Perimenopause - How do you tell?

[browneyes77]

As much as I’ve read up on this, I’d really value some advice/info from women actually experiencing the perimenopause.

So I’m 45 and still taking the mini pill. I know that the pill can somewhat ‘mask’ symptoms of peri (especially given that I don’t have periods on the pill, so have no idea how regular I still am).

I have found however that the last year or so I’ve started sweating heavily under my armpits, I get agitated very easily and my sex drive is practically non existent. I also suffer with palpitations, but that was put down to anxiety due to major problems with a nightmare neighbour (she threatened me and I ended up on anxiety tablets. I’ve come off them now and the palpitations are back). I’ve also had rapid weight gain (I did a couple of years ago during Covid but lost 2 stone which I’ve managed to put back on in no time 🙄)

Is there any way I can get some kind of indication as to whether I’m in perimenopause, despite being on the pill? (and without having to come off it).

Am I right in thinking you can have blood tests done with your GP that can test for hormone levels? And are GP’s usually willing to do it? Not sure if the things I listed above would be enough evidence for my GP to consider testing?

Any and all advice appreciated!

I would like to know this too but I do understand a blood test will not be of use due to hormonal monthly fluctuations

im taking a few supplements to see will it help (slightly younger than you)
I wonder what age is recommended for her or is that only full menopause

There's an app called the balance app which means you can track symptoms. You might be surprised at some you haven't noticed or put down to other things. My major symptoms have been chronic fatigue and chronic joint and muscle pain. I was misdiagnosed with fibromyalgia. HRT has almost eradicated this pain and fatigue. I also had bad PMDD and this has reduced greatly. I was getting nowhere with pain meds so I went to a private doctor and just asked for hrt, my sister suggested it years ago when I went from marathon running to barely being able to get off the sofa but my gp shrugged it off when I suggested it!

I would also recommend a Facebook page (if you're on fb) called totes merry peri. There's so much knowledge on there and also lots of help on medical guidelines and how to talk to your gp.

The blood tests wont really indicate anything as oestrogen fluctuates wildly in peri but at 45 with those symptoms it would be assumed its peri (or menopause as you dont know if you are still having periods) if every other possibilty is ruled out

When I was 46/47, I had two periods in the same month.
The doc told me I was peri. No blood tests.
It was only when my sleep became very badly affected that I started HRT.

The progesterone only pill won’t mask menopausal or perimenopausal symptoms.

Bloods aren’t routinely required for women 45 and over with symptoms.

You could ask for a discussion with the GP to see if you may benefit from HRT, if that’s what you’re keen on. You’d still need your POP for contraception.

This is what my doctor told me. I've now started HRT on that basis.

I think a blood test, which would cost the NHS money, wouldn’t really tell you anything. Based on your age you are most likely peri-menopausal.

At 47 my nhs GP did bloods, he said my hormones were a little low but in range. He offered to blood test me several times to try establish a pattern, and he gave me an alternative "or go in HRT now and see if it works?" - I took the latter

My symptoms were more frequent periods. I was averaging a 21 day cycle and it was prolonged and heavy.

I was sweating on my knicker line at night. Initially I feared I was wetting myself.

I would wake and struggle to go back to sleep, even though I was exhausted.

When awake in the wee hours i would have anxiety about things that logically weren't remotely anxiety-inducing.

I had terrible terrible brain fog and feared I'd "gone stupid". Coupled with a new job that demanded some energy and me being hired as a person with good insight and experience in my sector - this left me feeling utterly shambolic!

The HRT worked almost immediately.

I also have hashimotos and the symptoms are almost identical. I was sure I just needed a dose increase but it turned out my thyroid levels were spot on.

Good luck. I'm 48 now, I sometimes think I need a dose increase but by and large HRT patches have been a miracle.

Thanks all for your responses. Much appreciated!

@imnotthatkindofmum I’ll take a look at that app, thanks!

@Sidge That’s interesting. I was told that the POP could mask some symptoms. Obviously it would ‘mask’ the reality of my periods so to speak, as while on it I don’t know what their status is, but good to know it won’t mask the other symptoms, as I wasn’t sure whether to put things like my sex drive, moods etc down to something else.

@Anyfeckinusername I hear you on the sleep thing. My sleep can be dreadful. I often wake in the early hours and struggle to get back off, despite being tired. I wee so much too, but I was diagnosed with an overactive bladder a few years ago.

I have 2 auto immune diseases (Ulcerative Colitis & Alopecia Areata), so I never know if that’s effecting anything else in my body.

I think the ‘symptoms’ I’ve been seeing in myself could so easily be linked to something else, I don’t know whether it’s Peri or whether I’m confusing them with something else! Feels like a bit of a minefield!

My mom said she was 47 when she started menopause and they do say your mother is an indicator of the age you could too.

I think I’ll have a chat with my GP anyway about it to see what their thoughts are. As some of you have said, they may not think bloods are necessary (I hate needles anyway! 😂) and can advise me further hopefully!

@browneyes77 yes of course if you have no periods as a result of the POP you can’t rely on them as an indicator, and if your POP was causing lower mood and skin changes all along then that’s not an indicator either.

However if a woman had been happy and well on her POP for years then presented with peri or menopausal symptoms I’d be inclined (assuming all else was normal for her - I’ll occasionally do general bloods to check FBC, thyroid etc) to treat with HRT where appropriate and see how she responds.

Hope your GP can help 🙂

@Anyfeckinusername can I ask about the sweating in the knicker line? I've had this the last few weeks and it's driving me mad, has it resolved with the HRT?

The NICE guidelines state that women 45+ should be diagnosed based on symptoms. Go to your GP ( print the guidelines found online and take with you in case the GP isn’t aware of them ) and they should do a symptom check. I was 34/40 on the symptom checker, down to 4/40 on HRT. Sadly some of those symptoms are quite annoying, like fatigue and anxiety, but they’re better than before.

Blood tests don’t really help, except to rule out other issues like thyroid or say B12 deficiency.

There are c. 50 symptoms associated with perimenopause. Your oestrogen is falling. All cells in the female body have oestrogen receptors.

Essentially if you feel you have symptoms affecting your quality of life, ask to try HRT and see if it helps. There’s not much to lose. It either helps or it doesn’t, only one way to find out. It’s less risky than continuing to take the pill in your forties, in fact there is no risk associated with HRT before the age of 50.

The challenge is getting a GP to prescribe it. Many prefer anti depression or anti anxiety medication. That’s where symptom tracking is useful.

And obviously HRT is not a contraceptive.

Yes I think I am going to have a chat with my GP.

When I look through the list of symptoms and tick them off, I also find myself saying “well that could be because of this” or “I get that sometimes but not all the time” etc

For example. I’ve always suffered with migraines. To the point where I’ve been taking Triptans for years for them. So it’s hard to pinpoint that as a possible symptom when it’s something I’ve always suffered with.

The constant urination. I’ve had it for a few years now and went to the women’s hospital for a while with it, to be diagnosed with an overactive bladder.

The abdominal pain/constipation/diarrhoea- I suffer with IBD (Ulcerative Colitis), so these are also symptoms of that.

To be honest, the biggest symptoms for me have been my increased sweatiness (not specifically hot flushes, just sweating profusely in certain areas. My armpits sweat so much it comes right through to my jacket! It’s embarrassing!) and the fact that my libido is non existent. Those are the key things that have made me kind of go “hang on, maybe something is going on here”.

Yeah, I have hypothyroidism so some of my symptoms can overlap. They have a specific set of things on the checklist and certain symptoms raise the suspicions more than others. I initially got a checklist, then I had to redo it every 3 months.

If over 40 I would just presume it is peri. Peri is just the years leading up to your last period it isn't something that needs diagnosing per se. It is always handy to get ferritin tfts etc checked to rule out other issues but if you're over 40 your hormones will be fluctuating.

Women have 2 choices, ride it out and hope for the best or read up on it then tell their GP they are struggling with peri issues and request a trial of HRT. Doesn't even need face to face consults, unless you've got complicated medical history or a dinosaur of a GP it could be done via phone consult.

Doesn't even need face to face consults it does initially and then once a year, to check your blood pressure.

Many prescribe via e/phone consults in straightforward cases and many practices have DIY BP machines that you then submit the reading. Dependant where you live obviously but f2f is for ill people around here.

Oh I hadn’t heard of the ability to do it yourself. We have had face to face for a long long time where I am. But for my repeat prescriptions I don’t need to go in. I think they follow NICE guidelines and BP is part of that I believe.

It's nowhere near as bad but I still have it a little - but I don't suspect I'm wetting myself anymore thank god! (Was embarrassed writing that I have to say!) I realise now I never sweated much before and now I'm prone to feeling hot/stuffy generally. But yea it's improved with HRT!

So last week I rang my gp to request a hormone blood test to see if I am peri menopause . 45 and all the symptoms . she was great and said blood test was not needed , I am 45 and have all the symptoms . I started the following day in oestrogen patches and progesterone tables on a cyclical cycle . Hoping this elevates my symptoms and gives me back my life

Op I'm very similar, same age too. I have thyroid issues so I was putting things down to that. But lack of libido is my major one and brain fog. Gp appointment with Dr. Who specialises in women's health on Tuesday so expecting hrt.

I've just been prescribed HRT with no face to face consultation. One telephone appointment to discuss symptoms in depth and I was sent some information. And a second telephone appointment to get the medication prescribed.
I did my weight, BP etc at home. I've been told it will be reviewed again in 3 months, again over the phone and I'll need an up to date BP for that.
Due to communication difficulties I prefer face to face. But I can tolerate telephone appointments if there is no alternative and they didn't seem to want to see me at all.

@Punxsutawney ok that’s interesting. I actually got a BP machine but it was giving false readings ( I have low BP ) I heard you have to calibrate the machines? Is that right? I’d like to check mine at home too.

Please could someone share a link to the nice guidelines ?