To ask you what more I can do- Peri menopause

[Locksticks]

Hi. So I’m 40, and almost two years ago I noticed a few changes in myself. At the time I chalked it down to stress as I had a lot going on. Things didn’t improve and i started having problems with my sleep, then along came the hot flushes, night sweats, itchy skin, brain fog, unusual aches and pains, more frequent urination, and then all of a sudden I was an emotional mess eg crying over nothing, feeling irritated etc. Well fast forward to now and I still have all these symptoms along with rage, low mood, dark thoughts, loss of libido etc.

Back in 2021 i went to see my Gp and she prescribed me anti depressants. I didn’t know what was going on with me at the time and certainly didn’t suspect peri menopause so I reluctantly agreed. I stayed on them for 8 months and then eventually weaned myself of them as they made me feel worse and did not help alleviate my symptoms.

I went back to my doctors on two occasions last year and they agreed to do blood tests to check my hormone levels which came back normal and so that was that. Fast forward a year and I’m now feeling what I can only describe as utter desperation. My mood is terrible I’m constantly snapping at my husband which he does not deserve, I have reduced contact with friends and family because I’m exhausted as I get around 4 hours sleep each night. I am also autistic and since my peri symptoms got worse i’m less able to mask so don’t feel comfortable being around certain people.

FWIW since starting with these symptoms I’ve done what the doctors have suggested eg quit smoking, changed my diet and lost weight, reduced my cholesterol, took more exercise, tried anti depressants, stayed on the contraceptive mini pill despite not wanting to etc yet my symptoms have not improved. All I want is my old self back yet my Gp clearly thinks I’m just depressed as opposed to peri menopausal.

Can you see a different Dr? Diagnosis of perimenopause should be done on symptoms as well as (if under 45) blood tests. It's understood that blood tests can be difficult to diagnose as hormones can fluctuate - they should measure FSH levels on 2 separate occasions and tricky if you're taking any hormonal treatments at the time. www.nice.org.uk/guidance/ng23/chapter/Recommendations#diagnosis-of-perimenopause-and-menopause

I'd suggest you see your GP again, say you've tried lifestyle changes, take a copy of the attached with anything relevant ticked off and (if you wish to) request to try HRT. If they are resistant to your trying it do ask why - ask them to explain why your symptoms fit perimenopause yet don't all fit depression (itchy skin and bladder frequency are classic menopausal sympotms).
menopausesupport.co.uk/wp-content/uploads/2020/11/MENOPAUSE-SYMPTOM-CHECKER-Nov-20.pdf

If needs be ask to be referred to a menopause specialist (though if you have one in your area this will take quite a while)

PS really well done for quitting smoking

Hi. Yes I’ve seen three different GP’s up to now. They all said the same thing that I’m to young but my mum started with peri menopause at 39/40 and my Nan was the same. At my last appointment I asked for a trail of HRT as I’d already tried antidepressants but the Gp wouldn’t budge. The only thing she offered me was the mirena could but I categorically do not want it. I’m only continuing with the mini pill as I used to have really heavy periods. My husband has had a vasectomy so I don’t need it for contraception.

I was exactly like you described in your opening post and the same age too. I agree with the PP about seeing a different GP and being very firm about trialing HRT, I tried patches and it was honestly life changing - it's not 100% perfect and I still get some symptoms but my anxiety is back down to manageable levels, my sleep has improved, my hair is growing back, and my moods are more stable.

Mirena is one of the options for progestrone part of hrt then you would use estrogen patches or gel too

You're not too young. Point your doctors to the menopause doctor in Instagram. She's just written a book actually

OP,

Some GP's are relentlessly obtuse about peri menopause, but from your symptoms it does indeed sound as if you are in the trenches early.

First off in your shoes I would research a good menopausal supplement and start taking it.
Vitamin B complex and Starflower oil was one that friends recommended to me which really helped.

I would seek out a highly recommended acupuncturist which will help to balance you out.

Likewise a good herbalist would help ease flushes and regulate your sleep.

Menopause is a dose and you will be waiting if you expect most GP's to save you.

You will have to investigate and research alternatives that can definitely ease how you are feeling.

Having a low/zero tolerance for bullshit/annoying people/red wine were all a factor of my menopause.

My tolerance for red wine was the only thing that returned thankfully.

Mind yourself.
Self care is critical to how you will get through it.

The Mirena pill can actually be quite good for heavy periods - it knocked mine totally on the head. The only thing was, as my Dr told me, I wouldn't know when they'd stop naturally. It can also be used as the progestogen part of HRT.

I would try again and ask them to explain your symptoms as they can't all be caused by depression yet are included in the menopause symptoms checker. Mention your mum and nan and say that although you're aware of the average age of menopause(45-55) you're also aware that not everyone is "average". Push again in asking for a trial and if unable to help then a referral.

If need be contact the Practice Manager to discuss this further and how you might be better supported by your GP.

This post is really interesting to me OP as a lot of it resonates with me too. I’m too young at 37 though…

I had blood tests 8 years ago which showed it didn’t look like I was ovulating so that was the first sign… and I now have almost every symptom on the list that a PP put up (just not increased urination or hot flushes).

I have ADs which help but certainly haven’t cured.

but how do you know for sure if it’s peri when the symptoms are so general - it almost feels like a waste of time me even speaking to a GP about it

Get your vitamin b12 levels checked. Menopause and pernicious anemia have very similar symptoms. But if untreated pernicious anemia can cause long term damage so you should get that ruled out before assuming you are definitely in menopause. If it is pa, it can be treated with a course of injections.

I'm 37 and going through the same thing, I feel like I'm going crazy whilst being completely lucid.

I've written a letter to the practice manager begging for help because whilst my Dr is lovely he just doesn't get it.

I can't live like this anymore.

I've got some Peri symptoms. But I'm also on the pill so the GP I went to explained that the pill has the same hormones as HRT so would be masking /improving symptoms for me. She felt that I might as well stay on it as it's also birth control and if I went on HRT I'd have to stop taking the pill and then I'd need to figure out a different form of contraception.
I did get my bloods /thyroid checked and all were fine. I'm also taking vitamin D and K2 spray along with a tonic supplement.

OP: I am wondering about your 8 months experience with anti-depressants (SSRI?), if you can elaborate on it (were you in regular contact with the physician who prescribed them to you, increasing dosage/ trying a new anti-depressant over time.. and how did you feel taking them)?

If you can afford it I would recommend seeing a private consultant for some initial advice and tests at least. I did this a couple of years ago. My hormone issues were complicated and not peri related (or at least not wholly). I felt listened to, and the blood tests were useful. Let me know if you’d like an idea as to costs.

Sounds like you're having a really tough time. So everyone's experience of peri and menopause proper is different it seems but I would say herbs have helped me a lot.

Sounds like sleep is probably your number 1 issue as without sleep everything is shit, period. I would recommend sorting good sleep hygiene asap - no screen past a certain time, drink chamomile tea and then also maybe take something like this (this works wonders for me) https://www.avogel.co.uk/herbal-remedies/valerian-hops-dormeasan/.

Also try some relaxation exercises or 'sleep stories' if you wake up in the night - Calm app or Headspace have some great ones. You can listen to them and they help you drop back off again.

I was going through a period of waking up at 5.15am for weeks and have managed to retrain myself back to waking at 6.30-7am now which isn't exactly a lie in but better than it was.

If you have hot flushes people also recommend you have you own duvet but I am sure someone with experience of hot flushes will be along soon to help with that!

Ah also diet - are you on a menopause diet? As you'll be short of a lot of minerals etc now. I am eating loads of soya (it provides plant based oestrogen) and nuts, seeds and so on. I went to a herbalist to get my diet plan and its helped a lot, plus an anxiety reducing tincture. I'm not anti HRT at all BTW, just not needed it myself yet as herbs etc have helped loads.

I also use this on my legs which is an additional help for sleep plus ups your magnesium.
https://www.hollandandbarrett.com/shop/product/betteryou-magnesium-sleep-mineral-lotion

My peri started at 39/40 and your GP is an absolute idiot. Most of them are.

The best thing you could ever do for yourself is to go to a private Peri/menopause clinic.

Definitely go back. Ask if your practice has a menopause lead, many do.

Aside from that, the only thing you haven’t listed that might help is to quit alcohol. Made a HUGE difference to my weight, mood and energy levels going through menopause.

Handhold here. Just be persistent and ask directly for HRT. I tried for almost 5 years to get my surgery to speak to me about menopause - my peri started at around 36.

I was tested instead for diabetes (twice - just for context, I am in no risk category for T2D and had a BMI of 20 at the time), anaemia, and thyroid issues, before being told that my symptoms were 'just my age' as if that's a diagnosis in its own right.

After skipping 3 periods and them then returning (according to the GP that was stress apparently, and not hormone related!), they ran blood tests (which turned out to be pointless really as all looked 'normal') but agreed that after a further year of waiting they would consider HRT. They finally relented when I was 43, had waited said further year, and cognitive symptoms were causing me difficulties on a daily basis so I called and asked for a prescription.

I don't understand why depression and stress seem to be the 'go to' diagnosis for GPs, when hormones are blamed for almost everything else relating to women's behaviour and health throughout our lives.

I really hope they help you out OP. Ask for a well woman check? Maybe that will get you to a different practitioner in the surgery.

Just a thought on the pill. Last time I was prescribed the pill it hugely increased my symptoms, so I stopped taking it at that stage. Sobbing at my desk and overwhelming paranoia and irritation were not manageable on a daily basis. Wold you consider stopping that to see if it helps?

Agree with PP that it would be worth having an appointment with a private HRT consultant.
It costs a few hound pounds for the initial consultation, blood tests and HRT creams but definitely worth it if your life is being so badly affected by the symptoms.
I used “The Hormone Clinic”. It is based in the East of England but the consultations etc are all done via zoom and can all be booked via their website. HTH

Make a complaint directly to the practice manager and ask why on earth they are not taking you seriously.

Request a face-to-face meeting if necessary. I would honestly fight for this.

But it sounds like OP really does need HRT.

How common is pa? Because I’m assuming it affects less than 100% of women, which is how many menopause affects. So what’s more likely?

It’s exactly this attitude that women are having to fight against. It seems that GPs will diagnose a 40-year-old woman with anything except perimenopause…

Sure, with her family history - she also sounds like she needs more help right now especially around her sleep. Also, not all women can take HRT/ it's not a magic bullet.

I would suggest going to a private consult. I ended up doing this, as I was sick and tired of different doctors from my surgery refusing to consider that I could be peri-menopausal. Private consultant diagnosed me and I'm just sorting out my HRT prescription.

@Aquamarine1029

I would agree with this - opt out of the NHS and go private for issues like this if GP is no help. There are lots of specialists who will treat you without issue and the private sector is well ahead of the NHS with what they can offer you such as testosterone for libido loss etc.
good luck OP