treatment for her early menopause.  This and also terrible night sweats disturbing my sleep made me want to try HRT.  I found it brilliant and it cleared up all my symptoms.  However in the past 6 - 9 months I have been back to having lots of hot flushes, particularly at night which is severely disturbing my sleep.  I have just been getting my HRT on repeat prescription, and never had any follow up checks since starting.  I rang my GP (now a different one) and asked if perhaps I should change my HRT as it seemed not to be working so well, should I go on single hormone perhaps?   I explained my symptoms and she said she would look into it, asked me to take a blood test in case the flushes were anything to do with my thyroid.  When I phoned 1 month later I was told my blood tests showed nothing abnormal, so I asked her again should I change my HRT she said she would look into it and ring me back.  I heard nothing for a month so decided to take things into my own hands.   I did some research and found that there is a menopause clinic at the Chelsea and Westminster Hospital and was recommended by professor Studd's office (I heard him on Radio 4) to get a referral to a Mr Panay.  So I rang my GP and asked her for a referral, she  told me there was no stronger HRT for me,  I said that I would really like a referral to Mr Panay which she finally agreed to do, but she was very moody with me?    Am I wrong to ask for this referral?  Is it normal that you have lots of hot flushes on HRT after being on it for a few years?   Is it normal that you may need to change HRT type after years on one type?   Sorry for the long message - I thought I should give some back story.  thanks

[Galadriel]

Hi JM,

Reading through other ladies experiences on here, your situation seems normal. My sister is going through something similar after years of being settled.
If you have no faith in your GP's HRT knowledge then asking for a referral doesn't seem unreasonable to me. It does look as if menopause treatment is way down her list of priorities - heaven help her when it's her turn!!

Good luck at the clinic 

Galadriel x

[limpy]

JM - You are not being unreasonable.
HRT may need to be tweaked after a time, our bodies adapt and changes are needed.
Good luck with the referral.

[Hurdity]

Hi Julietmaria

How dare she be moody with you?!! She is completely uninformed if she says there is no stronger HRT. I have been on that dose of patch (50 mcg) for years but I am way older tham you and you could easily benefit from a higher dose. What she means is there is no higher dose of that particular brand but there are different types to try.

I presume you started HRT before you were fully at menopause ie had not gone without a period for 12 months before you started HRT? If so you won't know exactly where you are in menopause but from the time of the last period - or when the ovaries pack up, oestrogen declines radpidly over the next couple of years until it stabilises approximately - at a much lower level. It could well be that your own oestrogen levels have dropped and you are reacting to this with increased flushes?
Also do you get the flushes at any particular point in the HRT cycle? Sometimes women get flushes on the combi part of the HRT especially with some progestogen types. This happened to me with norethisterone ( the same progestogen as in Evorel sequi).

You would be better off using separate oestrogen (patches or gel) and progesterone so that you can take a higher oestrogen dose. Great that you have been referred to Nick Panay - on the NHS? Good luck with this and keep us posted. How long do you have to wait for an appointment?

Hurdity x