Specialist eg Annie Evans/john studd/nick Panay

[QueenCadbury]

I'm self diagnosed perimenopausal and the mood swings and 'rage' can be so bad that I really think I need professional help! I'm reluctant to go to my GP as I'd prefer to see a specialist even if it means paying. Has anyone else done this?

Having done my research I've come across Annie Evans, nick Panay and john studd. I had an email consultation with Annie Evans who confirmed I'm likely to be perimenopausal but my gynaecologist was a bit scathing about her and has put me off seeing her.

Can anyone recommend anyone...?

Am a bit confused by your post because you say your gynaecologist put you off seeing Annie Evans.
If you are already seeing a gynaecologist are they not working with you on your symptoms?

I can recommend my own Harley St meno specialist who is equally as qualified and good as Studd and Panay, but maybe you can say why your own gynae isn't offering any help?

I don't know anything about Evans but from what I do know she is a GP with an interest in women's health but not a consultant- correct me if I am wrong here!

Sorry for the confusion. I'm under a gynae for my endometriosis. His advice for both that and my rages is GnRH analogues to switch off my hormones with HRT to replace them and if that works a hysterectomy. It seems a bit drastic especially as my last laparoscopy showed minimal endometriosis .At the age of 40 with small dc I'm not sure that I want major surgery at this point. Maybe in later years but it's not the right time really for the family at the moment.

My gynae specialises in endometriosis and other surgical conditions and as fab as he is he's a surgeon so their advice tends to be to cut it out. I'm interested in seeing someone that deals more with the psychological side of pmt/menopause. I originally contacted Annie as she has a clinic local to me but if I'm spending lots of money on a consultation I want to be sure it's likely to be the right person for me.

Ah- see now!
Sorry you have endo but as you say if it's minimal then maybe an op is not the right approach.

If your endo is only in your uterus then an op would obviously sort it out, but if you have other adhesions then it won't and HRT would possibly make it worse.

The other point is that if you are peri at 40, that's very young. peri can last 10 years but equally it might only last 2-3 years. If your periods were to stop completely before age 45, that is considered prem meno and you need HRT up to age 51-52 anyway to protect your bones. You might find that HRT stirs up the endo again as it's fuelled by oestrogen.

Not all consultants are scalpel happy- there are others who are more holistic in their approach including the one I see.

Dr Evans is not a gynaecologist- as far as I can see on her website she is a dr who has an interest in women's health including menopause. I have slight reservations about her approach only because she seems to court the media whereas really busy consultants don't have the time or need to do that. But I'm sure she is fine if anyone wants general help.

I'd rather PM you details of who I see if that's okay? I'll do it now and send it over to your inbox.

I have been in your position and saw one of the three you listed. Huge mistake, massive!
Feel free to pm me if you want more details !

The only potential problem with her is that she is not a consultant, and cannot carry out investigations (I assume). She's not a gynaecologist. This means that although she can advise and give medication, if you needed a scan or a hysteroscopy to investigate anything you would need to be referred to someone else. MOST of what she advises is available on the web and on websites that specialise in meno, and from knowledgeable posters- many of whom pass on what they have learned from their own consultants.
IMO and it's only mine, if you are paying then it's better to see a consultant who can offer all of the above and not just at the level of a well informed GP.

Thanks everyone. I'd forgotten I'd posted this as when things are bad they're horrid and then in between things are fine and I wonder how I could ever feel so bad.

Hi there, did you see any of the 3 specialists mentioned or seek help elsewhere? I'm in what seems to be the same place at the moment and unsure which direction to go. Been toying with contacting John Studd or Marion Gluck directly as GP only willing to put me on contraceptive pill or anti-depressants and have my reasons for not wanting to be on either. I could ask for a GP referral but my private healthcare doesn't cover either consultant. Interested to hear where you're at since your last post. Thanks, C x

I've been seeing Marion Gluck for 18 months - very expensive but has literally changed my life - I now only have to go every 6 months to check the dosage (made by a bio-identical compound pharmacy in London). On top of the hot flushes, night sweats, weight gain etc I had massive/numerous fibroids and the GP wanted to refer me for surgery - MG prescribed natural progesterone lozengers and they have completely disappeared. My GP had no explanation... Also well worth reading Michael Platt's book on bio-identical hormones (available on Amazon).

Hi, reading this old post, I notice you recommend your own gynea you are or were seeing instead of Nick Panay or Professor Studd. Could you possibly let me know who that is so I can consider using that person. Thanks.

Hi, same request as cherrybrown...my GP has suggested I see Nick Panay for menopausal symptoms/HRT. Very interested to read thread and see that some of you have alternative recommendation. I would love to know who that is. Also noticed that Itwilbebetter posted that she'd seen one of 3 consultants mentioned and it was a huge mistake. Any advice would be gratefully received. Thanks

I would highly recommend John Studd, he is efficient,calm and listens to what you say - good luck

Have to agree with scarletthollie5 in recommending John Studd. After 3 years in the menopause wilderness; lack of sleep, hot flushes, anxiety, bereft as a consequence of any sexual desire going AWOL, I went to my GP. May as well have gone to the man in the moon. Other than synthetic HRT, which was a road I didn't particularly wanted to travel, sorry nothing else on offer. Undeterred and determined to get my life back, I researched and concluded that bioidentical hrt was something I would like to pursue. Went to Professor Studd in December 2015 and frankly my life has been transformed. Hot flushes disappeared, zero anxiety, sleeping like a teenager which is probably a consequence of return, big time, of sexual desire!!! All I read, and dared to hope was true, was true.

Just for other people reading...you don't need to see a private dr to get bio identical hormones. 99% of oestrogen now used across the NHS is bio identical, and all you have to ask for to get the bio / body identical progesterone is ask for Utrogestan. Your GP can easily find out how to use this ( dosage) from his drugs' guide.
I don't understand why an NHS GP would refuse these. If it's cost they complain about, offer to pay for them via a private prescription (from GP) and the actual cost is hardly any more than an NHS prescription fee.

No, you don't need to see a private Dr to get bioidentical hrt, as I discovered after the event, but my GP didn't suggest them. I would have no hesitation going back to them now and asking for what I want, even if that means a private prescription, as PollyPerky suggests. But this is with the confidence gained from seeing an expert in the field of women's health who is familiar with the hormone regime in question. It's a crying shame that far too many women are suffering needlessly (with appreciation that the hrt route may not be suitable for all) for the want of product awareness on the part of GP's. It's bad enough dealing with a plethora of symptoms without having to educate ourselves in order to navigate our way through the menopause.

Sadly, GPs are rarely menopause experts; they are just that- 'general' practitioners. Unless they have an interest in women's health and menopause and actively educate themselves then they won't be able to help. The British Menopause Society runs education workshops all year round for GPs but of course they are not mandatory!

There is a huge amount of information on www.menopausematters.co.uk both from the founder who is a gynae and women on the forums.

It's up to women to educate themselves really, and take responsibility, because GPs are never going to be able to keep up with every health issue.

The NICE report on the menopause is for GPs - to help them get up to speed, but judging by many posts on forums, not all GPs have read or digested the advice yet.

Hi ladies, Queend Cadbury, cjlh in particular, did you go to see any of those three specialists mentioned? If you did, how was your experience?

I am also looking for a meno experienced gyne who'd suggest what course of action to take. I'm only 39 but seem to be going through a peri meno. My periods are still regular, but oh boy, they became scanty. A day or two of very light flow, not like before when they were regular to heavy for 3-5 days. As this has been been on for more than a year with no improvement, it may only be another year until they completely stop. I read up about bioidenticals and that the current thinking is not to wait too long to start on them, not even until they stop completely. Perhaps some supplementation can be possible, so I want to see someone competent. My GP, young and green, was absolutely no use.

Oh, and I can't but notice that many posters in this and related discussions are 40 years old and already either peri meno or meno. My close friend has gone menopausal at 40. I wonder if this is some kind of trend that's happening. Again I read and apparently it's either plastics, chemicals (teflon coatings and such), or the under weight that may be the culprits. I am very lean and sporty, and when I was in my teens, training and eating little, this screwed up my periods. Then I had a long but successful reversal process, and I remember my GN always telling me of the importance of belly fat and how it regulates the hormones and meno cycle. Anyone here who is lean and into sport and has similar problems?

Thanks!

Where do you live Eb? Where can you access a doctor?

Nothing useful to add apart from I'm also 41 and going through peri. I know a couple of other people too so maybe it's a trend?

Hi
After some advice, suffer from fibroids heavy periods and what I would say is severe pmt for about ten days, post ovulation. Doctors not interested. Had mini pill for two trad no periods but no sex drive, bad skin and weigh gain. Just had fibroid removed and mirena coil fitted, two days ago under General anaestic, now feeling moody more than normal and down. Don't want ambulation or hystrectomy but can't stand hormones. I did like combined pill in my twenties but in weeks break had migraine. I am a migraine sufferer. I'm 42 next week. I just don't know what to do can anyone suggest who I could see please

Hi

I am 61 and am really suffering from mood swings which go on for days and I really need professional help. I used to suffer from PMT but the depression only lasted 2 days a month. Now it strikes randomly and lasts longer than 2 days. The only time I didn't get it was when I was pregnant and felt great the whole time. Please can someone recommend who could help? It was a relief to see other women are going through the same thing as me.

MAV- maybe start a new thread on this as it's not about the thread topic- you might get more replies?

If you are 61 you're not having PMT so presume you mean you have post menopausal depression or low mood? I think you should talk to your GP about this. The treatment can be HRT but if you are 61 and never been on it before, some GPs will be very wary as the risks are slightly higher for first time users. But the good news is that HRT started within 10 years of the final period has good long term benefits. How long ago was your last period and have these moods just started recently?

Hi
Thanks for responding PollyP. I am new to this site and not sure what threads etc are. In reply to your question, I am scared of the thought of HRT because it sounds similar to the pill and I was at my worst on that. My periods finished years ago. I think I have always had hormonal problems. I had the exact same severe PMT symtoms every month all my life and now they just seem worse but I cannot work out when they are going to happen.

At the top of the page you will see in blue Start a new thread. Click on that. Then you can type in the box and give your question a new heading. This thread - that's the title the poster has given it- is about which specialist to see. is that what you w ant to know?

The Pill and HRT are different. The amount of hormones in HRT is far lower than the Pill.