Doctor wants to prescribe anti depressants for the menopause

[pink1173]

I’m 46 and been in peri menopause for the last 4 years. Things are getting worse and so I went back to the doctors for some help. I also have recently been diagnosed with ulcerative colitis so battling that as well. She said current guidelines are to prescribe an anti depressant for the menopause to help with hot flushes etc. Has anybody else's doctor prescribed them for the menopause? I’m really not keen and just wanted her to talk me through HRT because if I continue not to get any sleep I might not it be responsible for my actions! Thanks

That’s exactly NOT the guidelines. Read them for yourself, print them out and go back to her.

Have a read of NICE guidance re menopause. I don’t think antidepressants will help with the hot flashes. Maybe I’m wrong but have a read! Gp’s need to work to NICE guidance x

Thank you! I have read them so will definitely take them with me. Seems so difficult to get a clear answer from a GP.

Yeah, I think this is becoming more common because HRT is often more expensive. These are NOT guidelines. Don't be fobbed off.

Antidepressants might be prescribed for some menopausal symptoms . It really depends on the entire picture and although HRT is first line in most cases it is not always the whole story. Look at menopause matters on line and then talk it through again with your GP. I think it is very unlikely that cost is influencing your GP unless this is a private practitioner.

Mine did and they definitely helped. I hardly get any now.

Although, I have also been suffering with poor sleep, low mood, lack of concentration whichnmy GP thinks is anxiety-related.

Btw ask your gP receptionist whether one of your GPS has a particular interest in the menopause and don't forget that some forms of HRT are very hard to get hold of at the moment and might not be available until March.

See a different doctor. If you still think you are being fobbed off, ask for a referral to see a gynaecologist.

She is talking crap. You need HRT to replace the hormones your body is missing. Anti-depressents will not do that.

Can you see if you have a menopause clinic near you??....I was sent to one after a bit of a fandango trying to get a new Mirena fitted and a decent chat about HRT options

TBH even there they were keen on the AD route but at the time I had a new coil and vagifem which had pretty much solved the issues that I had

We did chat through all the options after I had completed a questionnaire with some leading questions regarding stress/anxiety/depression/low mood/lack of self confidence...however after that and a discussion we/I clearly decided that some sort of replacement of what was missing would be better for me than adding in apparently unrelated imo ADs, and I decided to run with the vagifem and the mirena for a while

Recently went back to GP hoping to bring in some actual HRT ,and she flatly denied the existence of Oestrogel. Apparently I had imagined it. I narrowed my eyes at her and asked to be referred back to the clinic

Then she looked properly at my notes/letters and saw the followup from the Menopause clinic who advised Gel, 2 pumps daily if patient requires it at later date
..she changed her tune completely and started babbling about costs to the surgery...and maybe it was discontinued...maybe the pharmacy would be able to find something, and if the clinic had said I could have it then it shouldn't be a problem

I have the Gel and it's working well...hot flushes have completely vanished, sleep is better, my bones are not attempting to kill me from the inside out.

I was really peeved at the way she tried to fob me off mind you.

To sum up as it's a bit waffly...
Menopause clinic?
Do your homework!
Do not be fobbed off with stuff you think won't suit.

I'm on anti-depressants for hot flashes. (Venlafaxine). In my case it was because I couldn't tolerate the side effects of HRT. I did find a doc who has a special interest in menopause issues (am in the US and there's an association) and her view was that HRT was the most effective option if you can tolerate it, though not everyone can. The 2nd option was the anti-depressant route. It has definitely improved matters. I was getting uptown 10-12 flashes an hour at times and now it's only a few bursts in a day. So I won't pretend it's the first best option, but I am grateful for it.

At the moment I can’t take hrt and have been prescribed Prozac for mood anxiety and low mood. It has unexpectedly been really helpful in dealing with hot flushes, which have dramatically decreased.
A bit of googling revealed that some antidepressants have indeed been found effective in dealing with certain menopausal symptoms.

I sympathise regarding the lack of sleep, it affects your whole life so relentlessly.

I was prescribed Amitriptyline for (probable) peri-menopausal lack of sleep last Monday, and I've slept the whole night every night since (obv still early days). Prior to starting it I'd probably had fewer than 5 unbroken nights in the last 6 months. The dosage is much lower than for treating depression (I think 10mg as opposed to 75mg per day, although don't quote me, I don't have it with me right now to check).

Having said that, I've only ever had one hot flush during the day so my symptoms are different from yours. My GP said (sympathetically) that unfortunately there is an element of trial and error in order to find what medication works for individual women.

I think that am amitriptyline has given me a rash on my face. Think I need to stop taking it.

@pink1173 Not much to add except to agree with other posts.

ADs are not first line treatment and there is a HUGE drive from menopause specialists to educate GPs on this AND TELL THEM TO STOP PRESCRIBING THEM!

They have a place in women who have had breast cancer and can't use HRT , or women who have other serious illnesses affecting hrt use.

For all other women, HRT is first line treatment.

ADs don't give any other benefits either which HRT does- bone and heart health.

ADs can also have horrid side effects like muzzy head, constipation, dry mouth and more.