To pay for a private menopause clinic as GP so useless?

[Nearly40mumof4]

Hello, first time poster here. I’ve been struggling with my hormones for as long as I can remember. I had HG with every pregnancy and was hospitalised a few times with the vomiting, but when breastfeeding I was totally fine. My mum had a hysterectomy when she was about my age (39) and so I think there’s a strong hereditary aspect to this. Fast forward four children (youngest 4 now) and I think perimenopause has begun: shorter cycles, really horrible symptoms (mainly psychological and mental rather than physical) Seen GP several times but useless. I can’t tolerate hormone birth control as seem v sensitive to progesterone and nothing they suggest helps. I’ve tried all the mindful stuff etc etc but doesn’t seem to make much difference. I’m healthy weight and have a good diet and active lifestyle and have popped every supplement known to man. The symptoms come and go like clockwork, half the time I’m fine, the other half, I feel like a different person.

Even though we’re not well off, should I try a private menopause clinic? Do you think it’s worth it? A local clinic in York said £250 for an initial consultation.

Have you tried changing your gp? Or asking them to refer you to your local nhs menopause clinic ?

No I haven’t, but that’s a good suggestion. I have never thought about that, I didn’t know local menopause clinics existed. I have just been fobbed off and have it suggested that I’m either stressed or mentally ill (depressed or anxious), but I’m fairly certain I’m not, as the symptoms coincide with hormone changes during the month. I did agree to some talking therapy via the gp and they were nice but basically referred me back to gp and said, this woman is not mentally ill, she has hormone problems.

I'm 42 and as far as my Go is concerned far too young to need any assistance. I'm really struggling with the effect on my mental health, for 2 weeks out of every month I feel like myself, I'm happy, chatty and energetic. The week of and before my period I'm an anxious mess, even driving is hard, i catastrophise everything, suffer with imposter syndrome at work and generally just very sad.

This has been going on for a year now.

I'm too thinking of going private x

What have you been offered so far? Have you tried any hormonal medication? For younger women standard HRT isn’t always particularly helpful and without physical vasomotor symptoms there is a limit to what can be achieved for psychological symptoms (HRT is tricky to resolve these).

It may be worth trialing a combined pill such as Zoely, or Qlaira, to give you some hormonal “stability”.

I did this. I couldn't face some rushed appointment with a GP at my practice. I never see the same person twice and I wanted some kind of consistent care from someone as invested in my future as I am. I saw a private GP who is a member of the British Menopause Society. I had an hour long really thorough appointment and have a plan in place that will be reviewed in 3 months time with the same GP.

You can ask for an NHS menopause clinic referral but you’d be considered very young for HRT (which is probably all they can realistically offer). What treatment are you hoping for? And has your GP offered antidepressants? They can be very effective for hormonal mood disorders.

I was referred to an NHS clinic and was actually offered an appointment very quickly and dealt with in one phone call and prescribed testosterone which is what I wanted. Everything else was dealt with by my GP.

Its not easy to change GP, I think you have to be in catchment or something?

If you have the money I would do the consultation, my GP is rubbish as well although for other reasons, she knew nothing really about HRT although didnt quibble with me.

I have the same issues, extreme symptoms coming and going, I never know how Im going to be.

I went private. You can shop around and you can also do remote. Once I had a few private consultations I was much clearer about my needs and could advocate with my GP.

@crackadawn I know exactly what you mean, though my symptoms start as soon as I’ve ovulated and disappear when my period starts. It’s hard to explain to other people why/how you can be so different. I have the same kind of mind things too, also very vivid dreams/nightmares and a real sense of things seeming terrible and as if the world is ending. I get the driving thing too. Sometimes I have very dark thoughts and also feel incredibly rageful when I am normally gentle and patient. It is very lonely trying to hide it and pretend you’re okay. My gp seems to think I’m too young too I think, that’s why I thought about going private.

It sounds like you need to start with basic HRT, in which case you don't need to pay for a specialist, you need better primary care, which should be cheaper and more accessible than specialists. I would try a different GP or something like super drug online pharmacy. I'd consider mirena coil for the progesterone component if you're sensitive to oral progesterone. Jen Gunter has a handy sub stack page on progestogen options for people who are sensitive to it - paywalled and I don't have access any more but worth subscribing if this is an issue for you.

Sound like PMDD or PMS rather than perimenopause.

Again, using a combined pill with drospirenone would be more beneficial than HRT.

I urge you to do it - it literally saves my life.

I was thinking this too, sounds like PMT.

I wrote a response without checking exactly what youd advised, apologies...

Depends what progesterone is used. Progesterone is a natural hormone, it’s not a progesterone “intolerance” but rather a reaction to the fluctuations that drives PMS/PMDD symptoms. Drospirenone can be really beneficial for PMDD and inhibiting ovulation with a combined pill can stabilise those fluctuations too.

Saying “the pill is a bad idea” isn’t helpful as all pills are not equal.

Cross posted! So now my reply looks ridiculous LOL.

I was also thinking this.

OP you say you’ve always had hormonal difficulties and your current difficulties are clearly related to your cycle so what makes you think it’s menopause related? What specific menopause symptoms are you experiencing?

Sorry! What you wrote is very useful!

In fact, I may ask for this now Im older (life long PMDD sufferer)

Thankyou

My GP was utterly useless abour gynalocogical issues (despite being female herself). I only got a referral to a gyn when I sat and cried, refusing to leave her office & switched to private then to get operation quicker.

All of the following were better than GP.

1. Private gynacologist
2. Well Woman Clinic
3. Female Fertility Clinic

I'm 43 and would advise anyone to go private following the dreadful year long experience I went through dealing with GPs. I'm now on the right combination of estrogen, progesterone and testosterone and feeling great, but it took several face to face and telephone consultations before any of them took it seriously. I was also told I was too young, and one GP told me perimenopause couldn't be affecting my mental health so badly and lead to suicidal thoughts. It certainly did. You may be lucky enough to get an appointment with a GP who has an interest in, and has received additional training, in women's health and in particular the menopause and I would advise you to maybe secure another appointment asking specifically for one who is, but if this leads you nowhere then absolutely seek an appointment at a private clinic.

Ask to see a different NHS GP at your GP practice. Specifically say you want to consider perimenopause /menopause treatments.
if they cannot suggest anything then specifically say you want to be referred to the NHS specialist Menopause clinic (usually part local of NHS gynaecology or NHS sexual health clinic )
it may not be perimenopause-could it be PMDD ?

I agree your symptoms sound more like PMDD/PMS. A combined pill would be a starting point, if you can take them.

I finally went to a private gynaecologist in desperation expecting to pay thousands but it was actually a lot less than that. She Listened. I got her full attention for 30 minutes and it was calm. She's an expert. She gave me options.
I go every year now. She writes to my GP to get testing done and do prescriptions. A couple of years ago she discovered something troubling and referred me for further investigation.
I feel heard. Valued. Welcome. It's just so much better.

She doesn’t need to demand an appointment to discuss menopause symptoms, as these aren’t necessarily menopause symptoms! She needs to have a discussion with the GP (probably a different one) regarding her cyclically related mood swings and symptoms, and asking about possible treatment for that.

Certainly in my area she wouldn’t meet the criteria for referral to the menopause clinic at the hospital, and even if she did she’d be waiting about 12-18 months which is rubbish I know.