GP or Private Specialist?

[felineflutter]

I have been going back and forth over the last few year to the GP for menopausal symptoms I am 49. I have now been prescribed Vagifem after requesting it ( lovely advice from mumsnet) due to numerous consultations which have quickly eased my symptoms.

I have lots of joint issues which have caused degeneration in my fingers. I am sure this is due to perimenopause. I also only sleep for 5-6 hours a night and am constantly tired.

My question is whether I should go ahead with a GP appointment tomorrow and request HRT? I worry that I could spend another few years sorting out the right one by which point my joints may have irreversible damage. Should I just pay for specialist advice?

Does anyone one know which HRT combination I should start on and then I could go armed to the GP?

I went to a private menopause clinic as I got fed up with all the indecision from gp surgery and never getting to see the same doctor twice.

It was definitely money well spent as she took time to talk to me and went through my whole history before deciding which HRT would be best. I then had a few issues and queries when I started but had reply emails from her soon after I asked each one, something that would be impossible with our surgery!

I would say that if you can afford it it is best to go to see a specialist as you will get better overall care.

Definitely go to the GP, but armed with information. Most importantly the NICE guidance: www.nice.org.uk/guidance/ng23/ifp/chapter/About-this-information

This says that at your age you should be prescribed HRT for menopausal symptoms if no contraindications.

The most flexible and an often recommended option is oestrogel and Utrogestan capsules. There’s a useful summary of all the options here: www.menopausematters.co.uk/treatment.php

My GP hadn’t heard of utrogestan but willingly looked it up and prescribed it. There may be more awareness now after the patch shortages.

You can hold the private option in reserve. I went privately as well and it was totally unhelpful, in the end I got the help I needed from Menopause Matters website and my GP.

If your case is complicated, @felineflutter, you can ask to be referred to an NHS menopause clinic.

Might be too late for you now @felineflutter if you have had your appt.

I think you maybe need to consider other things that might be causing your joint pain. It's easy to assume it's menopause (and it may be) but equally it could be arthritis and the more serious type, rheumatoid arthritis. Don't want to scare you but you are very young to have degeneration of your hands and finger joints. This is not a sign of menopause. My advice is you ask your GP to refer you to a rheumatologist for advice on your hands. And treat the meno symptoms as a seperate issue.

I have had an appointment and my GP was fantastic she said straight away sequential HRT was better/less risk etc. So I am going to have a gel and a Mirena coil fitted. I may ask for the tablets though as I am not sure I do want the coil. She sent a link for Menopause Matters too.

@JinglingHellsBells thank you. Yes this does worry me but as I've been referred to two different consultants for other checks I feel I may be pushing my luck atm for another referral. I will mention it though.

Thanks for everyone's help.

@felineflutter Rheumatoid arthritis is an autoimmune disease. If you are being referred to other consultants, might all of the issues be linked?
Do take your hands seriously. Once the damage is done it's very hard to reverse it and it needs fast treatment to stop it getting worse.

That’s good to hear, @felineflutter. I agree with Jingling, your GP needs a full picture, and you should be referred as many times as necessary.