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Author Topic: Advocating for myself with my doctor. A question!  (Read 637 times)

Nanookster

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Advocating for myself with my doctor. A question!
« on: May 20, 2023, 05:32:47 AM »

Hi everyone,

A huge thanks to those of you who read or replied to my post yesterday about my doctor taking me completely off HRT. I felt so heard and understood.

(TL;DR: I have recently had a re-emergence of symptoms after taking HRT for 2 years. My doctor did a blood test and instead of increasing my HRT, he took me off it because the blood tests showed me oestrogen levels were now "good" but my progesterone was low, so he put me on Agnus Castus.)

I am even more furious this morning than I was yesterday that he did that. On Monday, I'll call him and demand to know some answers before asking to be put back on the HRT he took me off.

A question has been ping-ponging around my brain all night and it's this: When he did the blood test to test my hormone levels, he did so while I was still taking the HRT, so surely the results would be skewed. If my oestrogen levels were “good” is that not because I had oestrogen in my system because of the HRT? Or does it not work that way? #science

This is something I would like to raise with him, so I want to make sure I am on the right track here!

Thank you all in advance for your thoughts and opinions!
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Perinowpost

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Re: Advocating for myself with my doctor. A question!
« Reply #1 on: May 20, 2023, 07:09:19 AM »

Hi Nanookster

Yes your levels will have been better precisely because you were supplementing. I had mine done when I first became peri and still have them before and after starting hrt - fsh, LH, and oestrogen. There was a direct correlation between how I felt, I was so much better on hrt.

Also, quote the NICE guidelines (politely of course), there’s no reason you can’t stay on it if you want to.

Good luck x
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laszla

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Re: Advocating for myself with my doctor. A question!
« Reply #2 on: May 20, 2023, 07:19:15 AM »

Yes of course your E2 level is dependent on Hrt to a lesser or greater extent, depending on whether you are peri or post, ie whether you are still producing some oestrogen or almost wholly dependent on exogenous hormones.
Wherever you are on that spectrum your doctor's 'reasoning' is ridiculous.
Agnus castus is a good herb but it's fine to take it in addition to rather than instead of Hrt, my Meno specialist advised.
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sheila99

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Re: Advocating for myself with my doctor. A question!
« Reply #3 on: May 20, 2023, 08:57:11 AM »

Blood levels are often not useful in peri because your own supply can fluctuate from day to day and even within a day which is why the nhs prescribes based on symptoms. But you're right, your levels have improved because of the hrt. A similar thing happened to me, testosterone levels are within range therefore treatment not required. Apparently they couldn't work out they're within range because of the treatment.
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Taz2

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Re: Advocating for myself with my doctor. A question!
« Reply #4 on: May 20, 2023, 10:12:22 AM »

This is the Agnus Castus advice taken from the our menu on here https://www.menopausematters.co.uk/otherpreps.php

It does seem to be a popular thing to prescribe in Germany but only works if all other hormone therapy is stopped

Taz x  :-\
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Mary G

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Re: Advocating for myself with my doctor. A question!
« Reply #5 on: May 20, 2023, 11:04:13 AM »

Your gynaecologist was completely wrong to stop your HRT.

I had a very good German gynaecologist in Spain (now retired sadly) but she openly admitted she was no expert on HRT medication but obviously helped me with the gynaecological effects of HRT and hormones which was what I wanted.  I don't know if it's the same in Germany but gynaecologists actually do the scans themselves here which is really helpful because you can talk things through with them.

If this doctor refuses to prescribe, can you buy HRT from an online pharmacy or buy it over the counter perhaps?
« Last Edit: May 20, 2023, 11:06:48 AM by Mary G »
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Nanookster

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Re: Advocating for myself with my doctor. A question!
« Reply #6 on: May 24, 2023, 12:47:22 PM »

Yes of course your E2 level is dependent on Hrt to a lesser or greater extent, depending on whether you are peri or post, ie whether you are still producing some oestrogen or almost wholly dependent on exogenous hormones.
Wherever you are on that spectrum your doctor's 'reasoning' is ridiculous.
Agnus castus is a good herb but it's fine to take it in addition to rather than instead of Hrt, my Meno specialist advised.

Thanks so much, laszla. Do you still take Agnus Castus with HRT?
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Nanookster

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Re: Advocating for myself with my doctor. A question!
« Reply #7 on: May 24, 2023, 12:48:31 PM »

Your gynaecologist was completely wrong to stop your HRT.

I had a very good German gynaecologist in Spain (now retired sadly) but she openly admitted she was no expert on HRT medication but obviously helped me with the gynaecological effects of HRT and hormones which was what I wanted.  I don't know if it's the same in Germany but gynaecologists actually do the scans themselves here which is really helpful because you can talk things through with them.

If this doctor refuses to prescribe, can you buy HRT from an online pharmacy or buy it over the counter perhaps?

Thanks for your input, Mary G. I've spoken to him and he's put me back on the HRT. He also wants me to supplement with the Agnus Castus so I'll see how it goes.
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Nanookster

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Re: Advocating for myself with my doctor. A question!
« Reply #8 on: May 24, 2023, 12:50:23 PM »

Yes, I think you are absolutely right that your GP is confused, at best.

Does he think hrt cured your ovaries and now they're fixed, so they're good to go for another 40 years?

If you didn't laugh you'd cry.

To the best of my knowledge HRT won't affect the oestrogen quantity being produced by your own body unless it's tibolone, so that will continue to fall.

Perhaps he thinks it's not deficiency in oestrogen that causes symptoms, but fluctuations that cause symptoms? Certainly fluctuations will lessen over time as your levels will be lower all the time eventually.

It's hard to see what he could deduce from one blood test about how your levels fluctuate.

I had an idiot doctor once take me off my antidepressants (against my will) because I wasn't depressed any more, until a week or two later of course.
I don't think they believe in their own medicines sometimes, definitely ask for your medication that works back again.

You're so right, poppytoast! I don't think they do believe in their medications at times. It's exhausting having to go through the process of being put back on a medicine that he put me on in the first place!
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