HRT and me: Standing at a crossroads and not sure which road to take

After my heart-thumping visit to the gynaecologist because of bleeding and spotting almost every week on HRT, I waited eagerly for the GP’s phone call to discuss the results. And I waited. And waited.

I received a letter from the gynae herself that sounded as if everything was fine. She thought the bleeding was to do with the HRT itself (Evorel Conti) and suggested a change of regime might be appropriate. There was also talk about fibroids and a cyst and lots of words I resisted the urge to google. Dr Google is great – if you want to think you’re dying of some very rare disease.

And still I waited for a GP from my surgery to get in touch to discuss this. Even after I phoned up to ask.

Eventually, after several failed attempts to get same-day appointments and an e-consultation, I managed to get a telephone appointment with a real person! The menopause gods were obviously smiling on me.

HRT ups and downs

However, as we know with menopause, it’s a rollercoaster and a little black cloud gathered when the GP told me she wasn’t happy with one of the gynaecologist’s findings and wanted me to go back for further tests on my fallopian tubes.

She also wanted to check with the gynae about which HRT regime she would recommend.

As for the Evorel Conti: “Can you buy a blood pressure monitor and phone in your reading? If it’s okay, then I’m happy to give you a short-term prescription.”

So it cost me an extra £19.99 to get two months’ HRT.

And then I waited again.

About a week or so later, I received a text to call the surgery. Worried, I called first thing the next morning – to be given a telephone appointment for “sometime around lunchtime a week on Thursday” with a GP I hadn’t heard of. It was “not possible” to see someone who knew my history…

My heart sank.

My timetable of frustration

In July, it will be three years since I first went to the doctor to discuss menopause and HRT. In that time, I have:

• been given HRT tablets that did nothing for my symptoms;
• told I was depressed instead and put on anti-depressants that did nothing for my symptoms;
• told I needed stronger anti-depressants that… yeah, you get it;
• had expert advice from Mr Haitham Hamoda courtesy of the BBC Health: Truth or Scare and advised to use an oestrogen gel with progesterone separately;
• had that ignored by the GP;
• was started on patches that put me on a cycle of wanting to end it all or go on a killing spree every two weeks;
• been on the merry-go-round of trips back to the GP to explain how awful I felt with the progesterone only for them to give me other patches that did exactly the same thing, or have trouble prescribing anything else because of HRT shortages;
• finally had an appointment with a GP who agreed with Mr Hamoda;
• had that queried and overruled by another GP who had never met me;
• been transferred to the local women’s health centre to have a coil fitted and then received a cancellation the following day with a message I wasn’t eligible;
• gone cold turkey until I got help from Mr Peter Greenhouse (who wrote a letter to my GPs saying exactly the same thing as Mr Hamoda, only this time they listened);
• had a date for a coil fitting;
• and then been hit by Covid-19 and had it cancelled.

In between, I’ve told my story so many times to now five different GPs in my practice alone. I’m exhausted. I’ve been passed around, had GPs disagree with each other, had my voice ignored, been given hope only to have it snatched away again…

Thankfully, the latest GP agreed that adding another voice to the mix was not the best and he’s passed me back to see about getting the coil I should have had two years ago if my GPs had listened to me.

HRT: Sequential and continuous

As for the Evorel Conti, it seems the gynae isn’t happy with me taking it. It is a continuous HRT, where you are fed oestrogen and progesterone together, rather than a sequential with two weeks of one and two weeks of the other. Continuous HRT is meant for women who have gone through the menopause – that is, they haven’t had a period for at least 12 months. I am still perimenopausal, goddamit.

So why was I put on Evorel Conti? Age is a factor. On average, women my age have been through the menopause. I didn’t know if I had or not because on sequential HRT, around 85% of women get a bleed each month and I am one of them. Each GP would ask me when my last period was and I could only reply: “I don’t know.” As a result, the GPs did the maths and figured I was probably through the menopause and safe for Evorel Conti.

However, if I continue on this, the gynae says I would have to have regular scans to check for unusual womb thickening, which is a cancer risk. Obviously, I don’t wish to take that risk, nor have the cost to the NHS for something where there is an alternative.

I was also offered the chance to be referred to the local menopause clinic and while my heart soared, I turned it down. The waiting lists are so long that I could be hanging around for at least 20 weeks – if not a year – and if I were to be on Evorel Conti for that time, then I’d have to go for scans. Changing to a sequential HRT would put me back on the progesterone downers, another risk I don’t want to take.

What to do?

I should be delighted at the prospect of finally getting a coil, but I’m not. I know of women who found the progesterone in that even too much to take. What if I have it fitted only to be in the same boat?

Which leaves me…

Confused.

Angry.

And scared.

I’m no science denier – I know man landed on the moon, the world is round, Elvis is dead and Bill Gates isn’t keeping tabs on what my 90-year-old mam is doing via her Covid-19 vaccine. I’ve written about the pros and cons to HRT and know it isn’t the big bad and has many, many benefits for women.

But you see, I’ve never had this great HRT joy that people talk about – the feeling that you’re 20 years’ younger, strong, full of life. I had better days before the HRT, when I went months without a period, before the hormones started their rollercoaster and I was hit with symptoms again.

The most I can say is that I’m “meh” – and I think I’m only that high because I’m also taking anti-depressants because I was so worried about the progesterone.

I know HRT advocates will say it’s the anti-depressants and they could be right. I also know the last year has been unlike any other I or anyone else in the UK has lived through. But more often than not, my HRT journey has been stressful and worrying, with periods of feeling as low as can be.

The coil doctor is meant to be calling me this week to discuss options.

I don’t know what to say…

What advice would you give? I’m open to all thoughts in the comments below

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