42 and skipped some periods. Is GP visit advised?

[Wellhellothere1]

Hoping someone can advise as I can't really find out the answer online. I'm 42 and usually have a fairly regular cycle. I missed a period last year and saw the GP and she suspected it was due to me running a lot more than usual. This year I missed a period in Feb and my last period was at the start of August, so I've missed September's period almost. I think I've had a few hot flushes but this may be in my imagination!
Is there any point going to see my GP do you think or do I just get on with it?

[Heratnumber7]

No point, unless you want to go onto HRT. I've not had a period for several years. It's bloody great. I've never bothered with going to the GP.

[YesILikeItToo]

I told my GP about this and he was super-unconcerned. Just said that these things happen and the worst of it is planning when to have towels in your handbag. Mine seem pretty random now, I'm your age

[Wellhellothere1]

Thanks. The lack of periods don't bother me at all. I think I'm more concerned about what the menopause will do to my face

[notangelinajolie]

Mine stopped at 37. I had a baby and they just never came back. Can't say I missed them . I mentioned it my GP years later and he wasn't the slightest bit interested.

[Wellhellothere1]

Notations-did you notice your skin became drier? Think this is what bothers me most.

[Wellhellothere1]

Notangelina not notations!!

[danTDM]

I'm 46, mine stopped just like that 2 years ago. Face no drier, waist a bit thicker if I have to find something. I do look after myself a bit more now though. I probably look better now tbh.

[PollyPerky]

I'm really shocked at the GPs who have dismissed some of you- it's medical negligence based on ignorance.

Sorry if that sounds a bit arsey but the fact is that having no oestrogen 15 years or even 10 before the average menopause is a BIG risk factor for osteoporosis and heart disease in later life (and by that I mean 50 not 90!)

Anyone who has a premature menopause (classed as before 40) should hot foot it to their GP for a DEXA scan - bone density.

The same applies to periods stopping before 45.

This is the clear, unequivocal advice on NICE and there is a charity that advises women on early menopause - //www.daisynetwork.org.uk
It's co-run by one of the top gynaecologists in the UK and his advice is HRT for early or premature menopause.

There is no risk with HRT before 51-ish as all you are doing is putting back what you ought to have.

Seriously- you need to ask for bone scans and not wait till you are 50+, break your wrist or ankle easily and find you have osteoporosis.

Not trying to scaremonger but this is fact.

[notangelinajolie]

Skin fine. Hair loss is my problem . My hairdresser keeps recomending all kinds of wierd and wonderful pills and potions but unless I come into money sometime some they are way out of my price range.

[PollyPerky]

There is a link here to a paper on HRT and POI ( periods stopping before 40) You will find the paragraph on page 63- premature ovarian insufficiency- and the dangers listed of early menopause. Although this paper talks about under 40, it also applies to the 40-45 age range.

Nick Panay was the former chairman of the British Menopause Society and runs the menopause clinic at the Chelsea and Westminster Hospital, London.

//file:///C:/Users/User/Downloads/menopause_int-2013-panay-59-68%20(1).pdf

[danTDM]

Not fact here in Spain, they do not have this opinion at all. Healthcare her is fabulous. I am very well and do not need HRT thanks! With HRT, the advice changes constantly, the menopause is completely normal and natural.
Perimenopause is normal in your 40's.
50 average menopause, when it's all over, gets bandied around, but most people I know here and in UK had menopause well before 50 and are not on HRT and are all fine and fit as fiddles.

If you are early 40's OP I really think you will look as such, just because someone is 50's with periods will not make them look younger than you!

[Wellhellothere1]

Thank you so much Polly. This is exactly the kind of information I'm looking for. I'll spend some time reading this and then see my GP.

[danTDM]

42 and periods slowing down is not premature menopause

[YesILikeItToo]

Gosh, Polly, that's alarming. I think my GP's point was that he thought that it wasn't a sign of menopause. Can't recall what made him think this, but he certainly seemed to be ruling it out.

[PollyPerky]

Dan 42 is early menopause and before 40 is premature menopause.
Here is an NHS link explaining it.

www.nhs.uk/Livewell/menopause/Pages/Prematuremenopause.aspx

[PollyPerky]

It depends on what you mean Dan. If you mean periods still dribbling on and being irregular at 42 yes, that is not early menopause. But if they stop completely at 42, then it is.

[PollyPerky]

The fact that some women are 'fine' if they had their menopause early is not a scientific study is it? How can you tell what is happening to their hearts and bones by their faces? The effects of an early menopause aren't obvious for maybe 10 or more years in some women.
Anyway- it's not me you should argue with about it- but the experts! They've done the research and made clinical decisions.

[OctoberCarrot]

Thanks pollyperky for important info. At 44 I have not had a period in nearly 3 years. Wasn't overly concerned but will make a gp appointment this morning to get everything tested and take what is needed. Family history of heart disease so pretty panicked.

[fatmumma]

Have been into see Dr about absent periods have been fobbed off with what is now in the press as unnecessary blood tests. Yet I am the one that feels guilty for making a fuss, should be Drs.

I have been suffering for years with various symptoms of the menopause but Dr not interested

[PollyPerky]

fat you have to make your dr listen. Go in with a list of your symptoms. Take the list on the NICE guidelines under 'diagnosis'- all linked to on here loads of times . Also listed is the fact blood tests aren't worth doing. If your GP is useless you will have to go along and politely explain all of this and not give up.

You have to be assertive sometimes to get what you need - or change your GP- or ask for a referral to a gynae if your GP doesn't have a clue.. Last resort pay for a private appt and get some expert help.

You really don't need put up with this nonsense from them.

[Wellhellothere1]

Just wanted to feed back on my GP visit this morning after all the helpful advice from Polly. I've not had a period for nearly three months now but have no vasomotor symptoms. I think I feel a little 'braIn fog' but nothing too bad.
Anyway the GP explained I was probably peri menopausal and my periods may well return (but obviously may not). She didn't check my FSH levels as she said these would only be recommended for women under 40 who are experiencing premature ovarian insufficiency. And FSH levels fluctuate so may not give an accurate picture.
I asked about HRT for osteoporosis prevention and she said they wouldn't prescribe for this indication as HRT is not licensed for this. Only licensed for vasomotor symptoms. She said as long as I had a diet rich in calcium and did sufficient weight bearing exercises I would be low risk for osteoporosis.
With regards to cardiovascular prevention, she said the jury is still out on if HRT protects. The studies are conflicting. And again HRT is not licensed for this.
So she was very nice but I think the message was only to start HRT if I start to get bad vasomotor symptoms. Not sure how I feel about this.... Just processing it all really at the moment.

[PollyPerky]

Glad you went to the GP but she's a bit out of date on a couple of things. If you feel strongly- and after all it's your body and your life- I'd think about doing some research, printing stuff off and going back.

The NICE guidelines are very clear that HRT should be the treatment for women with menopause under 45 (some consultants raise this to 47.) The guidelines also say don't do blood tests on women under 45, not under 40. As you are 42 she ought to do blood tests.

This is from Menopause Matters ( person who writes this is chair of the British Menopause Society. www.menopausematters.co.uk/pm-definition.php
Premature Menopause: Definition
Premature menopause, or premature ovarian failure, is frequently defined as being menopause that occurs before the age of 40 years, but in the developed world, it is thought that it should be defined as menopause before the age of 45 years, the loss of estrogen having particular long term health risks in this age group.


If your periods do stop before 45 then HRT is recommended for both bones and prevention of heart disease. The jury is not out on it, as several studies show that HRT started within 10 years of the menopause protects against heart disease- it's called the 'window of opportunity'.

HRT is also available for women with low bone density. There are many consultants who would offer this to women under 60.

I think you have to see how you go and if your periods stop before 45, ask to be referred to a consultant for a 2nd opinion. If she won't agree, raid your savings and pay for the initial appt.

[PollyPerky]

sorry :) senior moment. (typos) blood tests not to be done on women over 45! But 42, yes!

[PollyPerky]

This is an extract from this paperwww.imsociety.org/manage/images/pdf/a823762338f365490761dccd8e792ccc.pdf The paper is on the website of the British Menopause Society website- defintely worth looking at for up to date research and statements.

"Together, the accumulating evidence suggests
that initiation of MHT early after menopause may beneficially
affect CVD risk.
The ‘timing hypothesis’ appears important when considering
MHT effects on mortality. It is noteworthy that even in
the WHI – which included women with a mean age of 63
years – the mortality in the intervention group was not
increased (HR 0.98, 95% CI 0.70–1.37)86. In a meta-analysis of
19 randomized trials of postmenopausal women, mortality
was significantly reduced in the women on MHT aged under
but not over 60 years95. This is supported by a recent observational
study with over 290 000 MHT users showing that
protection against cardiovascular mortality was more pronounced
in younger MHT users96. Furthermore, a recent
Cochrane review also showed a significant reduction in allcause
mortality in women initiating MHT within 10 years of
the onset of menopause91. It has been estimated that ‘the
avoidance of estrogen’ in newly postmenopausal women (age
50–59 years) following the publication of the WHI in 2002 has
led to almost 60 000 excess deaths in women in the US during
a 10-year period97.

Further, evidence from a Finnish population-based,
observational study suggests a transient increase
in risk of CVD mortality in women who discontinue postmenopausal
HT98."

[Wellhellothere1]

Thanks again for your time Polly. I'll have a good look at all of this and either go back to my GP in a month or so or look into seeing someone privately.