Pretty sure I'm peri-menopausal, doctor dubious.

[SilverDragonfly1]

I'm 41 next week. Have had all sorts of irritating issues with gynae stuff for the last two years, including severe pain on ovulation (had 2 scans, nothing there at all apparently) and escalating PMT.

For the last year my periods have been coming more often, with about a week of breakthrough bleeding beforehand and slight bleeding at ovulation too (recent smear test clear). My skin is a mess, with cystic acne that I haven't suffered since my early 20s.

I told the doctor all this last year and initially she said I was 'too young' and upped my long term anti depressant dose- the pre menstrual rage was really scaring me and it has become manageable since. After a couple of visits because of the pain, she did the tests mentioned, but said there is no point doing a blood test as hormones go up and down through the month so the result wouldn't be reliable.

TBH I was quite surprised at how dismissive the medical personnel I've encountered are about these symptoms. I realise menopause isn't a big deal to them and that although I'm youngish I'm not anomalous. But because of the pains, the bleeding and the PMT, I really would like it confirmed or denied so I know whether to seek more help.

HRT won't be an option I think, because I got a DVT and clots in my lungs while on the pill (this was in 2010). Or is it? I don't know, since a mere 'women's issue' isn't taken seriously even by the other women in the health profession I've encountered...

Sort of a rant/offloading, but any thoughts or similar experiences would be welcome.

I am of a similar age and I am Perinmenopausal. My initial symptoms were just like yours. I waited til I had been 4 months with no period and was then checked for the hormones in my blood. And again a few months later. Doc thought I was likely right and put me on hrt. If you can't have hrt though I am ignorant of what other options are pen to you . But if gp being silly I advise seeking an initial blood test and speaking to another go.....

It took my mum 14 years of peri-menopause before her periods completely stopped- in the end she had some sort of procedure (ablation?). So am wondering if it will be a very long road!

Thanks so much for your reassurance

Silver- I think you ought to go back to your dr or change GPs if that's an option.
The NICE menopause guidelines say no blood tests for women over 45 as peri is to be expected, but you are almost in the premature menopause group- meno under 40 and certainly a lot sooner than the average age of 52.

I don't know about HRT for someone with your history- certainly pills are out of the question but transdermal HRT is possible but you really need to see a gynae who specialises in meno and prem meno.

If you can't use HRT then you need advice on lifestyle measures to offset low oestrogen. Def ask for a referral to a gynae who deals with menopause.

ps- have a look at Daisy network

Thanks Polly. I will look at pushing it again when I have the energy :)

Silver I'm a nurse working purely on a women's ward - I was having a conversation with our female consultant last week who said that it is certainly not unheard of for 40 yr old women to be going through the menopause .

We have had a couple of women lately who have been 40/41 and who were most definetly clinically going through the menopause.

Please please change your GP to one who hears who and who will take all the relevant blood tests .

Incidentally I am 39 and my lovely GP is putting me on the mirena for peri menopausal flooding etc .... She says the mirena will help me get me through the menopause much easier .

I had a minor stroke about 15 years ago, but the doc was happy to prescribe me transdermal HRT recently. It was a balanced decision ie I am otherwise healthy, low BP, non smoker etc etc. It's worth a chat since I no longer have PMT rage and/or depression. But I did have to persevere. I was given blood tests that showed nothing (but then it you are peri rather than completely menopausal then nothing much would show) and I had to go back and keep on insisting that I just didnt feel right.

Well, I will give it a go Jeff. I don't think POI is me Polly as I am still having periods, in fact more bleeding than previously, although it is lighter overall. Wouldn't touch the mirena with a bargepole though I'm afraid

Really appreciate the comments. I have been feeling very alone and only found out today that we have a menopause board!

Hi Silver this sounds very similar to my story and the results I've had each time I've been to the gp.

I'm 43 now but my symptoms started 6 years ago, my mind was a complete fog, couldn't remember where I put anything, rages that came out of no-where and my periods started getting further apart.

Then ovulation became excruciating but a scan showed nothing.

Then my periods pretty much disappeared - 2013 and 14 I had a period in February & one in march - they were so heavy, I'd flood within 45 minutes. Then last year nothing, in fact nothing until July when I had a 'normal'ish period followed by ind in August. Since then nothing.

In between these periods, since 2013 I get hot flushes. They usually stop a few months before a period arrives. Anything up to 30 flushes a day.

I've been told several times that periods can stop for many reasons. When I'd not had a period for over a year I was sent for blood tests but they showed nothing. I was told to go back if I don't have a period for 2 years.

I struggled at first, because I always imagined that menopause was something years away and it's very lonely as people don't talk about it. But my family is complete and I'm
Much more accepting of it now although those hot flushes drive me insane and I've so far found nothing to help ease them.

Prudence I really really feel you need to spk to go. Those extra years without oestrogen will not be good for your body (bones in particular). My gp basically said that of course hrt was my choice re risks etc but with so many years without the hormones my body should be having he strongly recommended hrt for me (with no family history of breast cancer). Surely this is an assessment that should also be made for and with you based on your risk factors etc? If one gp doesn't take seriously I strongly feel you need to spk to another. I am on a low dose of hrt and nearly all my symptoms have simply disappeared.....

It is a relief to hear about someone else having pains Prudence although I'm sorry you had them. There have been two occasions where I was wondering if I should go to A&E (and I have a high pain threshold and hate hospitals!)- on one, the only reason I didn't get an ambulance was because my husband was asleep and I was in too much pain to talk or move to wake him, even though we were both in the same bed- thankfully that level only lasted for a few minutes, then it went back down to merely extraordinarily painful and I was able to stagger downstairs and take some codeine and ibuprofen.

It is the danger of osteoporosis that mainly troubles me and is why I want to continue pursuing a diagnosis despite feeling rather silly and embarrassed.

Prudence
It is very important that you seek medical advice.

Medically speaking you have had an early menopause- bordering on premature menopause. The treatment for this is HRT. Without oestrogen for 10 years before the average menopause ( age 52) you are at a much higher risk of osteoporosis in your 50s and heart disease later in life.

The risks of HRT do not apply to women under 50. You need to replace what you should have in your early 40s. The risks with HRT (which are tiny anyway) do not kick in until 5+ years on HRT over the age of 50-ish. So you could use HRT right up to 55 / 56 without any risks at all (though you need a dr to assess your medical history.)

This is SO important. Thankfully nowadays we see fewer old ladies with dowagers humps- caused by collapsed vertebra due to osteoporosis. The reason there are fewer is because women who need oestrogen due to early menopause are , on the whole, being treated.

You have got to take this seriously and go to your GP.

If they won't help then you might want to think about going outside the system- and this applies to anyone not getting the support they want from their GP. Menopause and its symptoms are not very high up the list of priorities for the NHS due to it being broke, in terms of cash, but there are many private consultants who can help you if your GP can't.

You have to be proactive though and look after yourself- 'cos if you don't, no one else is going to bother!

Polly thank you for that. I am 41. I genuinely didnt know that the risks of hrt don't apply to me. I thought that the sub 50 age group wasn't quoted in the risk factor data because of insufficient knowledge and numbers. I am even more happy that I am on it.

Oh silver, that's just what my pains were like. And I've had 2 babies with no pain relief. In fact one time I was on a flight and even I was beginning to wonder if I could be have ectopic pregnancy or about to give birth (despite being 100% sure I couldn't be pregnant). I could actually feel contractions. And no pain relief - no one had anything!

Polly, thingswedoforlove, thank you. I will call tomorrow to make an appointment. I will write down a time line with as much detail as I can remember. There is one doctor I've seen at my surgery who is very good, but he usually works in another town.

My mum was was late 40s/ early 50s when she was peri menopausal. I've no idea about her mother (you didn't talk about such things) but she did have a very prominent hump.

Please read what Professor John Studds says about anti-depressants! So many peri-menopausal women are put on anti-depressants when they should be taking HRT. You need hormone help as your body is leading up to the change, that is when we all go bonkers. NOT afterwards! Please see if you can take some gels. I was in a depression with mood swings, terrible flushes, never sleeping, always tired, aching and arthritis and this has all gone since i went started taking gel hormones 4 months ago. Don't wait until your periods have stopped, the very time you need hormone help is in the LEAD up to the end!! I went to the Marion Gluck clinic and I was VERY disappointed. I met a young, inexperienced doctor who seemed cold and unsympathetic about menopausal issues. There was no sign of Marion Gluck. I was prescribed a cream which seemed to make things worse and after 6 weeks I stopped applying the cream. I didn't go for a follow up as i didn't trust the inexperienced doctor i had seen. Later on, after visiting a proper doctor - Professor John Studds - i was put on the correct dose of hormones. John Studds looked at the prescription that I had been given by Marion Gluck and was not impressed at all. I think the word 'quack' was used.

Went to the doctor today and he agreed that it is very likely. I am going to have a blood test for FHS, which will have to wait until 6 days after my next period (so in about a fortnight at the current cycle!) then we will discuss further treatment.

mikail Thanks. I have clinical depression so am on ADs long term but am hoping to lower the dose once the hormonal changes are under control. As I have a history of DVT and pulmonary embolism, HRT will be a last resort rather than the first option.

Silver- the NICE guidelines suggest that women in your position are referred for blood tests to a haematologist to assess their clotting risks if HRT is to be used.

I'll bring that up at the next appointment then- thanks Polly

Great news silver, good luck with it. You got an appointment quickly.... Mine is still more than 2 weeks away!

My surgery has walk-in from 7.30-10.30, so I always go to that at the crack of dawn- not hard when your stupid body wakes you up at 5 every day! I don't work (carer for partner) which makes doing that a lot easier of course. The doctor has given me a short course of sleeping tablets to try and break that cycle, but not sure if I will take them tbh.

Don't want to appear to hijack this thread but thought I'd update on here as I've just had my appointment.

Armed with some great advice from you on here, along with links on what to read, and my own 'timeline' I feel that I was able to be heard today.
I don't like going to the doctors, I think this stems from being 'told off' for 'wasting his time' when I was very young. He diagnosed tonsillitis but 36 hours later I had emergency surgery for peritonitis. I also got discharged from hospital when in very early labour at 29 weeks as hospital staff didn't know how to set up the monitor for twins. History of early, quick labours and 3 hours later I'd got 2 babies in incubators.
Anyway, I feel quite at ease talking to this doctor, he takes his time and talks with you and listens. By his own admission he's not the best to discuss menopause with but I've had several blood tests. When I saw him 2 years ago my fsh was at 21.7. He suspects that today's results will confirm menopause/peri which he said will he if fsh is over 26. I have questioned him on what we will do if it's 25.7 or lots of other possible scenarios, to the point that he has said he will look at the results whatever, and we will follow up.

Results should be in by the end of the week.
Thanks for all your advice, it's given me the confidence to be heard and hopefully I'll get some answers.