To expect my GP to investigate possible early menopause?

[Albadross]

I've been to see various doctors over the past year or so and told them my periods are getting further apart and I feel hot and prickly a lot. It sort of feels like I'm blushing profusely but I know I'm not.

I had IVF 4 years ago because my AMH level was virtually 0 (I had no eggs left), but at the time my FSH levels were normal. I'm only 36 so GPs fob me off and haven't even checked my hormone levels since.

In the lead up to having the IVF I'd had the worst night sweats imaginable but none since after giving birth.

AIBU to expect some further investigation, or will they just say there's nothing they can do even if I am starting the menopause now?

Is it because you want another baby?

No I don't think I'm able to anyway, but I'd like to know if taking the pill will worsen things or stabilise them - I can't cope with the adverse effects of everything being so imbalanced all the time

YANBU but you might have to put up a fight.

I first went with Meno symptoms age 29. I was finally confirmed as having post-menopausal FSH levels at 36. It took a lot of visits to persuade them to do the blood tests.

It wasn't so much that the GP didn't think it was happening, it was more that they weren't that bothered. To them it's not a medical problem, it's just a timing issue.

To me at the time it was a huge issue and it took me quite a while to come to terms with it.

I am now on the contraceptive pill as HRT. It really helps with symptoms and it is meant to help with bone density.

Now I am out the other side I'm quite glad I've got it over with, but it didn't feel that way at the time.

Even if you are starting the menopause now the only thing really to think about is protecting your bones so giving you oestrogen in the form of HRT or the pill is probably the best thing to do. Have a look at the menopause matters website.
You certainly need hormones though.
I do think mentally it is a hard thing to come to terms with when you are young so having a definitive diagnosis is important if you need it.
Sorry you're going through this so young.

The blood tests aren't very reliable as they can change (which is why a lot of GP's wont automatically send you for bloods), and in early peri-monopause - the stage before you stop bleeding all together can last for years with a range of symptoms which include, hot flushes, forgetfulness, achy limbs, needing to pee a lot and quickly, getting angry or crying for no real reason - the list goes on. You reach Menopause official one year after your last bleed.

I had a very supportive Junior doctor, and she researched a lot for my visits on menopause. I'm on HRT at 45, as she was worried about my bones. As Music says above MM is a fab website for learning more and talking to other women. And if you feel you can't cope with the symptoms, keep visiting your GP as it could be something else altogether.

Yanbu. Even if it's not, at least they can rule it out. But if it is, it's important that they start you on HRT for your bones.

Go back and insist. It really pisses me off that so many women are dismissed by their Drs and that a lot of GP's don't seem to know about NICE guidelines.

Have you read up about what type of investigation you would want? I would suggest seeing your GP and being specific about what you want so they can either explain why they don't think it's necessary or can arrange it. I would suggest two FSH tests, at least one month apart. As a PP said, the tests for menopause are extremely unreliable unfortunately.

Thank you all - I'm now taking progesterone only pill but I guess maybe I need the estrogen one instead perhaps? I've also got a long history of anorexia and calcium deficiency as recently as 4 months ago, but my notes are pages and pages long and summing it all up is difficult so it sounds like I need to ask about FSH tests again.

The situation with my fertility was really sprung on me so I've not really allowed myself to think about what it means for this to be happening. But I think as a minimum some balance would help me deal with all of this. As it is I feel like my life is totally out of my hands

Have you directly asked? My (lovely)GP told that if I want any further tests/ treatment for my ongoing arthritis I have to ask because he may not realise if I hint

What investigations are you concerned that you need OP?

You are certainly young to be menopausal but as pp said, the menopause is defined as a full year without a period. The problem with peri menopausal symptoms (and your symptoms do fit for that) are that investigating often doesn't find anything. The peri menopause can last for a decade or more - we have no way of telling. FSH and other hormone levels are pulsatile, so their levels vary through the day. Checking those levels while you are still having periods is often requested and often done (dare I say especially by male GPs who then suggest follow up with a female GP to discuss the results) but ultimately not very helpful clinically.

Having said all of that we can manage your current symptoms. The combined pill may well help your symptoms more than the pop and if it's otherwise suitable/safe for you to take it then it's an excellent choice at your age. So that would be worth discussing.

Also worth considering that menopause can make women feel regretful of life choices re: children etc no matter what age it comes. If you have had fertility difficulties then I'm not surprised you are feeling more sensitive than someone else might about the possibility that your fertility may be finishing for good. I'm sorry if it makes things feel even more unfair and more frustrating that you can't get a straight answer.

Sorry that was long

your bones are at risk with early menopause (if that is what is happening here) and you have the added risk of osteoporosis with your history of anorexia.
Go to your GP and insist on some blood tests.
If you are menopausal/perimenopausal you SHOULD go on HRT for health reasons at your age.
A previous poster stated 1 year without periods means post menopausal. This is incorrect - 2 years period free if under 50, 1 year if over 50

takemetomars the 2yrs under 50/1yr over 50 refers to how long a woman should be using contraception after her last period. The definition of menopause is the same whatever the age.

And the combined pill does the same job as hrt in younger women as regards nine protection. It is often a better option though because it provided contraception as well as symptom relief and bone protection.

The other point OP is to check which progesterone only pill you're on - if it's cerazette/zelletta then that in itself can mess up your periods, although wouldn't cause your other symptoms. So as I said above, all worthy of further discussion, if not necessarily investigation by way of blood tests

bone protection. Don't know why you'd want to protect your nine?!

I've also got a long history of anorexia and calcium deficiency as recently as 4 months ago

What is your BMI now, and what is your calcium status?

Anorexia is a huge risk for osteoporosis, it's more dangerous than early menop, not simply because no periods, but the long term nutrient deficiency. If OP is 36 now she may have 20 yrs of anorexia behind her.

Friend was diagnosed as having bone thinning while still in her early 30s, you're not too young for bone density scans.

lljkk you're right of course about bone density scans - but that's independent of OP's menopausal status (although any menopausal treatment would help her bone density, if she already has osteoporosis the treatment would be different)

I'm not entirely sure what I expect to happen - I guess because of how I'm feeling I just want to know if it's that or something else and virtually everything I talk to my gp about is put down to my ED - and I was first diagnosed in 1994 and have repeatedly relapsed ever since.

The last time I had a normal cycle was in 2011 and that was whilst on the pill, so until the last year I haven't had a natural period.

My current BM1 is 21 and my last calcium check after 3 months on double dose calcium/vitamin D was normal. I have no idea how long I was deficient before that but my BMI was

If you are genuinely concerned, then insist on it being investigated further and/or that you are referred for a second opinion. You have a right to have your concerns looked into. I had a hysterectomy in my 30's (kept my ovaries) and I've had menopause symptoms on and off since - I couldn't tell you if I've been through it or not, I was in such a state after my hysterectomy - and the doctors haven't been great. It's difficult getting them to take you seriously but you have to keep pushing and insisting.

If your doctor is being dismissive, ask to see another one in the practice, or if that doesn't work, request your records - usually freaks them out and they'll take you more seriously.

If it's the menopause then mooost women get hot flushes, not night sweats. They happen at all times of the day and it feels as though someone has turned the thermostat up by 5-10 degrees. You feel incredibly hot for 5-10 minutes and then return to normal. Sweating at night and hot and pricky sounds different. If you are concerned it may be the menopause you could ask to have your hormone levels checked so you can take HRT to protect your bones (the breast cancer risks just apply to women taking it after the average menopause age.) It sounds as though you'd be better concentrating on developing a better relationship with food rather than moaning about your GP though as having a low BMI can muck up your periods and hormones. Getting all stressed about hormone levels and introspective about your health might just make your anorexia worse. If your BMI was 15 a year ago I'd give it a few more months, but if you do decide to get your FSH checked be specific about what you want checked and why when you see your GP.

If it's the menopause then mooost women get hot flushes, not night sweats. They happen at all times of the day and it feels as though someone has turned the thermostat up by 5-10 degrees. You feel incredibly hot for 5-10 minutes and then return to normal. Sweating at night and hot and pricky sounds different

I'm sorry, but that's not true. Everyone's symptoms are different and night sweats are a well known symptom of the menopause (although it could also be something else). Formication, which is a prickly sensation a bit like ants crawling over your skin can also be a sign of menopause.

I don't get the night sweats anymore - they stopped when I got pregnant and have never returned. The thermostat thing is exactly what I feel - I work in an office with air con and whilst colleagues say the temp is fine, I'm there flushed and flustered.

2rebecca I now have a normal relationship with food. And you came off a little insensitive there Yes I'm moaning, because I've been to see them multiple times and they've not even implementing the most basic checks as advised months ago by my psychiatrist - I specifically asked them what bloods I would need to pick up deficiencies quickly as a harm reduction strategy, and they did nothing.