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[Dandelion]

Ok don't tell me off but what Norethisterone.? A progesterone? I thought there was only two Provera and ustrogen xx

No one's gonna tell you off, norethisterone is a synthetic progestin.

[Butterfly22]

Ah thank you, I feel like I should have known this but I've never heard of it x

[Dandelion]

Ah thank you, I feel like I should have known this but I've never heard of it x

You weren't to have known.

[Callisto]

Hi, sorry I missed this thread, not logged on for awhile.
I finally achieved estrogen, Utrogestan and testosterone on prescription from my NHS Scotland doctor in the Lothians. I almost danced a victory dance but it was short lived! The Tostran was out of stock (is Testogel more expensive than Tostran hence they prescribe Tostran instead? It's a moot point as I received  neither and had been previously told by private gynae that Testogel is now hard to get hence I was prescribed Tostran as alternative).
The next time I went to my highly sympathetic NHS doctor to request a repeat prescription for gel and Utro, he told me that he had been reprimanded for writing the script for Utrogestan and that unfortunately I'd have to go back to my private doc to get that even though he could still prescribe the gel so that means I have to pay consultancy fee for the private doc plus medicine costs..(at a push I don't mind paying for the progesterone but I do the consultancy fee which is £150 per yearly consultation /I am on a low income).
 Posts on this thread seems to suggest that if I go back to NHS Lothian doctor and state Utro is the only plant-based micronised progesterone and that I have already been prescribed it (albeit privately)  for three years, that according to 'small print' in NHS Scot guidelines he may be able to override the system to write me a prescription despite Utro not being on their list?
I feel my levels of anxiety rising again..just when I thought I had struggled to victory in terms of achieving
prescription on NHS in Scotland.
Thanks for all who have contributed to this thread.


😐Callisto

[Hurdity]

Hi Callisto - I don't think we moved any further forward on this one - except the links I gave a couple of pages back (the recent letter about the shortages and the footnote to the original decision) suggested that the recommendations can be overriden as you suggested, and as they can in England. I am sure it is up to the doctor - that they should be able to put a note on your records to prescribe utrogestan - it is the only licensed body-identical progestogen for HRT and therefore should be available. If this is the case then the doc needs to have more of a spine and argue this - even though pressure is being put I imagine on cost grounds? Maybe it is more difficult to override the system in Scotland because prescriptions are free whereas in England there is a charge? However it is a licensed medication and therefore you should be able to have it on repeat through the NHS.

Quite right you should not have to pay for a private consultation nor pay privately for the progesterone - heavens!

One suggestion is to write to Dr Currie - I think she might have been asked for clarification on this previously but no member has reported back since. The other alternative is to write to her as a consultation - but this does cost £30. You would need to be very specific with your question so that you can then tell the doctor how to get around it or what to do on the system - if necessary?

Hurdity x

[Clovie]

Hi Ladies

 

I finally got my appointment to see the menopause specialist (as referred arranged by my GP after telling me they could no longer prescribe Utrogestan even though it was the only prog that works for me as I am highly intolerant of the synthetic progs and I've tried a few and to get it I'd need to see a specialist and explain I cannot take synthetic progs) ...)

Well, when I got into the appointent room she had no idea why I was there, (What had my GP surgery letter actually said??? I WILL be getting a copy of that) and then when I explained briefly she told me point blank I could NOT have the Utrogestan at all under any circumstance,

This was NHS Lothian.

She was rude and unsympathetic.

I am so upset.



I am going to have to get it elsewhere, like buy it abroad?   Do you need a private prescription to buy it from abroad?
Will my GP continue to prescribe the Estrogel without the Utrogestan?

 

[Dandelion]

Hi Ladies

 

I finally got my appointment to see the menopause specialist (as referred arranged by my GP after telling me they could no longer prescribe Utrogestan even though it was the only prog that works for me as I am highly intolerant of the synthetic progs and I've tried a few and to get it I'd need to see a specialist and explain I cannot take synthetic progs) ...)

Well, when I got into the appointent room she had no idea why I was there, (What had my GP surgery letter actually said??? I WILL be getting a copy of that) and then when I explained briefly she told me point blank I could NOT have the Utrogestan at all under any circumstance,

This was NHS Lothian.

She was rude and unsympathetic.

I am so upset.



I am going to have to get it elsewhere, like buy it abroad?   Do you need a private prescription to buy it from abroad?
Will my GP continue to prescribe the Estrogel without the Utrogestan?

 

I'm so sorry that you cannot get the utrogestan.
There are online sites that you can buy hrt from but they have to be registered with the MHRA and often they need GP approval, not much help, I know, but that is only what I know.
There may be sites that sell other forms of micronised progesterone under a different name abroad, but I don't know how to go about finding such a site.
One consolation is that other scottish women must also be in the same boat, maybe there may be a way of  hooking up with other scottish women who can help.
Ah, I've just though of another thing, PALS, I don't know if PALS exists in scotland or you have an equivalent.
PALS  helped me get a second opinion from a different specialist regarding a non menopause issue, maybe there is such an organisation, if not PALS who you can go to.
PALS helped me a lot, they got me a GP appointment, GP's had a meeting and a second specialist appointment was arranged.
Wish I could help you more, hope other women come on and can offfer even more suggestions.

[Clovie]

Hi Ladies

 

I finally got my appointment to see the menopause specialist (as referred arranged by my GP after telling me they could no longer prescribe Utrogestan even though it was the only prog that works for me as I am highly intolerant of the synthetic progs and I've tried a few and to get it I'd need to see a specialist and explain I cannot take synthetic progs) ...)

Well, when I got into the appointent room she had no idea why I was there, (What had my GP surgery letter actually said??? I WILL be getting a copy of that) and then when I explained briefly she told me point blank I could NOT have the Utrogestan at all under any circumstance,

This was NHS Lothian.

She was rude and unsympathetic.

I am so upset.



I am going to have to get it elsewhere, like buy it abroad?   Do you need a private prescription to buy it from abroad?
Will my GP continue to prescribe the Estrogel without the Utrogestan?

 

I'm so sorry that you cannot get the utrogestan.
There are online sites that you can buy hrt from but they have to be registered with the MHRA and often they need GP approval, not much help, I know, but that is only what I know.
There may be sites that sell other forms of micronised progesterone under a different name abroad, but I don't know how to go about finding such a site.
One consolation is that other scottish women must also be in the same boat, maybe there may be a way of  hooking up with other scottish women who can help.
Ah, I've just though of another thing, PALS, I don't know if PALS exists in scotland or you have an equivalent.
PALS  helped me get a second opinion from a different specialist regarding a non menopause issue, maybe there is such an organisation, if not PALS who you can go to.
PALS helped me a lot, they got me a GP appointment, GP's had a meeting and a second specialist appointment was arranged.
Wish I could help you more, hope other women come on and can offfer even more suggestions.

Thank you so much for your kind words and suggestions Dandelion, much appreciated xx

[Dandelion]

Thank you so much for your kind words and suggestions Dandelion, much appreciated xx

Hi Clovie, good suggestion from Stellajane, re Scotland.
I just wish I could help more.

[Clovie]

Ugh - that's the worst thing - going to see a specialist and them not having a clue why you've been sent there! It happened to me once, not meno related, but it made me feel I was being a timewaster when it was my GP's decision to refer me! I also got a rude and unsympathetic reaction.

Maybe start a new thread with Scotland in the title to get some local responses?

Thank you so much, appreciate it, and I certainly will do that when I don't feel so emotionally drained because of today's awful experience.
I feel it's so unfair and I feel so powerless....

[Clovie]

Thank you so much for your kind words and suggestions Dandelion, much appreciated xx

Hi Clovie, good suggestion from Stellajane, re Scotland.
I just wish I could help more.

Thank you Dandelion x 

[Hurdity]

Hi Ladies

I finally got my appointment to see the menopause specialist (as referred arranged by my GP after telling me they could no longer prescribe Utrogestan even though it was the only prog that works for me as I am highly intolerant of the synthetic progs and I've tried a few and to get it I'd need to see a specialist and explain I cannot take synthetic progs) ...)

Well, when I got into the appointent room she had no idea why I was there, (What had my GP surgery letter actually said??? I WILL be getting a copy of that) and then when I explained briefly she told me point blank I could NOT have the Utrogestan at all under any circumstance,

This was NHS Lothian.

She was rude and unsympathetic.

I am so upset.

I am going to have to get it elsewhere, like buy it abroad?   Do you need a private prescription to buy it from abroad?
Will my GP continue to prescribe the Estrogel without the Utrogestan?
 

Hi Clovie - so sorry to hear about your dreadful and upsetting experience with your menopause specialist. How remiss of the GP not to explain why you had been referred. Sounds like the specialist is out of order. Did you take along any the documents that were linked to in this thread?

You will see from the below that (former member) Kilted Cupid was able to be prescribed by her GP in Lothian so there is clearly lack of consistency here.

Great news! I've just returned from my GP (in NHS Lothian) and Utro can be prescribed for ladies who can't tolerate any other type of prog. You'd have to have a really difficult GP to not prescribe it for you if it's your preferred prog and you get on with it.
So, ladies of Scotland, fear not, you can get your Utro if that's your choice.

In addition I quoted from other documents implying that individual discretion could be used despite its lack of recommendation by NHS Scotland (on cost grounds). https://www.scottishmedicines.org.uk/media/2002/micronised_progesterone_utrogestan_final_march_2009_for_website.pdf

Firstly from that document , just to remind you (so you don't have to read the whole sorry thread  !) the key point here is the small print at the end of the document when Utrogestan was not recommended.
?This  advice  does  not override the individual responsibility of health professionals to make decisions in the exercise of their clinical judgement in the circumstances of the individual patient, in consultation with the patient and/or guardian or carer. ?

In addition, here is a letter sent by Scottish government about HRT shortages in Aug last year in which Utrogestan is listed as available. The letter implies that individual discretion might be used: https://www.sehd.scot.nhs.uk/pca/PCA2019%28P%2918.pdf. For example this wording: "The  table  also  provides  an  update  of  all  HRT preparations  that  remain  available.    Clinicians may  be required to switch patients to alternative HRT products that contain the same active ingredients for a temporary period". Utrogestan is clearly listed as an option to consider.

Finally, if you haven't done so already, I would strongly suggest also that you have an e-mail consultation with Dr Currie if you  have the funds ( it costs ?30) to get clarification on this issue once and for all. She will know exactly what the position is and whether the specialists are out of order or within their rights to refuse you micronised progesterone. We can help you word that e-mail if you would like us to although your actual experience and what the doctors have said are powerful in themselves. It is what your rights are in your circumstances that are important. I don't see how any doctor or specialist in UK can refuse to prescribe a licensed medication such as this if it is clinically indicated for you due to progesterone intolerance and because there is no other progesterone product available.  On principle I would not want to take a synthetic progestogen.

I presume the specialist will reply to your doctor and I wonder what s/he will write? I would ask to see that letter as well.
   
Don't give up ? I know you don't feel like fighting as you have been slapped in the face but try to be strong and gather together all the information you can as a dossier and prepare to confront them at the highest level that you can ? starting with going back to your GP, and then just keep going...

All the best

Hurdity xx