GP: ‘You can’t be perimenopausal if you are still having regular periods.’

[BoPeeple]

Is she right? She is the menopause specialist at my surgery and I’ve had three appointments with her for a range of symptoms:

Insomnia
Vaginal dryness
Aching legs and bottom
Other muscles aches

I also have irritability, dry eyes, brittle nails etc.

But I am 40 and still have regular periods, although my cycle now varies between 25 and 31 days. She says that I am too young for perimenopause and as I am still having regular periods it’s very unlikely.

She’s referred me for blood tests for auto immune conditions.

Can anyone set me straight? Do regular periods mean you can’t be perimenopausal?

I feel rubbish and am at the end of my tether.

I have no advice to add I'm afraid but I do feel like I'm a similar position to you OP. I was at the GP a few months ago because I felt like I was going a bit mad and had a sudden spell of anxiety plus some irregularity with my periods. Hormone tests were all clear.

I'm 44 next month and my DM had early menopause so perhaps I'm a bit too aware of watching for this IYKWIM - however I've just had an 18 day cycle and checking back I see during the past year have had cycles usually around 22-24 days but odd ones at 15, 26, 30. Not exactly clockwork any more. But I know if I took this to the GP he/she would probably dismiss peri.

I'm very irritable atm and probably more anxious than usual. I felt very strange, mentally, ahead of this last short cycle. I generally sleep well but do sometimes wake in the night for a bit - wouldn't describe it as insomnia though. I honestly can't tell if it's peri menopause or stress/burnout, which I think I'm also experiencing. It's so hard to distinguish between the two! I wish I could though, as I would like to know how best to 'treat' whatever it is my body is doing right now And either way, unfortunately, as you are experiencing OP, I don't feel like a GP would be much help at this stage...

@LizLemonsGlasses

I feel exactly the same - just ‘odd’ mentally. I’m surprised your GP isn’t interested though, as your cycle is clearly irregular. More irregular than mine!

I really feel we should all keep pushing and pushing on this so our symptoms aren’t dismissed. GPs still seem so clueless. Like you, I just want to know what’s wrong with me. I find the not knowing is making me anxious about every little symptom, and I’m normally quite laid back.

Good luck, I hope you get some treatment.

@ADreadedSunnyDay

I don't understand why she's testing you for lupus either OP. Aching /swollen/ stiff joints can be part of it but usually Drs look for more than one symptom before testing.

I know! And I explained to her that my aches are muscular, not particularly joints. I think lupus is more joints.

I also don’t have weight loss or a rash, or crashing fatigue or any of the other symptoms of lupus. But I do have valuable dryness that has already responded to local oestrogen, dry eyes, brittle nails, irritability, mood swings…

I wonder why she is so reluctant for me to be peri?

Valuable dryness? 😂

Should read ‘vaginal’.

I’m 44. My periods were regular as clockwork until they suddenly just stopped just under a year ago. I had lots of the symptoms of peri menopause but not given a blood test until I hadn’t had a period for 5 months and I had literally begged my GP.

Am on HRT now and it’s completely cleared up all my symptoms. So yes, you can have regular periods and be in peri menopause! I’m still seething as I thought I was going mad for about 4 years it it was just raging hormones.

@MaisyMary77

Can I ask what were your symptoms?

Your post actually gives me hope that, if I can just get them to agree that this is peri, HRT might make me feel like me again.

I’m so glad you feel better. Did you have any side effects from the HRT?

Symptoms were insomnia, hot flushes, night sweats, muscle aches, racing heart, palpitations, anxiety, dry eyes, even itchy ears. (didn’t know that was a symptom but apparently it is as every thing starts drying up 😂 )
For the last couple of years my periods got extremely heavy-I was prescribed tranexamic acid for them. I was tested repeatedly for overactive thyroid as I’d lost weight-the anxiety made my appetite go away completely. Also tested for lupus and other things. GP suggested I should have CBT at one point. Then COVID struck and I stopped bothering with the GP and just put up with everything.

It wasn’t until I’d caused a car accident (fatigue-to my absolute shame. Fortunately it was very minor and nobody was hurt) and found out my younger sister had started HRT about 4 years ago-we’re not close so I had no idea,🙁, that I finally put 2+2 together and sent the GP a begging email with a full list of my symptoms. Within 2 weeks I was on HRT.

I’ve had no side effects other than weight gain-which I probably needed anyway. GP also prescribed me mitrazapine for the insomnia and anxiety, has taken about 6 weeks but am finally starting to feel like myself again.

Oh my goodness, I have itchy ears!

How do you email your GP? I feel like I’m not being listened to in person as she just talks over me and isn’t actually paying attention to what I’m saying, so I wonder whether putting it in writing would be better.

Thank you so much for replying.

My surgery had stopped doing face to face appointments; only telephone appointments available. They have an online booking system where you list symptoms. I listed everything! Think it was the only time I felt like I was taken seriously.

BoPeeple I had the same issue at 40. Went to the GP with regular periods but a list of symptoms the most troublesome of which was anxiety (brand new first MH issue of my life). I was told I was too young to be peri and needed antidepressants. To cut a long story short that was BS after 4 tough years I paid £250 to see a Bupa menopause specialist (2 session online) who took me seriously and I was prescribed HRT. My anxiety and many of the other symptoms vanished - what a surprise! I appreciate you can't afford private but could you save over time and stretch to £250?

@Level75

I’m seriously tempted to just borrow the money or something.

The stubborn (ragey) part of me, however, asks why should I bloody have to? This should be basic stuff for GPs - it happens to half of their patients.

Not one of the GPs at my surgery works more than three days a week, it takes a month to get an appointment with the menopause ‘specialist’ and then she doesn’t listen to a word I say.

And then I end up paying for private anyway? It just seems so unfair.

I totally get that. When I did go back to my GP (a lovely one happy to continue my prescription) I asked for a referral to the local menopause clinic. She tried to persuade me to go back to Bupa to save NHS money! To be fair to her she thought I had ongoing private healthcare which I don't.

Do you think it is all about money? My GP was quite happy to prescribe me the pill, which is cheap as chips. So she’s not worried about the risk to my health of taking hormones…

I just can’t think why there’s this National reluctance to accept that women need HRT.

It's about the money in scotland as we get free prescriptions but the GPs are only allowed to prescribe from a formulary ... they will not offer certain HRT at all (utrogestan) in my Board area because the cost/benefit analysis has not been made sufficiently. So I'm pretty clear it's expense. Add in that there's much more awareness of HRT and more women are approaching GPs for help - my GP referenced that she'd had a lot of women ringing about HRT.

I had the similiar issues when DS was 6 months old and we discovered he had lacto-intolerance. GP prescribed special formula but only prescribed two tubs at at time (lasted approx 5 days) so spent days to-ing and fro-ing to the chemist. My lovely GP (now retired) explained if she prescribed more it would take her over a certain threshold of spend and it would prompt an alert on the system / flag up overspending. Much easer for all to keep below the radar and not prescribe above the threshold.

So I had my blood tests back and I was positive for ANA (it says it is 1:100, which they’ve called ‘significant’).

Does anyone know how to interpret that? Is that particularly raised?

My ESR was 10mm/hr which they have said is ‘borderline’.

No one at the GP surgery will speak to me and I haven’t got an appointment until 30th, so I have no way of interpreting these results. I just spoke to the receptionist.

I understand these are markers for inflammation. I had the tests on Thursday and on Thursday evening I came down with the most horrendous throat (now better). Could this have skewed the results? Or could hormones be involved?

Or have I actually got an autoimmune condition?

I feel like I’m going mad…

Nearly 54 & periods only just beginning to change from 44 years of bang on every 28 days. But for 3 yrs + I had most other peri symptoms. I also had severe anaemia & sleep apnea: blamed all on that. Eventually I lost my job.
GP has finally agreed to HRT: a bit late!

Sorry no expertise in this area @BoPeeple but I imagine if was deeply worrying for the doctor they'd be fast tracking you. Is there any way you could get a telephone appt before the 30th to discuss?

I think your results mean a high possibility of an auto immune disorder.

Could be @Haybo26 but I wouldn't jump to conclusions - maybe the sore throat caused it?
@BoPeeple hope you are feeling ok.

Thanks all.

I managed to speak to a doctor (not the one I’ve been seeing about peri menopause) on the phone and he said that the ESR is well within the realms of normal and even the ANA result doesn’t mean much. He said he’s not worried, although apparently my rheumatic factor was also slightly raised so I can’t say I’m massively reassured.

I’ve still got my appointment on 30th so will ask the original doctor what it all means then. Meanwhile, I still think my symptoms are hormonal, but not sure if I should keep pushing for HRT or if they’ll even listen to me. It’s a mess.

Should have said - my C-reactive protein test was normal, which the Dr seemed to think means I’m unlikely to have an autoimmune disease.

@BoPeeple

Should have said - my C-reactive protein test was normal, which the Dr seemed to think means I’m unlikely to have an autoimmune disease.

I'm being scanned next week to exclude AxSpa, but my consultant rheumatologist hasn't even suggested a blood test. He said he'd rather go on MRI imaging, and may follow up with blood tests afterwards. Not sure how a GP can be so definite if the specialists are not. I had strep throat a few years ago, which later caused me to have erythema nodosum - apparently that would have shown in my blood test results, so perhaps it was just your throat?

I hope you get some help @BoPeeple

I think they go on a combination of family history, blood results and symptoms. In my case there’s no family history, the blood results, while abnormal, aren’t particularly worrying, and there’s only one symptom that matches up (muscle aches).

My other symptoms are insomnia, vaginal dryness (which responds to Vagifem), bloating, irritability, forgetfulness and anxiety.

Surely based on everything I’m more likely to be peri than have an autoimmune disease?