To keep on at GP?

[Babayagadreamhome]

I think I've been perimenopausal for a few years. I'm 51 now and my mother reached menopause at 52. I recently had bloods done and the results were satisfactory but showed low vitamin D which GP has now prescribed for me. I have all the symptoms of perimenopause (rage, anxiety, hot flushes during the night, joint pain, occasional palpitations, brain fog, low mood and no interest in things).

The GP told me that it doesn't matter what time of the month the blood tests are done, but I usually feel worse for roughly 7-10 days before and after my period so would a test closer to my period give different results? I did a home test kit last cycle (day 2 and 9) which was clearly positive, but don't know how reliable these kits are. The blood tests were done on day 15.

Do I try to make an appointment with my GP to discuss this further or just let it go?

Definitely, and take along a copy of the NICE guidelines which clearly say that women over 45 who want it should be prescribed HRT without blood tests, just on the basis of symptoms (which you have). The whole problem with peri is that your hormones are fluctuating all over the place so blood tests are basically meaningless - it's sort of true that it doesn't matter when they're done but that's because they can be unreliable any day of the month! If that GP won't help, try a different one.

You don't need blood tests, but you should be able to explore a trial of HRT if that's what you're wanting.

We prescribe based on symptoms not FSh if you're over 45.

If you want to try HRT then just ask to try it!

It's really weird how some GPs act as gatekeepers for a treatment that most menopause gynaecologists rave about and are very happy for women to try it.

When I was having hourly flushes, I told my gynae (who I was seeing for something else) and he said 'Fine- try this- (Oestrogel) - brilliant stuff'.

I had already done all the lifestyle things to try to help- no booze, exercise, good diet etc.

Don't waste money on tests. Even ones done by a lab are useless as PPs have said.

Just out of interest, why are GPs prescribing Vit D rather than telling patients to buy it in the supermarket?

What a waste of NHS money, it would seem.

Thanks for the replies. I'll give them a call to discuss. My mother went through this stage with zero symptoms other than slightly heavier periods. I've always had issues with my reproductive system since my periods started (age 10), relieved by going on the pill during late teens, two awful pregnancies (didn't go back on the pill due to DH having a vasectomy) and symptoms have got gradually worse since early 40s. GP has done bloods tests at various intervals since then but have told me to watch diet, alcohol etc. to see if they help. Covid put things on hold. I've started a new part time job which needs me to be organised and 100% on the ball so this has pushed me into needing to do something.

Does anyone know if HRT can be prescribed over the phone? I currently have Covid and in isolation until at least Monday

@JinglingHellsBells I was wondering if they're giving me a stronger dose than you can buy in the shops

[quote Babayagadreamhome]@JinglingHellsBells I was wondering if they're giving me a stronger dose than you can buy in the shops[/quote]
Whatever you buy yourself you can just double or triple the amount if that is the dose your gp suggests.

The usual dose is 10mcgs a day but I use high strength 25 mcgs a day (think it's Vitobiotics) but obviously you could take 2, 3 or whatever your GP says to take daily.

Yes they can prescribe over the phone. I suggest you do some reading around all of this first so you have some preference for what you want. There are tablets, patches, gel, spray and different types of progestogens with all of those.

The website of Dr Louise Newson is a good place to find fact sheets, or the Women's Health Concern, or Menopause Matters, All are written by doctors.

I prescribe over the phone (as long as I've got access to records!)

Be aware there seem to be some supply issues with some products - I've had women telling me they're struggling to get gels.

We also only prescribe Vit D where there is a diagnosis of osteopenia, osteoporosis, or underlying pathology causing these.

I have psoriasis everywhere and lichen sclerosis, and apart from the steroid treatments I buy all the creams, lotions and shampoo even though they're prescribed and I could save myself £20+ per month. I'll take this prescription for now and will probably buy them myself afterwards.

Thanks for the website suggestions. I'll take a look before calling the surgery.

That's good to know @Sidge. I'll definitely give them a call in the morning.

I've been taking Vitamin D supplements for a few months anyway (always do over the winter). They're labelled max strength 4000iu. I'm wondering if my levels are low enough for concern despite taking a supplement. Something else to worry about

@JinglingHellsBells

Just out of interest, why are GPs prescribing Vit D rather than telling patients to buy it in the supermarket?

What a waste of NHS money, it would seem.

If there's a deficiency that is having a clinical effect a medicine is usually preferred over a food supplement.

Medicines are manufactured and tested in such a way that guarantees the content. Food supplements come with much less assurance of quality. It's not a problem if you just need some vitamin D (or whatever), but if you need a specific minimum dose a medicine is more reliable.

A fortnight in the sun would be best of course.

@WiseUpJanetWeiss That's interesting to know about the difference between prescribed and shop bought.

Will definitely try to get out in the sun more. Over the last few years I've become far less tolerant to the heat (anything over 21/22 is uncomfortable)and have avoided going out in strong summer sunlight unless I can help it, and have been covered up when I've had to. Summers have been spent following the shade around the garden. I'm very pale skinned, burn easily but don't tan.

Don't feel guilty about taking prescribed vitamin d or creams etc. I don't think that is the reason for an underfunded nhs. And I'm sure you pay your taxes!

I hope your gp listens. I'm thinking of asking myself but I'm younger than you. I was going to request a blood test but maybe I shouldn't bother.

@fruitpastille I don't think it's that I feel guilty about taking the prescriptions, I just think if they're things I can just buy off the shelf in Boots I may as well. I will order a repeat of the creams when I re-order the steroid creams but often I run out in between so it's handy to have extra in.

Covid has wiped me out today and I didn't get up early enough to ring the surgery. Tomorrow's a new day which will follow a better night's sleep hopefully

@Babayagadreamhome There is a Vit D spray (with added Vit K) which gives 3000iu per dose. I bought mine in the supermarket.
I'm not sure if there is a clinical difference between Vit D in a prescribed version and one OTC. You need to buy VitD3, which is supposed to be better than other options. Vit D is stored in the liver, it's not a water soluble vitamin. It's pretty difficult to over-dose on it- there is online guidance on max amounts. I made the comment about cost as the NHS has cut right back on drugs and supplements that people can buy- this included hay fever meds and paracetamol.

OP I'm just wondering if your surgery has an econsult service? Mine was brilliant - I submitted my e-consult at 6.00 am and my first HRT presription was ready by the time I left work that afternoon!

Bloods are useful in ruling out other issues, not helpful in diagnosing perimenopause.

I spoke to a female GP this afternoon. Her advice was, because of my heavy, painful periods, to have a Mirena coil fitted. Told me to do some research and if I decide on the Mirena that Estrogen could be prescribed alongside. I have to ring the sexual health clinic to arrange an appointment (couldn't get through this afternoon) but will probably go down this route first. I've read the horror stories and the success stories and have decided to give it a go.

The GP also told me that my FSH levels are very very low, meaning this could possible drag on a few more years. I know, from posters on here, that blood tests aren't reliable for diagnosing peri menopause but Christ, I can't put up with these periods much longer!