Just want someone to offer and ear & advice. GP won’t.

[Crinklyoldhag]

I’m mid 40s. I’ve had perimenopause symptoms for 6 years and a baby in the middle of that. My periods were regular as clockwork, only missing when pregnant (I’m not!) then through early lockdown they came every two weeks. Then stopped. My period has been missing for 4 months now, the worst peri symptoms have gone with it (no bad thing) From the moment it was first due until now I’ve felt like it was always just about to start but it never has. I still have insomnia, panic attacks in my sleep (I never have them awake) and can now add swollen and stiff hands and shoulders that I never had before. Moods up and down like pms but all the time now. Hair falling out at root. Massive midriff weight gain but my bloods are all fine. Great even.

GP is really dismissive and refers me to a website rather than talking stuff through with me. I have osteoporosis in my spine and I’m really worried that if this is the start of actual menopause that I’m making my bone health worse by not seeking hrt which I know has protective qualities for younger menopausal women . My gp (alleged practice expert of meno) went on about the many risks of hrt but wouldn’t say what they were because it would take too long. In the end they said the decision was mine but to go inform myself off a website menopause matters (which I’ve read over and over but don’t find the answer to my questions)

I don’t know who to talk to about this. I’m really terrified of the osteoporosis getting worse or more widespread (I also have osteopenia in hip). I take calcium for it and not due another dexa for a few years. The other symptoms I can live with as I’ve done it for 6 years but the osteoporosis terrifies me.

The other GPS are all male and won’t discuss menopause as it’s my GPS speciality and I can’t swap practices during the pandemic (I’ve tried).

I have no one to talk to about this - my mum was mid 50s and sailed through her menopause so lacks sympathy. I’ve no friends at this stage in life. I really don’t know what to do and I’d love a sympathetic ear with some advice.

Sorry for being so long

Oh and another thing - GP says covid is likely reason for my missing period. They way they were talking I’m surprised they didn’t blame 5G as well

Have you joined the forum on the menopause matters website?
There is also an email consultation service on the website too.

Your GP sounds like a twat. If any consolation on the osteo, my entire family has it after 50 and my grandmother lived with it for 50 years with no exacerbation, but she did get put on some sort of medication for it. I don't know what but I know she never went on HRT. You should push for more on this point, HRT is not the only route to go down. It is usually a very slow progression though, even post menopause. I get regular dexa scans at 42, so hopefully mine will get picked up quickly when it happens.

Your GP is treating you appallingly. You need to change either to a meno consultant (and you may have to resort to private to get an appt soon and advice.)

I can offer a lot of advice - I'm a health writer and have written on osteoporosis, early meno and hrt, as well as having personal experience of some of that.

What started the dexa scanning?Family history? Fractures?
were you referred to a consultant rheumatologist for advice and treatment? If not you should be.

Taking calcium is NOT a treatment for osteopenia. There is a lot of research on this and it shows that calcium supplements can be harmful and cause hardening of the arteries. You should get 1000mgs of calcium a day from food and not need to supplement.

The next point if that hrt before age 51 does not carry risks. Your Gp clearly knows nothing, At your age you need to replace estrogen.

Your next dexa scan should be 3 years after the last one.

Have you not been referred to a menopause consultant or a bone specialist?

Please take control of this and see another dr. Meanwhile, there is a lot of info on the Royal Osteoporosis Society website and also that of Dr Louise Newson. If you want names of private consultants I can let you know names of good drs in the south of the UK.

@Tootletum bone density falls off very fast post menopause- up to 5% of bone can be lost each year in the first 2-5 years after the last period. It's very serious and too many women are not diagnosed till it's advanced and then they need to use drugs with horrible side effects.

You will need to be referred privately when consultant has a diagnosis that will be flagged up at gp practice. Sorry but it is sometimes the only way.

Google your local Spire or Bupa find a consultant contact them and take it from there. Take it out of gps hands.

Follow the Menopause Doctor on Instagram.

For most women the starter HRT prescription is usually something like 2 pumps of oestrogel plus an Utrogestan tablet for all or part of a month depending on period status. Read up about this combination or others involving patches) on menopause matters and the Balance app run by the menopause doctor who’s on Instagram, and look at the NIce guidelines pinned to this topic and go back and say you want to try this combination (or similar).

Point out to the gp that the risk of breast cancer on this type of HRT is less than it would be if you drink more than a small amount or are overweight.

I don't understand your first sentence @justasking111

" will need to be...." ??

The OP can self-refer to consultants if she chooses (many don't bother with a GP letter any more.) Some might and the GP would have to write a letter.

@Abraid2 OP is only 45. There is NO risk of hrt if used before 51 (average meno age) and it's purely replacement. (This is clearly explained on Menopause Matters website and Dr Louise Newson's) and it's disgusting a GP doesn't know such basic facts on HRT!

@JinglingHellsBells I was just talking about the experiences in my family, where it's been diagnosed and treated.

@JinglingHellsBells

I don't understand your first sentence *@justasking111*

" will need to be...." ??

The OP can self-refer to consultants if she chooses (many don't bother with a GP letter any more.) Some might and the GP would have to write a letter.

Sorry in Wales our private consultants Spire insist on a referral letter from the gp . May be different elsewhere.

not sure how old you are in mid 40s but you can ask for the combined pill. It has oestrogen and progesterone in it and GPs will now prescribe it up to the age of 50 and it will sort out the perimenopause symptoms.

@Tootletum hrt is licensed for younger women with osteoporosis. Drugs for older women with severe osteo can only be used short term for 2-5 years anyway and can have serious side effects.

@justasking111 Spire is just one private medical group- there are many others and each consultant is different. I made 2 appts at a Spire hospital in England for my mum and neither consultant wanted a gp referral - depends on the doctor. many are happy for patients to make their own appts.

Sorry in Wales our private consultants Spire insist on a referral letter from the gp . May be different elsewhere.

Consult a private GP. Bloody hate this stupid system where GPs can literally fuck your health by blocking your access to a consultant.

@RadioActiveBrain

not sure how old you are in mid 40s but you can ask for the combined pill. It has oestrogen and progesterone in it and GPs will now prescribe it up to the age of 50 and it will sort out the perimenopause symptoms.

Her shitty GP probably won't. She'll be offered a Mirena at most.

Thank you all. I’m not in a financial position to pay privately arhlough it does seem the sensible option. I’m in Scotland where the NHS works slightly differently & I would need a GP referral for a private consultant.

@JinglingHellsBells thank you - what you’ve written was my previous understanding of the situation from research but my GP just played it down. She isn’t refusing HRT just won’t discuss options or pros and cons with me. She told me read menopause matters. I have osteoporosis & osteopenia from taking high does steroids for four years for an autoimmune disorder in my 30s. My dexa scan said return in 5 years and I have another woman or three to go I think before my next. I had them every year for three years before that. I do see a rheumatologist for the autoimmune disorder but they don’t know about my haywire hormones, never mention the osteo-issues and my appointment keeps being cancelled as my rheum is off on long term sick so haven’t had a chance to discuss it. I’m going to call the helpline tomorrow (today) about it all.

Thank you @Abraid2 I shall go look at Instagram. Everything I’d read had said the risks were low at my age but my GP was insistent they were too great without being willing to discuss them.

I suppose my concern for starting was what if I don’t actually need HRT yet and this is all just a random blip. My FSH was low which doesn’t indicate meno, although I’m aware it’s not a reliable marker in peri. If anything it was too low (when I was trying for a baby it was 8something and now it’s only 3.) I just wanted to know whether it would be a problem taking it if it turned out not to be periM related but something else. And if it’s something else causing no periods, what is it?

@Crinklyoldhag Good to hear your update. BUT I can't stress enough that if you have diagnosed osteoporosis (T score below -2.5) you NEED ongoing treatment. Your drs are being medically negligent by not treating you properly. AdCal or whatever calcium you are taking is not treatment in itself. You could have a case in future for medical negligence. The dexa scans should be done every 2- 3 years , not 5 years.

why does your rheumatologist not know about and treat your osteoporosis? Honestly, the whole situation is terrible! These drs simply are not doing their job.

Established osteoporosis in someone your age needs early treatment. That could be drugs for osteo, OR HRT especially as you now have peri men symptoms.

Long term, more women die from complications of osteoporosis, than all female cancers combined - it's really that serious - because their spines collapse and this can cause disability, reduced lung function (and they get pneumonia easily in old ag) and hip fractures can reduce mobility and create disability.

You need to kick up a fuss and get proper treatment! I am actually speechless that you are experiencing all of this.

Going back to your question about is it peri and do you need HRT- yes and yes! All classic peri symptoms and no harm using hrt.

I’m in Scotland where the NHS works slightly differently & I would need a GP referral for a private consultant

I am, too. It depends on the clinic. Quite a few don't require a GP referral.My son receives private care and we didn't need a GP referral (thankfully, as we also had a shitty GP and had to find a way to change). Ask anyway and just be clear and honest, 'I find my GP obstructive and unsupportive and am unable to change due to X, Y,Z'. It's the truth!

@JinglingHellsBells if you think that’s negligent I was told just to get over the counter calcium rather than have them prescribe it! The dexa scan timescale came from the hospital scanner’s recommendation based on no change in the previous scan rather than the gp.

@Batshitbeautycosmeticsltd when I first saw a rheumatologist I paid for a private consult and I had to be referred by my GP to be accepted. I’m wondering if there’s a menopause clinic as I suspect that would be more open to self referral.

Someone upthread mentioned Mirena. I tried to get it fitted but they couldn’t get it in and I chickened out of going to get It fitted with contraptions to wedge open my cervix. I struggle with smear down there so that sounded like hell.

[quote JinglingHellsBells]@justasking111 Spire is just one private medical group- there are many others and each consultant is different. I made 2 appts at a Spire hospital in England for my mum and neither consultant wanted a gp referral - depends on the doctor. many are happy for patients to make their own appts.[/quote]
I already pay Spire annually so would be a waste of money to go elsewhere.

@justasking111 must be a very different set up where you are. Never heard of anyone paying a private hospital group. Is this a type of medical insurance? Most medical insurance covers you for treatment anywhere, not one business.

My friend who is a gp says she is definitely going to take hrt when she hits menopause.