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[Wrensong]

No problem Teresa  .  Though it's frustrating & can be a serious impediment to our progress/recovery & we can be left feeling powerless as a result, it's not really anyone's fault that many medics lack HRT knowledge.  There has been insufficient training & until relatively recently with the raising of the profile of menopause, relatively low demand for HRT in the last 2 decades as everyone was scared off, patients & clinicians alike, by the misleading & hugely detrimental outcome of a large study that was poorly designed & sensationally reported.  It stuck in the collective psyche & has proved hard to dislodge. 

Plus, GPs have long been hugely overburdened, with massive patient lists & too few staff, so finding time to learn about menopause can't be easy.  With the drive of Newson Health & other determined advocates for women to increase awareness & education, hopefully that will all change.

Frustratingly for all concerned, it's not only GPs who lack knowledge - I've had some surprising, heartsink conversations with gynaecologists & clinicians of other specialties women are obliged to go to for help with the issues menopause throws up, where it's become apparent that the level of knowledge has been less than we need & might reasonably expect.  As we all know, it can be tricky to make progress in such situations & if tactful, respectful perseverance in making a point we know to be correct/feel to be important doesn't work, the only course of action sometimes is to go to another doctor.  All the more reason to learn as much as we can, to be our own advocates & increase our chances of being heard.

Good luck with the 75mcg patches.  Would be good to know how you get on if you feel like posting.
Wx

[Teresa]

Thankyou Wrensong,

I do appreciate you coming back to me and totally agree with you. If it hasn’t have been for Davina Mcall and her programme on HRT earlier this year, I probably wouldn’t have gone for HRT, but she spurred me on.

I have had a bit of a conflicting message from The menopause specialist on this site, I wrote to her earlier this week and asked her the same question ( I gave her all the details) she thinks that I should give it another month on the 50s. She thinks I’m jumping too soon, especially between the patches and pills. She also said there was a concern that the Progesterone might be not be enough to protect the lining if the womb if I go too high and onto the 75. I did mention my reading was low and gave her the figure. Her rationale is that I was one month on tablets, then on two different patches and may absorb more next month. If I don’t, she suggested I may absorb better on gel. She said blood tests aren’t normally an indication as we all respond differently to the oestrogen ‘lack’?

I’m now in a bit  of  :(a  situation.

Perhaps I’ll do the 50 in Evorel for another month after all 
And if still no improvement, perhaps I need to up the progesterone too if I up to 75 next time? Aaaargh!

I’ve had no breakthrough bleed this past 2 months. I had a spotting when I was on the Elleste. I did notice a difference on the Elleste, but I wanted a more natural HRT which is why I went for the patches and utrogestan.

So now I am in a quandary 

Teresa
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[Teresa]

…. I don’t think my GP will have a clue if I have to up the progesterone…
Do people do that?
I thought the next one up was 200 mg?
If I’m still not absorbing and not having blood tests, I won’t have a clue either 

T
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[Wrensong]

If you mean Dr Currie, I would go with her advice & see how you feel on the 50s for a bit longer if you can bear it, especially if she is concerned that the Utrogestan might be inadequate to protect your endometrium at a higher dose of oestradiol.  It's helpful to have the facility to ask these questions of an expert when GPs are unsure, without a potentially long wait for a menopause clinic appointment.  If you still feel you need to go up to 75mcg after another month on Evorel 50, could you ask Dr Currie what she recommends you do about progesterone?
Wx

[Teresa]

 Hi Wrensong,
Thankyou…yes, it was Dr.Currie.
I think you have come up with very good ideas 
I will do that and ask her that very question.
Phew, this is so tricky to navigate isn’t it? It should be easier than this. she replied this morning when I was writing to you earlier. I wrote a few days ago and thought my question to her may have got lost.

I will do as you suggest and the 50 patch is on.

Thankyou for all your valuable help.
Teresa
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[Wrensong]

Bless you, I'm glad you've been able to decide on next step  .
Wx