Why are GPs so clueless with Peri?

[Joto369]

I'm 48. My symptoms include hideous anxiety, mood swings, foggy head, midcycle migraines, chin hair and itchy nipples, drier bits and if Johnny Depp crawled into bed with me I'd tell him to sod off. Underneath all this crap (and that's a shortened list) I feel like me. I just want to shake my whole self and then I may feel ok. There is a pattern with it all BUT my periods are still regular so they won't do a thing. Has anyone got any advice or maybe a magic wand?

After my period not aftercare! Yes to the sweating description as well!!

I had a totally different experience at my GPs yesterday. I'd gone for a smear test and I asked the nurse whether taking supplements would help with the hot flushes I've started to get. She insisted I spoke to the GP even though I was fine - she said it was worth getting all my symptoms on record in case I needed support at a later date.

So I waited for the GP who was just brilliant. My hot flushes are coming at the rate of a dozen or so each day but aren't unmanageable. We talked about how my cancer treatment 10 years will probably mean I have quite an intense menopause. She asked what I wanted to happen as a result of our talk and I said I'd go back if the hot flushes start to make life difficult.

Great experience, I was really impressed

I'm not really sure what you're wanting your GP to do? You don't seem to be clear about what you're hoping for.

They offered HRT to manage symptoms which you declined, an antidepressant - which one and why? Many GPs will offer venlafaxine which whilst it is an AD can be beneficial in managing hot flushes, mood swings and cognitive function I believe.

Anyway I hope you get sorted soon, maybe a private specialist will be more holistic and more helpful

Furbys have PMd you.

Furbys my understanding is that the BMS courses which run for half a day to day or only a few hundred quid at most. Doesn't a GP practice pay for this type of CPD or do GPs have to fund it themselves? Certainly the BMS conference isn't that expensive and last year it was all about the new guidelines.

OP You really do need to see another GP or go back to the one you saw. If you read the NICE guidelines and print them off, there is a whole range of peri symptoms. Saying you must have the two she chose in order to have HRT is just bollocks.

Hi Sidge. I'm hoping to feel better and the minefield of info or lack of from my GPs doesn't help. I've been offered AD's in the past when I've presented with low mood and anxiety linked to periods. A few days later I feel perfectly fine so really didn't want to take them as having tried citalopram and prozac both made my anxiety much worse. And as I've now learned it shouldn't be a first line for menopause. I didn't decline HRT as it wasn't discussed like that - just we can give you a tablet which sounded more like the pill so I need to query that . I took venlafaxine 15 years ago when suffering from really bad depression - it's a very strong AD with some not so nice side effects and withdrawals so I really would like to avoid that route. From another site mirena may be better as the pill and HRT may make the fibroids/PCOS worse. I understand it is all very trial and error but I've suffered so long with all things hormones I'd really like to get it right as far as I can

Having a Mirena coil will reduce the bleeding if you have heavy bleeding. If not, it's still an option as the progestogen part of HRT. You'd need estrogen separately and could have pill patch or gel.

Also it depends on your fibroids if you'd be suitable for a coil fit- keep going till you find a GP who knows their stuff.

Aaah I see. Fingers crossed you get sorted soon

I will!!!! Will update when I speak to GP on Wednesday. Thank you

So just spoken to GP. 'We only prescribe HRT for flushes as there is no proven link between HRT and reduction of anxiety'. Explained I don't feel depressed or anxious all the time but have an awful spaced out feeling (which lifts eventually) and yes occasional anxiety/panic attacks (2 since last week) 'That's what happens when you are anxious all the time - AD's would help'.

So you re going to hit them over the head with the NICE guidelines aren't you?

Psychological symptoms

1.4.5 Consider HRT to alleviate low mood that arises as a result of the menopause.

1.4.6 Consider CBT to alleviate low mood or anxiety that arise as a result of the menopause.

1.4.7 Ensure that menopausal women and healthcare professionals involved in their care understand that there is no clear evidence for SSRIs or SNRIs to ease low mood in menopausal women who have not been diagnosed with depression (see the NICE guideline on depression in adults).

I'm going to call the other surgery in my town and see if they have a specialist gp/at least with an interest. And then hit them over the head with the guidelines! !!!!