Murderous rage

[golfbuggy]

So I think I am perimenopausal. At least either that or I have turned into an irritable irrational person for no reason.

I seem to go through bouts of just feeling murderous rage at the world for no apparent reason. During these times I have to work very hard not to explode. I don't like much like the person I am becoming but I seem to have no control over it. Is this "normal" and is there anything I can do about it?

NC

This is me.....along with poor sleep patterns, anxiety and night sweats.
I can't go on like this.

Just had a particularly bad weekend and have given in and got a doctors appointment for tomorrow.

Doctors appointment yesterday (sorry if this if highjacking your thread a little).

I'm 46, but took my husband with me. Right decision as I got in with the nurse practitioner and burst into tears. Between the two of us we got through all my symptoms (I had a list).

1st comment from her is that I'm a little young for any menopausal problems as it's usually over 50!

She agreed that something wasn't right. Has taken blood to check thyroid, iron levels etc and also female hormones.

For the next two weeks (until blood results return) I have sleeping tablets, because "if we can get you sleeping better, then you should be be able to cope".

Now I understand that more sleep may help with my general mood, but I'm not convinced that it'll help with the rage. Apart from give me more energy to really go for it!

Anyway, she doesn't want to put me on anti-depressants until the blood tests show no problems with my thyroid. Now my understanding is that AD's aren't given for peri-menopause, but do I just try them?
I've explained that life is actually really really good at the moment (nice job, helpful husband, money in the bank, no debts, eating well, exercising) and the broken sleep, night sweat, rage and panic attacks doesn't feel like standard depression.

Just as well hubby was with me as the rage was building!!!

Took one tablet last night, got four good hours sleep, then a sweat woke me up and I couldn't go back to sleep.

I'm back in a fortnight to see her.....

With all due respect to nurses everywhere, unless they have been on a recent course for menopause, they are not qualified to deal with it. many of them, as shown on this and other meno forums, talk utter bollocks. The are not doctors.

Of course you are not too young! meno is defined as between 45-55. Average age is 51,. That means some women will start at 45 and others 55.

You have every symptom of menopause. Has she not read the latest NICE guidelines? Out a year ago. Clearly not. They state emphatically that a) blood tests for peri meno are not to be done - this was BBC headlines again only last week. b)ADs and sleeping tablets are NOT prescribed for peri meno unless there is a clinical diagnosis of depression.

She is treating you completely incorrectly. Don't waste your time on someone who clearly knows bugger all about menopause and isn't even up to date with the latest guidance.

Make an appt to see a GP who has an interest in meno. if there is none at your practice, ask them to refer you to an NHS menopause clinic, or failing that, and they cannot give you the right treatment, go outside the dear old NHS and see a consultant of your choice who will treat you correctly!

Sorry for the rant but it is shocking that nurses make these decsions when they are not up to it.

Thanks Polly That's all as I thought, but it's so hard when you're reminded at the beginning of the appointment that you only have ten minutes (in response to "I've brought a list of my symptoms with me") and you start to panic, cry etc.

I have the appointment in a fortnight. I've no reason to believe that my bloods will show anything.....I can manage to rage on for that amount of time, but I will be going in fully armed with the NICE guidelines for my next appointment.
I'll report back in a fortnight.......

How does your practice work? Can you sidestep the nurse and see your GP? There seems little point going back to see her if she knows not a lot because you won't have confidence in whatever she suggests next!

Side stepping the nurse is difficult, but probably not impossible, but even if it was possible I don't think we have a female doctor at the practice at this time. I've already asked if there is a Well Woman clinic but there isn't.

I will ask if there is Well Woman clinic as part of the wider area, but yes if I don't have confidence in her at the next appointment I will be asking for a referral to either one of the doctors or a clinic elsewhere. I don't want to take AD's unnecessarily. I may as well make good use of the confrontational skills that this rage is giving me. I don't have a history of standing up for what I want which was a) a big flag when I started doing it and b)sends me into a panic attack when I do it!

Why would you want a female dr? Male drs treat women's issues too :) My consultant is a man and I feel totally comfortable discussing 'wimmins' issues with him.

I don't really understand how the practice works - surely if you want an appt with a GP you just ask for an appt with a GP? Or not where you live?

Nurse (who can't prescribe) or Nurse Practitioner (who can prescribe) or a phone consultation. Once you have been passed onto a doctor then getting an appointment for an ongoing issue is fine...any new issue and you're back at triage (see above)!

Also once you have a agreed ongoing problem/issue etc then you can book an appointment in advance (ie I have an appointment in a fortnight with the nurse again and she could then make me a further appointment with a doctor. However I can't ring up and make an advanced appointment for a new issue, that has to be done on the day at 8:45am.

It's a useless system, but I try to work within in rather than fighting it all the time. Hence the next appointment with the nurse and then I can ask for a referral to a doctor at a time pretty much of my choosing!

My comment about a female doctor was more that my own very elderly male doctor hasn't been brilliant in the past (smear/mirena/problems removing/cyst etc etc) that I thought if I was going to see someone else at the practice it might be easier to talk to a women. In general I have never had a problem with doctors, either male or female. It wasn't a slight. I reread what I wrote and understand how it could seem.

That sounds an horrendous system! so the practice operates a triage system where the nurses screen who needs to see a dr?

So you can't just phone and ask for a GP appt (in person not phone?)

It's madness- because it wastes the time of nurses who aren't drs and who could be doing other things.

Do you only have 1 practice in your town? I'd change!

Or are you saying you can book an appt with a dr, but you have to ring on the day? That's normal for most practices now.

in theory, yes ring on day, ask for doctor, get questioned by receptionist, get doctor same day.

In practice, ring on day (9am) , ask for doctor, get questioned by receptionist, get told no appointments left apart from nurse, ask for one for doctor for tomorrow, get told to ring 9am tomorrow!!!

Tote - coming back to this a bit late but you may see it.

Drs' receptionists are known for being dragons but only 2 weeks ago there was a lot of discussion - in the press and on radio /TV- about how they should not be working as a triage system; they cannot decide who can see a dr.

If a receptionist quizzes a patient, all they need say is it's a personal matter which they want to keep confidential and they want an appt with a dr, not a nurse. Fair enough to say it's urgent or not urgent, but the gate keeper role of receptionists goes too far sometimes- patients need to remind them of this politely.

Not too late, so thank you Polly. It's always worth knowing for a future time.

The sleeping tablets (as expected) aren't doing much for me. I am getting a few more unbroken hours sleep, but the anxiety level and temper is still there, just under the skin await to release itself to some unsuspecting person.
I'll ride it out until a week on Monday and see what happens then with the blood test results. I also will have with me what will be by then a very educated husband (he keeps getting emails from me saying read this etc). He's no pushover, so will be speaking for me if necessary.

Okay - I was back at the doctors this morning - I've decided I need to change practices.........
This was this mornings conversation....it was a different nurse to last time. I can cope with that I don't expect them to work all the hours and they have my records.

Nurse: What can I do to help?
Me: I saw last week. I think I may be peri menopausal, but I had bloods taken and I'm here to get the results.
Nurse: Have you not had a letter?
Me: No, what letter?
Nurse: Asking you to see a doctor for your test results. We can't give you your test results.
Me: Why didn't she specify that last time:
Nurse: Not sure. But you'll need to make an appointment - it won't be anything to worry about!

Now in the state I'm in, my husband had hold of me at this point as I was getting a tad wound up. Also he pointed out, that had I been on my own last time, that me not understanding would have been likely given the state of me, but since he was with me he can attest it definitely wasn't made clear.

So I have an appointment with a doctor this afternoon. I assume letter must have been sent end of last week by 2nd class.

Do I also assume that if they've gone to the trouble of asking me to make an appointment, that they've found something in the results and they wouldn't have me make an appointment just to say nothing found?

This is not helping my tension, rage and tearfulness. Had a rant about doctors down the phone at my mum. Ahhhhhhhhhhhhhhhh!

So sorry, tote.

I'm getting the run around about menopause too from my GP. Finally persuaded him to refer me to a gynaecologist over a shitty fibroid, so I'm going to try and take advantage of that. I'm 55 btw.

OP I just had an appalling week and I'm sick of it.

Yep, GPs can be crap about the menopause. The NICE guidelines are really helpful as is the Menopause Matters website.

Be persistent...

For 'the rage' my GP suggested Agnus Castus tablets - which have proved surprisingly good. I definitely felt more even when on the pill as well which was providing oestrogen. Come off it though as was getting v depressed on progesterone days.

I suggest that when you see the dr you say you have all the symptoms of peri meno and want to try HRT (if you do.)

Your GP cannot refuse unless there are significant medical reasons why they think you can't have it. These are almost non-existent- include things like recent heart attack, clots etc. My consultant told me recently that some oncologists are now 'allowing' women who have had breast cancer to use certain types of HRT that are considered breast safe.

Do not accept a prescription for crap Premarin which is cheap and contains synthetic hormones. Patches are safer.

Polly Thanks to you I went all armed this morning with the NICE guidelines and highlighted all the symptoms I have and also the relevant bits about treatment. I was ready for 'that' discussion.

So a little knocked back that I didn't get to use it all. However I will still have it with me this afternoon when I see the doctor. I guess there could be three things the doctor could say this afternoon

1. They've found something completely different wrong with my bloods
2. The bloods do show peri-menopause levels
3. Nothing wrong with bloods.

I'll be back later to update....

Don't forget that blood tests for FSH and estriol in peri can be all over the place so even if they say you are not peri meno, your symptoms say otherwise and that's what they should take note of.
My own blood test showed I was post meno when in fact I continued to have periods for 2 more years.

Blood test confirmed peri meno! Doctor said I'd been beating the odds to manage this long!

Lots of information to read on different treatments and another appointment in 10 days time.

Thanks for everyone's help.

Eek! I'm on Premarin and it's the best I have been on. At least it stopped my periods.