Perimenopause, PCOS, mental breakdown - almost ready to try anything

[Gentleness]

I'm 47 and think I've probably been in perimenopause for years. A history of depression, which I now realise has been related to hormonal changes all along, has hidden it I think. I've had depression badly a few times since my teens, usually a type of burn-out. I was diagnosed with PCOS in my 20s and treated with Dianette and Metformin. It was a disaster, mentally and physically. It took me years to get back on an even keel and I'm left with a real fear of using hormonal drugs.

After my 3rd child, born when I was 39, I had PND again and a series of illnesses due to being so run down. I've been on citalopram ever since. Over the last 3 years it's become more and more evident that this isn't depression any more. It's cyclical fatigue and mental chaos. I thought I was bipolar. Around ovulation I am wired, my heart rate sits in the 90s for at least a day, it's as if I am permanently in fight or flight for around 3 days, super irritable and I have crashing fatigue - 14 hours sleep at a time. Then coming up to my period I am totally constipated, exhausted, no energy or motivation, paranoid, furious and such low mood that in the worst times I'm just so desperate to die. I can barely get out of bed. It's ridiculous. That lasts around 3 days too. Periods are ok, heavier than they used to be and I get the crashing fatigue and brain fog, but I'm back to being myself at least.

In between these times I feel better than I ever have. I'm certainly not depressed. But my cycle is getting shorter - from 32 days in my 30s down to 28 after my last full term pregnancy, 25 this year and the last 2 have been 21 and 22 days. I feel like I am lost for about half my cycle.

It is so hard on my family. I dream of getting on some kind of perfect HRT and finding they are willing to forgive me for being such a nightmare. But the only thing my GP has offered is an old fashioned progesterone supplement (a friend with medical expertise in this area advised there were much better options) so here I am still on SSRIs. I've got a referral for a specialist menopause clinic, but have been waiting nearly a year now. Do I spend our savings on a private appointment? I'm going to need to really trust the expertise of someone prescribing me hormones, but I am also so so sick of this and ready to take any quack drug available just to stop wasting so many days and stop being such a bitch and loser.

Has anyone experience of hrt with a previous hormone imbalance? Am I being unreasonable in hoping for a dream solution? Is it worth waiting for a specialist or should I just try anything I can get? Is it an investment to start off private when we likely couldn't maintain that cost?

That sounds exhausting OP, I’m so sorry.

If you can spare the money, a private appointment will give you more treatment options.
I was given a GP diagnosis of severe PMDD with many of the symptoms you describe. I had an appointment with the Newson clinic and was told it was most likely actually peri and premature ovarian failure causing the issues. They prescribed an oestrogen gel and a vaginal progesterone (both body identical) as I am intolerant to synthetic oral progesterone - It makes me feel like I am going mad.

I feel like a different person now so it was worth the money : I had to pay for the consultation, first few months prescription and a follow up before my prescription was transferred to my GP but it was worth every penny. It cost about £450 in total for everything. Now I pay for everything as an NHS prescription.

With the Newson you can see pharmacists who are slightly cheaper than the Drs but give the same advice.

I am appalled that your GP won't even let you try HRT.

What's behind that decision?

Your history as you have explained it here, doesn't seem relevant in some ways because everything you describe is peri meno and should be helped by HRT.

Is there no other GP at your surgery you can see?

I don't know your finances, but the cost of an appt lasting 45 mins or so with a private specialist is £300-ish.

If they prescribe HRT it's possible they can write to your GP with recommendations to continue to prescribe.

The other option is to stay with the private specialist - they usually do a review after 3 months, then another at 6 months, at a lower fee.

If you do choose a specialist make sure they are one of the best (I can give you names) as they need to be a gynaecologist with a lot of experience in treating hormonal issues and menopause.

Thanks for your comments. The gp has offered me something related to hrt, but it's what my GP friend described as "the old version". When they weren't prepared to change the prescription or even aware there were better versions available, I realised I needed more specialised help. So technically I don't know if I could say they've refused hrt.

@JinglingHellsBells, I would love some recommendations for specialists please!

I've heard of the Newson clinic @AngryAtAssholes and you are selling it well - you're giving me hope!

Can you go back to GP armed with the Nice guidelines, especially part 1.4 which basically says you should be offered HRT.

@Gentleness I will send you a PM. Let me know if it doesn't come through.

I don't know if this will help you, but I used to have similar to what you describe around period time. Started with peri. I started taking a good Probiotic (mainly for peri related stomach issues) but the effect on my mood was amazing, those horrible days have gone. It's been about three months, and I'm so relieved they've gone

the old thing was because gps arent able to get the decent meds because of brexit

your story sounds a lot like mine i have suffered from hormonal changes since i was 11 . when i was 13 tried to kill myself . if you can get a decent doctor get blood tests for things like thyroid problems

with gps not seeing people because of covid it would not be easy to do this now but i would encourage anyone suffering like this to seek help but dont go expecting easy cures or answers

What’s your diet like OP?

What you're going through sounds really tough. I am not really sure you should go down a road that wont be sustainable for you in the future, but I do get that you need support. As for your family, I am sure they understand you, and love you even at your bitchiest moments 😅