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[GypsyRoseLee]

I must confess that I hope both the female GPs at my practice suffer a dreadful peri menopause.

Another quite elderly male GP I also saw was surprisingly sympathetic and knowledgeable about hormones and menopause. Turned out his wife had had serious problems in this area.

[Mary G]

vickypk, if you are happy with everything else move related then I would do as Daisydot suggested and seek help privately.  You should not have to move because of your doctor.  Most private menopause specialists do telephone consultations if that helps.  They will then write to your GP with their recommended prescription so that you can get your HRT via the NHS.  We now know this doesn't always work but it seems to more often than not.  It must be worth a try?

[vickypk]

Hi Daisydot and MaryG
Thanks for your replies they are very helpful.  I think my depression is move related as well, and the GP isn't helping with it all.  If I had a considerate doctor here, maybe that would help me.  Just because I had a lovely GP in London it isn't a reason to move back. I didn't know I could do a phone consultation, I'll look into that.  I know I have options to consider thanks.  Hope you are both fine
Vicky x

[Hurdity]

Does it actually say in the Nice guidelines that there is no time limit? Isn't it such a pity that we have to battle with people who are supposed to be helping us. I understand that the risks have to be pointed out but it was the way she handled the whole appointment that really upset me and made me angry.

sidse I am so sorry to hear you have experienced inadequate treatment from your GP. As far as I can see there is no mention of time limit in the NICE Guidelines at all. If there was, it would be stated. This is all it says about starting and stopping HRT:

Starting and stopping HRT

1.4.22 Explain to women with a uterus that unscheduled vaginal bleeding is a common side effect of HRT within the first 3 months of treatment but should be reported at the 3-month review appointment, or promptly if it occurs after the first 3 months (see recommendations on endometrial cancer in the NICE guideline on suspected cancer).

1.4.23 Offer women who are stopping HRT a choice of gradually reducing or immediately stopping treatment.

 1.4.24 Explain to women that:

    gradually reducing HRT may limit recurrence of symptoms in the short term

    gradually reducing or immediately stopping HRT makes no difference to their symptoms in the longer term.

The various menopause societies (eg BMS) have issued recommendations which do state that there should be no artbitrary time limit - and this is based on the most up to date evidence.

Also as far as I know Dr Currie does not intervene in individual cases - I mean what authority does she have in relation to a paricular GP and practice? To research the GPs you can either find the ifnormation online if your practice lists the docs and their qualifications ( mine does) and once you've done this and identified the ones that have the basic gynae qualification, you can also ask the receptionist (or in-house dispensary if there is one) which is most ysmpathetic to menopasue and readily prescribes HRT.

This is really something we have to work at as well as all the education and publicity that is going on. Going privately for those who can afford it is all very well but changes nothing. The NHS is there for us. 

I presume you now have the medication on repeat? I always order mine online and althoyugh my reveiws are always overdue according to the prescription they never ask me in for one - I just make an appointment as I need to eg if I want to change something! I must be lucky!

Good luck...

Hurdity x

[Hurdity]

Hi Ladies
I moved from London to Dorset 6 months ago, never had any problems with my lovely GP in London regarding my HRT.  As soon as I went to my new GP here I have had problems with them wanting to stop the HRT and put me on anti depressants.  I wasn't depressed when I moved here but I am now, the new GP prescribed me 4 months worth so far, but I am dreading going back to see him.  I am even considering moving back to London.
xx

See my post below to sidse. Please do your research into the practice and find a GP who is sympathetic to menopause and is happy to go along with the latest recommendations. This is quite wrong unless you are medically contra-indicated for HRT. I hope you didn't take the anti-depressants - they are absolutely not the right treatment for menopausal symptoms and you should be on HRT first and foremost if not depressed!

Re NICE recommendations - CLKD - if doctors do not choose to follow them then what exactly is the purpose of them? They are surely to enable doctros to make the best possible decision for thier patients based on the most up-to-date information with the knowledge of their pateint's particular medical history?

Any doctor who refues to do so is surely acting contrary to the NHS fundamental principles and should be brought to account. Here they are (for England anyway - but will be similar for rest of UK):
https://www.nhs.uk/NHSEngland/thenhs/about/Pages/nhscoreprinciples.aspx

A couple of them:

Principle 3
The NHS aspires to the highest standards of excellence and professionalism
•   in the provision of high-quality care that is safe, effective and focused on patient experience
•   in the people it employs, and in the support, education, training and development they receive
•   in the leadership and management of its organisations
•   and through its commitment to innovation and to the promotion, conduct and use of research to improve the current and future health and care of the population
Respect, dignity, compassion and care should be at the core of how patients and staff are treated – not only because that is the right thing to do, but because patient safety, experience and outcomes are all improved when staff are valued, empowered and supported.

Principle 4
The NHS aspires to put patients at the heart of everything it does
It should support individuals to promote and manage their own health. NHS services must reflect, and should be coordinated around and tailored to, the needs and preferences of patients, their families and their carers. Patients, with their families and carers where appropriate, will be involved in and consulted on all decisions about their care and treatment. The NHS will actively encourage feedback from the public, patients and staff, welcome it and use it to improve its services.

Hope this helps and do not despair - there is light at the end of the tunnel and we will encourage you all the way. Daisydot had great success with her local practice after writing lots of letters. Do you have someone who can support you while you fight this - friend/family?

Hurdity x

[sidse]

Thanks Hurdity. Yes, it is on repeat but I am sure that I am going to be in the same situation again at the next review although I will at least see a different GP. It was the refusal to issue a prescription until I had a review which was so stressful as I had ran out and coming off it so abruptly is definitely not good practice. You are lucky that they don't seem to be as strict with reviews at your practice.

[Hurdity]

Heavens - definitely not good practice. If you had run out and they refused to re-issue until a review then you should have had an emergency appointment surely - at least that same week? It's appalling that it is not seen as sufficiently important in some circles. Yes I do feel very lucky where I live and this particular practice and the particular female GP with gynae specialism who has been there for over 30 years and carries on one session a week because she enjoys it!

Hurdity x

[sidse]

I was lucky to be on the phone when a cancellation came through otherwise I was being told to go to the drop in clinic which would have been awful. It is not good at all is it.