GP prescribed anti-depressants

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Hi, I am 46 and experiencing various peri symptoms - brain fog, joint pain, weight gain however the worst is def the broken sleep, anxiety and complete loss of confidence and self esteem. I had one ovary removed in 2015 so don’t think it’s implausible that this is peri stage however my GP has prescribed Prozac.

I have a few issues that could be affecting me too - lost my job last year and now contracting, which is unsettling and ends shortly, and I didn’t get a permanent role where I’m working that I really wanted - which resulted in me crying to my manager (this is really unlike me!); teenage daughter who will be going to uni next year; mum with mental health issues. I ended up crying to the GP when I went so feel our discussion re HRT was sidetracked in favour of talking about the symptoms I am experiencing.

My question is how do I go back and assertively raise the HRT point again? My GP was a young male so should I request a female GP?

Thanks in advance for any pointers.

I don't think there is any point asking to see a female Gp. They aren't necessarily any better. My consultant is male and he's wonderful.

You just need to 'throw' the NICE guidance at them. It's pinned at the top of this forum and says very clearly (you need to scroll down it to find diagnosis and treatment) that ADs have no place in the management of peri meno (in women who can use HRT.)

And you also need to ask specifically for HRT and say you have researched it and want to try it.

I agree with printing off the NICE guidelines and going back.
Research what you want and be nice but firm.
Have you started the AD’s

There are 2 references here from NICE not to offer ADs (you can read it in the guidance- I've just copied and pasted it.)

1.4 Managing short-term menopausal symptoms
The recommendations in this section are not intended for women with premature ovarian insufficiency (see recommendations on the management of premature ovarian insufficiency).

1.4.1Adapt a woman's treatment as needed, based on her changing symptoms.

Vasomotor symptoms
1.4.2Offer women HRT for vasomotor symptoms after discussing with them the short-term (up to 5 years) and longer-term benefits and risks. Offer a choice of preparations as follows:

oestrogen and progestogen to women with a uterus

oestrogen alone to women without a uterus.

1.4.3Do not routinely offer selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs) or clonidine as first-line treatment for vasomotor symptoms alone.

1.4.4Explain to women that there is some evidence that isoflavones or black cohosh may relieve vasomotor symptoms. However, explain that:

multiple preparations are available and their safety is uncertain

different preparations may vary

interactions with other medicines have been reported.

Psychological symptoms
1.4.5Consider HRT to alleviate low mood that arises as a result of the menopause.

1.4.6Consider CBT to alleviate low mood or anxiety that arise as a result of the menopause.

1.4.7Ensure that menopausal women and healthcare professionals involved in their care understand that there is no clear evidence for SSRIs or SNRIs to ease low mood in menopausal women who have not been diagnosed with depression (see the NICE guideline on depression in adults).

Thanks, I’ve not seen the NICE guidelines before but have read through them and I will go back and reference them.

I have not started the ADs as genuinely do not feel depressed - I still enjoy life and making plans with friends and family.

Think I was so overwhelmed to be talking about my feelings that I lost sight of what I feel the issue is, if that makes sense? I had a list of symptoms written down and I didn’t even take it out of my pocket.

Along with the NICE guidelines, show your gp this article. AD's are not appropriate for peri/menopause.

www.independent.co.uk/news/health/menopause-antidepressants-symptoms-worse-hrt-shortage-a9148951.html

If you can go private, I highly recommend it.

I started anti depressants after experiencing anxiety etc. I now know it was as a result of perimenopause. I'm on HRT and feel much better.

Anti depressants can be good for some people in certain circumstances, there certainly shouldn't be a stigma around them, but for me personally they killed my libido dead and made me feel consistently flat. So no lows or anxious peaks but no happy times either.

As PP have said, print off NICE guidelines to take with you. And if there is a local menopause clinic ask for a referral.

Ask around local middle-aged female friends at the same surgery for which GP is good for this sort of thing, or, failing that, go for an older female GP.

I had physical and psychological symptoms and it was the more personal physical symptoms plus the all-pervading feeling of detachment and doom which really got to me.
I knew it wasn't depression-depression (IYSWIM) as my life was totally fine and I have had "normal" (albeit mild) depression before. And of course all the physical symptoms were a bit of a giveaway - OMG the night sweats - soaked sheets - they were something else!!

I googled what various different HRT meds were good for and booked a 9am Monday appointment with one of the female GPs in my surgery (before she'd woken up? Haha) and came out with a prescription for the one I'd asked to try first, 5 minutes later.

I was prepared for side effects and having to try different drugs, but - took the first pill that evening - and half an hour later the cloud lifted and I "felt like myself" again.
Now I understand why so many women say "you'll take this away from me over my cold dead body!"

@Aquamarine1029 unfortunately as I am contracting, I don’t qualify for my company’s private health insurance or def would.

@Cinabun Thanks and that is good to hear about your experience with the ADs. My mum has suffered from depression all of my life and I know there is no stigma for ADs, I really don’t feel I need them.

@Inthewainscoting This is so how I feel!!! I have described the sense of detachment to my DH as it feeling like two different to people - the capable woman who has had a good career and undertaken lots of further qualifications, as to the one I feel now who is looking down the barrel of the gun to find a new job and having zero self belief, I can’t reconcile the two.

I have just messaged a close friend and neighbour who I know is on HRT and she has given me details of the GP at our surgery that helped her so first thing Monday I will make an appointment with her.

Thanks for kind listening ear everyone.

Sorry you've experienced this. You could also download the Balance app and track your symptoms and then take this along to your appointment - see Dr Louise Newson / menopause_doctor on Instagram