I think I'm in peri. It's hell. What are my options?

[WhereAreWeNow]

I'm 44. I've always had bad (heavy and painful periods) and my PMS has been getting worse over a number of years but it's now just totally out of control.
I'm exhausted, achey, and I have terrible insomnia for 2 weeks before my period,.
I'm so irritable, tearful and angry for a good two weeks before my period - I veer between depressed and raging. I'm horrible to be around.
My periods are still regular but increasingly heavy and painful.
I can't concentrate and I have the worst memory.
I've also had a lot of joint pain. I had been worried that I have osteoarthritis but I'm now wondering if it's another symptom of perimenopause.

So the first question is, does this sound like perimenopause?
Second question is what can I do about it?

I've got a GP appointment (phone) on Friday. What should I be asking for? I'm scared of HRT because of cancer risk.

TIA

@CoffeeChouxBun Refuse. NICE says GPs are not to do blood tests.

Read the NICE guidance top of this forum and talk to your GP and educate her!

Oh! I was quite pleased to be offered a test. How else can I tell if my periods have stopped without coming off the minipill to see what happens?
If I'm still ovulating and my general health is good, I may be able to stay on the minipill ( which is what I want).
If my periods have stopped, then I dont need to stay on it.
I've just had a quick look at the diagnosis section of the NICE guideline ( and have bookmarked to read in full when I have more time) and I see it does say no blood tests to be used in diagnosis -- but it doesn't say why? Im not really asking for a diagnosis of menopause as such. I just want to know if my periods have stopped... if you see the difference?? I'm a complete beginner in all this so I don't understand why I'm being advised to refuse. a blood test.

Yes, those are all peri symptoms @64sNewName. Unfortunately, there are a lot of GPs who have little/no interest in women's health and spout out-dated information (see this thread as an example - offering women anti-depressants, recommending blood tests to confirm low oestrogen, etc - all no longer required).

So do your homework - visit the Menopause Doctor and Menopause Matters websites, get answers to many of your questions before you go and see a GP, and make sure you know your rights. Some GPs will try to fob you off with ADs, particularly if anxiety is one of your symptoms (I see that isn't on your list). I didn't mention anxiety when I saw my doctor, because I didn't want to be fobbed off with ADs! I'm not depressed, never have been, but declining female hormones can make some women feel anxious. Since I went on HRT the anxiety is gone ...

Your GP sounds useless.

I am not a dr but I do read (and write) about menopause. ALL the info is out there for a GP to find and some of it is bloody basic stuff.

The rule for women is that by the age of 54, it is usually ok to ditch contraception as the chances of conceiving and carrying to full term at this age is almost impossible.

HOWEVER, the reason for no blood tests- as your GP ought to know!!!! - is that hormones in peri are all over the place. It gives a reading for that day only. It might show you have a normal , fertile FSH level or one that shows you are post menopause- a test on 2 days can give 2 different results. This is why NICE says do not test. Because it's unreliable.

It's shocking that your GP doesn't a) know this anyway and b) has not read the guidance published in 2015 and hailed as THE BIGGEST new directive on menopause for decades.

Sorry but I'm so angry over useless GPs who don't seem to do any ongoing professional development.

You need to make a choice- either carry on with the mini pill for another year, come off it and use condoms or something else, and see if you have periods, or take a chance and use nothing.

At 53 the odds of being pregnant are tiny.

@CoffeeChouxBun ^^ that was for you :)

@JinglingHellsBells - thanks for replying. I'm grateful for your time and knowledge. If the blood test only gives a snapshot of that very day, then it's fairly useless and I will use that knowledge appropriately. If it says I am ovulating, then I am. If it says I'm not, then that means i'm not only on that particular day so I can't act on that information.
For me, it's not about preventing pregnancy, or the unlikelihood of carrying to full term at my age. It's about debilitating period pain which has dogged me for my entire life. Pain on a par with labour contractions which cast a gloom over my life when not on the pill. I am seeking to avoid that pain and all the limits it put on my life. I can't just come off the minipill and hope for the best.

Ah- get it now! Have you had undiagnosed endometriosis?

Thanks zafferana. I don’t think anxiety is really an issue for me, thankfully.

I will ring the GP. Weirdly nervous about it. I think it’s been so drummed into me not to take up their time if I’m OK just muddling along — even though I’m gradually finding I’m not my old self at all.

My question is, what happens when you eventually come off HRT? Do all the symptoms come flooding back? Is it just delaying the inevitable?

My question is, what happens when you eventually come off HRT?

You can use hrt for life. Coming off is your own choice. There are women of 80+ using it. My dr has someone in her 90s on it.

Do all the symptoms come flooding back?

Everyone is different. HRT helps when your hormones are all over the place so some women are fine once they stop using it. Others are not and carry on using it for a long time/ forever. However, this would be
exactly the same if they had taken HRT or not.

Is it just delaying the inevitable?
No. Some women only have symptoms for a few years, others for 20+ years- you don't know which you are. You can start and stop HRT as much as you want depending on what suits you.

Also, using hrt even for a few years has health benefits- less heart disease, stronger bones and better pelvic/ vaginal health.

Now I'm confused....I thought you could start HRT at any age. I am 54, still have regular periods and not really experiencing any unmanageable symptoms. Does that mean if I then get symptoms I am now too old for HRT? I was putting it off so I can stay on it longer?

@JinglingHellsBells thank you! I’ve just turned 50, have been managing my symptoms and still have regular periods but high anxiety, which happens regularly a week before my period. Might HRT help with that? Bad headaches too.

which bit are you confused over @Baaaahhhhh?

I don't think anyone has said there is a limit when you can start HRT- other than the first 10 years after a final period is considered best. Drs call it the 'window of opportunity'- the years when you will get the most benefits to bones and heart.

You can stay on it for life so no point waiting to enable you to use it when you are older.

The old days / directive of 'use only for 5 years' are long gone.

Posting this again as these videos although fairly long are very informative.

This video is very informative
www.facebook.com/1813454045540962/posts/2751618768391147/?extid=0&d=n

Also this one for those of you who have had cancer

www.facebook.com/1813454045540962/posts/2767684820117875/?extid=0&d=n

Menopause support fb page
www.facebook.com/supportformenopause/

Thank you so much - it’s so important we talk about this. I am another one who thought (assumed) I wouldn’t get HRT as I am recovering from massive pulmonary embolisms (not Covid related)

My memory is shocking, I ache but am starting to not sleep well which is just completely disastrous for me. The thought of this lasting for the next few years is hideous so will make a Drs appointment.

JinglingHellsBells. Thanks. Yes, I suppose it is the decision of whether to take it as you start peri-menopause, during, or after your periods stop. As you say, if the advice on duration has changed, I don't suppose it really matters. I don't need it for symptoms (at the moment), I am more interested in it for the protectative effect for heart and bones. I am lucky, in that my periods are still regular at my age, so I haven't really looked into the detail of it yet.

I'm on it mainly for protective reasons, I have a condition that evidence suggests is worse in women not on HRT, though my consultant for that condition knows nothing about it, I had to do the research myself, which I find shocking. When you look into it there are so many conditions linked to low oestrogen, but the general conversations about HRT seem to just relate to the alleviation of traditional menopause symptoms rather than thinking more broadly.

That’s it Tabby

People seem to think it’s about managing hot flushes whereas low oestrogen is key to so many health issues

I started hrt at 42, I had almost regular periods but too severe menopause symptoms. Hrt helps me to function normal again, without pain, depression, night sweats etc. Actually I am better than before menopause! Hope it lasts!:)

@Emerald13 I'm glad HRT worked for you. Could you tell me a bit more about your symptoms? I'm trying to work out whether I've got peri symptoms or if there are other things going on that I should get investigated. Also, what kind of HRT did you go on at 42? I'm trying to work out the difference between all the different options of gels, pills etc.

@Newgirls
I don’t imagine acupuncture can help bone health you need calcium supplements if your diet doesn’t contain sufficient calcium or exercise for like running or something.

PS in general everyone, re joint pains, I’ve had a great result from taking an omega oils supplement from Asda £3 i think. Took six weeks and I no longer creak. I have literally oiled my joints. It’s amazing. I still feel the floor a bit and wear slippers all the time as the subcutaneous fat layers have famished in the soles of my feet, but no creaks is good!

@WhereAreWeNow I just want to add another voice to the other posters who recommended black cohosh. It’s changed my life. I was so anxious and depressed for about 10 days before my period started about 2 years ago (when I was 44). I was hysterical at times. Just not like myself at all. A lovely female GP recommended me black cohosh and I was sceptical - said I’d give it 3 months and 2 years later I still take it religiously. My period is due today and I’ve had absolutely no PMT symptoms. My periods are still fairly heavy for the first few days but I find ibuprofen helps that.

But it’s the difference in my mental state that is amazing to me - I feel like myself

Hi Now! I had insomnia, night sweats, depression, awful body aches, tiredness and a kind of feeling that something is wrong with my body. I tried 3 types of hrt and I am on femoston 2/10. I prefer pills cause it is more easy to use for me. I am CrossFit athlete, so I sweat a lot.:)

Thanks @ComeOnGordon. I'm a bit sceptical about herbal remedies but I guess there's no harm in giving it a go. Do you take it all month or just in the 2 weeks before your period?

@WhereAreWeNow I get the scepticism. I take it every day. I obviously have odd days where I forget but they’re few and far between since I know how good it is for me. I’m hoping to keep taking it through my menopause