Can’t believe it is so difficult to get a gp to recognise my Perimenopause situation.

[Septemberintherain]

I’m 50 in March.
8-10 years ago, I felt on top of the world, really great.
However, since the age of 45 (ish), everything has started to go to pot and I feel like a crumbling, old statue.
I have endless digestive issues (IBS and dyspepsia diagnosed after lots of tests), awful anxiety/depression/low mood, anger and emotional meltdowns, zero libido, sore down below and during sex, night sweats the week before period, periods so heavy causing anaemia that became so low I needed an infusion (period issues caused by recurring uterine polyps which are most likely hormonally charged), aura migraines during periods, sore tongue, tinnitus which is driving me to insanity…….
I have seen at least 4 GPs, none of them seem eager to acknowledge I may be in perimenopause and keep prescribing antidepressants even though they exacerbate my already shot to bits digestive system.
I thought I had found a nice, understanding GP after moving surgeries recently but again, she overlooked the potential peri symptoms and prescribed me Citalopram.
I had my 6 week review this morning. She asked how I got on with them and I told her they had exacerbated my gut issues leaving me feeling worse than ever, she seemed so angry with me saying that is to be expected and I need to push through for 2-4 weeks.
I explained this is difficult due to the fact I do not get paid sick pay from my job and therefore can not take time out for feeling so poorly and I also care for my mum who has dementia, so taking a med which is leaving me feeling worse rather than better is hard going.
I then asked if I could be in peri? She seemed annoyed, almost eye rolling and said “well I’m pressed for time and will print you off some info” (I had been in the consulting room for around 6 minutes by this time!).
She went on to ask if I am fully aware of the breast, ovarian and uterine risks of HRT?
She seemed to be putting me off. Told me to read the literature and make another appointment, if I really wanted to.
I came out of there and bawled my eyes out.
I feel that, as much as I can not afford it, I will now need to go private. At the end of the day, I want to be seen and treated by someone understanding and knowledgeable on peri and the menopause.
I am now confused as she kept reiterating how it raises the risk of bc (yet so much I read on info sites like Dr Newson say that’s outdated info) and really didn’t seem happy to talk peri yet they all hand out prescriptions for antidepressants like they are sweeties.
I know I can not contribute all of my issues to Perimenopause but surely, at almost 50 (and the fact my mum had very similar issues at this age), it should be something they would be exploring.
They seem to think antidepressants are the panacea to absolutely everything these days!

I'm sorry, but in no way surprised I'm afraid

So frustrating, isn’t it? DesMoulinsRouge

I think it's concerning that you say 'She went on to ask if I am fully aware of the breast, ovarian and uterine risks of HRT?' but didn't mention anything about risks of long term use of antidepressants, which many doctors seem extremely reluctant to acknowledge. Absolutely agree you should be able to be seen and treated by someone understanding and knowledgeable on peri and the menopause.
I have had many friends and people I've met through work prescribed low dose SSRIs seemingly just to get them to go away (as in the GP says "don't worry, just try these, I'm sure you'll feel better")
I'm a bit younger than you but fairly sure I'm right at the start of peri - not much looking forward to the next few years if my existing mild symptoms get worse. When I mentioned this at my GPs they pretty much said they wouldn't even consider HRT until 'things are so bad you really can't cope any more' - I was slightly horrified by that remark tbh!

It sounds dreadful OP and it also sounds like peri! Did any GP bother to suggest the pill? I was having a nightmare time - extremely heavy periods out of nowhere and terrible stomach pain I'd never really had before during time of the month, energy up or down all over the place, extremely fatigued before period, bloating, worse skin, everything, moods all over the place, a feeling peri was ruling my life, the list goes on....

So I tried taking the combined pill and boom, all symptoms just disappeared overnight then never came back. Periods extremely light in non pill week. The only way I can describe the change is day 4 of my normal cycle when I always felt great, balanced, energetic, etc is how I now feel all the time. It's honestly one of the best things I've ever done!

I know it doesn't work for everyone but might be worth a try?

My GP (female) just stated not much was known about female hormones and peri symptoms so not much she could do. I did get a prescription for anti nausea tablets though. no idea why.

My female GP quizzed me on what I knew and advised me to follow Louise Newsome if I wasn't already, and to watch Davina. I was there for something else entirely. I don't think I'd have had any problems getting HRT, but I said I don't see the point when my only noticeable symptom is irregular periods (I know there are those who say where woman should unless they have dpecigic contraindications like a family history of breast cancer.)

I wish everyone could have a GP like mine.

Honestly some GPs are hopeless.

Read up a bit then go back and tell them what you want, absolutely no need to pay for a private consult. Say as you are 50 you are obviously in peri and as it is having such a massive negative impact on your life you want to try body identical hrt (oestrogel or patches plus utrogestan to protect your uterus lining). Suggest they read up on NICE guidelines and then say you will do a review in 3mths, a phone consult will suffice.

I am absolutely for people going hrt free if things aren't unbearable but that clearly isn't the case with you. Go back, ask for hrt and tell them yes you've read there are some small risks but your quality of life is such you're happy to take that risk.

I don’t know about your symptoms but two HCP I have seen we’re so pro HRT, no issues, barely any questions beyond which do you want

I can't believe so many women are still being fobbed off like this. Get back there and demand HRT - you need the hormones which you're deficient in to be replaced, not to be fobbed off with anti-depressants. Makes me angry.

what Janiie says above - ask your doctor to watch just one minute (from 29:35) of Dr Newson's vid:

My male GP was hopeless and almost implied I was annoying.

I went privately with Spiced Pear and the doctor couldn't have been more helpful. And she had all the cancer stats at her fingertips, there is a lot of information out there and more all the time.

I had a totally different experience, my gp referred me to the menopause clinic and I was prescribed HRT straight away. I am 52 and deep in the brain fog/anxiety.

It's appalling that the standard of care differs so greatly.

It's a disgrace @Septemberintherain

but you have to say what you want.

Don't go in saying you might be in peri.
Tell your dr you are.

Don't accept anti depressants that NICE says are not to be used (in the 2015 menopause guidance.)

SAY you want to try HRT and don't accept being fobbed off.

There are also no added risks of uterine or ovarian cancer.

There are also ( according to the British Menopause Society statements) no added risk of breast cancer using transdermal estrogen + Utrogestan for 5 years.

You can do a lot to get what you want by reading all the stats and quoting them when you see your GP.

It annoys me like hell that GPs behave like this.
There is NO menopause consultant who would behave like this so it's a disgrace that a GP is a) out of touch b) not educated and c) withholding correct treatment.

don't accept it.

and you allowed her to get away with that comment????

You are allowed to contradict GPs !

She ought not to be working.

Many GPs are getting away with spouting crap.

The NICE guidance came out 7 years ago.

They state very clearly that the diagnosis and treatment is to be based on a discussion and also NOT to offer anti depressants.

In 7 years it seems many GPs have not even bothered to read the guidance that will affect 51% of all patients (women,)

which other profession - law, education, other HCPs, would be 'allowed' to ignore guidance for 7 years?

@JinglingXmasbells

Our GP surgery has many issues right now for many people, counsellors are investigating. The problems run deep...

Thanks everyone, that has made me feel better.
I have become so low due to my symptoms that my confidence is rock bottom, I really felt like a naughty child who had failed to do what the grown up had asked of her, I literally had to bite my lip to stop myself bawling right there in the seat. Pathetic, I know, but the frustration of not being listened too has weakened me, it’s really hard to be strong and firm when you feel like shit.
I know antidepressants help many people in various situations but I’ve tried them many times and each time they have made me feel worse, all of the doctors I’ve spoken to are fully aware of this yet still keep pushing them.
And antidepressant are not going to protect me from the awful things my poor mum suffers from, osteoporosis, heart disease and dementia.

It's awful that so many women have this experience. You expect to be able to be vulnerable in front of your GP, but it seems we have to educate ourselves, arm ourselves with the facts, and get assertive with them.

I have one practitioner that, whenever I speak to him, tries to make me take anti depressants, despite having zero history of depression. It makes no sense. Especially when the HRT improves every symptom when it's right.

I'm sorry you've had this expertise. Book that appointment, prepare yourself with info, and go back to demand proper healthcare.

Softplayhooray I suffer from aura migraines so sadly can not take the combined pill due to stroke risk.
Thanks JinglingXmasbells, I really do need to go in, strong, with info in hand but I hate that it’s such a battle, it really should not have to be the case.
When I was explaining my symptoms to her this morning, I had this distinct feeling that she thought I was over exaggerating. She is a woman in her mid to late 30’s and all I kept thinking was ‘give it 10 odd years, just wait and then see how it’s feels!’

The lovely doctor at Spiced Pear pointed out that:

There are increased cases of breast cancer with progesterone HRT BUT:

That depends on how many years you use it for
Breast cancer is one of the most treatable cancers - be breast aware and catch it early
The data for increased cases is based on a type of HRT that isn't prescribed anymore so is out of date
More women die of heart disease than cancer (and definitely breast cancer) - and HRT is protective of heart disease

I was busy freaking myself out as GP had prescribed a northisterone containing patch, and not utrogestan. Turned out this was wrong on many levels, not least that he hadn't noticed I needeed contraception. I resent having paid full price for my HRT but at least I know it was prescribed by someone who knew what they were doing.

My drs seems to be keen on medication... we're surprised when I said I didn't want hrt. They don't have that much training it seems other than drugs but have referred me privately to a natural menopause centre

This is so poor. Get all your facts together and approach them informed, and politely demand. Be firm but insistent.

@AnnaMagnani I wonder if your dr explained the risks in full?

There are risks with all HRT used nowadays - not just the very old types.

The progesterone determines the risks as they said.

The most risky are MPA, then Norethisterone, (both of these are in patches and MPA is in tablets), with dydrogesterone (only in Femoston tablets) being less risky, and micronised progesterone the least risky.

@JinglingXmasbells she couldn't have been more thorough in her explanation - it did go on for best part of an hour!

I edited rather than post it all in a 4 page post.

For me the big highlight was that breast cancer goes up, but doesn't mean death. While loads of other bigger causes of death - esp heart disease and dementia go down.

I'd recommend the Menopausal Not Mad website for up to date information. I've used them to obtain Testosterone on top I'm my HRT