Hi newbie - needing advice

[gekard]

Hi Everyone

I've just joined the site, hoping to get some help advice, and to share with others the joys of menopause

I'm very interested in bio-identical hormones but my GP says they aren't available on the NHS. Does anyone here have any experience of taking bio-idental HRT, and if so, how would I go about getting them if my GP won't prescribe?

I've been period free for 10 months and experiencing symptoms for quite a while: hot flushes, vaginal dryness, palpitations, joint/muscle pain etc. but as I also have a thyroid condition the symptoms can sometimes overlap with menopause symptoms and makes it difficult to know exactly what's causing what

Any advice re BHRT would be greatly appreciated. I am willing to pay for it if GP refuses (after speaking with CCG) but would need advice as to how to go about obtaining it and dosages etc.

Thanks in advance x

[jacksfullofaces]

Welcome
Your GP is wrong - most of the hormones prescribed by the NHS are bio identical. Many of us use oestrogel and Utrogestan both are bio identical options your doctor can prescribe for you.
What thyroid condition do you have? I also have a thyroid disease and it can make things difficult. As for dosage it is individual for each woman which is why Oestrogel is a good option - it is easily tailored. There are options for obtaining private prescriptions. Spire hospitals offer a GP service and HRT can be prescribed - consultation fee around £80 plus private prescription charges.
Jacks

[gobe]

Gekard!

[gekard]

Hi Jacks and Gobe and thank you for the welcome

Jacks - I have had Hashimoto's disease for 13 years and for most of that struggled with thyroxine only treatment. Last year I was referred to an endo and he prescribed T3 which has improved some things but not others. It's very difficult when thyroid and meno/peri-meno symptoms overlap, to tell what's causing what. I have had bad muscle and joint pain for a couple of years, and thought it was thyroid related, but as it hasn't improved with the addition of T3, I'm thinking it could be low oestrogen.

I'm currently waiting while my GP speaks to the CCG about bio-identical hormones - apparently as they are not routinely prescribed (so he says) I would have to put an individual funding request to the CCG for it, if they refuse to prescribe it.

I have spoken to my local pharmacy today, and she confirmed that Oestrogel can be obtained on prescription, and isn't any more expensive than the other HRT meds, but she hadn't heard of Utrogestan. Do you buy that privately, along with the other hormones you take? Also, do you regularly get your hormone levels checked i.e. progesterone, estrogen and testosterone? My GP has only tested FSH and LH so I have no idea which are low and if so, how low Would I have to get this done privately?

I've been trying to read as much as possible about meno and HRT but there's just so much conflicting info, brain fog soon sets in and I end up confused. I just know I want to feel better. I've struggled for the past ten years with not knowing (and not being properly informed by my GP) about the correct way to treat thyroid disease and gone through peri without any help, that I want the next ten years to be different. Basically I want my life back. What I have learnt is that when it comes to health you have to be your own advocate. Thank God for forums

Gill x

[jacksfullofaces]

Hi Gill
I was tentatively diagnosed with Hashimoto - but my thyroid swings hyper so I'm currently on beta blockers while my GP workds out best course of action. Basic TSH and T£ in range but raised antibodies and peroxidase levels.
Utrogestan is available on NHS although not a common form of prescribed progesterone. With obtaining gel it is best to tell your GP that you have IBS so cannot cope with tablets and your skin is itrritated by patches. This justifies the prescribing of gel rather than cheaper tablets.
Often you can be palmed off with norethisterone so tell the doctor you don't get along with it.
For further reading I recommend Uzzi Reiss Superwoman and Thierry Hertoghe Hormone Solutions. I take 10 mg daily of DHEA (Amazon) for my thyroid disease and peroxidase levels fell from 166 to 36 - quite a jump in the right direction.
Hormone levels are not routinely tested on NHS but symptom relief will frequently tell you how the hormones are being absorbed. For vaginal dryness you should also request Ovestin crea as systemic hormones are not quite as effective for relieving atrophy. Personally I think every female aged over 40 should use a vaginal cream to help avoid prolapses.
Plenty more information on hormones on this site and I can help guide you through NHS prootocol for getting that prescription.
Jacks

[gekard]

Hi Jacks and Pinky

Thank you so much for your posts and for the great advice and information. I have a telephone appointment with my GP tomorrow and I'm definitely going to request a trial of Oestrogel and Utrogestan, and will also mention Ovestin as well. It's been nearly a month now since I last saw him and I'm fed up of waiting for him to get back to me with an answer about the bio-identicals.

Jacks, thank you for the tips about swerving synthetic HRT I guess it's about being one step ahead of them and not being fobbed off. I did in fact take synthetic progesterone in the past for PMT and it didn't agree with me, and us thyroid sufferers often have IBS (although I don't at the moment) and other stomach issues, so hopefully he won't take too much convincing. I have also ordered the book by Thierry Hertoghe, and am looking forward to reading it.

Pinky, thank you for the advice re further reading, and I will definitely check out those websites you mentioned.

I will post back when I've spoken to the doc tomorrow. Fingers crossed!!

Gill x

[jacksfullofaces]

Jun 26, 2013 22:18:47 GMT gekard said:

Hi Jacks and Pinky

Thank you so much for your posts and for the great advice and information. I have a telephone appointment with my GP tomorrow and I'm definitely going to request a trial of Oestrogel and Utrogestan, and will also mention Ovestin as well. It's been nearly a month now since I last saw him and I'm fed up of waiting for him to get back to me with an answer about the bio-identicals.

Jacks, thank you for the tips about swerving synthetic HRT I guess it's about being one step ahead of them and not being fobbed off. I did in fact take synthetic progesterone in the past for PMT and it didn't agree with me, and us thyroid sufferers often have IBS (although I don't at the moment) and other stomach issues, so hopefully he won't take too much convincing. I have also ordered the book by Thierry Hertoghe, and am looking forward to reading it.

Pinky, thank you for the advice re further reading, and I will definitely check out those websites you mentioned.

I will post back when I've spoken to the doc tomorrow. Fingers crossed!!

Gill x

Hi Gill
Glad to be of use. To obtain Ovestin tell the doctor that sex is painful and you are dry. Say you have tried lubricants without success and it is disturbing your relationship with partner . You have to fit NHS protocol and I have the British Menopause Book so am clued up on the protocol. Menopausal treatment is akin to handing the doctor the answers which fit the protocol.
best of luck
Jacks xx

[Deleted]

I have yet to come across a pharmacy that stocks oestrogel or utrogestan as the norm. I have recently moved and neither items were in at the local Boots. This surely shows how often they are prescribed by GP's. I have a first appointment this week with a new GP who actually asked in a telephone consultation when I was trying to get a repeat script what I used oestrogel for! It doesn't bode well for the actual appointment. I won't even tell her I am using utro vaginally on alternate nights rather than the conventional way, as I am pretty sure I won't get any more if I do! I think Jacks and Pinky are right and you have to make a stand for what you want. It looks like I am going to have to go through that procedure all over again with the new practice.

[jacksfullofaces]

I have a first appointment this week with a new GP who actually asked in a telephone consultation when I was trying to get a repeat script what I used oestrogel for!

Jaycee
I would have been tempted to tell her that if she consulted MIMS she would learn that oestrogel was used to treat menopause
Jacks

[gekard]

Hi All

Had my telephone consultation with my GP today and he's prescribed Oestrogel and Utrogestan (both by Marlborough Pharmaceuticals). He wouldn't give me Ovestin though as he said the vaginal dryness would be rectified by the Oestrogel.

Hi Jaycee My usual chemist didn't have either but another local one had the Oestrogel in stock and could get the Utrogestan tomorrow, so not too bad really. They did say however that the Oestrogel is hardly ever prescribed, and I asked if that was due to cost and they said no, it's more or less the same price as the more popularly prescribed HRT, so not sure what the deal is

Unfortunately, I've handed the script in to the chemist and forgotten to take a note of the dosage instructions (my GP didn't advise me as he was rushing to get off to lunch!) so I'm not sure how much to start off with - is it best to start low and build up? It just says "apply once daily" on the box of Oestrogel. Not sure about the Utrogestan as I haven't got it yet! Any tips on dosing would be greatly appreciated! Many thanks

Gill x

[Deleted]

Hi Gill. Your GP could be right as oestrogel works for me re vaginal dryness. You will soon know as I don't think it takes too long to kick in. The great thing about gel is you can tweak the dosage. There are all sorts of instructions with the utro and I don't know how critical they are, such as take on an empty stomach last thing at night. Apparently in other countries its exactly the same preparation but used as a pessary. Another knowledgeable member, Candy sent me a link ages ago to a read only report that my clever son managed to convert to enable printing detailing a survey with excellent results using utro vaginally on alternate nights. This way I don't get any interference with digestion.I tend to use two and a half to three pumps once a day but I think Jacks uses it twice a day and I do wonder if that might give a more even dose as its spread out. I guess you will have to see what works best for you. At least you have the goods now and things should improve for you drastically.

[jacksfullofaces]

yes Gill your GP could be right - although a percentage of women still need vaginal oestrogen because systemic preparations don't always solve the issue ( this was the case for me)
Oestrogel peaks at around four hours and drops at about eight hours. This is why I spread my doses. However my thyroid also messes with my metabolism and I was always good at kicking medication out of my system. So I have two main doses with sometimes a small tweak during the day. I also posted a link here about medication and menstruation. If like me you are in peri during the low phase of menstruation - blood volume increases and can remove therapeutic levels of medication.
Congratulations on getting the prescriptions.
Jacks xx

[gekard]

Hello Jacks/Jaycee

I got advice on the dosing instructions today from the surgery and it's one pump of Oestrogel daily (continuously) and 100mg of Utrogestan days 1 - 25. Does that mean I have three days off from the Utrogestan? i.e. base it on a cycle of 28 days? Also, does that dose sound right? I'm thinking my GP is starting me on the lowest dose which can be increased if symptoms don't disappear. If so, how long would you give it before increasing?

Still haven't got the Utrogestan though - the chemist hadn't been able to get any today, so it might be Monday. I've started using the Oestrogel however, and I have a question about that:

I have been using a natural progesterone cream (Natpro) for a couple of years now, usually from day 14 to day 28 although it's been a bit more difficult since my periods stopped to know when day 14 actually is, so sometimes I've just used the cream when I felt I needed it i.e. when feeling low/tearful etc and it's normally worked. So my question is, when I get the Utrogestan, should I leave it a couple of weeks before starting to take it, to let the old Natpro clear my system, or should I just start to take it when I get it, alongside the Oestrogel? I don't want to be overdosing on progesterone!

Thanks.... Gill

[gekard]

Hi Pinky

Thanks for your reply. I think I'll go with the one pump of gel for a week or so, and if I haven't noticed any difference, up it to two pumps, and leave the progesterone for a while, in case the Natpro cream is still effective. I will also check out Prof Studd's website.

With regard to dosing, is the way my GP has suggested me taking the HRT correct? i.e. Oestrogel continuously, and Utrogestan for days 1 to 25? If so, when would I start with the Utro again? I'm thinking day 28?? I've not had a period for 10 months so have just counted the first day of gel as day one.

Gill x

[jacksfullofaces]

Jun 29, 2013 11:22:45 GMT gekard said:

Hi Pinky

Thanks for your reply. I think I'll go with the one pump of gel for a week or so, and if I haven't noticed any difference, up it to two pumps, and leave the progesterone for a while, in case the Natpro cream is still effective. I will also check out Prof Studd's website.

With regard to dosing, is the way my GP has suggested me taking the HRT correct? i.e. Oestrogel continuously, and Utrogestan for days 1 to 25? If so, when would I start with the Utro again? I'm thinking day 28?? I've not had a period for 10 months so have just counted the first day of gel as day one.

Gill x

Gill
I will add that the description for applying oestrogel can be very vague - Pinky put up some directions from Dr Annie it should be well rubbed in otherwise absorption is erractic with gloop taking hours to dry out.
Good luck
Jacks xx

[gekard]

Hi Jacks

I'm finding that it rubs in well and dries quickly, probably because I'm only using one pump.

Do you have to alternate where you apply the gel, or is it ok to use the same place on the body every time?

Also, would you be able to answer the question on my last post about how my doctor has advised I use the HRT?

Many thanks.... Gill x