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[Mogster71]

Hi ladies - hope you are all doing ok?

I was going to post earlier in the week but I decided to let the dust settle a bit so I am writing without so much emotion, I had a real meltdown at the time! I'm hoping that some of you experienced ladies can advise, because I honestly am not sure which way to go.

Bit of back history, I have tried a couple of oral HRT formulations this year, both of which I've reacted to progesterone-wise. My male GP who I first saw, suggested HRT straight away as a way of protecting my bones, arranged an immediate Dexa scan as I have a history of being borderline osteopaenic. This was back at beginning of June. My peri symptoms really ramped up this year, and I've been back and forth to the GP a few times, when I can actually get granted an appointment. I've not seen my male GP since, and he's now away long term.

Anyway, I've been going it alone for a couple of months and things have been on the slide again; headaches have increased, migraines have come back, I have a period pain on most days (with no bleeding) and now I'm a member of Club VA   I haven't bled naturally since March/April time.

I went to see my GP this week and told her all of this and asked to try separate gel, but the outcome of the appointment was that they would look into what was available for me. The first thing I was offered was Antidepressants, and a suggestion to go to the local GUM clinic as someone there would be able to offer me advice about Mirena.

They did speak to me later that day and offered me Evorel, but they only have one box of 8 patches and had no idea when further stock would be available again. Apparently my GP doesn't think the gels would work for me, no idea why. I have declined the Evorel because of the shortages, there just didn't seem to be any point in starting something I can't get any more for a while? Was I wrong to do that?

Any ideas what else I could do or ask for, please? I do have my womb so can I/should I think about topical oestrogen?

Thanks so much if you can give me some pointers xx

[CLKD]

Oh dear more GPs without a clue.

Ask for a referral to a menopause clinic, not a gynaecologist who is unlikely to be any more clued up than your Dr. 

GPs should be able to refer you to a Gynaecologist for a coil - maybe put in 'Mirena' into the search box here and see what pops up? make
notes ;-).

What are you sing for the VA?

[Mogster71]

Hi CLKD

I bought some OTC but other than that, nothing. I feel rather unsupported really. They did say they can refer me to a Gynae but that it would take 40+ weeks. I was so upset, I told them that it feels like my insides are stuck together!! This has definitely worsened over the summer.

I honestly don't want to go back to see that doctor again. I left feeling like I was being demanding and a nuisance 

[Whatsupwiththis]

Mogster....Did you discuss topical estrogen versus systemic?  I am on topical estrogen both Vagifem and Estragyn EVERY DAY and I do have a womb plus I was/am 68 before starting so you should be fine.  GSM ( the "new" term for VA or VVA) needs to be treated properly.  Maryjane, Hurdity, Dancing Girl or CLKD or numerous ladies on this forum could provide necessary info in UK.  Good luck and get that vagina smiling again.

[Ladybt28]

Mogstar, is that the only GP in the practice or can you see others if there are any others?  You are most certainly not being demanding or a nuisance and you are perfectly entitled to make a list of what you wish for.  You are suffering, the GP isn't!

Nice guidelines say that you can have whatever you want within reason.  Just say, Everol is on a shortage list so that's a good reason not to start and there are plenty else on the shortage list and so be clear that you are not starting something which you cannot get and so "you need something you can get".  Oestrogel is not on a shortage list, nor is provera that goes with it or utrogestan and so you can be clear what is on the shortage list (I would print out and take it with you!) check out the shortage list which is up to date on this forum.  There are other patches not on the shortage list and pills too. Which types of progesterone did you react to?

The VA is the thing that needs fixing quick - its so debilitating and nasty.  You need a topical VA treatment such as Vagifem, Estring or the like. 

If that person is the only GP then you are going to have to bite the bullet.  Make a list of what you want and why and then present it to them saying you know what you are talking about you have researched it in a proper manner and ask them what reason they are giving for you not being able to try the things you have asked for.  I know it is the most terrible thing to have to do especially when you are feeling so rough but these types of GPs are common and they need educating and mustn't be allowed to make us feel disadvantaged.  If you look on the forum list there is an actual letter than Dr Newsom has put together for "troublesome GP's" who wont prescribe hrt (I don't see why it cant be used if you have a list of things you would like to try) which kind puts them in their place.  Might look heavy handed but they are not the ones suffering you are.

Whatsupwiththis is right - there are plenty of ladies who can give you info on how to treat the VA and what to ask for.  Do the same with the HRT you want to try too xxx

[Mogster71]

Thanks LadyBt

Although not the only GP they are the only partner, so I suspect any other doctor I saw there would have to go through them It just feels like such an uphill struggle!

I reacted to norethisterone - I don't know if it would be any better transdermally - but with it I had adrenaline rushes, hair shedding and upset tummy. Femiston 2/10 seemed too strong for me all the way through.

The VA has got worse this year, looking back it has been going on a while. I definitely don't want it to get any worse. That part of the conversation wasn't even addressed. It is very hard to be assertive with this when you are close to tears all the time, and feel like you have the upper hand with knowledge.

[Whatsupwiththis]

Mogster...Vagifem is the "go to" pessary for VA.  I believe in the UK many ladies with VA get on with Ovestin.  Vagifem is good for internal use but doesn't get to the external areas while creams such as Ovestin can do both.  Some women use both...Vagifem inside, Ovestin outside.  You do not need progesterone with either one even with an intact uterus. 

[CLKD]

You shouldn't have to go 'through' another GP but should be able to make an appt. maybe with a Practice Nurse.   

You could ask your local Pharmacist for advice too, info to take to the next appt. at the surgery.  Don't go in all guns blazing but tell the GP/Nurse "I've been in a lot of difficulty with X, Y, Z and have read on MM Forum that there are various precautions and medications that can ease menopause symptoms.  I would like to try X because I need to relieve .......... "  Make a double or late appt. if possible so that you don't feel rushed.

[sheila99]

This makes me so cross. If they weren't ignorant they wouldn't have had to go away and look it up before they spoke to you. And they still got it wrong, evorel contains norethisterone which you already know doesn't suit you. It's the 'go to' patch at my surgery. Knowledge is power so read up on the options. Ask the gp how they can tell gel isn't going to suit you. I'd like a crystal ball like theirs! I suspect your gp knows less about it than you do.
You need a referral to a meno clinic not a gynae. I'd ask for it anyway, you can always cancel if you no longer need it.
And I agree with what's been said about va, it needs treating ASAP. Don't be fobbed off again, you're entitled to treatment.

[CLKD]

Do U want us to join you at the Surgery door  . Clubs raised with VA leaflets ......... I'll fire up the charabanc.

Seriously, do let us know how you get on?  Make a list to take and ask to go through it - 'what do I need to ease these symptoms?'

[Mogster71]

Sheila99 exactly....I know!!  I can't do norethisterone, I specifically asked for gel and I told them my insides feel like they're stuck together 

There is another female GP in the practice who I have spoken to on the phone when I couldn't get an appointment before, I think I'm going to give the surgery one last try before I jump ship. I just don't feel I want to see the same person again and be insistent. If that doesn't work I've already sounded out the practice manager with a view to moving to a different surgery.

Haha CLKD it might be a good plan!! Yes! (and definitely pun intended lol)

LadyBT I will definitely print off the shortage list, great idea. I was also told that they don't have access to every single possible HRT, it depends which healthcare supplier your GP surgery uses.

Sigh.

[CLKD]

One shouldn't have to fight 4 treatment 

[pepperminty]

Hi Mogstar71,

try looking on Louise Newson's site   https://www.menopausedoctor.co.uk/ and print off a couple of bits and present them to your GP. The treatments part on this site explains the dosages and types. Femosten 2/10 was too strong for me but 1/10 is ok. I add a little Zumenon every other day as a top up, which gives me a little more estrogen. Look at the progesterone types as Noresthisrone is very strong and can cause reactions . You still have lots of options to try.   There are several types of local estrogen for the vagina, it can take months to work. It is horrible when you feel vunerable and have to fight to get good advice. Is there a menopause clinic that they could refer you to?

PMX

[Mogster71]

Hi Pepperminty

Thank you for your kind message - I do think when I went from the 1/10 to the 2/10 this was too strong for me, as although on the 1/10 the progesterone upset me, with the 2/10 Femiston I didn't feel right all month.

I have just phoned a lovely lady at a local Boots pharmacy to ask some advice about norethisterone, as I was unsure if I reacted orally if the same would happen with transdermal, and she said it would...just not as quick. She also agreed that it was pointless starting an Evorel patch only not to be able to get it again, plus it has norethisterone in it anyway!! 

I am eye-rolling myself into oblivion here....

CLKD it definitely feels like you have to fight for what you need at the moment. It's hard enough as it is. I don't need antidepressants, even though I explained that my heart races it does it on it's own not because I am panicking about anything in particular.

I have printed off the BMS list of shortages, and also the Practical prescribing guide. I might just drop in to the dispensary today, seeing as I can't get an appointment with either of the other doctors until next week at the earliest. I can totally see why this drives some people to distraction, this has taken over my bloody life this year!

[CLKD]

Let us know how you get on!