Hi, wondering if anyone knows of a friendly gynecologist or doctor in the Normandy region who is HRT friendly? All the French gynecologists I’ve seen refuse to prescribe HRT to perimenopausal women. Have to be post menopause (1 year). Any recommendations for a willing doctor? Thanks!
Can’t help with a name, but an explanation perhaps of why the situation is like it is.
The impression from Ameli’s take on the question of HRT, is that while available in certain circumstances, in the absence of overwhelming perceived benefit to the patient when weighed up against the risk factors, they appear to be indicating that it would be preferable to prescribe other, non-hormonal, alternatives.
If Ameli are stating that publicly, then within the health system, there will be pressure on practitioners not to prescribe HRT.
Currently, the main reason for the negative attitude to HRT in France appears to be outlined here, and mentalities will be slow to change, as few Obs&Gyn or even GPs want to be faced with the risk of a potential lawsuit later on down the line, or the possibility of being investigated by Ameli for overprescribing drugs which are known to have a contested risk/benefit assessment. Presumably, this approach/mentality would be applied even more cautiously in perimenopausal women.
Looks like Caen might be your best bet.
I got HRT from my GP initially. After I made it clear I was likely to kill myself or someone else otherwise.
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Wow no one in the Aquitaine!
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Were you in perimenopause or menopause?
Péri . He did say I had to go and see a gynaecologist but prescribed until I could get an appointment. . But then he’s a sensible dude!
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Thanks Cat. There are lots of menopause specialists around but zero perimenopause help! Maybe I’m just not a good enough actress (!) although I was told by a GP here that mental health issues are not linked to menopause. Unbelievable. I’m curious, did your gyne agree to HRT too? Where are you based? Someone mentioned thay could be scared of going outside the FR guidelines and get hit with a lawsuit. It’s an interesting take on it, could be true.
It isn’t illegal to prescribe HRT, but if the patient subsequently develops one of the known risks associated with HRT then from a medical insurance perspective, they are potentially opening themselves up to a future lawsuit, and many fear that they would be hung out to dry by the Caisse de Maladie to fend for themselves instead of being supported. One (but not the only one) of the reasons why there are so few Obs&Gyn specialists in France today is due to a decline in entry into the specialisation due to, among other things, past lawsuits which have increased insurance premiums for these specialists beyond most professionals’ acceptance levels.
Even with fairly sympathetic GPs, it can still be difficult to get HRT prescribed in France for perimenopausal symptoms, as the current thinking by some (including my OH’s GP who is neither a revolutionary, nor an old crusty) is that the body is still adjusting to the beginning of the change, and that the effects can be mitigated by other non-hormonal treatment that have far fewer associated risks. This is the thinking that would require adjustment in order for change to filter down to patient-level care, not dissimilar in many ways to the other fairly conservative approaches in healthcare areas throughout France. Unfortunately, it can end up being a bit of a lottery.
I’d be interested to know what percentage of doctors/GPs in France are women?
This is crazy - to see how crazy try reading the same text with another drug
If doctors applied this doctrine uniformly then they would never prescribe anything because all drugs have side effects - it should be about benefit vs risk and some women get debilitating symptoms from menopause - for some man to declare that they cannot take HRT to help with these seems unsympathetic to say the least.
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I agree wholeheartedly.
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