I think menopause is coming for me. What now?

[Magicunicornpower]

Posting here for traffic. What to do now, who to talk with? Does your GP in UK refer you to an endocrinologist for HRT? Do I have to go private? Symptoms are very mild for now, but I am dreading it already. Any wise words? Thanks

Just ring the doctors, you’ll speak to a nurse. They give you HRT if you want it

Just like that? No tests to check hormonal values or anything. It's like one size fits all? Thanks x

You won’t be referred, GP will prescribe HRT if needed. They can do some bloods via GP.

My practice has a HRT nurse. It took me about 3 months to get past the gauntlet of reception allowing me an appointment. But once I saw the nurse she immediately prescribed me trial HRT and a blood test to check deficiencies etc.

It was a lot better than I expected. I had assumed I'd get told I was just anxious but that seems to be reserved for when I try to advocate for DC.

No, it’s definitely not standard to be referred to an endocrinologist. It’s symptom driven. I think a blood test might only be required in certain scenarios ie if you’re young.

No point in bloods as peri menopause is literally fluctuation in hormones. So one day you might be fine, next day low.

You don't need to do anything, just see how things go. If at some point you want to try HRT then speak to your GP.

You don’t have to dread it. Many women go through it perfectly fine and HRT isn’t always the panacea. I’ve felt a hell of a lot worse on HRT. It’s cured my hot flushes but other things are worse. I’m still working it through with my gp.

No tests no, fluctuations in hormones make it hard to get accuracy is my understanding.

Its not a one size fits all, there are a multitude of possible treatments depending on symptoms.

The GP or menopause specialist nurse (if your practice has one) will take a history, check things like your blood pressure and together, you can decide where to go from there.

In my experience, the culture around women’s health is changing and I for one, felt listened to and able to work with the nurse in the decisions around my health.
Don’t dread it, tackle it proactively and arm yourself with knowledge and education around this phase.
It’s a fucker, no doubt but you will take it in your stride and kick the arse out of it as you probably have done throughout your life in dealing with the shit show of being female and all that throws at you.
You’ll be ok, honestly, you will.

I didn't do anything! Yes a few v mild symptoms so i'm lucky i guess.

My best advice is cut down on your calories cos once you hit meno your body doesn't seem to need to eat anything more than a blackberry a day to pile the weight on 😩🤪

You shouldn’t be given blood tests unless you are under 45 and even then this should be just to exclude other issues (as per NICE NHS guidelines) - blood tests for menopause itself aren’t reliable and shouldn’t be used as oestrogen levels fluctuate so wildly. So basically go and see your Gp and ask for HRT. If you have other complex health issues this is the only time they should refer you to a menopause specialist (this was the case with me as I have Addisons and lupus etc).

How old are you? If you are under 45 you may be referred for blood and other tests to rule out other things which may be causing symptoms first.

Over 45 and the protocol is supposed to be offering HRT as the first option without tests. Treat the symptoms. In practice there are a lot of GPs who are shockingly useless with women's health and will fob you off with anti depressants or all manner of other things and will just not listen. Have been there. So my advice is to make a list of all the symptoms you have. Lack of libido and hot flushes seem to be the only things which GPs listen to. And just keep parroting "I'd like to try HRT please" on repeat.

Good luck - pop over to the menopause forum where many women can share experiences and advice.

I went to GP at 44 with so many symptoms! Rage, night sweats, hot flushes, moods up and down, smelling cigarettes among other things but told I was too young 🤦‍♀️. I went private, they checked bloods, I had next to no testosterone, my oestrogen and progesterone weren’t too bad but based on my symptoms the private gp recommended trying progesterone first then added on small amount of oestrogen. I’m starting to feel a bit better now but it’s taken a few months to get right. I keep a journal of symptoms and moods and I can track when things are at their worst etc, it’s handy! My NHS GP has now taken over my prescriptions so it saves me money. I probably spent around £1k on blood tests, appts and meds woth private, it’s worth it if you can afford it as they really explain it in great detail. Appts are often 30 minutes!!

You don't have to do anything if you don't want.
If your symptoms are mild and not bothering you, there's no need for hrt.

If your symptoms start to get bothersome then they can be treated with hrt so then you just make an appt with your GP, explain your symptoms and ask for help

I’d recommend educating yourself as much as possible - both for your own understanding of your body/what’s causing symptoms and also so you can advocate for treatment if required. I found The Little Book of HRT v helpful (it’s not just about HRT!).

Yes! I am 44 and I am experiencing some of those symptoms. I feel like it's too early for me, but my mum was menopausal at 45, so...

There's no reliable blood test for perimenopause, but they may want to check things like iron levels, thyroid, vitamin D etc. Go in to your GP appointment with a list of your symptoms - the Balance app is free and really useful for recording your symptoms, periods, sleep, nutrition and exercise over time

Why do you think 44 is too early? Average age of menopause is 52 in terms of when periods actually stop but oestrogen levels start declining in most women around 10 years before that so 44 is very average to have peri menopausal symptoms.

Yes, just like that. If you want tailored HRT solutions you will have to go privately at a Marion Gluck or Female Health Clinic. I did the latter but ultimately ended up going back to GP and having the same HRT prescribed there for free, so the blood tests are a bit of a waste of money/time.

Just carry on as normal. It will happen. Buy a fan and wear more cotton clothes if you feel you need them.

I started perimenopause at 44, it's well within the normal range. As others said, perimenopause is the time between hormones starting to fluctuate and your periods stopping for good, and it can last for 10+ years

There are long term benefits to using HRT - reduced risk of heart disease, osteoporosis and dementia - so I would highly recommend it even if your short term symptoms are manageable. Your symptoms may well ramp up over time as well

If your GP shuts you down and won't discuss HRT, I highly recommend Newson Health if it would be a possibility for you. It's private healthcare so not cheap but they're specialists in menopause so they know their stuff. I had an excellent experience with them. But definitely start with GP first - you're entitled to evidence based healthcare on the NHS!

I’ve decided to come off it. Just tapering off now. The lows of the progesterone weighs out the rest of it …. Actually apologies to hijack the thread, anyone have any experience of this?

Stop thinking about it as this terrible monster that is "coming for you" for a start.
Some people only ever have mild symptoms.
Day at a time, if hurdles pop up deal with them as and when.
And stay off SM gloomfests.

I'm 42. I think I could have spent another year or two with no sleep and anxiety about random things but HRT has helped me so much.

Are you sure it's going to be bad? I've gone through menopause (61 this year) and I didn't have any issues.