Perimenopause advice needed please

[Dumbledora]

Hi.
I'm 44, GP has said I'm in peri (no bloods done) , just based on symptoms, which are:
-periods closer together, heavy for 2/3days,then brown discharge for about 7ish days-v slight towards the end. Normal annual smears but Hpv+ on last 2 tests, no abnormal cells though.
-horrific anxiety, which is worse immediately after period
-dry skin and hair
-awful sinus type headaches for about 10 days before I get af.
-Joint pains again before af
-hot flushes and insomnia

Probably more but can't remember!

I'm currently taking Citalopram 20mg and Propranolol 40mg 3x day. Also Menopace, magnesium, folate, Vit D and epo.
I can't take hrt due to really strong family history of breast cancer. Also I'm obese which complicates thing further.

I feel so old! Does anyone have any suggestions on anything that might help?
Thank you, and sorry for the essay!

Hi, no specific advice really, I was diagnosed at 41 & still struggle 6 years later, I have a Mirena coil & am on oestrogen only oral meditation which has helped. - but I totally get why you can't have that, a friend of mine found Black Cohosh to be really effective & the usual healthy lifestyle advice is recommended such as getting enough sleep, relaxation, exercise and a healthy diet - however, as much as I try to pay attention to all four of those aspects there are still some days much worse than others, however, positives, it's made me a whole lot more knowledgeable about myself and my needs, it's not all bad, despite the god damn awful anxiety & lack of sleep (hence being on here at this hour on a Sunday!) I've managed to complete a vocational degree, progress in my career and, sporadically, participate in short distance running events. Small changes can help and I'd recommend Dr Rongan Chattergees book "The four pillars of health" for simple but effective advice. I'm currently also considering the advice re nutrition from Amelia Freer and I'm just about to order her books - sorry to hijack your post but I wondered if anyone had any experience of her work?? Give yourself time to get used to the idea & try to see the change in your life as a time to reassess and reevaluate. You are not alone!

Sorry it's Dr Rangan Chatterjee

Your situation is complicated. Your GP ought to refer you to a menopause gynaecologist.

First, medical advice is that you should use HRT if you are under 45/ 47 and are well into peri menopause. This is to protect your heart and bones 10 years from now.

Why are you using ADs- have you had a diagnosis of depresssion? If not and they are for hormonal based anxiety, the treatment is HRT not ADs. This is NICE advice for GPs.

What kind of breast cancer history? It does not apply to women of your age. At 44 you are REPLACING what you ought to have up to around age 52 anyway. It will not increase your cancer risk at all.

Again, this is medical advice. It sounds as if your GP is not clued up .

Breast cancer risk and HRT only applies if you have had BC yourself, or a mum or sister who have BOTH had BC and at a young age ( before 50.) Other family members do not count because a lot of BC is lifestyle related, not genetic.

Weight- being overweight is a far bigger risk factor for developing BC than HRT. Is your GP helping you manage your weight loss? What are you doing about it?

You need to re-assess the whole situation with the help of a dr who knows more about it.

Good luck!