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[Kathleen]

Hello ladies.

 I am 60,  post meno and I've been taking Tibolone for 5 months.  I'm having an awful time and I've learned that a private hospital where I live has a menopause clinic and wondered if they could help me, I'm also considering emailing Dr Currie. My question for you ladies is do other consultants prescribe Prof Studd's regime or is it exclusive to him? I don't feel well enough to travel to London but like many of us here I am desperate to feel better/ normal.
I look forward to hearing from you and thanks for reading.

Take care.

K.

[CLKD]

Firstly: 

Secondly: what's to lose by sending a query to Dr Currie?  In the meantime, maybe ring the Secretary at the Clinic and ask what is likely to be prescribed .....  have they heard of Prof Studd and his regime?

If you seek an appt. with the Clinic, even be cheeky and ask if any ladies close to you that have sought treatment, would be prepared to share experiences?  Of course the Secretary would have to check records and ask those particular ladies for permission to divulge  ..........

[Mary G]

Kathleen, sorry to hear that the Tibolone is not working out for you.  I use the Professor Studd regime of Oestrogel/Utrogestan/testosterone and it is available on the NHS but we hear varying stories on here as to how easy it is to obtain it and different doctors seem to have different views on it. 

The key to the success of his regime is his prescribed dose of each product and that depends on the severity and type of symptoms you have i.e. is it just temperature control (hot flushes/night sweats) or do you have depression and anxiety too?  Another factor is how well you tolerate the progesterone part of HRT and as you probably know from reading posts on here, he does not necessarily stick rigidly to the NHS guidelines on progesterone and will prescribe a lower dose of progesterone for women who are either sensitive or intolerant.  Sadly, too many HRT regimes fall over on the progesterone component meaning many women give up on HRT altogether. 

So yes, you can get his regime from the NHS but I doubt they will prescribe it in the same way - in other words, the actual products are not exclusive to Professor Studd but his prescribed dose is exclusive.  For me, the real breakthough was the low dose of vaginal Utrogestan and also the flexibility of the Oestrogel - the only oestrogen product that finally stopped my debilitating sweating. 

You could try CLKD's suggestion and ring the private clinic and ask about his regime, they may well have heard of it.  Another idea would be to ring Professor Studd's secretary and ask for a telephone consultation, you could explain that you are not well enough to travel.  He will write to your doctor with his recommended prescription and you should be able to obtain it via the NHS thereafter. 

I hope you that helps.  Please let us know how you get on.

[CLKD]

   Mary G

[Hurdity]

Hi Kathleen

As has been said the hormones are not exclusive to Studd's regime!!! His progesterone dose is far less than the licensed dose and as we have seen on here other gynaes don't necessarily approve of doing this without supervision. I am absolutely fine on my HRT regime and my oestrogen and progesterone have only ever been obtained on the NHS through my local GP practice. We have arrived at my current cycle through mutual agreement and I have had various scans along the way so I know how my uterus behaves and does not over thicken.

We have had this discussion (about your situation) several times before and to me the only way you can sort out what you need is to go back to a cycle - because I think you were  taking Evorel conti which is continuous synthetic progestogen every single day.  The Tibolone is a different type altogether and sounds like it doesn't suit you. This (the progestogen component) could be contributing to anxiety, preventing the elimination of hot flushes and interfering with the beneficial effects of the oestrogen. Many women are fine with it but others are not. I know I wouldn't be!

I thought you had tried utrogestan before and didn't like it - but can't remember how you took it?  If it were me the first thing I would do is to separate out the oestrogen and progestogen part of HRT and give yourself time on the oestrogen only to see how you feel. You might need a meno specialist to support you through this unless you have a small amount of funds for a scan after a year of perhaps trying a longer cycle? Of course it also depends on the state of your uterus - whether you have/had fibroids polyps etc.

By all means e-mail Dr Currie - but I do know she sees no need for bleeding and tends to be inclined to favour no-bleed regimes - and also due to the decreased risk of endometrial cancer. However if the 50 mcg regime did not work for you she may well suggest changing to separate patch or gel so that you could increase the amount of oestrogen relative to the progestogen - to see if this at least eliminated flushes. It would be best to get this right before thinking about testosterone but Studd's regime is pretty standard and usually includes the T from the start - the only thing that seems to vary is the number of pumps of gel!

How sympathetic or knowledgeable is your local GP?

So in summary:

I think you need to decide between bleed or no-bleed
If bleed - then cycle length?
You need to have separate oestrogen and progestogen so that you can increase oestrogen
Patch or gel - no reason necessarily to stop patches but just try an increased dose - your body is used to these after all?
Then finally which product? Utrogestan oral or vag, or Provera (oral only).
Oh - and I don't think you need to go and see John Studd to get this!!

You really have my sympathies - because my flushes and sweats stopped within days of starting 50 mcg oestrogen 10 years ago and only returned when I stopped HRT or reduced the dose. This surely has to be the first function of HRT and should be relatively easy to sort out.

Good luck and do let us know what you decide!

Hurdity x

[Kathleen]

Hello Mary G and Hurdity.

Thank you so much for your detailed and helpful replies. This is only a flying visit to the forum as I'm having technical problems but I wanted to thank you both for your time. I will consider all you've said and  respond properly when I can.

Take care ladies.

K.

[CLKD]

Send that e-mail to Dr Currie - she's the Medic and is dealing with this professionally every day.  Heather is the Consultant that set up this web-site to include the Forum. whilst leaving the facility of asking questions.  Make the message short and to the point - what's to lose