I am probably just venting here
After trying 3 different GPs at my previous practice (none of which seemed to know much about HRT or make me have much faith in them), I switched practices to one which a friend had recommended - telling me that her GP specialised in the menopause and was doing her training with the BMS. To switch practices, I had to do an intake interview, provide a urine sample, do the whole blood pressure bonanza and all the rest of it. I really liked the young GP who did my intake but really I was there to see this GP my friend had recommended. I mean - she was doing a training with the BMS, right? So she had to know her stuff. She might be a bit conservative (like the BMS) at the worst, but even so I'm not really doing anything very radical...
I had to wait 4 weeks for a double appointment with her, but I wasn't in a rush...
Saw her today and OMG, NOPE! This is what I was told:
1. If my Estradot patches get increased above 75, I will need additional progesterone. I tried to point out actually, it's if it goes over 100, some believe that additional progesterone should be provided. But since I am already taking desogestrel POP, I would probably be fine even then... But no. Apparently she has just done a training with the BMS and this is what she was told.
2. I shouldn't be using both Vagifem pessaries (2x weekly) AND Ovestin. It should be one or the other. No matter that I am using one internally and one externally. And... I'm not applying the Ovestin to the vulva, am I? (Errrrrrrr... where else would I be putting it? On my nose?) She conceded I might apply it very sparingly maybe once a week to my urethra but that's all. I managed to get both to stay on my repeat prescription list by agreeing to be very sparing. Because she had 'never heard' of someone having both. (?!?!).
3. If I start to bleed, I'll have to go on sequential HRT apparently. Even though I have endo and endo sufferers should have continuous HRT. So I should just stay on the desogestrel and not try going to 200mg of utrogestan because woe betide I might bleed.... (Could I not just switch back to desogestrel should that happen, even so!? And anyway, she hadn't even asked me if I was bleeding and when and how much already, to date!)
4. There is no optimal level of estrogen for bone protection. She should just treat symptomatically up to 100mcg - so there is no need to check my estrogen levels. (I tried to explain that yes, they should treat symptomatically - in that blood tests should not be required before HRT is prescribed - but that doesn't mean there isn't also a minimum estrogen level which is optimal for bone health. Which is at the very very least 250nmol+, but optimally around 450nmol+ really. But no, apparently this is wrong. She has never heard it.)
5. I am on testosterone for low libido, right? Because there's no other reason to be on it. She can show me the BMS statement from last week (thanks, but I've already read it and found it very conservative)....
Now thoroughly depressed. Also didn't really feel 'seen' or my concerns really appreciated or investigated. She was not concerned about the high blood pressure symptoms or heart palps unless I pass out or faint, or have chest pain associated with it. She couldn't suggest anything for the over-production of mucous I get from my right nostril, especially after eating. Or the tearing right eye. She offered me some steroid spray but I refused, knowing it's not allergies.
Then she told me my time was up. And I didn't like her as a person very much either. It's one thing for a doctor just not to know much, but they can at least tell me that and investigate. They can make me feel like they're on my side.
So - now it's back to the drawing board. Thank goodness for my (incredibly expensive) Newson GP in all this. I do have all my meds on repeat at least now, but this GP is not someone I'll see again. I think I am now at GP number 7. And this one was supposed to be doing a BMS training.
I might need to change practice AGAIN.
I'm not a doctor or a medical expert, but I've had to learn a lot about all of this myself. I am managing myself through it all. And I just keep looking for someone who knows more than me, someone I can really trust and know is on the right page. And someone I have access to, in person. (Newson GP is remote.) So they can do exams on me, refer me on for tests, do bloods etc. There is going to be a local menopause clinic opening here in October, so might now try to hang on until then.