Sertraline. and Peri Menopause.

[Roseformeplease]

Anyone been prescribed this? Depressed but told that this is a good way to treat symptoms of peri (hot flushes etc). Need something as very low and knackered, not sleeping and boiling hot. Thanks.

Ah thanks Piggy.
As another poster said today, her consultant said most GPs know bugger all about HRT. They haven't studied it and their info seems to be based on the old research and scare stories from 12 years ago. The British Menopause Society is trying to inform them via training days but it is going to take ages and of course it is not mandatory.

You ought to push for HRT if you feel you need it in time, due to your history with bones and your prolapse.

Michel the time limit on use of HRT has now gone- the BMS website has a consensus statement on this which I have copied and pasted a link to on the 26 March on this thread. GPs have to inform women of the risks but if the woman wants HRT, accepts the risks and is benefiting then treatment should continue (says BMS.)

pinkfrocks thanks for the update about time limits I will take a look. I have only been on HRT for four years unfortunately in my case it took about two years to be diagnosed as fully menopausal. Hope others have better luck.

Have just been to the Doctor who agreed HRT. When I mentioned Oestrogel, as recommended by the lovely, and knowledgeable pinkfrocks, she said it was not one of the recommendations of my region of the NHS. She was offered tablets with a pause for a "period" but I refused as I don't have periods! She he offered patches and I cited their issues with getting the dosage right and stuck by Oestrogel (which, incidentally, a medical friend also recommended). She did some looking up, and needed time to decide. So.....she is seeking an e-mail consultation (we are very remote so this happens a lot, apparently) from a Gynaecologist at the big hospital in the city.

She is going to phone me in a day or two when she gets a reply. Basically, she was happy to prescribe it, but unsure of it with Mireno etc.

Any more advice welcome in case she calls and wants tablets / patch. I really do feel the gel seems a good bet because of the control it gives you.

But, given that pinkfrocks (New Username pinkfrocksrocks) knows more than my GP, advice welcome!

And, to anyone else reading this, please be informed before seeing your GP. They don't seem to know very much about peri-menopause!

Oh dear- what a funny GP!
FWIW my gynae who is extremely eminent in the UK (won't bore you with the details) says Oestrogel and the Mirena are the gold standard of HRT (if women can tolerate the Mirena- I probably can't for other boring reasons...).
I was offered gel almost 7 years ago as he said it was 'brilliant stuff' and have stuck with it.

I am a private patient so have to buy my own gel. It's not a fortune- in fact not much more than the price of a prescription (in England.)

If you have to, offer to buy your own!

ps- I just think it is dire beyond belief that something as mainstream as gel ( most women in France on HRT use it) needs her to ask a colleague. FGS!!!

I am another peri menopausal woman on ADs for my symptoms of low mood and anxiety which clearly relates to my cycles. I changed GP a while ago (for different reasons) so believe there is a lack of knowledge and willingness to recommend HRT .I have access to private health so asked for a referall but "it's not needed".

I think I need to make my own appointment! And inspired by this thread..so thank you

new I didn't think that a GP could refuse a referral letter if the patient was self-funding? It's worth talking to your insurance company first about level of cover, because most will not cover menopause itself. But they will cover symptoms that may be due to menopause! ie they'd cover a consultation for heavy periods or anxiety etc but once it was diagnosed as hormonal they'd probably pull the plug on funding routine appts. I'm only saying this as some of my friends have experienced this with their insurers.

Please seek a second opinion newstart.

The first GP I saw dismissed my sudden anxiety and low mood, as just standard depression and tried to fob me off with beta blockers. Even though I explained that my life was absolutely fine and nothing had changed to cause these symptoms. Even though I mentioned that my periods had gone a bit haywire lately, and had suddenly got much lighter (a big marker for being peri menopausal).

The second GP insisted I was suffering with clinical anxiety and depression and insisted I took ADs. Even though I explained that for roughly 2 weeks of the month my symptoms pretty much disappeared. And again explained that my periods had gone a bit odd and my symptoms were definitely linked to my menstrual cycle. She dismissed me totally.

Even after being on the ADs for 6 months and explaining that I was STILL getting intense anxiety/low mood for 2 weeks per month my GP refused to believe that my true problem could possibly be hormonal. And even when I stopped taking the ADs and my anxiety/low mood continued appearing for just half the month, she still wasn't curious.

It was only when I fortunately saw a third GP who actually knew something about hormones that I got some help. He quite correctly pointed out that ADs simply don't stop/start working for half the month every month. He referred me and thank God he did.

I think you can self refer to menopause clinics? It's worth a try.

Update - at last - The Gynae at the local hospital finally got back in touch with the GP and agreed wholeheartedly with the idea of Oestrogel, which I now have on repeat prescription. The only proviso is my Mirena coil is changed every 4 years, not 5. I should be picking it up tomorrow, or Saturday and will report back.

Phew! Rather delighted that the advice from on here has sorted out the GP and helped me get something that might sort me out. I had to stick my head out the window today WHILE TEACHING to cool me down.

Just come late to this thread but just to say so glad you've got what you wanted in the end Roseformeplease. I despair at the lack of knowledge of many GPs about menopause when the information is out there on the web for anyone to read, without a medical degree!

I totally agree with what pinkfrocks and others have said regarding ADs - if you have no history of depression and it comes out of the blue as you enter the peri-menopausal years - then it is clearly hormonal and should be treated as such. As for the age thing - no GP should dismiss the possibility of menopause on the basis of age, nor even blood tests. These are unreliable and should only be used as a guide - and certainly a diagnosis should not be made on the basis of one test alone. Periods and symptoms should give a better clue - although of course basic blood tests should be carried out to help rule out other causes.

Also to add that I am 62, and have been on HRT for over 8 years now and intend to stay on it for the forseeable future - health permitting. I also have used a patch for all the time I've been on HRT - Estradot 50 - which is very convenient, very small, only has to be changed twice a week and delivers a constant dose of oestrogen directly into your system (just as Estrogel does).

Thanks Bellacio. I picked up my Oestrogel today as it took ages to arrive (remote corner of the UK). I have been advised to split my two pumps into 2 separate ones and so did one this evening. It was ridiculously easy and quick. I will take one more in the morning.

I think that I am going to give it 3 months and then come off the anti-Depressants. Hopefully, I won't have to keep sticking my head out of the window like a dog and will get my mojo back. I am just so lazy and weary all the time.

Didn't see the updates but thank you for the responses.

Apologies for hijacking the thread but there seems to be a wealth of knowledge.
My GP practice seems completely unwilling to consider a referral.I have had very heavy periods,fatigue, fuzzy brain, insomnia and low moods/anxiety after ovulation.I seem to ovulate and have regular cycles so am I considered peri? I am 50 so know that it's most likely.

The Ads seem to work but I only take them premenstrually.I've seen several gp's in my practice and the answer is always the same..no need for a referral and hrt not recommended.I am happy to pay if necessary as the symptoms can be completely debilitating. I had a demanding and rewarding job but had to give it up as I wasn't able to cope for 2 weeks of the month!
I have found a specialist from menopause matters so will try to get an appointment. I am just outside London and very happy to take recommendations however.

see page 11 of the NICE guidelines out today- this is a draft and out to stakeholders for review by end of July but the message to GPs is very clear- do not give ADs as a first line treatment (page 11) for menopause flushes etc.

www.nice.org.uk/guidance/gid-cgwave0639/resources/menopause-draft-guideline-nice2

Oh and they are also being told to refer women to other HCP with meno expertise if they don't know the right treatment ....

suggest you read the whole link.

I am 44 and been peri menopausal since about 41. Being taking HRT for two years now and still feeling drepressed, no motivation, I’ve put two stone on and have awful anxiety. I’ve been trying to muddle through it but now been supplied with antidepressants by my GP. Any advice would be appreciated