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

Just catching up with this and never realised autocorrect had changed to Peru. A place I've always wanted to visit but shall use instead of peri henceforth :)

I'm with JinglingHellsBells in GPs should really be better informed regarding women's health. It's shocking how so many women are just offered ADs in the first instance. There is so much more info out there so arm yourselves with knowledge before you go to GP.

With the benefit of hindsight, I think I probably had PMDD and when peri arrived, the combination was fucking hideous, as was I to many people. It felt like none of the medics I was seeing were talking to each other or actually listening to me. I've had better information by educating myself online at Menopause Matters, and on Mumsnet, learning from others' experiences. No-one knows you like you know yourself and no one size fits all. It's a balancing act finding out what suits you best.

It is believed that PMDDis the reaction my body has to changes in hormone levels than the levels themselves. Given that everything hormonal that I took did not help me at all and sometimes made me worse would substantiate that I had it so I really avoid anything that will change my hormone levels because I know I'll get a 4 day migraine and a pile of other crap to go along with it.

The vits I take work for me - I don't know how but so far so good. For the first time in about six years I actually feel energised and hopeful.

Don't be fobbed off by GPs and don't fear HRT either. Though it didn't work for me, it works for others and the risk is minimal. And if they use the word 'dear' in the same sentence as 'putting up with it' then walk out and demand to see one who is more professional.

Don't discount herbal remedies. After all mAny drugs originate from flora, so it's not an unreasonable direction to go in. Homeopathy is nonsense, but herbal remedies really can work, you just to find one the works for you. Not unlike finding the drug that works for you.

@ComeOnGordon Black cohosh does have possible side effects, the main one being liver disease. It's not usually recommended to use it long term for that reason.

The same goes for all other herbal stuff. There is very limited evidence that they work - the research is mixed - and all drugs whether prescribed or over the counter supplements have a 30-40% percent placebo effect, so some improvements people feel are due to this.

It's worth a go, but you still need to be careful with herbs and also they won't help heart health or bones longer term.

@JinglingHellsBells that’s true that all drugs have side effects but thankfully I’m not suffering from them and can safely say that this is not a placebo effect. I work in medical research hence the scepticism but the difference in my mental health is significant and therefore I will recommend it to others. It’s up to people to make their own decision whether they take it. As @Baaaahhhhh says many drugs come from flora and aren’t dismissed.
I’m taking other measures to ensure my bones and heart are healthy at the moment and if it comes to it will happily take HRT if I need to. There are different options out there

You might like to read the research on black cohosh because there are some quite nasty side effects if used for too long and in high(er) doses. Something very simple like St John's Wort has significant contraindications if used alongside other drugs .

Did you know that modern HRT is made from yams? (Just tapping into your comments on using plants.)

I did read the research before I took it as I think anyone would before they took a medication that was unknown to them but the benefit I feel from it outweighs the possible risks for me at the moment. If I had any concerns about side effects I would obviously stop and get it checked by my doctor. Had liver tests done as part of a blood test this year and all fine thankfully.

I think it’s up to women in conjunction with their doctors to make the decision they feel is right for them given all the information. This is what’s right for me at the moment

Thanks so much to everyone who's posted with tips and advice. I've been doing a lot of reading and listening to podcasts. I've become a bit obsessed in fact.

One thing that's got me worried is the bone stuff. This isn't something I'd given much thought to before but all my reading is making me realise what a big deal osteporosis is. I've got bad joint pain. I ache and creak. You can hear my coming a long way off because all my bones click. I thought maybe this was osteoarthritis but I'm now worried it could be osteoporosis. I'm vegan and I think my mum has osteoporosis. I'm not sure if I should be begging the GP for HRT (but I've still got regular periods and no hot flushes/sweats), asking for a bone scan, stopping being vegan, or just going to Holland and Barratt and buying a load of calcium tablets. Or maybe all of the above

Now I'm in the good phase of the month (just finished my period, sleeping like a baby, moods are normal), I feel fine and would feel like a fraud asking the GP for help. But I know that when I'm in the 2 weeks before my period I'm a different person and I can't cope at all. I need to keep a diary of symptoms to remind myself and to show the doctor how crazy my hormones are.

I hear you. I am veggie, mostly vegan and I had to massively up my iron and b12. You have to have an excellent diet to get what you need - tho that is true of meat eaters too!

If you have a family history it’s well worth taking this very seriously

. I ache and creak. You can hear my coming a long way off because all my bones click. I thought maybe this was osteoarthritis but I'm now worried it could be osteoporosis

Osteoporosis is not like that. You only know if you break something after a minor fall or accident. If you break a vertebra which can happen without a fall etc, you'd be in agony. There are NO day to day symptoms of osteoporosis which is why it's often diagnosed at an advanced stage.

I'm vegan and I think my mum has osteoporosis

You need to check with your mum. If it's in your family your GP should arrange a bone scan

. I'm not sure if I should be begging the GP for HRT (but I've still got regular periods and no hot flushes/sweats)

You do not need either of these for HRT but clearly you do need a) some peri symptoms or b) low bone density diagnosed

Holland and Barratt and buying a load of calcium tablets. Or maybe all of the above

Calcium alone will not treat or prevent osteo.

You need at least 800-1000 mgs calcium a day If you are not eating any dairy you will only get it from pulses, dried fruit and green veg or fortified foods like soya milk or other plant milks.

Start by assessing your daily intake.

Have a read of all the info on the Royal Osteoporosis Society website.

Thanks @JinglingHellsBells that's very reassuring about osteoporosis. I'll check with my mum about her diagnosis (I can't remember if she's got osteoporosis or the precursor).
I eat pulses and soya but probably not enough to maintain healthy calcium levels.
I've bought a calcium and magnesium supplement. I did try magnesium for tender, painful breasts (just taking it for the 2 weeks before my period) earlier this year and I think it helped a bit so I thought I'd give it another go.
I'm still mulling over what to ask the GP for. I got the feeling she would prescribe what I want - HRT, pill, antidepressants - but I'll have to do her job for her and work out what I need and tell her exactly what I want.

This documentary is good as a starting point for anyone worried about menopause leading to osteopenia/osteoporosis and other menopausal symptoms. It was on BBC a year or so back and is hosted by Mariella Frostrup:

www.bbc.co.uk/programmes/b0bt4c3m

It's only available for another five weeks, so get watching!

Ooh great. Many thanks for that @zafferana . I'll make sure I watch it before it disappears.

Just an update. I'm really not coping well at all. I had a few good weeks after my last period but I'm now nearly a week overdue (having previously had regular periods) and I'm a mess. I'm not sleeping. My nerves are jangling. I feel like I've got cortisol coursing through my veins. I lost it with DP over nothing earlier. I haven't been able to concentrate at work.

All in all, I'm a wreck

I've been doing lots of research re different treatment options but struggling to decide. I'm scared of anything that might make it worse.

I can't work out if it's my estrogen that's making me feel awful (sore breasts, heavy periods) or progesterone (feeling like I'm losing my mind). I worry that HRT/mirena/pill could just make it worse by giving me more of these hormones that are making my life a misery.

I'm trying to get back in touch with GP but it's proving easier said than done.

I think I'm going to ask her to prescribe Qlaira (suggested by @JinglingHellsBells as an option I think).

[quote JinglingHellsBells]@Newgirls the cancer risk for women under 50 is zero because at 50 you'd be expected to have these hormones in your body anyway.

The risk for older women is less than 1 in a 1000. But it's 28 times that if you are overweight.[/quote]
Where do you get the 1 in a 1000 stat from out of interest? This NHS info states that 63 in 1000 over 50s will develop breast cancer with an extra 15 to 20 who take HRT. That is a big increase. The risk lasts too for years.

Peri and the menopause is not by any stretch a breeze but taking something that increases the risk of breast cancer significantly is crazy imo.

Op I'm sorry you're struggling. Has your gp suggested CBT for your anxiety?

This is from the NICE guidelines - it breaks it down more accurately:

What is my risk of breast cancer?
Your overall risk of breast cancer will depend on many things. Other factors that increase risk of breast cancer include smoking, family history, alcohol use, and obesity. The new study showed that an increased risk of breast cancer with HRT is similar whether HRT is taken orally (swallowed) or delivered via patches or gels or implants.

In the UK about 1 in 16 women who never use HRT are diagnosed with breast cancer between the ages of 50 and 69 years. This is equal to 63 cases of breast cancer per 1000 women.Over the same period (ages 50–69 years), with 5 years of HRT use, the study estimated:
• about 5 extra cases of breast cancer per 1000 women using estrogen-only HRT
• about 14 extra cases of breast cancer per 1000 women using estrogen combined with progestogen for
part of each month (sequential HRT)
• about 20 extra cases of breast cancer per 1000 women using estrogen combined with dailyprogestogen HRT (continuous HRT)
These risks are for 5 years of HRT use. The numbers of extra cases of breast cancer above would approximately double if HRT was used for 10 years instead of 5.

1.6% chance of breast cancer without HRT and 8.3% with doubling to 16.6% over 10 years? Have I got that right? That's higher than I thought it was. But then an article in the BMJ states the following:

The new findings are consistent with NICE recommendations2
and should be viewed alongside the benefits of HRT,
which
for many women considerably outweigh the risks. Risk means
different things to different women, and each woman must be
given information in context and be supported to make an
informed choice about her best treatment options.
The Lancet study did not address mortality, only incidence of
breast cancer, so findings must be weighed against a recent
systematic review that showed that starting HRT close to the
menopause may also reduce all-cause mortality and cardiac
death, with no evidence of an increase in breast cancer
mortality....

1.6% chance of breast cancer without HRT and 8.3% with doubling to 16.6% over 10 years? Have I got that right? That's higher than I thought it was.

It’s 6.3% with no HRT (63/1000*100). The risk of breast cancer increases significantly in your 50’s and beyond but I presume this includes the impact of weight and alcohol consumption on rates.

I’ve just been reading through this thread and want to say a huge thanks to everyone sharing their expertise and experience.

I’m 37 with a mother and grandma who both went through early menopause. I’m pretty sure I’m in peri and have started really trying to educate myself so this thread is v useful!

My GP suggested a blood test last week and I did question how that would work, just taking bloods on one day of my cycle. He said as long as he knew what cycle day they were taken it was fine. It’s good to have back up of my own thoughts on this having read some other posts!

I had a blood test but it was done at the same time bloods were drawn for other tests too (my cycle had shortened to 16 days and it turned out I had an ovarian cyst). The GP said it confirmed I was menopausal, though I’m still having periods at the moment. They didn’t ask me what cycle day I was on so possibly just good timing.

The private menopause doctor I spoke to said she doesn’t usually do blood tests but goes by age and symptoms.

The thing is, unless you have symptoms, no GP is getting in touch at age 45 to discuss potential risks of menopause on heart and bones etc. and most people are unaware of this until they start Googling at the onset of symptoms. I love the NHS but dislike the fact there are no regular checkups and wish a more preventative approach was taken. Surely in the long term that would be worthwhile?

Hope you get some traction with the GP @WhereAreWeNow

I'm only just 40 but this post is really resonating with me, thanks so much for starting it. Both my mum and sister had early menopause (but also breast cancer treatments in their 30s)

I spend 10 days a month "vibrating on a high frequency" - anxiety, anger, lack of focus. It's affecting my work and I'm borderline suicidal some days.

Strange aches and pains.
Insomnia from day 10 of my cycle onwards.
Every other period is 2 days of flooding, the first time it happened I thought I was dying.

I'm BRCA positive (breast and ovarian cancer gene) and not sure if HRT is an option (I haven't asked). I had a double mastectomy in my 20s and was supposed to have an oophorectomy this year, but cancelled indefinitely due to covid.

It sounds a bit self indulgent, but I'm counting ahead and thinking Christmas is going to be ruined by coinciding with the week before my period.

I'm trying vits this month (D, B12 evening primrose oil) but maybe I should head to GP - I shouldn't be dreading family events a month away because I might have PMT.

Hi @Nitw1t - your symptoms sound exactly like mine except thankfully I'm not suicidal. Please don't put off seeking help if you're having suicidal feelings

"Vibrating at a high frequency" is such a good way of putting it. That's exactly how I've felt the last few days. Sometimes I'm literally trembling with the stress/rage/anxiety racing through my body.

I don't know much about any of this but I've been doing a lot of reading in the last month and I've seen various articles suggesting that even women with a history of breast cancer can take HRT but you'd need a specialist who really knows their stuff.

The risk of breast cancer taking her compared to not is low, but I do think it is disingenuous to not mention them especially when listing the health benefits associated which are not significant either.

It still remains an added risk that some women don't want to take which is fair enough.

I used qlaira for a while, about the same age as you and v similar symptoms, it worked well. I’ve switche£ to femeston now which keeps my moods more stable. I’m 52 and hoping I’m nearly in menopause rather than peri but don’t want to come off the hr5 to find out.

Hrt, once I found the right one, was a lifesaver, and I’m not exaggerating. Got my life back.

Thanks @GiraffeNecked. Did you feel the Qlaira gave you your life back or was it switching to Femoston that made the difference? And can I ask, did you have any trouble convincing your GP to prescribe Qlaira? I've heard some are reluctant because it's expensive compared to other contraceptive pills.

Glad you've got your life back!