perimenopause and FSH

[vintagefiend]

Hello, ok it's a long one!
bit of a niche question: is it possible to have a normal FSH (result from one blood test), but still be in perimenopause?
I know I'm in perimenopause based on symptoms- for example my PMS is becoming unmanageable...extreme anxiety etc and this is not something I experienced in my twenties or thirties...I am 42.
In addition, I have extreme fatigue, acne, headaches and horrible mood swings throughout the month...definitely new (within last couple of years) symptoms, not experienced previously. Periods becoming erratic in timing, length and heaviness.
However, I saw gp about 1yr ago with this problem, had fsh blood test and it was fine- so tried mirena coil which was awful (tho i know it works for some)!
Symptoms have inevitably worsened over the last year so I returned to gp today and begged for HRT!
To be fair he was great, really listened but felt that, from medico-legal point of view I ought to have FSH checked to see if I am in perimenopause- so i've had my blood test today...await result.
i'm concerned that- given hormonal fluctuations, my fsh might be ok today and i did put this to the gp and he agreed, it could be misleading. He was v honest with me- he's not particularly up to date with hrt/perimenopause and was happy for me to tell him about oestrogel/utrogestan!! he's not a defensive gp.
however, i'm worried that if my fsh is normal- he may be reluctant to prescribe hrt... tho he did acknowledge my "compelling" argument based on symptoms!
Obviously, i'm quite young- but my mother and aunt were early and mid forties for their actual menopauses- i told this to gp and he said that was important.
So i guess i'm asking, would he be going way out on a limb in prescribing me hrt if there's a lack of lab evidence? am i too young- or can a patient's symptoms be enough for diagnosis? how does the amount of oestrogen in oestrogel compare with contraceptive pill (combined) which i have been offered fairly recently, so if they're happy for me to have oestrogen in oral contraceptive pill, could i argue for oestrogel?
i return to gp on friday- to get result- and hopefully commence hrt. he's definitely happy for me to research and advise him- so if there is evidence that women in early forties with symptoms of perimenopause can legitimately be treated with HRT, I need it!
thanks so much for any help.

hello again, something has just occurred to me!
quite a few people have mentioned utrogestan or similar on days 15-26 (or thereabouts) of cycle. But what if your periods are not reliably every 28 days eg my last came on day 21 but the one prior to that was day 27- does it not matter anyway- are you ultimately overriding your own cycle with the hrt? and creating a new cycle if that makes sense?

HRT resets your cycle, just the same as the Pill does.
If you are in peri and still having periods then it may take a while to reset completely and in the process you may get breakthrough bleeding from your own cycle.

understood, pinkfrocks, thank you.
i've just called my gp surgery and found out that my fsh is normal- i'm a bit gutted! i have appt later today i just hope that he'll prescribe nevertheless.
at least i'm armed with the knowledge that these tests are not good indicators of perimenopause and that many of the women on here taking HRT had normal FSH.

also thanks lauren for that info x

I ended up with 2 bleeds on it of my own and then the 'forced' one, been having ivf for a few years so wasn't practical to stay on it so went on buspirone instead which helped my symtoms a lot, I have a few packs of HRT - Prem pak and climival that are going in the bin if you have no luck?

thank you so much for the kind offer, lauren but happily the gp prescribed hrt for me today no problem- so you can bin 'em! obviously i'm v pleased.
i do hope your ivf is successful x

Thankyou! And I'm pleased they did I hope it works out for you x

Happy to help vintagefiend.

My symptoms such as the anxiety, depression and mood swings were so awful that I couldn't believe that it was only my hormones causing them. I had no idea they were so powerful.

My consultant told me that he saw women who had symptoms so severe that they bordered on psychosis

If you get chance read up on Marian Keynes (the author) as she suffered a complete breakdown due to her hormones. I recognised a lot of what she describes.

Just read that you have been given HRT

Would just say though that it can take a while to work. Some women feel much better almost immediately. But for others it can take a few months, especially if anxiety and mood swings are the real problem. So don't get disappointed if you're still very up and down with your symptoms for the first couple of months.

When I was still suffering with anxiety and random low mood after the first month I thought HRT wasn't going to work for me and I panicked. But I stuck with it and stuck with it. Very hard sometimes.

I have been on HRT for 11 weeks now and I feel it has only really just started to kick in fully this last week or so.

Good luck x

I feel like I've possibly been misdiagnosed after seeing this. I had all the peri menopause symptoms and took them to my GP who said I should try the pill?! Luckily I didn't trust that diagnosis, however my cycle has returned to normal now and the erratic symptoms have decreased. Told GP this and he said it has been known to last from months to years. I'm only just turned 30 so I'm grateful its righted itself it seems but should I be getting further testing??? Ugh. Scared now.

thanks again, kontiky- i will not expect immediate results and if i do get them then, bonus! i think we have quite a similar experience of perimenopause- ie extreme emotional symptoms and no vascular symptoms, so it's v useful for me to know how things have worked for you. i'll look up marian keyes' story- i knew she'd had severe depression but didn't realise it was hormonal.
sycamoremum- i can't offer any words of wisdom as it's all been a new learning curve for me and there's a fair bit to take in! obviously you're young so i'd have thought they'd be keen to establish for certain whether or not you're in perimenopause- can you ask the gp for some assurances? hope you get some answers