Hi jobeckett
I'm not sure why you want to go to a private gynae?
You are almost there - with your prescription!
One thing I'm not clear about is that you are taking Evorel sequi but I hope you mean just Evorel 50 (Evorel sequi is a continuous combined HRT with two weeks of Evorel 50 (50mcg oestrogen) followed by two weeks of Evorel conti which has the 50 mcg oestrogen + added norethisterone).
However you can't tell anything after 1 week!!! the easiest test for deciding if HRT is working is elimination of flushes and sweats but unfortunately (or probably fortunately you will think!) as you are taking ADs these have probably stopped the sweats so the improvement won't be so obvious.
However you are also taking utrogestan more or less continuously and this could cause a permanent sedative effect especially in t he mornings and can cause nausea too.
Your GP sounds as though she is sympathetic so why not go back to her and suggest going on a cycle so you only take progesterone for a short while per month. That way you will get the benefit of the oestrogen without the permanent sedating effect of the Utrogestan. You should still be on cyclical HRT anyway if you are still having periods.
Personally I prefer Estradot as they are very small but I am sure Evorel are just as good - its just that if you need to increase the dose they are rather large whereas Estradot are tiny.
If you are on a cycle you would take utrogestan (2 x 100mg) from say Days 15 - 26 (or 17 -28) or if you are late peri-menopause with very infrequent periods and therefore not much of your own cycle, even try a calendar month cycle ( take utrogestan on the first 11-12 days of each calendar month).
I would try the regime you have for 3 months at first and see how you feel but preferably with the progesterone on a cycle (ie 2 x 100mg for 11 -12 days preferably vaginally to minimise side effects.
Your doctor should be able to agree to this - after all you have the oestrogen and separate progesterone - and you don't need to pay a private practitioner. The only thing they will give you is a prescription for testosterone too - but it's better to get settled on oestrogen and prog HRT before adding testosterone (if necessary - because some women do not need it.
John Studd pretty much has a one-size fits all prescription which has been widely publicised on here and seems to be 2-4 pumps oestrogel, 7 days progesterone every 4 weeks and small blob of testosterone. From what I've read on here (shoot me down those who've consulted him, if this is not true!) the only variation is upping or reducing the gel pretty much!
If after trying your oestrogen and prog for 3 months it's not right - then you can increase the patch size ( they go up to 100 mcg) or try gel.
You don't need to spend all this money!
I am appalled that the NHS waiting list for Nick Panay is 18 months - I mean what are women to do in the meantime - it is criminal. Those without the funds don't stand a chance. If one pays to jump the queue what happens to those women - the queue gets even longer
. I don't think he should practice privately. Studd does because he's retired from NHS and is in Harley street only. There should be more NHS meno gynaes!
Also can your GP not refer you to another NHS gynae with shorter waiting times? Have a look on the list of specialists and see if there is someone else?
Hope this is helpful - it's jumping about a bit!
Hurdity x
