totally confused. any advice please?

[Hadiever]

Hi
I am age 48. Still having regular periods but have been having some symptoms of menopause such as being very short tempered, tired a lot of the time and a bit achy. I also have vaginal dryness which can be uncomfortable. My doctor gave me blood tests.
Today I went for results and saw a different doctor who said my results are high and I am post menopausal. She asked was I sure I had periods! I then went on to ask about HRT and to be honest she didn't appear very knowledgable. She asked about my family history of cancer and blood clots. A yes to both of these. Also I am a smoker. She then said she would need to double check whether I could have HRT or not and would phone me later. She did pescribe some vaginal gel for me.
I am feeling a bit nervous now and wondered if she says I can't have HRT is there anything else that may help? And what type of HRT I should ask for? Any help would be most welcome.

Oh dear- sounds as if you have a lot to take in.

Family history is irrelevant . The only relevance would be 2 first degree relatives (mum and sisters) with recent . or early breast cancer.

Being blunt, most of us die from heart disease / strokes or cancer. So pretty much all of us know someone in our family who had these.

It's the type of cancer and when it happened, and the type of blood clots- having a stroke at 40 is very different from one at 80.

You need to stop smoking- you know that - or you will most likely get cancer or heart disease. (Lecture over.)

Are you getting help to stop smoking?

If you do use HRT then you need transdermal- patches or gel which has less risk of blood clots - because smoking will increase your risks of blood clots with or without HRT.

Thank you PollyPerky for replying.
I know I need to stop smoking. I find it impossible. When GP phones I will ask for the gel if she offers this.

Hadiever, just checking, you did have your blood test on or around day 3 of your cycle? Inept GPs often test at the wrong time and the results can be misleading if you're still having menstrual cycles.
It's also smoking that can cause a lot of hormonal problems as it depletes the body of estrogen and can cause early meno. I have just quit smoking too so I'm up on it. You may get improvements in symptoms if you quit?

I feel my symptoms have improved since quitting but I'm still not right. I'm also still having periods and have not been prescribed HRT yet due to high blood pressure (I think crying all the time and getting no sleep due to night sweats probably causes high blood pressure...). I've been referred to specialist Gynae menopause expert on the NHS, seeing her next week so have hopes to be on HRT by the following week...

I agree with Framey but would also add that NICE has now told GPs not to do blood tests for meno on women over 45, and just treat the symptoms.
This is a) to save money but b) blood tests are usually inaccurate because as Framey says even if they are done on the 'right' days, hormone levels vary from day to day in peri. So women need to be treated whatever the test says- it might be accurate or it might not be!
Smoking does exacerbate meno symptoms and smokers tend to have an earlier meno by about 2 years.

When you say you have been given vaginal 'gel' do you mean cream - in a small tube of 15gms? Only asking as one poster here was given Oestrogel (as used for systemic HRT) by an inept GP who carried on swearing blind it was the 'right' product even when the poster and a pharmacist had said 'Errr, no.'

Thanks for all the replies.
I know I should stop smoking but I am honestly useless at stopping. I have tried everything! Tbh I have a very short fuse at the moment and I can't imagine this getting better with lack of nicotine!!
The GP phoned me last night and said I could have HRT patches- are there any you would recommend? GP said I am limited to which type as I still have periods.
The vaginal stuff she has given me is vagifem pessary to be used twice weekly. I haven't got it yet.
I said I would look at types of HRT and then make an appt to discuss the patches with her.
Re the blood test. I can't remember when in my cycle it was done. She was surprised I still had periods given the result.

Have you tried hypnotherapy for smoking or nicotine patches? You are limited with HRT patches- some women like Estradot.

I have tried both but just can't seem to stop!
Thanks I will have a little read up on that type of patch.

What about vaping?
Stopping is not as bad as you think, I went cold turkey and it just took a couple of days to get through the worst. Now I don't even think about it. The impetus for me was finding out that smoking makes the awful symptoms worse