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[bear]

Hi Clovie,

I have just sent you a PM.

BeaR.

PS. I rest my case 

[Hurdity]

Hi Clovie,

I have just sent you a PM.

BeaR.

PS. I rest my case 

Bear what case? Referring to a pm (ie your ps) on an open forum is not really helpful as none of us know what you mean - as it's then all very cryptic! If you have any further information that sheds light on this issue - ie under what circumstances that docs can override these 2009 recommendations or those in the local formulary - this would be very helpful if you vould post as I don't feel it has been resolved yet. I know it's Clovie's thread but I think there are others who would benefit - if you don't mind, Clovie?

Hurdity x

[bear]

Hi there,

If Clovie wants to post the information, it's entirely up to her. I've done what I could trying to help her. Good luck, Clovie!

BeaR.

[Hurdity]

Ladybt28 - there's big changes being proposed for Scotland over the next few years. Independence is looming and to that effect, Scotgov want to put their best foot forward in terms of being seen to favour certain demographics. Whether we like it or not, fertile women are a priority, as they should be, and my guess is that the health budget for them will increase and some more expensive drugs eg utro, will take a hit for those in the population who can use something less expensive. I completely understand this thinking and applaud efforts to keep certain demographics favoured eg, elderly, infertile, mental health, it's a fairer society. We all have budgets and need to carve up the funds in the fairest way possible whilst providing the necessities.

INteresting - I would view post-menopausal women who may live for 40 years for their life post-menopause - as a priority especially as getting it right for them could save the NHS thousands later in life re cardio-vascular problems, osteroporosis etc. Also it is well known that the mental health of women can take a dive as they enter peri-menopause and may well persist in the absence of the right treatment which includes having the right hRT that suits them. I think the whole point about this is that some women CAN'T easily use something less expensive, due to side effects etc (including anxiety and depression?)  and there is still the question mark over the potential role of progestogens (especially the less expensive synthetic ones) and breast cancer. So it's not an easy one (maybe more difficult in a country that provides free prescriptions to all - which I think is amazing!). Even if it were available (Utrogestan) probably most women will still be given and be happy on most of the common cheaper brands of HRT, it's just that we don't tend to hear about them (no idea about the stats on this!).

Hurdity x

[KiltedCupid]

Ladybt28 - there's big changes being proposed for Scotland over the next few years. Independence is looming and to that effect, Scotgov want to put their best foot forward in terms of being seen to favour certain demographics. Whether we like it or not, fertile women are a priority, as they should be, and my guess is that the health budget for them will increase and some more expensive drugs eg utro, will take a hit for those in the population who can use something less expensive. I completely understand this thinking and applaud efforts to keep certain demographics favoured eg, elderly, infertile, mental health, it's a fairer society. We all have budgets and need to carve up the funds in the fairest way possible whilst providing the necessities.

INteresting - I would view post-menopausal women who may live for 40 years for their life post-menopause - as a priority especially as getting it right for them could save the NHS thousands later in life re cardio-vascular problems, osteroporosis etc. Also it is well known that the mental health of women can take a dive as they enter peri-menopause and may well persist in the absence of the right treatment which includes having the right hRT that suits them. I think the whole point about this is that some women CAN'T easily use something less expensive, due to side effects etc (including anxiety and depression?)  and there is still the question mark over the potential role of progestogens (especially the less expensive synthetic ones) and breast cancer. So it's not an easy one (maybe more difficult in a country that provides free prescriptions to all - which I think is amazing!). Even if it were available (Utrogestan) probably most women will still be given and be happy on most of the common cheaper brands of HRT, it's just that we don't tend to hear about them (no idea about the stats on this!).

Hurdity x

Menopausal women are not producing future generations, I'd imagine that's why governments prioritise fertile women. And yes, our NHS apparently outperforms the rest of the UK. I'm happy with their decisions.

[Hurdity]

Menopausal women are not producing future generations, I'd imagine that's why governments prioritise fertile women. And yes, our NHS apparently outperforms the rest of the UK. I'm happy with their decisions.

I was referring to your mention of the other groups particularly, and also I'm not sure what you mean that governments prioritise fertile women - in what respect? You've lost me there. Not clear why lack of approval of utrogestan for HRT on cost grounds has to do with fertile women  but maybe my poor elderly brain isn't working properly!

Re your being happy with NHS decisions in Scotland - that's great for you, but many women are not, in terms of the utrogestan issue in particular which is the subject of this thread, especially those (the many) who cannot afford the private treatment in England that some have taken advantage of in order to get the HRT they want (need...) that is denied them.

Hurdity x

[KiltedCupid]

Menopausal women are not producing future generations, I'd imagine that's why governments prioritise fertile women. And yes, our NHS apparently outperforms the rest of the UK. I'm happy with their decisions.

Re your being happy with NHS decisions in Scotland - that's great for you, but many women are not, in terms of the utrogestan issue in particular which is the subject of this thread, especially those (the many) who cannot afford the private treatment in England that some have taken advantage of in order to get the HRT they want (need...) that is denied them.

Hurdity x

Name the many women who aren't happy.

[Ladybt28]

Well it doesn't really relate to me but I'm gonna wade in regardless  - just to say that after my experiences on different hrts and finally finding the only thing that works for me is gel and utrogestan - I would be terrified and extremely unhappy if our Executive in NI (haha that's hypothetical cos we don't have a functioning one..but...) suddenly decided that because they gave free prescriptions they were suddenly going to reconfigure the health budget and say Utro was too expensive and that meno women were only allowed cheaper drugs. On top of that if they then, instead of saying it was about money came out with a load of out of date reports and stats that justified their decision by say "they were doing it for our own good so we didn't all get cancer"! I would be terrified and rageing!

There have been a number of women in Scotland Kilted who have written on the forum about problems with prescribing in Scotland along with the women who report problems with prescribing of hrt in general throughout the UK.  That sentence is a generalisation, and I wrote it and Hurdity's sentence "many women are not happy..." is also one, but "name the women who are not happy" is a little confrontational if I may say so.  The wider issue might be that whilst in a huge, wider, general discussion, there can be for's and against's for "governments prioritising fertile women" this forum relates to issues faced by menopausal women whose lives are destroyed and blighted when medical science has the solutions but refuses to dispense them.  And they are indeed destroyed..jobs, marriages, homes, the real damage is hidden and never discussed until maybe very recently.

On the issue of money - I would comment that in this day and age, if "governments" and society in general consider women able to work until we are 65 plus, so they can collect our tax revenue so they can "prioritise fertile women to produce future generations", might I respectfully suggest the wider conversation should be that they give us access to the relevant medications - ALL OF THEM, that might allow us to do so in some comfort and quite frankly it is not much to ask for really especially as our tax revenue will be contributing to the "fertile women's" maternity leave!   

Now - no hair pulling, punching or gauging ladies  I like my head, I don't want it ripped off - just lively discussion for the good of the menopausal women everywhere 

[Hurdity]

Thanks Ladybt for your comprehensive and well-argued reply - it's not just me then! It is such a complex issue and one which affects us all - I don't know what the proportion of menopausal women in the general population is (in UK) but must be pretty high.

Name the many women who aren't happy.

Ladybt: "Hurdity's sentence "many women are not happy..." is also one, but "name the women who are not happy" is a little confrontational if I may say so."

Quite!

Hurdity x

[KiltedCupid]

Ladybt28 - I don't know, but I suspect that the reason utro has been stopped for hrt use is because it's original use is intended to save lives, ie. support pregnancies and saving lives would be part of the criteria used to reach a decision. I'd imagine utro is not the only pharmaceutical to be targeted in this cost cutting exercise but it can be replaced, without risk to life.

[Ladybt28]

but KiltedCupid the issue is that it is the only micronized progesterone of it's kind and for some of us actually, although it might sound dramatic, synthetic substitutes would be "life threatening".  What might you suggest it is replaced with because "many women" on this forum would love to know after their trials and tribulations with other forms of progesterone?  In my case, I got to within hours of taking my own life sent totally dolally on a course of one continuous synthetic progesterone and although other forms of progesterone were "better" (ie didn't make me actually capable of suicide) you could hardly describe them as "better" just because they didn't actually make me collect tablets or want to jump in front of train every minute of every day, but only once a day every day!  What kind of a life is that?  Some of the stuff we go through we wouldn't allow to happen to a dog let alone a human and if you had a "disease" with the symptoms of menopause you would get every medication and intervention no questions asked.  It makes no sense to me.

I would counter that indeed Utrogestan does save lives but this issue of menopause, quality of life, menopausal suicide has been a totally taboo subject.  Menopause is described as "natural" but I have written in other posts I would totally counter that in the last 30 years since the invention of the pill, and feeding our animals hormones, there has been a dramatic change in the incidence of hormones in our water supply, through plastics in the environment and this is having a major impact on things like meno, fertility, and I know it would be totally controversial, but it is just my opinion, the changing shape of the human body and changes in sexuality across the board.  Therefore I suggest that meno is now no longer the "normal" it was once considered to be.  Plus it was always a problem, remember Victorian women of a certain age could be committed to sanitoriums for the "nerves"!  My view is that actually menopausal women have continued to be sidelined but because they wish us to continue working this can now no longer be ignored.  100 years ago you didn't live to 60 and if you did you were not considered "useful to society" after the age of 45 or 50.  But now we are useful to society - but the powers that be haven't caught up yet.

[bear]

Hi Ladybt28,

I think it's just a matter of being referred to a Menopause Clinic, the same way as some women in England have to be under a specialist to get testosterone. Utrogestan is not being denied to menopausal women in Scotland, it's just not the primary choice. When you have a free healthcare system, number of patients and price of medicines are important when deciding where to allocate limited resources.

BeaR.

[KiltedCupid]

Ladybt28- I completely understand where you're coming from, I believe peri played a large part in the break up of my marriage and some questionable decisions I made after that. I also suffered twice with post natal depression so I'm aware of the power of our hormones and how they can wreak havoc and that finding balance is incredibly difficult not only at this stage of our lives but thoughout our reproductive years. There are some lucky women who seem to dodge all the hormonal turbulence but that's all it is, luck, and possibly genetics. Doesn't seem fair but what can you do?

In terms of alternative progesterone, I'm going to ask my gp for Lutigest or Crinone gel if she can't give me utro and I'll post her reply so other members can be updated. I've only just started a new utro regime as my preferred hrt is no longer available, I'm not happy about that but once again, what can I do? I just have to pick my way through as best I can.

[Ladybt28]

but BeaR - check out Clovie's first post on this thread that started all this and the one on page 3 of the thread where she states "it is being stopped in Lothian". Being "denied" is exactly what she has experienced and going forward more Scottish women are likely to experience the same even those who have been on Utrogestan on repeat. Although my understanding on all the links and documents that you, and Hurdity and Kilted have been discussing is not even close to what you understand, the general gist seems to be that the Scottish Government are making a concerted effort to get it withdrawn from being prescribed to menopausal women using spurious out of date stats about cancer or any means they can when in fact the underlying issue is money and a mistaken belief that all women are able to take any progesterone and even better if it is a cheap one without any consequence,

I know this is a very, very general summing up and possibly wide of the mark in semantics but it points to a wider issue around prescribing for menopausal women and a rather worrying one.

[bear]

Hi again Ladybt28,

Utrogestan has already been given a green light on NSH Grampian, so no, it's not being denied, it's just a matter of priorities and resources, but it is available for menopausal women.

https://foi.nhsgrampian.org/globalassets/foidocument/foi-public-documents1---all-documents/fgd201909.pdf

I don't want to sound confrontational, so I won't post on this thread any more, I think it's easier to generalise and suppose than to investigate and understand exactly what are the real facts.

Clovie has mentioned that she has been prescribed Utrogestan by a specialist and only been denied it by her GP, so all I have said makes total sense.

Just been trawling  the net, and apparently in 2009 there was a statement to say utrogestan was not to be recommended for HRT treatment in Scotland.
But, also Tayside Health board ‘s current HRT recommendations, are for Utrogestan only to be prescribed by meno specialists from clinics and are not recommended for GP' s to prescribe as first line treatment. There doesn't seem to be anything more recent than that, or more broadly, cross countrywide. So not really sure what info your GP is going on.
I am hoping my GP doesn't know yours!!!

Hi Choc Ice 

Thanks for this!
Hardly a recent thing is it? I've been with my GP for FIVE years now and just now mentioning it. Hence I think it's a cost cutting exercise perhaps!

My Utrogestan was actually prescribed by a meno specialist at a clinic so I'm hoping I can keep it.
Either way I'll be arguing my case for keeping it!   

Edited - please could you give me a link to the Tayside info? Thank you in advance

BeaR.