Dr Frank? Rhianna? Would really appreciate advice re. my HRT prescription?

I'm 43 and have been having infrequent periods for about 6 months no hot flushes but depression. I've been prescribed Tibolone by my doctor but have been told (and it says in the literature) that this is only to be prescribed after 12 months no bleeding. My last period was 7 weeks ago!


I'm also concerned about side effects as I'm already prone to water retention and really don't want to gain weight.Dr Frank? Rhianna? Would really appreciate advice re. my HRT prescription?
Rhianna kindly directed my to your question. As usual she has put a lot of medical knowledge and effort in to her answer.





Frankly unless there is either something not in your question, or your doctor knows something I don't, I am at a complete loss to explain any justification for his use of Tibolone. Agreed it is indicated to aid the depressed mood that is sometimes linked with the menopause, however as you rightly point out the data sheet states that it should only be given to women who have been 12 months without a natural period. Since I agree the drug does not seem to be indicated for your problem as you have stated it, any possible side effects would not be justified.





Go back to your GP and ask him to clearly explain why he felt it necessary to prescribe this drug outside its licence and for exactly what purpose. Incidentally any prescribing of any drug outside the licence should be carefully explained and justified to the patient, who really needs to give informed consent.





To many of the poorer doctors explain little of what they do to patients, often I fear the reason is that they can't explain what they doing as it follows no rationale.Dr Frank? Rhianna? Would really appreciate advice re. my HRT prescription?
Hi, first of all, has your Dr referred you for further tests regarding your bleeding? All instances of irregular and infrequent bleeding at any age, particularly perimenopause should really be investigated.





With regards to the Tibolone, a bit of an odd choice, I don't understand why your GP has prescribed this to you. It is generally used for symptoms of the menopause, it is usually prescribed for post menopausal women. You're right, this drug is usually prescribed after the menopause has been defined (no period for 12 months) This is because the medicine may cause irregular menstrual bleeding if it is started sooner than this





It's a synthetic steroid that mimics the activity of the female sex hormones oestrogen and progesterone and the androgen testosterone in the body. The drug helps restore the balance of hormones in the body, in particular oestrogen. He as probably prescribed it for your depression, which can happen as oestrogen levels decrease.





The most common side effects are headache, dizziness, nausea and sometimes a rash. Not every women will get water retention. I suppose your Dr could have prescribed this to you as you are slightly early to be experiencing perimenopausal symptoms, it will help prevent osteoporosis.





Hope this helps.I'll mention your question to Dr Frank, who'll be able to shed more light.


Best wishes.
Go to web md and do some research. Here's one link to some info.


http://www.webmd.com/menopause/default.h鈥?/a>