I need to help myself now

[ElephantsandTigers]

Definitely feel like I'm leading up to the menopause if not peri-m especially after reading an article in the paper today. I'd put the symptoms down to other things. Anxiety, exhaustion, feeling very low, bleeding out of time, early/late period, lasting longer, being shorter. I already know my oestrogen levels are zilch.

GP referring me to a HRT specialist. Has put me on mirtazapine and I take 1/2 a tablet.

Are there any supplements or food stuff I could take to help me before I see the specialist please?

Has anyone taken these - MenoCool Black Cohosh? My main problem is low mood and anxiety.

what is the drug your GP ha s given you and why? what is your diagnosis? If it's an anti depressant, they are incorrect to prescribe this for moods and anxiety that is hormone-related. The meno specialists who wrote the NICE menopause guidelines made it very clear that ADs 'have no place ' [their words] in the treatment of women with anxiety etc that only occurs for the first time during peri meno.

Why is your GP not prescribing you HRT? Unless you are a very unusual 'case' they ought to be able to give you HRT.

Why the referral?

My personal advice is you try estrogen and see how you go- HRT- and go back to your GP asking why they won't sort this.

I am on the drug mentioned in the OP due to very low mood due to personal stuff though I'm now starting to wonder if it's to do with menopause and not that. I just don't know.

GP didn't feel comfortable giving me HRT hence the referral. Can't complain about that.

I just need something now as I expect it will be a while before I see the specialist.

So your GP, who treats 50 % of the population is not au fait with HRT enough to prescribe? That's shocking, frankly.

Is there no other GP at your practice who can help you? You might have to wait months for an NHS referral.

I am no expert on prescribed ADs but I would imagine you need to be careful of mixing herbal products with them, if they are supposed to have the same effect (on mood.)

You really need some proper advice and treatment with HRT now.

Have you considered raising the issue with the practice- ie that they are not confident in prescribing main stream HRT for women in peri? It's a disgrace really. Not your fault, of course, but it's not usual to refer women for specialist treatment for meno unless you had a lot of other health issues that might affect HRT use.

I am struggling with knowing the cause of my feelings. I assumed it was something els but now im wondering if it's hormonal. Surely it is better that she refer me to someone who will know for sure than prescribe me something that she feels may cause a problem. Right now I'm not very well and getting through the day is very difficult. I'm seeing her again in two weeks.

The 'rule' from NICE is if these feelings coincide with peri meno then HRT is the treatment- you can read this on the NICE meno guidelines yourself- all online if you google. If this is the first time you have ever had low mood the assumption is it is meno and not other types of depression.

Yes it's good to see a specialist, but you may have a 6-month wait and no, it's not good that a GP cannot feel confident to prescribe you HRT.
The BMS run courses all year for GPs to try to get them to update their knowledge on meno and HRT- sounds as if yours needs pointing in that direction!

I'm sorry you are not feeling well, but at the very least your GP ought to feel confident enough to offer you a low dose HRT such as Femoston or a sequi patch. I wonder what criteria they have used to refer you to the specialist ? Is it because they are unsure if your moods are depression or menopause? Are you seeing a gynaecologist and do you know who? best check them out and see if meno /HRT is one of their specialisms.

I'm peri, still have periods, but felt so flat, low, tired etc. My gp put me on a progesterone only pill and the difference is incredible. I also take menopause for the B vits and omega 3 to help with the fuzziness in my brain. Seems to help so far. Good luck

It's born the first time I've felt low as I've had PND but it I still the first time I've had anxiety. I had a trauma and thought that was why I was anxious. Now I'm wondering if the trauma has brought on the menopause and I'm anxiously because of the M and not the trauma. I'm not seeing anyone.

It's not..

madrose -I do take starflower oil and Angus castes but need more. Since being in the new stuff I've slept a bit better but I don't eat very well always so need extra vitamins. Are they all the same or some brands better than others?

I'm not seeing anyone .

I meant who has your GP referred you to? Is it a gynaecologist? Or is it someone to assess your mental health?

Am I missing something? I can't understand why your GP is unable to offer you HRT for what appear to be classic meno symptoms.

There is no good evidence that any herbs etc help menopausal symptoms. I have left links a few times here to an info leaflet by the royal college of gynaecologists (RCOG) on alternatives to HRT- have a google. They show which don't help at all and which may help a bit.

Hi Elephants,
I have very similar situation to you.
I have had PND and depession and anxiety in the past. I am now peri menopausal (i know this from the symptoms you also describe) i knew i was feeling terrible as a result of hormones because for some of the monthly cycle i would feel fine. it is very difficult if you have experienced trauma to know what's what. I've experienced a few too many losses in the past few years and grief can really cause havoc - that said i pushed for HRT. So I would say give HRT a try.
If the doc seeing you in 2 weeks wants to refer you to a sepcialist that's fine but i would ask for trial of a patch for while you wait for the appountment.
Look up menopause matters website, read all of PollyPerky's post and arm yourself with all the facts.
You may have some other issues going on but if you are peri menopausal then your hormones need sorting out.
Chat on here some more if you are feeling low xx

PP - the GP is referring me to someone who specialises in HRT.

KD - that's exactly it. I've had two large traumas in the last two years and after both I started two lots of therapy so I don't know what is causing me to feel the way I do, GP thinks hormones rather than trauma, whereas the therapy has also brought up lots of unexpected difficult feelings so I feel lost and exhausted.

I don't know how long the tablets will take to help me feel better but I have stopped waking at 4 which is good but I'm finding it hard to get up in the morning.

I'm only going to repeat myself here so apologies for that!

I can't really understand where your GP is coming from. Can you? It's within the normal, everyday work of a GP to prescribe HRT. If your GP can't do this, you should ask why. Have you asked why?

I also cannot imagine a consultant being too happy over a referral for something as straightforward as HRT for peri meno. This is not common practise. Your GP sounds lacking in skills and confidence re. menopause.
Do you not get this impression?

Your GP seems unaware of the NICE guidelines which are simple and clear: if a woman turns up with a host of peri meno symptoms, then HRT ought to be offered. If it doesn't work, then either the dose is not right, or the type, OR there is something else going on as well as / other than menopause.

Your GP is unwilling to even TRY you with HRT before sending you to a consultant .

Have you thought about seeing a different GP at your practice? At the very least you should question the one you see on why they won't or can't offer HRT for 3 months to see how you feel on it.

Polly is right the GP should be able to just prescribe it - give it 3 months and then revise/tweak whatever. Waiting around for a specialists appointment when they will only prescribe the same thing your GP can seems silly.
The thing is most GPs, even the ones who are supposed to be the experts in women's health often have very limited understanding of HRT. I as offered ADs but i knew i didn't want them.

Elephant i'd advise you to make another GP appointment and this time ask for HRT. This treatment can run alongside any counselling you may choose for your trauma healing.

I feel your pain xx

That's right Kalifornia. The thing is, if you read forums you will see that most women would give their right arm for an appt with a specialist but GPs won't refer- even when women have tried countless types of HRT or have had things like breast cancer where they need a specialist's opinion!!! I suspect the consultant will be very annoyed with GP to have something so run of the mill sent their way.

How old are you and how long have your periods been a bit haywire?

I know why the GP hasn't prescribed HRT and while I think she is being over cautious I didn't know enough at the time, or feel mentally well enough, to push her. This GP has got things done, i.e. referred me for tests then further tests when another GP told me to find out what test I needed, so I do trust her. I'm seeing her in two weeks. It's not too long to wait and I'll discuss it again with her then. It is complicated with the traumas I've recently been through and as I've said, neither of us knew what was causing my issues but the GP does think hormonal. She prescribed what she did to help me get some sleep so I could maybe see more clearly.

The whole point of this thread was to ask what I could do in the meantime. I prefer the holistic approach where possible and appropriate.

If your GP thinks this is hormonal they ought to prescribe HRT. You ought not to need a referral to a consultant - which could be months- to get HRT. That's just silly.

You haven't said how old you are, which is highly relevant, or how long your periods have been erratic. Yes, life events can affect periods, but in women aged 45+ erratic cycles plus everything else you describe as having, are likely to be peri meno.

I don't understand why you are defending your GP. Their behaviour- anti Ds for sleep issues that they admit themselves may be due to hormones go against all current medical advice. Maybe do some research, ask on other forums, etc because no matter what I post you don't want to accept it. I hope you find the answer anyway.

I'm 45. Periods been off for a few months. I'm just saying what I feel about the GP. I have listened to what you have said, and if you've read all my posts, you will see I have said I will ask her about it when I see her in two weeks. As I've said, the GP has her reasons for prescribing the AD and not prescribing HRT.

I have read many of your posts PP and I have no idea what your qualifications are but I find you quite adamant that you know best and you make it very difficult for me to want to engage.

I'm not sure what you want me to do, and quite frankly I didn't care. I have read it all, made notes and will ask the GP the relevant questions in two weeks. Have I said anywhere I think you are wrong? No.

I am not telling you anything that is not medical advice. None of what I have said is my opinion. It's what NICE says.

I am sorry you find it hard to engage. My concern as was that of the other poster on your thread was that a) you'd wait 6 months or more for a non urgent meno referral and b) not be offered anything your GP could offer now and c) that you seem not to question what your GP was offering (ADs) when menopause seems the likely factor.

If you take issue with my frankness and reporting of facts, I am sorry. Maybe ask on Menopause Matters forum and see if anyone has any other ideas. I am not a member there so you are safe! :)

Hi! I have a similar experience, I am peri with severe symptoms and mood changes, high FSH and very low estrogen. My first gyn offers only antidepressants and ignorance!!! I m psychiatrist and I can understand the difference between hormone imbalance and psychological causes for depression. HRT offers a more stable hormonal state that affects our whole psychological and physiological being. If HRT doesn't help, it s possible you to need psychotherapy with or without antidepressants! Just my opinion...Take care! 💐

I just feel my head is full and I just don't have the time or space or energy to work out what to do for the best. I'm suffering with mental issues too, my brain isn't working too well, so a lot of the time I can't even come up with the right words. The trauma could have made me anxious but now that I've read the menopause can cause anxiety too I'm just argh.

I think that's a combination of psychological factors and hormonal imbalance and that makes your mental state and symptoms more severe. I feel that you need help immediately. Your trauma is psychological I guess, not physical...?

Not physical, no. Emotional.

I lost the ability to speak full stop plus eat unless dh was there as well.