How to talk to GP about HRT

[Judystilldreamsofhorses]

Hello, I’m dipping my toe into this board with what are probably stupid questions. I know there are very knowledgeable posters here and could use some help, please.

I’m 48. A few years ago my cycle started getting much shorter which was a nuisance as I have always had heavy/painful periods. I spoke to the nurse at my smear who suggested the Mirena or POP. I started the POP, and my periods pretty much stopped. Yay.

Over the last year or so I have been suffering from TERRIBLE anxiety. But who hasn’t, pandemic etc? I have also been having awful acid reflux. In the last few months I am getting a lot of breakthrough bleeding, and have also reverted to having skin like a 14 year old boy, which is upsetting!

So - is it time for HRT? Will a doctor dismiss me because I am not having “classic” symptoms like flushes? I absolutely hate going to the doctor and find it very hard to advocate for myself - a bit of white coat syndrome, I suppose. My surgery are seeing no patients in person.

If I can get a phone appointment how should I approach it? What do I want? (Definitely not to be palmed off with anti depressants.) Or should I wait until the flushes come for now?

Sorry for the long post and sounding so pathetic. I feel pathetic. I am an adult woman in a professional job and scared to talk to a doctor! I am in tears just writing this post, that is how completely ridiculous I am!

You’re not pathetic or ridiculous, you’re in peri menopause. It’s absolutely normal.
No words of wisdom, just solidarity 💐

Start the conversation with 'I want to go on HRT, and here's why....'

Worked a treat for me

You just need to start by saying you think you are peri menopausal and want to try hrt.

I've been on it 4 months and didn't have classes symptoms like hot flushes. For me anxiety and really awful rage we're my main symptoms but after reading more I've had symptoms like insomnia for a while but have always put them down to something else.

My gp did run blood tests just to rule out other things like thyroid/low iron etc but was really good and said she was sure it was peri but wanted to be thorough. Turned out my iron levels were low as well.

Thank you SO much for the replies. I have a proper needle phobia so I am not sure I can cope with bloods actually - the covid jabs almost finished me off!

I had a chat to my mum earlier - she started HRT at 43 and said it was a game changer. At that point (she’s now in her 70s) it was only prescribed short term but her GP allowed her to remain on it until she turned 60 because it helped with her arthritis symptoms a lot.

Agree with above posters. Just ask. They will give you a blood test to rule out other stuff. But should offer HRT if all clear. I think GPs are getting better at prescribing HRT. Don't be frightened.

I went on it at 45. I don’t get hot flushes but had dreadful anxiety and awful joint pain. I printed off a list of symptoms (and there are more than you think), ticked off the ones I had, took it with me, and said I’d like her to consider putting me on HRT. And she did.

The no face to face appointments doesn’t help me - I have a fear of the GP like other people have of the dentist. I am fine at the dentist! Maybe I will hang on until they start seeing people again, I think I would find that a bit easier. I didn’t realise you had to have bloods though.

@Judystilldreamsofhorses

Thank you SO much for the replies. I have a proper needle phobia so I am not sure I can cope with bloods actually - the covid jabs almost finished me off!

I had a chat to my mum earlier - she started HRT at 43 and said it was a game changer. At that point (she’s now in her 70s) it was only prescribed short term but her GP allowed her to remain on it until she turned 60 because it helped with her arthritis symptoms a lot.

They won't take blood.

At 48 you are well into the 'diagnose by symptoms'.

For anyone unsure on this look at the NICE guidelines pinned at the top here. No blood tests needed for women over 45.

Ah, thank you @JinglingHellsBells - I am actually 49 shortly so well over 45! I’m in Scotland if that makes any difference though?

I went to my GP with anxiety and brain fog that was really affecting me at work (not conducive in a fast paced stressful job) and it was taken seriously by GP. I don't have hot flushes and am still having periods but was prescribed HRT. It has honestly made such a difference to my life!

I'm finally getting some sleep again and the anxiety and brain fog is affecting me less in work. Until I started on HRT I hadn't realised how many of the other menopause symptoms I was putting up with like painful joints, mood swings etc. All of these are starting to improve too.

I didn't have to fight my corner nor did I have to wait for blood tests - it was just based on my symptoms. I'm 47.

They didn't take blood to diagnose menopause- they took blood to rule out other causes such as thyroid issues/low iron etc which all can cause similar symptoms.

As a result of these bloods my very low iron levels were detected as was my high blood sugar. Thankfully they caught the high blood sugar early so it's pre-diabetic so hopefully lifestyle changes will help rather than medication.

I totally get where you come from re phobias as have a fear of the dentist. But the blood work, if the gp thinks it's needed can save longer term issues and may be completely fine.

When I went to speak to the GP about four years ago, regarding HRT, was never given a blood test, just listed out my symptoms and put on HRT, best thing ever. Maybe when booking appointment ask if one of the GPs specialise in Menopause - they will be much more sympathetic . I think generally attitudes have changed within the medical service as how beneficial HRT is and how awful the Menopause can be for women. Don't wait any longer OP, there is help out there

I called the GP in December knowing I was perimenopausal and had been for a couple of years.

I had a phone consultation and explained my symptoms to the Dr said that i knew i was perimenopausal and wanted to start HRT, an appointment was scheduled for the next day. I was sent some website links with information to read before hand incase there was anything I was not aware of. The face to face appointment was great, weight and blood pressure was checked and I was prescribed patches which is what I wanted.

As a PP said in a lot of cases menopause awareness has improved greatly. That being said I do have a female Dr and am lucky she was absolutely wonderful.

My friend just went on it via phone calls. She knew the NICE guidance and listed her symptoms. The doctor suggested bloods and she stated she didn’t need them after 45. She got her HRT. Although the doctor suggested she then wanted to check thyroid etc bloods but not hormone levels.

Be well informed. Have the NICE guidance to hand and a symptoms list. Be assertive. Lots of info/support online.

I did mine all on the phone. Just popped in to see the nurse for the blood test (and yes it was to rule out thyroid/other issues).
It was very straightforward.

@Judystilldreamsofhorses. Please don’t put it off, HRT can really benefit you, especially, I’m finding with the crushing anxiety. I was worried about seeing the GP too. I wrote a letter listing all my symptoms and sent it in by email to request an appointment. Once I got my appointment I took a list of my symptoms, handed it to the GP to scan over and I think that helped both of us.

You don’t need bloods taken to determine if you need HRT, but it seems a lot of us get bloods taken at this point to rule out anything else and check our general health. This seems prudent given it’s the time in our lives when we often gain weight and develop HBP etc. please just be brave and make the appointment. You will feel relieved once you do.

Thanks for so many helpful replies. I think I might wait until they start seeing patients in person again - being able to hand over something in writing sounds ideal for me. Hopefully that will be some point this year.

There’s no e-consult at my surgery so you have to explain yourself to reception, then you get an “appointment” between 8-1 or 1-6 which isn’t great for me workwise (teaching).

I started HRT about a month ago, and like you I was very nervous about speaking to the GP. I thought they would dismiss it as I am only 44. I thought I'd have an appointment with someone who didn't know about it.

I did the GPs a disservice I think.

We have to fill out a form on the doctors website to request an appointment and I saw there was a specific 'Women's health' section. I ticked the box that I wanted to talk about peri/menopause and was asked to list what I thought my symptoms were.

I was getting night sweats, shorter and heavier cycles, vaginal dryness and trouble sleeping.

I honestly thought they wouldn't take me seriously or would force me to have blood tests.

The GP called me within 24 hours - turned out she was the menopause specialist at our surgery and I had a prescription within 2 hours. Didn't have to go and in see her but she wanted me to do my blood pressure on the machine in reception and email her the results.

She said no need for blood tests. Based on my age and symptoms she was happy to put me on HRT.
She discussed the various options - patches or gel (gel as I play sport and the patches could fall off). Mirena or tablets (tablets as I didn't tolerate mirena well in the past).

Have to make a review appointment for 3 months.

I was so pleased to have such a positive experience with the GP and so impressed.

Don't put up with your symptoms. It can be sorted out on the phone. Just make sure you have your list of symptoms and be prepared.
It's not worth waiting until you can get an appointment - it could be months away.