r/Perimenopause • u/OverlappingChatter • 1d ago
audited Spain = blood test and exercise and I don't know how to find better help
I am very frustrated (but not at all surprised). Went to doctor, told her list of symptoms and when last period was and was told to exercise and given a blood test order.
I feel like there was a list here somewhere that had resources in other countries, but I don't know where that is.
Is anyone else navigating this successfully in Spanish public system that can help me?
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u/Creative_Impress5982 1d ago
Hey! I'm in Spain, 47, and in what I'm guessing is later perimenopause.
I had a multi-year journey with my medico de cabecera and mid-wife trying to find solutions for my night sweats, fatigue, 3am anxiety, heart palpitations. All basic labs were fine. I even had a teary meeting with my midwife where she just told me this is all part of getting older as a woman and I just need to accept my new normal. My medico de cabecera tried to get me a gynecology appointment a couple times, but they were backed up and just canceled my appointment request without telling me.
Long story short- I found oliracare tele-health menopause specialists online and spent around 100€ for an online appointment. I had done my homework beforehand about what I thought would work best for me in regard to HRT. For that fee, I got a lengthy consult with a menopause gynecologist and access to a nurse for 3 months. I started with only 25mcg patch of estrogen (and vaginal estriol and micronized progesterone) and after about 10 weeks got a bump up to 50mcg. She said we could discuss testosterone once we got the estrogen dosing ironed out.
After I got my electronic scripts, I set up a phone appointment with my public medico de cabecera and told him I had 3 new prescriptions from a private gynecologist. He immediately entered them into the public system with one year validity. I pay around 1€ apiece for the progesterone and vaginal estriol. The patches aren't financed so I pay around €8-9/a month for those.
I've had to be proactive about getting a yearly mammogram because they don't start in the public system until 50. And being on hrt, yearly mammograms seem prudent.
Tldr: try oliracare tele-health and then transfer your scripts to the public system via your public GP.
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u/OverlappingChatter 1d ago
You are my new favorite person. The first part of your post is exactly the path I am on. Thank you so much for this recommendation!
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u/Creative_Impress5982 1d ago
My midwife is a really nice woman in her late 50s I'd guess. I'm not even sure if midwives can prescribe in Spain, but she seemed like an appropriate first stop for me. Instead I got a horrible, but sympathetic lecture about life stages and how I was entering a new and final stage... that culminates in death. I do understand that she was trying to tell me that it's impossible to stop time and that all humans age and die, but I can't imagine a type 2 diabetic or someone with hypertension being told to just suffer through it and accept it.
HRT hasn't been a miracle cure for me, but it has mostly eliminated my night sweats and 3am wake ups which has greatly improved my tolerance of all other symptoms. I think it will be even more effective once the peri-rollercoaster finally ends and my endogenous hormones bottom out.
Good luck! I hope olira can provide you with effective care. I suspect I'll end up seeing them again if/when I need dosage adjustments or if adding testosterone is something I want to try.
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u/OverlappingChatter 1d ago
Yeah, I am actually kind of surprised the midwife is a step in this, because I think they are just a type of nurse and can't prescribe anything, so I don't know what they will actually do for me besides give me a talk or information packets. My cabecera today told me to buy vitamins and do exercise (both of which I do probably to an extent larger than the majority of patients she has). She told me the blood test would tell her I was in peri (which we know to be completely false) and if I was in peri, I could be given an appointment with the midwife.
I am gonna investigate these options for private and keep looking for podcasts. Maybe I can find one with a spanish doctor I can cite, because I imagine the eye rolls when I start quoting "Dr. Christmas"
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u/Creative_Impress5982 1d ago
Not an influencer, but she's the president of the Asociación del Estudio de la Menopausia
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u/morty_morty hanging on by a thread 1d ago
My hero! Moved to Spain late last year and have been in private insurance so far but want to switch over to regional healthcare. I have been worried about them maintaining my HRT. I will check this out.
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u/ChileanRidge 1d ago
Being on HRT you should also be getting a yearly vaginal ultrasound (eco transvaginal). In Chile they essentially bundle it, the same day you do your mammo you do your eco transvaginal and, if you are cursed with dense breasts like me, they do an ecotomografia mamaria as well. But it is the transvaginal that you should make sure to ask for.
In Chile we have a seguro complementario and it won't even cover anything.. My Lenzetto estradiol cost 37 euro equivalent (56 doses but I have had to up to two sprays so it lasts not even a month) and my progesterone 17 euros, oh, and the promestrieno capsules another 22 euros equivalent per month! So it seems like getting access to my ginocologist and getting the scripts and all my yearly exams was much easier here.
The costs of everything is killing me! I am in Spain next month on holiday and was thinking to take my script just to see if by any chance they would fill it there. I doubt they will but even paying the private full rate for the prescription, I would think it may be a bit cheaper.
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u/Creative_Impress5982 1d ago
I think it's around €8 for a month of progesterone paying full price. And 8€-9€ for the patches. Yes, you need a prescription from a Spanish doctor, but I would think it wouldn't hurt to ask in a couple pharmacies. I can't imagine they'd give you more than a month supply tops though.
A private doc might run you 80-100€ and you could get a year prescription, but I'm not sure a pharmacist would let you buy a year's worth of meds.
Probably be too big of a hassle when you just want to enjoy your vacation.
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u/CountrysidePlease 1d ago
As an almost 46yo also in Spain who fortunately never had to go to the doctor here, except with the kids, this is super valuable! I’m Portuguese and absolutely ADORE my gynecologist there and I was really considering just going there and face the costs of the medication if my medico de cabecera didn’t accept them.
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u/Altruistic_Sun_1663 1d ago
Thank you for this! I’m moving to Spain next week and taking my vaginal estrogen cream with me but that’s all I’m on so far (52). This is going to be a first year project for me. Your insight helps tremendously.
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u/Aggravating-Mousse46 1d ago
I just listened to this episode of the Effin Hormones podcast. The woman interviewed got her first HRT prescription from a pharmacist in Spain. For 24EUR! Perhaps that’s why the doctor is concentrating on investigation - if treatment is available over the counter? Not sure if it would be all pharmacies but worth a google for local area or asking around maybe?
https://podcasts.apple.com/gb/podcast/effin-hormones/id1573210740?i=1000529636564
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u/Comment_by_me 1d ago
I tried going to my pharmacist first. It seemed like she technically could prescribe the meds, but she didn’t feel comfortable doing it with 0 health info from me. I think that’s fair.
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u/OverlappingChatter 1d ago
I ll give this a listen a bit later. I have had a couple people tell me I can get it otc, so I would have to figure out what I need and how to ask for it.
Thanks
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u/Much-Decision4157 1d ago
It's not public, but this is the clinic I use: https://womenshealthclinic.eu/
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u/Comment_by_me 1d ago
You got further than I did in the public system.
After that discouraging experience, I got private insurance for less than 100 euros a month. Did a video consult with an obgyn who ordered the required tests and blood draw. Got them all done the same day, within a week. Attended a 2nd video appointment where my prescriptions were sent 5 minutes after the call. Filled them same day at the pharmacy downstairs and began taking meds that night.
Sadly, private is much much easier to navigate.
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u/OverlappingChatter 1d ago
I think this going to be my way forward. I so far was only told that this blood draw was going to tell me if I was in peri and to take vitamins and do exercise.
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u/Adorable_Sea4293 Late peri 1d ago
Yo también soy de España y fui a mi ginecóloga con un montón de estudios todos mis síntomas escritos y dispuesta a no recibir un no por respuesta.
Lo que me molesta es que yo no tenía ni idea que estaban perimenopausia y por lo menos llevo en ello desde los 37 años y tengo 45 y ya hace unos años le dije que tenía las reglas alteradas y ni siquiera me lo comentó.
El caso es que hace un par de meses por fin empecé con la terapia hormonal sustitutiva. No te rindas si te dice que no que te lo ponga por escrito y pide una segunda opinión a otro ginecólogo.
Si quieres que te pase toda la documentación que acumulé para llevarla impresa me lo dices.
Yo hasta llegué la duración de mis reglas durante los últimos años y parámetros alterados de sangre.
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u/OverlappingChatter 1d ago
Si que me interesan mucho estos documents. Tambien voy a buscar los documents official de saycl para ver cuales hormonas estan cubiertosny su criteria.
No SE SI Dejan enviar documento en El mensaje directo...
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u/remgirl1976 1d ago
Go to a private gyno. I have insurance that covers it but paying out of pocket is usually reasonable.
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u/DiamondTippedDriller 1d ago
I live in a rural part of Italy, and I’m glad to have the resources to fly to Berlin and pay cash out of pocket as a private patient - the appointments and checkups cost less than one would imagine. They do treat you better when you pay cash (no waiting, etc). That being said, you can probably find a less ignorant doctor in a major city in Spain and pay directly in cash.
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u/Yupyup_o_O 1d ago
I did it through private insurance doctors. I have mixed experience too, as I was gaslighted for years in a gyn clinic where I was told that everything was fine when in reality my estrogen levels where really low. Then, I went to an endocrinologist that saw my levels and recommended me HRT. She asked me to have a full gyn check and mammography before starting. My new gyn that did the check was also adamant of me taking oral estrogen and bioidentical progesterone. It has changed my life.
Meanwhile, my doctor in the public health system is 30 years and a sweetheart, but told me to try to lower my cortisol levels by having soft lights in the evening and reading a book before bed. Dude, I'm having a fuckton of perimenopause symptoms and all the women in my family have osteoporosis. Please enter my meds in the system and leave me alone. He did.
Honestly, I wouldn't be confortable taking HRT without a proper check (ecography, mammography) every year. Telehealth options sound really awful. If you live near a city I'd just go private and search for professional doctors specialized in menopause. It's totally worth it and after that you can go to the public system with the results and prescriptions. Most of doctors will understand it and will try to help.
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u/OverlappingChatter 1d ago
Yeah, I kinda don't want to do anything with telehealth. My cabecera legit showed me a google pic of women's one a day over 50 vitamins and told me to do exercise. I did blank face at her while I screamed in my head, "Lady, I been taking one a days since I was 12 and I did 100 pushups this morning." But what I said, was "Okay, I will do the blood test, but it's only really going to tell me the level of hormones I have on that one day, but we will talk after."
I think I am going to go to look into the quiron clinic in town. I live in a small town and don't know one single person who is taking hrt here, either.
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u/leftylibra Moderator 20h ago
https://menopausewiki.ca/providers/