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Feminism: chat

Gps paid extra for depression diagnosis but not menopause

46 replies

WarriorN · 01/07/2021 07:03

I don't know the ins and outs of this and would hope a Gp would put the patient first but if true it's really not great. You can see how a culture of depression diagnosis over peri symptoms becomes the predominant idea.

Gps paid extra for depression diagnosis but not menopause
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ItsSnowJokes · 01/07/2021 07:07

I am part of a menopause Facebook group and the amount of women that have to fight tooth and nail (and a lot end up going private) to get HRT is staggering. This doesn't surprise me at all. Most are offered anti depressants on their visit even though this is against nice guidelines. The amount of uninformed GPs that are around about menopause is just astounding. The most they get is about 1 hour training in menopause. When 51% of the population will go through this at some point there needs to be more training.

Women should not have to suffer through menopause.

WarriorN · 01/07/2021 07:21

Yes, I'm accidentally in 3 now and I've seen this so many times.

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Hannu · 01/07/2021 07:27

This reply has been withdrawn

Message from MNHQ: This post has been withdrawn

WarriorN · 01/07/2021 07:58

Oh gosh Hannu, that's awful. I'm so sorry 😞

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RufustheBadgeringReindeer · 01/07/2021 08:09

Its a dreadful state of affairs and the lack of training is ridiculous

Y0YO · 01/07/2021 13:08

@WarriorN

I don't know the ins and outs of this and would hope a Gp would put the patient first but if true it's really not great. You can see how a culture of depression diagnosis over peri symptoms becomes the predominant idea.


Yep, I ended up on antidepressants when I needed HRT because GPs hand them out like sweets.

I've been fighting for years to get the right care and it's just exhausting.

It's depressing too that half the adult population don't matter enough.
Melroses · 01/07/2021 13:08

I also find it shocking how many women are offered anti-depressants as a first line, rather than hrt.

I was so excited when the new NICE guidelines came out in 2015 but it seems to be a massive uphill task to get some doctors to notice they exist.

Thelnebriati · 01/07/2021 13:43

I'm another one that was offered AD's but can't get HRT. I was taken aback because I do have a history of needing AD's but these days I'm pretty good at tracking my own mental health and asking for them when I need them - I went to the GP with physical symptoms. And they know my history.

TheWeeDonkey · 01/07/2021 15:25

I went through menopause at 40 due to hysterectomy and have has exactly the same experience. My GP treats menopause just like puberty, something you just have to deal with. I've just completely given up on them, every time I've tried to discuss menopause related problems they try to make it about my mental health. TBH I've completely lost my faith in doctors in general.

LizzieSiddal · 01/07/2021 15:28

My young male GP offered me anti depressants only a couple of months ago. I quoted the NICE guidelines to him and he then offered HRT but I’m so angry that even young GPS are still so ill informed.

Wallpapering · 01/07/2021 17:42

I no longer go see my GP, think it was dismissal regarding pre menopausal final straw. I don’t think ever seen a GP that hasn’t tried to give me prescription for antidepressants, could have arse ache and somehow it’s because depressed.

Thing is I have had depression really bad but I know it’s circumstantial - root causes, it’s easier to keep quiet about it because am done with trying to explain happy pills are not happy pills that make everything go away.

I’m glad went in with DD was offered anti depressants at 15, as this wasn’t cure to extremely heavy painful periods that made miss school or couldn’t sleep

WarriorN · 02/07/2021 08:24

Diane of the menopause network has been doing a series of YouTube chats

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DysonSphere · 02/07/2021 23:00

I have been talking about this situation on a couple of other threads. All too often, women are being effectively treated like they have hysteria.

Women are treated abysmally within the NHS. I've come to the reluctant conclusion that the dire state of women's care must be due to the structure of modern medicine being designed by men. Either that or sheer bloody mindedness.

Through inadequate treatment, I've been suffering to the point I became so ill I no longer wanted to live. And it wasn't because I was depressed, it was because hormone levels were so low, my neurotransmitters were at inadquate levels and it affected my brain. Also the emotional frustration of not getting treatment. What I went through made me wonder how many women are sectioned without their hormone status ever being considered?

Peri-menopause can give you terrible symptoms, including depression. But all too frequently - almost universally - GPs dismiss the physical cause and prescribe the anti-depressants.

Often the assumption is that the 'depression' is the cause in itself as opposed to a symptom of underlying inbalance/illness.

It's not just peri-menopause/menopause either, many are unaware of the huge scandal around treatment of thyroid illness in women (women often develop TI around peri-menopause or a ramping up of pre-existing illness because of the effect of excess oestrogen on takeup of thyroid hormone) If a woman does not respond to standard thyroid treatment she is effectively screwed, unless she fights the system or hops from gp to gp to gp in hope of finding one who is even halfway informed.

Inadequately treated women can look forward to increasing ill health with serious knock on consequences, including early menopause. Even with new NICE guidelines, doctors are on the whole woefully uninformed about how to properly dose for optimal health or even interpret results. Stories here of women developing premature osteoporosis - it's bleak, but I have heard it before, some even develop heart disease. There is no accountability.

If women go to the GP with a set of 'soft' symptoms, - difficulty concentrating, lethargy/motivation, achy muscles, feeling emotionally off, racing thoughts, maybe losing her hair - the likelihood of the GP doing a detailed hormone profile and looking for optimal ranges (that's another thing) - as opposed to attributing it to 'stress' and dispensing ADs at least initially, is low. Especially if she has young children or has just given birth - well then it's often just a given.

If you already have a medical history of depression you will almost certainly fall foul of diagnostic overshadowing. I regret ever talking about my low feelings to my GP. Once 'low mood or depression' is on your notes, it often affects the direction of all future care, and how seriously you will be heard thereafter.

I know women who scrape their pennies - some of these women are so ill they can no longer work - to get privately treated or dispensed medicines which should freely available on the NHS.

And what is the point of it being available if women face a system where misogyny is so rife and their needs are so under prioritised that they can't access it through ignorance! Ignorance of some pretty basic things pertaining to how women's bodies work! So they ask and are met with umbrage or flat out refusal.

All the time I was ill and undiagnosed I was told:

'you're stressed' if I said I wasn't stressed, I was asked "how could I not be stressed with 2 children under 5?" And treated like I was in denial.

"of course you're finding life difficult, you don't earn very much and are a single parent" If I reacted incredulously to this, or refused a prescription of ADs I was told I was being 'oppositional and non cooperative'

Actually told once that because I was a young woman of carribbean origin and a minority group, I should expect to experience more 'life challenges' and stress and this was the cause of my inability to sleep.

Asked about my income
Asked about relationship status
Told by one professional she "had heard it all before from many women'" and some pain relief in combination with ADs always worked.

At one point I actually started gaslighting my own self.

All the time I was suffering from extreme peri-menopausal symptoms caused by untreated thyroid illness. But even when treated, I faced even more difficulties when my treatment didn't work. Even printing out NICE guidelines only resulted in a hostile response. As if I was questioning their professionalism.

Anyway this post is too long but my god it's awful. Until I encountered it I had no idea. I now am struggling to pay for private help. I am far from unique.

MrsCapGarland · 03/07/2021 16:36

What is the source of this claim regarding payments? I’m asking because I know someone relevant in government and I’d like to have checked out sources before discussing it with them. It certainly tallies with my experiences - I felt like I’d been put out to pasture as too long in the tooth to matter anymore…

osbertthesyrianhamster · 03/07/2021 16:50

I highly advice everyone to take out private medical insurance and treat it as equally vital to building and contents and car insurance. My own teenage daughter works and we work together to structure her budget to include this once she cannot be on our policy any more.

I have nigh on zero trust in GPs and find the NHS as unfit for purpose in many ways and this is definitely one of them.

They hand out ADs the way they used to hand out benzos and amphetimines and painkillers and we can fully expect in the future these, too, will be a target for curtailment and people told to get off them.

osbertthesyrianhamster · 03/07/2021 17:02

Flowers Dyson, and no, you far from unique.

DysonSphere · 05/07/2021 19:14

Thanks @osbertthesyrianhamster

DysonSphere · 05/07/2021 19:15

@osbertthesyrianhamster

I highly advice everyone to take out private medical insurance and treat it as equally vital to building and contents and car insurance. My own teenage daughter works and we work together to structure her budget to include this once she cannot be on our policy any more.

I have nigh on zero trust in GPs and find the NHS as unfit for purpose in many ways and this is definitely one of them.

They hand out ADs the way they used to hand out benzos and amphetimines and painkillers and we can fully expect in the future these, too, will be a target for curtailment and people told to get off them.

Yes, this is a VERY good idea and wish it was something someone had advised me to do when younger. At that time ill health seemed very remote.
WarriorN · 05/07/2021 20:14

@MrsCapGarland

What is the source of this claim regarding payments? I’m asking because I know someone relevant in government and I’d like to have checked out sources before discussing it with them. It certainly tallies with my experiences - I felt like I’d been put out to pasture as too long in the tooth to matter anymore…

I'm afraid I don't know @MrsCapGarland

I saw it shared in two fb meno groups.
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gordongrumpy · 05/07/2021 20:18

I'd be really interested to know the source for the idea GPs are financed like this.

WarriorN · 05/07/2021 20:19

Peri-menopause can give you terrible symptoms, including depression. But all too frequently - almost universally - GPs dismiss the physical cause and prescribe the anti-depressants.

Yes and it's quite possible anti ds can help too, but better if the root cause was tackled first, and I bet most would find that's all they need.

I had this exact experience as a younger woman when I started to have thyroid problems. I just got iller and actually rather traumatised as I couldn't come off the ads for a long time due to withdrawal effects, which impacted study, relationships and friendships hugely.

(In fact I do also know of a man who had hyperthyroidism do a few years and lost his job and nearly his wife before it was worked out. But it's overwhelmingly women who have thyroid disease and also often post partum. Again it can be missed if assumed it's pnd.)

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WarriorN · 05/07/2021 20:22

"Did NICE guidelines and the Quality Outcomes Framework change GP antidepressant prescribing in England? Observational study with time trend analyses 2003–2013"

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WarriorN · 05/07/2021 20:24

Mean prescriptions per patient per year doubled from 2.06 (2.05-2.07) to 3.98 (3.97-3.99).

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