Please arm me with the correct info to tackle my GP!!

[Iusedtobecarmen]

Hi
I'm finally admitting I need some help.
Well I say finally, but I actually contacted the Newson clinic last year. Got an appointment through a few weeks ago but couldn't really afford it at that time.
I haven't rebooked yet but I'm now thinking I cant justify the cost when I cam see my GP?

Anyway, I have horrendous anxiety, some of which is maybe circumstances , but the rest is probably hormonal.
My periods were pretty regular and normal flow until October but I haven't had one since. I'm 50.
My main worry though is vulval changes.
For ages I've had irritation and itchy. Now I definitely feel like my labia is shrinking.
I've been using Ovestin cream which I got online from superdrug. I was considering buying some vagifem??
Anyway I think I will ring GP tomorrow but I'm prepared for a possible battle. My sister rang her GP recently and was told to have bloods and given anti depressants

I mentioned:

Night sweats
Itching skin keeping me awake
Mood swings
Brain fog
Itchy vulva
Burning feet

Thankfully I had a sympathetic male GP who prescribed HRT for me. Good luck!

Thanks.
I'm just wondering actually what meds to ask for (or decline), depending what they offer .?

Hi, these should help - tick off all that apply in this general menopause symptom checker: menopausesupport.co.uk/wp-content/uploads/2020/11/MENOPAUSE-SYMPTOM-CHECKER-Nov-20.pdf
And this one for GSM (genitourinary syndrome of menopause aka vaginal atrophy): menopausesupport.co.uk/wp-content/uploads/2020/11/GSM-OF-MENOPAUSE-SYMPTOM-CHECKER2.pdf

These symptoms should be discussed with your GP in conjunction with your age and where you are with periods. GPs should use the Nice Menopause Guidelines and if under 45 blood tests to measure FSH can be done to diagnose menopause (not sure how old your sister is?), whereas if over 45 we should go on symptoms. HRT should be prescribed first rather than antidepressants.
www.nice.org.uk/guidance/ng23/chapter/Recommendations

The section starting 1.4.9 deals with a vaginal atrophy. Local oestrogen such as what you’re taking can help with this they can take up to 3 months to work. You can use Ovestin internally and externally as needed so perhaps ask your GP to prescribe this rather than buying it online. Moisturiser can also help such as YES products or an external emollient like Epaderm ointment.

@Iusedtobecarmen

Thanks. I'm just wondering actually what meds to ask for (or decline), depending what they offer .?

Perhaps discuss trying HRT to see if it helps with anxiety, this would usually be taken sequentially as it hasn’t been a year since you stopped having periods. Evorel Sequi patches might be a good choice especially given short supply of other options, and transdermal rather than oral have a better safety profile. balance-menopause.com/uploads/2021/10/Menopause-and-HRT-feb-22-update.pdf

You could also request to be prescribed Ovestin for the vaginal issues and perhaps ask to be examined to see if anything else should be ruled out.

Have a read of this. You don’t need bloods of over 45. They also can’t refuse you HRT unless it would have damaging to you. Say what you want and why.
cks.nice.org.uk/topics/menopause/

Sorry see that someone has posted similar.

Hi thanks
I'm aware of the NICE guidelines regarding offering HRT based on symptoms
It's more a case of what medication to ask for as it seems a lot of GPs have no clue.
I know Dr Newson seems to prescribe Utrogeston.
There are so many types of HRT that its mind boggling!
The only symptoms that I have are anxiety and the vulva issues.

@over50andfab
Thanks
Yes this is what I want to go armed with. In case the GP does offer tablets or something more outdated.

I have the Mirena coil so just have the Evorel 50 patches. It's been brilliant and I no longer want to scream blue murder at DH for his annoying cough.

[quote Iusedtobecarmen]@over50andfab
Thanks
Yes this is what I want to go armed with. In case the GP does offer tablets or something more outdated.[/quote]
There's nothing outdated as such (Premarin which has ethics considerations is no longer offered on the NHS), it's rather what suits best and individual risk profile which is a discussion between patient and HCP. Many women take oral HRT very effectively but might move to transdermal options as they age and risk profile changes. Reasons not to be prescribed oral HRT might include risk of clot, high blood pressure and obesity. This doesn't include Utrogestan which is a micronised Progesterone oral pill btw. d2931px9t312xa.cloudfront.net/menopausedoctor/files/information/226/Easy%20HRT%20prescribing%20guide.pdf

Labia shrinking = Lichen sclerosis. The itching would also be part of this.

@Tootsey11
I did used to think maybe was LS. Though, to be fair, the itching was a while ago. Now it's more irritation I guess.

I did think combined with my age and I know atrophy is a sign of menopause then its due to that?

It could be either tbh. I started with irritation soreness and rawness. It has taken 2 years on vagifem and ovestin to feel somewhat normal. Because of the length of time to get any relief they thought I had Lichen sclerosis there was no itching and no white patches.

Shrinkage of labia with atrophy generally means they look less plump and thinning but they are still very much there. Ls means they start disappearing literally. I would get started on vagifem to see how you go and use the ovestin on the outside bits, to see if the irritation subsides. It is a horrible symptom of meno and can be very debilitating.

I use the investing outside and inside with the applicator.
Just looks like labia thinning and less plump, smaller in that way .

Ovestin*

I wouldn't presume your GP would resist prescribing HRT. Mine was very keen to prescribe for me, talked through all the pluses and minuses of different types very clearly. You can always change types at a later date too. Good luck

Thanks I'm ringing as soon as they open tomorrow