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[crosscat]

Is any one else experiencing this from their GP? I can't tolerate fenoston or any other oral HRT (makes me so sick I dont absorb it, anti emetics all cause drowsyness and therefore can't take those either). So patches are my only option if I am to get any relief from really debilitating symptoms-specifically Evorel Sequi. Given this isn't available at all in my area due to the shortage, my GP insists that there is absolutely no option other than to take sertraline or citalopram combined with amytryptyline for vaso motor symptoms. I can't take the latter because of the excessive drowsyness and I use machinary and tools on a daily basis and I am not depressed. There is absolutely no evidence to support the efficacy of antidepressants in treating my symptoms anyway. I asked for a referral because surely there must be another way? This was refused and I was left with "we cant help you if you aren't prepared to take antidepressants and heart medication". If I wasnt depressed when I went in, I sure was when I left. I have sourced some Evoral sequi online but I am so disappointed in my Gp who I will have to see again when I can get these on the NHS later in the year. Why do GP's do this? is it just me?

[Dotty]

Have you tried Oestrogel? X

[CLKD]

Your GP is being stubborn.  Also it's the end of the NHS Financial Year.  I don't think that they can refuse a referral, I would look to see if there are menopause clinics: not gynaes!! : and ring to find out the appt protocol.  You may be albe to go without a referral. 

Some ADs do ease some menopausal symptoms.  There are patches too but I don't know much about HRT.  Hopefully someone will be along.

Maybe put the medication that you have been prescribed into the search box on here and see what pops up?  Make notes ;-)

[Ladybt28]

Hi Crosscat,
I think this is the updated list (Hurdity posted under another thread) which shows what is and isn't available and if it isn't when it might be.  It might give you a better idea as to what you can actually ask for rather than relying on the GP who obviously hasn't a notion.

https://thebms.org.uk/2020/01/british-menopause-society-further-update-on-hrt-supply-shortages-27th-january-2020/

I agree AD's totally inappropriate and no it's not just you, it happens all the time.  Have a look at the BMS link and then look up what you think might suit or ask here on the forum.
Let us know how you get on. 

[Perinowpost]

Stand firm Crosscat and don't give in, your GP is out of date. Is there any chance you're going to Spain at all, you can purchase evorel there under the name evopad?x

[Baby]

Bloody disgrace. I have lost count of the times I have told my gp I am not depressed just unhappy about feeling like  s... all the time unfortunately having been on long term antidepressants it's easy for them to blame it on depression but I now my triggers and for instance my daughter coming round never before gave me a panic attack.

[GFmom]

I was on evorel sequi for awhile, the last few months I had to buy them from an online pharmacy, they are now totally out of stock.. I have food allergies and my Dr could not come up with an alternative.. I did my own research and I came across a memo from the British menopause society giving alternatives to the Sequi. I called the Dr and requested eostrogel and utrogestan. He has prescribed this for me,  checking on here I know that I can use the utrogestan as a pessary because there is soya lecithin in the capsules.
 So here's hoping this will tide me over until they get Sequi back in stock..
Hope you find an alternative

[CLKD]

   GFmom - do you wear an SOS alert bangle/necklace?

[suzysunday]

I am a past long time user of antidepressants and the label really sticks.

[crosscat]

Hi thank everyone who responded to my message. Thank you for the information, I really appreciate it.  Baby, it's really useful to know that I could have been prescribed estrogel and utrogestan, and also thanks Stellajane because it's the vasomotor symptoms that I have that are really crippling. I get paliptations, dizzyness, while at the same time get very very hot and unable to do anything. If I have to teach, I just can't do it. This is part of my livelihood, I'm frelance so I cant just go off sick.
Thanks Ladybt28 for that link, I'll look it up. Really helpful and Perionopost, yes I do need to be more assertive. My GP is just keen to get me out of the door asap because she honestly can't answer any questions with anything other than 'no'. It's like head banging against brick wall scenario. I asked for a referral to a Manopause clinic, which was wholly appropriate but that got 'no' as well. I think oestrogel suggested by Dotty would be one of the options my GP could have explored. She just wasn't prepared to even think about it. But looking at the manopause matters decision tree I should have had my referral request granted and maybe at that clinic, these options could have been explored.
It's pretty bad that my GP isn't up to speed at all with alternative solutions given this shortage. She doesn't even know about the 2019 Lancet paper that is freely accessible via the NHS website and gives the most up to date evidence on breast cancer risk. So what is she basing her precribing decisions on if she's not aware of current reasearch? it's very frustrating and I feel like I am likely to be labelled as a troublesome patient. 

[sheila99]

Well if she'd treat you appropriately you wouldn't be troublesome! I've had to be assertive with my gp too. Do your research so you know what you want and why so you can argue your corner. Maybe take the Nice guidelines with you.

[Yavina]

Hi Crosscat, I can only reiterate the message that you are 100% right to insist on getting the right treatment for your symptoms.

I was prescribed many ADs, first 7 years ago to treat ?anxiety? symptoms  and sleep issues. None did the trick, and the side effects were terrible. Then 3 years ago, they gave me bupropion to alleviate my 'depression?, and later sertraline on top to help me sleep because bupropion wound me up too much. After more than two years I slowly stopped taking them because I felt so bad I couldn't do my job anymore, continuously felt super wired and tired at the same time, had hot flushes, couldn't sleep, and lost 90% of my physical endurance. It took me many months to get over the AD withdrawal symptoms.

Now I realize that all these were perimenopause symptoms, not mental health issues. I now take Estrogel and Utrogestan and I no longer have anxiety, heart palpitations, or mood flateness, my hot flushes have reduced to 5% of what they used to be and my endurance is (very) slowly coming back.

Had I been given HRT instead of ADs, I wouldn't have had to stop working, because my symptoms would not have increased to such an acute level. I would not have lost friends and support and been left with no life, feeling like I was a total failure.

Keep fighting Crosscat, I promise you it will be worth it.

[crosscat]

Hi Yavina and Sheila, and everyone else who has so kindly responded to me. Well today I saw the clinical practice manager. I wrote to her outlining the outcomes of my two GP consultations, refusals to refer me, and insistance that the only thing they could do was offer me citalopram and amytryptylline. And that, as a result I'd gone off and bought patches online. Expensive but when you're that desperate..
But anyway the fact my hair is falling out in shed loads (dismissed by GP1 as a 'normal part of aging') - really? one that mysteriously appears with all the other horrible menopausal symptoms and I'm 51 no 81, has been adressed with blood tests to investigate what is causing this abnormal loss. The concern I had stated that I felt I was at risk of osteoporosis because I was sick all through my pregnancy and my daughters skeleton was basically formed from mine (this was completely ignored by GP's1 and 2  has now been taken seriously and I'm having a bone scan this week.
I have a prescription for Evorel Sequi which, if I am prepared to shop around and travel, I may be able to get and the promise of a referral if I need one.
BUT THE BEST BIT! (and this is thanks to you encouraging me to be more assertive) the whole practice GP's and nurses are having menopause training evening with a specialist so my treatment from GP's 1 and 2 doesnt get repeated.
So result! The only better result would be if the flippin shortage of transdermal HRT got sorted more quickly.

[Perinowpost]

Result!!! So pleased for you Crosscat, perseverance really does pay off. Hope you like the patches (I do), wishing you luck with the scan and keep us posted x

[sheila99]

 
I am so pleased for you and everyone else who will benefit from your actions. Sometimes they need to be told...