Wants to give me prozac for perimenopause...

[wonderwoman21]

I am sure you lovely ladies may be able to help or commiserate maybe!
For the last year or so I have been experiencing quite extreme symptoms of fatigue, aches and pains, temperature changes, anxiety, and extreme PMS. I believe I am at the perimenopausal stage. I had postnatal depression before and was not myself during puberty. My best time of life was when I was pregnant. My symptoms all add up to hormonal fluctuations.
Then I had a period that was heavy, very painful and lasted three weeks. I believe this is all connected to hormonal changes.
Of course, the doc refused to do a hormonal check , suggested I get a coil fitted in hospital and just some painkillers. Then he suggested prozac which I don't want to take due to the side effects and the bad reputation that the anti-depressant has.
I have been very worried about the extreme PMS, my very low mood and anxiety and the extremely heavy bleed which I have never experienced before in my life. I worried about cervical cancer and went back today to see a female doc and asked for a smear. She refused it, said it was a screening procedure (which I know) and that it was unlikely to be cervical cancer anyway! Okay, that is nice and reassuring but I'd still like to know. She said to get a smear, I'd have to request one privately. This explains all the poor women and girls who ask for a smear because of unusual symptoms and getting refused one because of the NHS rules. So I asked to see a gynecologist to see what caused the extended bleed and general advice as to what is going on and got refused that too! As I had an internal examination/scan over a year ago which only showed small fibroids (which she said must have caused the excruciating pain I experienced during this last period, pain I'd never had before), she considered it wasn't necessary and that my best course of action was prozac! In other words, my anxiety is to blame...She never asked how heavy the period was or anything.
I have magnesium oil spray that I use, am going to get Menopol that I have heard is very good but has anyone any other suggestions with regards to all this? I hate feeling so awful with all these symptoms and not being taken seriously.
Thank you

[AuntieStella]

Are you up to date for smear tests? If so, then it's correct not to carry one out now (your symptoms don't sound like a cervix problem, but even if they did what you would need once symptomatic is colposcopy not smear).

I do think you should go back and see another GP and push for a scan and a gynae referral. Marked change to menstrual cycle is a symptom that shoukd not be ignored on age grounds. It may be that your fibroids have grown, or they you have developed something like endometriosis or adenomyosis. And knowing which it is might affect treatment choices (mirena coil is sometimes a very good option).

[wonderwoman21]

Thank you AuntieStella. I asked for a smear because I've had laser treatment on my cervix before for moderate dyskaryosis but now my smears are up to date. I will push for another scan and a gynae referral. Thank you :-)

[pinkfrocks]

How old are you now?

[pinkfrocks]

Okay- let's look at all these points in turn.

I think you have been treated very badly. prozac and other ADs are not 'first line treatment' for menopause though many drs are quick to prescribe these, mainly IMO to get women out of the surgery. ADs have no place in the treatment of women aged 45-55 who- as part of peri- are having symptoms like depression and anxiety. HRT ought to be the first option unless there are reasons not to offer.

How long since your last smear? If it is under 3 years- and you have one every 3 years- then cancer is unlikely to be the cause of the bleeding. If you really want a smear then you can pay for it privately- it's around £50.

I think you need to decide what you want. Heavy periods are normal leading up to menopause, for many women. Your dr was right to suggest a Mirena coil (IMO) as an option but the gold standard for someone with your problems would be the Mirena to control the bleeding and oestrogen as a patch or gel to help your mood. This is what many consultant gynaes who specialise in menopause would suggest.

It's unlikely that a scan would show anything more than was found a year ago. I have a small fibroid which was found 7 years ago but it's never grown even though I use HRT.

Painful periods and worse PMS are both very common peri symptoms. If you are able to consider HRT then in your shoes I'd ask to try it and see how you feel after 3 months. It would regulate your cycles after a while and the bleeding may well be less.

[wonderwoman21]

Thank you very much pinkfrocks for your response.
I think because of I have suffered from anxiety for many years now that I am being fobbed off as a neurotic, health obsessed woman!
I am 44 years old. It was because of this unusual heavy and very painful bleeding that lasted three weeks and prior to that incredibly bad PMS which led me to the doctors. The symptoms and sensations that I experienced were intense, and I still feel them sadly, though not as bad now as I have come to the end of that period.
My last smear came back normal and was about a year and 5 months ago, so I am not due for another yet. I think I was just trying to rule cancer out. And as a scan was performed not that long ago either, perhaps that also wouldn't show any abnormalities...again, that was to put my mind at rest (being the anxious, neurotic woman that I am!).
But I will go back and push for an appointment for the coil (they couldn't put it in at the surgery because of the way my cervix is positioned) and also oestrogen as a patch/gel to help with the symptoms. And I even a scan just to be absolutely sure there isn't something else going on.
I think sometimes you really have to push to get your needs met, which is quite sad really. Sometimes it feels as if they are playing God with your life. But never to give up!
Thank you again for all your really helpful comments.

[pinkfrocks]

Hope you get some better treatment.
TBH if you had CC and were bleeding from that it would be advanced and a Dr would be able to see the cervix on examination - so at the very least they should take a look even if they don't take a smear.
The usual thing is to treat heavy periods as a peri issue unless you have other symptoms that make a scan necessary. A good dr should be able to feel large fibroids etc by examining you.

[VenusRising]

Sorry to butt in LaQueen you sound very like me. I've pm'd you with a question.