Urgent help please - dr appt this afternoon!

[Freeekedout]

Hi, I know this is really last minute, but I have an appointment with the GP at half three.

I initially went to see her about a month ago because of weight gain. I also mentioned constant fatigue, brain fog and in the recent past have discussed lack of libido, palpitations (ECG came back fine) and aching joints, specifically my hips. She tested my thyroid and it came back borderline, but with TSH levels on the high side. She suggested at that point going back in three months for retesting, said it might be perimenopause and said they would test hormone levels at the same time as retesting the thyroid.

I have since read a LOT about perimenopause and I tick just about all of the boxes. I have NEVER had regular periods, so I have no idea how they would test hormones on certain days of my cycle. I also have a Mirena, so I haven't really had periods anyway for a good few years. The Mirena ran out during lockdown so I was prescribed the minipill (Cerazette). I stopped taking it after the last appointment because I didn't want hormones to impact on blood results. However, having read what I have recently, I'm not convinced that blood tests are completely necessary and would they be reliable if they aren't carried out on specific days in my cycle.

Not sure what I'm asking, really! What would you be saying to the GP? I'm 43. NICE Guidelines are very clear for over 45s and under 40s, but it's very grey for the 41-44 year olds!!

I'd push for every test going and not get fobbed off if the results are inconclusive.
I would say your symptoms should be enough for further investigation/HRT

I would say you have read about perimenopause and relate to most of the symptoms described. Blood tests are a very good idea. Good luck.

But how will they do the blood tests on the right day if my cycle had always been wildly irregular and I don't have periods?

Need to ask for your actual thyroid results and ask for thyroid antibody testing too. Then look them up. Some countries say you should be medicated earlier than others. The n the UK they leave it as long as possible! Difficult though as can be several things and hard to decide what is from what. I’m a bit older and have had full hysterectomy, but have everything you have. I have fibromyalgia and thyroid issues, but also menopause obviously!

TSH is 3.68 (0.27-4.2)

There’s a scale on the menopausemstters.co.uk that will allow you to score your symptoms against a validated set of criteria, and might back up what you’re saying. You could also keep a diary of your cycle and symptoms. Could you directly ask to be referred to a menopause clinic?

Have you had covid? Your symptoms sound very similar to my long covid symptoms

How was the appointment? I am not a dr, but I have had blood tests on any day, it didnt matter where I was in my cycle.

Thanks all, and apologies for the abrupt messages.

I don't think I've had Covid (something that could've been, in Nov 2019 but that would be too early. Was off work on and off for six weeks). Thanks for the menopause matters link, it's a really interesting site to explore.

I think I've struck lucky with my GP. She was incredibly sympathetic and took time to really listen to me. There was a lot of information to take on so I'm confused by parts of it but this is basically what she said:

I well have a blood test in the next few weeks to test FSH levels. I asked how that would work because I'm not having periods - old mirena in situ - and my cycle had always been very irregular. She explained that high hormone levels would confirm perimenopause but we would still great the symptoms if the hormone levels weren't high.

She asked about the irregular periods and whether I'd every had my ovaries scanned. I haven't, to my knowledge. She said that there is a possibility that I have PCOS and was surprised that this hasn't been raised before. However, at 43, I'm lucky to have conceived two DC naturally after less than a year of trying for both. She said that she would request a test for the PCOS hormone at the same time as the menopause test.

Then she went on to explain my options and this is where I got confused. She said it would be a good idea to have the old mirena removed and replaced, but I explained my experience of having it put in was horrendous and wasn't sure I could repeat it. She said she could get me an appointment with her best nurse to remove it and if at any point I wanted to stop I could, so I'm thinking about it. She also said that she would be happy to prescribe diazepam if I decided to have a new mirena fitted. I will think about it but don't think I can do it.

I would need estrogen and progesterone. This could be in the form of a combined pill, but these aren't licensed with the mirena (I think that's what she said).

There was talk of creams and patches but I can't remember clearly. But she said that in order to ensure I was protected from unwanted pregnancy she would be giving me an awful lot of hormones which she was reluctant to do. Since coming home I've thought that maybe my DH might like to take a bit of responsibility and, as our family is complete, consider a vasectomy. I don't know if that would alter my choices with regard to HRT/hormone treatment.

So, I'm going for a blood test (need to get through to the surgery to book an appointment which might take a while!) and then go back to discuss the results about ten days later. I really did feel like I was taken seriously and that my GP will help me to find a solution to the symptoms even if the blood test doesn't show an elevated level of FSH.