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[linseymc]

Hi. New to this forum. Would greatly appreciate some hrt guidance.

I'm aged 48 and was diagnosed as 'being in the menopause' via blood test by a male dioctor 4 years ago. I asked for hrt as I was bordering insanity and he told me to eat a Mediterranean diet and go for a walk. I've since asked for hrt 4 more times and told no.

I'm at the point where everyone thinks I've lost the plot and I'm actually becoming quite aggressive. So I'm pretty desperate now.

Anyway, after 4 years of hell I've just found out I can buy hrt over the counter in Spain (I want to kiss Spain). My daughter lives in Gibraltar and has said she will buy some for me and bring it over in a coup of weeks. Only prob is it's a minefield! Which do I get?!

I still have erratic periods. I still have my uterus. I would like to use a patch.

Could any of you kind souls recommend a good one to try and what dose to start with?

Thank you in advance for any help you can offer this poor crazy insanely demented creature who is literally at breaking point. Xxxxx

[linseymc]

Ps. I'm on a progesterone only contraceptive pill if that makes any difference. Xxx

[Mary G]

linseymc, your doctor sounds utterly useless.  Have you seen my thread about buying HRT over the counter in Spain?   It's wonderful to have the freedom to walk into a pharmacy and buy what you need.

There are many types of HRT to choose from but assuming you are not post menopause and tolerate progesterone well (you are on a progesterone only pill)  it should be easy to find something suitable.

Personally I would recommend Oestrogel (you simply rub it on your skin) rather than patches because I find it absorbs better and it is very easy to quickly adjust the dose - I didn't like wearing patches either.  I can't see any reason why you can't simply use Oestrogel with your contraceptive pill acting as the progesterone component.   There is a list of the different types of HRT on here. You could also consider having a Mirena coil.

Most of the UK brands are available over the counter in Gibraltar (Main Street) or your daughter could go over the border into La Linea for the Spanish brands which are cheaper.  They are big on Climodien which would be worth looking into and I think there is a thread on here about it but all the pharmacists are very knowledgeable and can give advice. 

Go for it!

[Hurdity]

Hi linseymc

Firstly 

Also I am so sorry to hear about your treatment by your doctor and refusal to prescribe HRT. This doctor should be challenged and reported to the practice manager or higher up if necessary, if his refusal is not based on a specific medical reason.

The NICE Guidelines on menopause deem a woman to be peri-menopausal over the age of 45 based on symptoms and cycle length alone – so if your cycle has become irregular and erratic and you are experiencing flushes and sweats then this is sufficient to diagnose menopause and to prescribe HRT. Blood tests are not needed.

It is your right to have appropriate HRT for menopausal symptoms provided you have no medical contra-indication to taking it.

By all means eat a mediterranean diet and take more exercise – this will be very beneficial – but buying HRT is a no-no. Please do not buy it online – whatever your daughter and Mary G say. This is not necessary and definitely not advisable. The right doctor should be prescribing it with knowledge of your medical history and under appropriate supervision. There are plenty of suitable HRT types available here on NHS. They are listed under Treatments (top tabs – pale green banner). We can advise you before you go back to the GP. I suggest you phone up and ask which GP in your practice understand menopause and is expert on HRT – there must be someone. I gather that some practice nurses can prescribe in the first instance – but may be more limited in the variety they can prescribe?

Based on the products available - yes patches are great - I have used them for 10 years +. There are two combi types available or you can use them separately with progesterone. Read up on the different types and the rest pof the information on this website about menopause ( same top tabs) and then ask any more questions if you need to and we will try to help.

Mary G – I know you mean well, but you really should not encourage anyone to buy HRT online. Linseymc needs a medical assessment before starting it and regular medical supervision and review, which is available on NHS – but may need a bit of a push!


Hurdity x

[Hurdity]

PS This is what Dr Heather Currie had to say recently on this issue on another thread - she is a leading gynaecologist and founder and manager of this website:

Thank-you for bringing this to my attention. I would love to be able to contribute to this forum more often if time permitted!
I would not recommend buying over the internet or abroad. Products such as Oestrogel and Utrogestan are readily available on prescription in the UK and there should be no need to bypass the current system. If your GP is unaware/unwilling to prescribe, then ask to be referred to a specialist service. My job as chair of the British Menopause Society is to provide education so that there is a general level of understanding across primary care, and to increase the number of specialist services around the UK--we are well on the way to doing this but much is still to do.
Best wishes to you all
Heather

Hurdity x

[Mary G]

Who said anything about buying HRT online?  I'm talking about a responsible adult going into a properly regulated pharmacy in Gibraltar or Spain and buying legitimate, branded HRT from a qualified, registered pharmacist.   

If more doctors did their jobs properly women would not be forced into impossible situations like linsey and this is not an isolated incident, it comes up on here time and time again and it's a disgrace.   

Linsey, by all means have a full assessment and uterine scan before starting HRT but not with that doctor, find someone who knows what they are talking about.

[dahliagirl]

Yes - I would agree that it would be good idea to look into seeing the practice nurse.  They do such a lot more these days.

My current one is a prescribing nurse and I see her for my reviews and she can change my prescription which has been helpful.  In my last practice, it was the nurse who advised me to see the doctor about my joint problems.  This was good, because they then did full bloods, including thyroid and vit D.  A lot of people have it done before they go on hrt and it does rule out a few other things that may be causing problems.  They may have more idea about how the practice works and who to see.

Using the POP as progestogen - the only one that is high enough dose is Cerezette, or the desogestrel generic versions.  It is not licensed for this use though and is not used over here.  The only progestogen only contraceptive that is licensed for hrt use is the Mirena coil which you would have to go to Family planning for.  The other two are the older lower dose (norgeston and micronor are the brand names).

You would still need to see someone regularly for BP check and to go through things, and to be referred on if there are problems.

[Katia]

Lindseymc, why won't your dr prescribe you with HRT?  Is it contraindicated for you for some reason?   If your on the progesterone only pill, is there a reason why the doctor doesn't want you to have estrogen? 
I'm sure the pharmacy in Spain will ask you questions before giving it to you. It's not just there on the shelf to pick up.  I think it is in the Middle East though.

[Hurdity]

It is not advisable to buy HRT from any source - online or otherwise, if it hasn't been obtained by prescription with a proper medical assessment from a doctor who can discuss your medical history before using it. That's what I meant when I said to linseymc that buying HRT is a no-no and also buying online. There are lots of different issues but the primary concern is the health of the woman! Also that's what Dr Currie said (online or abroad) - and I included her quote in case anyone reading thought it was just me going off on a rant or something  !!!

As dahliagirl says none of the current preparations of POP are licensed for use as part of HRT so there could still be endometrial thickening if using oestrogen alone which is why it is especially important to do this under medical supervision. (As an aside I am interested to know that Cerazette is used for endometrial protection off licence as part of HRT - do you have any info, links etc? Thanks).

linseymc - I do hope you haven't been put off by our caution as we only have your health and well-being at heart

Hurdity x

[suziq99]

I'm sure the pharmacy in Spain will ask you questions before giving it to you. It's not just there on the shelf to pick up.  I think it is in the Middle East though.

Err no they don't usually unless it's only available by prescription, they will tell you any contraindications but other wise will give you what u ask for.