Do I need to see my GP?

[Inforthelonghaul]

I’m 49 and haven’t had a period for over 18 months. I’m fairly fit, not overweight and don’t currently have any ongoing symptoms other than getting hot at night sometimes although I have had bouts of insomnia, flushes and mood swings over the last couple of years.

Should I be concerned at all or just relieved that hopefully I’ve got through it ok. Just don’t know if I should be seeing a GP and getting checked or if I should be worried about things like osteoporosis as I’m below average age for menopause. Any advice please!

When did you last see your gp? I think a general health check up when you are over 40 is worthwhile. E.g. if you haven't had your blood pressure checked you could have high BP and not know anything about it.

Thanks waffly I’ve had a fair amount of medical attention in my mid forties for another reason entirely so happy that I’m fit and healthy just also fully menopausal several years earlier that expected. I think I will make an appointment just for a chat.

When you say 'getting it checked'- what do you want checking? The insomnia, flushes etc are very classic symptoms. No need to discuss unless you want HRT or can't take it and want to try other drugs.

I honestly don't think a GP would send you for a DEXA scan for your bones now, BUT I do think you should think about HRT because a) you sound as if you are still having symptoms (not clear if you are, or had) and b) stopping periods at 47 is 'young' -ish. If you don't want HRT (symptoms not bad enough) then it would be worth having your bones checked in maybe 5 years from now.
Do not expect the NHS to offer this- it's something you may have to be assertive for and ask, or even pay for it privately. Most GPs are very negligent or ignorant about this.

If onset is before 45 there's a case for replacing hormones until the 'average age' of 51 for primary prevention of osteoporosis (NICE guidelines). I should study the guidelines and see if you have any questions or needs. Otherwise, just keep on as you are.

@JinglingHellsBells - a question about Dexa scans. I'm 54 and been on HRT for over a year. Osteoporosis is a big problem for the women in my family, although I'm the first on HRT. When would it be worth me having a Dexa scan do you think? It's something I'd be happy to pay to have privately if it's worth doing. My diet is very good, weight low and I'm fit and active. What do you think please?

@babyfoal

The biggest loss of bone is in the first 5 years after menopause (ie last period.) worst case, 20% of bone is lost in those 5 years.

I think you should have one soon ( ie next 6-12 months.)

IF your bones aren't in great shape you will need to have them regularly ever 3 years. But you need one to set the baseline and more later on to see how much % of bone you lose between each scan.

Don't go for one of the cheap heel scans- they aren't good. You need the full one of your hips and lower spine. Costs vary- can be around £200 but once ever 3 years isn't bad in my opinion.

I had a Dexa scan at 54 which showed that I have borderline osteoporosis. (My T-score for my hips was -2.4 and osteoporosis starts at -2.5). Both my mum and grandmother suffered from it. My doctor offered me drugs that crystallize the bones, making them more brittle! So I am treating it with exercise and diet.

Scans are done every 2 to 2 1/2 years.

You say that your weight is low. Thin people or those whose weight is normal are far more likely to suffer from osteoporosis than those who are overweight as excess weight helps bones. The flip side is that those who are overweight are more likely to suffer from osteo arthritis. My BMI was 21 and I was advised to put on some weight.

If you can afford to go private, I would recommend that you do so. Even though I saw what my mum and grandmother went through (and they both died early due to complications arising from treatments) it wasn't until I saw my results in black and white that I took it seriously.

My T score was the same in my hips in my late 40s, long before I was post-meno, and it is now almost normal, as a result of diet, exercise and HRT. It can be improved but takes a concerted effort for years and years.

Thank you very much for the advice. I'll have a look and see where I can get a scan done ASAP. I'm determined not to end up like my mum and sister.

I've emailed the Spire hospital. No time like the present.

Just check they do them- not all hospitals have the equipment. You also need to make sure that every time you have one, the machine is the same one- so that means you should go back to the same place (unless impossible, of course.)

Ok thank you.

Well, the Spire have got back to me and said they haven't got the equipment, so can't offer bone scans. I'll have a look at London clinics.

You need to check if they need a referral form or if you can self-refer.
The results have to go to someone- so that would be your GP usually unless a consultant has referred you.

Most of the big London private hospitals will offer DEXA scans and some smaller 'clincis'. PM me if you need to.