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as she kept reiterating how it raises the risk of bc (yet so much I read on info sites like Dr Newson say that’s outdated info) and really didn’t seem happy to talk peri yet they all hand out prescriptions for antidepressants like they are sweeties.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!

Given you're close to 50, you are almost certainly in peri (can start up to 10 years before menopause and average age of menopause is 51) so I wouldn't be asking, I'd be telling and asking what treatment you can have please.

Spot on reply!

Your GP should also know - and highlight - the health benefits such as reduced risk of osteoporosis, dementia and some cancers. Its professional negligence for a GP not to know more about peri menopause and menopause.

So sorry you have been made to feel like that Op - take some virtual handholding from here, go back and ask for a blood test and an appropriate HRT prescription.

Where - broadly - in the country are you? Someone might be able to recommend a different surgery.

Thank you everyone.
I have just made another appointment so I can discuss my options (will take all the print offs and all your recommendations with me). Sadly, it’s not for another 5 weeks. I also tried to get a double appointment so I wasn’t rushed like I was last week but apparently that is only allowed if the GP has given the go ahead first!
I am just so very fed up with this battle, it’s been going on for so long, it has really worn me down and I was so taken aback when the GP was so very annoyed with me after I explained the antidepressants were making me feel poorly. She wanted me to just carry on feeling so unwell on them, I don’t know why they keep pushing antidepressants before everything else?
My dream right now is to get some relief from this crap before I turn 50 in March.

Thank you mulligatawnysoup.

Have you had your b12 levels checked? Some of your symptoms sound similar to pernicious anaemia. Sore swollen tongue is one. Maybe worth ruling out.

Just do an econsult or phone consult, no need to wait 5 weeks. Say you are experiencing unbearable issues, you are 50 and peri menopausal. You'd like to try HRT, body identical (read up on whether you want patches or gel), then say you'll submit a review in 3months. I mean this kindly you don't need double appointments or to have a face to face.

All the info is there online you just need a prescription. Best of luck.

Janiie appointments, whether face to face or otherwise are all around a 5-6 week wait, we’ve had a huge amount of new estates built in our area recently which has seen hundreds more people in our village and nearby areas, the surgery is completely overwhelmed with only 4 GPs (2 part time). It takes 2 days just to get through to the surgery. This morning, I was caller no 25 and didn’t get through until 5pm.

HappyScot2022 I had a series of blood tests last month. B12 came back at 263pg which is apparently normal.

I was going to mention b12 too, sore tongue leapt out at me. The blood test for b12 is not very specific, you can have issues even with a 'normal' level. Do you have any numbness in hands/arms/feet? Tingling, crawling sensations? Palpitations? Fatigue?

I hear you. I didn’t get HRT till I reached the magic age of 50. Before that I was too young/not that bad/just depressed. I spent all of my 40s with increasingly awful symptoms.

when you are in there, tell them what it’s like in your worst day. Don’t play it down.

Id also recommend using the econsult if they have it. You can list all your symptoms so you don’t forget anything. and if you do need to go in, the GP can make an appointment for you, at ours they have access to the future appointments.

don’t wait another month.

'whether face to face or otherwise are all around a 5-6 week'

This is terrible. Our non urgent appointments may have a wait but all econsults or phone consults tend to be within 48hrs.

Isnt there a nurse practitioner? They can prescribe HRT.

Akite I really did think I had low vitamin b12 levels because of the sore tongue but apparently it’s all normal.
potplant It’s beyond frustrating and I have felt like I have been banging my head against at the wall for the last 5 or so years. I’ve had these symptoms which are getting worse since the age of 45 but each GP I’ve seen just keeps telling me ‘I’m not quite there yet’ and palms me off with antidepressants. Of course, I would stay on them if I felt they helped but they don’t yet the GPs still keep pushing them on me. Sadly, the surgery doesn’t offer econsults.
Janiie I will,call tomorrow and see if the nurse practitioner could help.

Whereas I had loads of the symptoms you describe and hadn't stopped my periods (also not quite 50). Was given HRT and a proper respectful consultation.
Also in an area notoriously hard-pressed for appointments with loads of new housing (SE coastal).
Weird.
Not sure if it relevant but I bet I sounded pretty unstable at times, maybe next time don't hold back the tears?
They should experience the full wrath of peri woman!

That’s the thing which upsets me the most Windtunnel
I am feeling so awful with my mental and physical health (I also have a lot of outside stress as I care for my mum who has Alzheimer’s), when I went in to see the GP I just couldn’t stop the tears (I hate crying in front of people) and told her I sometimes feel like walking in front of a lorry (that’s no exaggeration, I feel so low).
She told me when I feel that way to call 111 and press option 2!

Really sorry this happened to you @Septemberintherain . I believe GPs are being pressured to cost cut all over the place and HRT is a hugely impacted area. As is treatment for aura migraines, incidentally. I have a very rare type which is even higher risk for stroke - yet the GP was trying to fob me off that my meds are no longer available and push me onto antidepressants / meds that state they shouldn't be used if you're a stroke risk! Kicked up enough fuss and lo and behold, suddenly the meds are available again. I couldn't believe it and makes me so cross it's also impacting people like you who have a genuine need for a treatment and are being fobbed off.

Thank you TippyToesKnows, my dh keeps telling me to go and make a fuss but it’s so tough when it’s against my nature as I naturally lack confidence. I think I may have to bring him with me so he can account for my very low state of mind and peri symptoms. I feel like a child saying that but my own voice is obviously falling onto deaf ears!
Incidentally, which meds do you take for your aura migraines? I have suffered every month, during my periods, for 17 years but have never been offered any help for them.

So you have seen 4 different doctors, told 4 different doctors you are perimenopausal and want HRT and four different doctors have refused to prescribe?

That is pretty shocking!

In fact it is so shocking I think you should complain to the practice manager. I don't understand how all four doctors could refuse a request for HRT from a 50 year old woman who requests it, unless it is contraindicated but they would have told you that

This is awful op. I'm so sorry you are suffering as you are. Telling someone to ring 111 if they feel suicidal is just so utterly inadequate and surely negligent. Didn't she suggest referring you for counselling or cbt? I know there are long waits but she should have suggested something.

I know it will be hard to be assertive when you feel so low that's why a nurse practitioner appointment or phone consult may be easier. Type out a little script to keep control of the conversation, start with 'I am 50 and suffering intolerable peri issues, I've read the NICE guidelines and want to try HRT. Please prescribe body identical that is oestrogel and utrogestan and I will submit a review in 3months time'.

If you have the money, I'd suggest getting an appointment at the Newson clinic (I can personally recommend it). There isn't even a waiting list at the moment and they will likely prescribe you some sort of HRT, if that's what you want. I have a cyclical version (still have periods) which sorts out a lot of the other stuff. Plus the massive benefit of not having to wrestle with the NHS.

Oh I'm so sorry you're having this. I'm 48 and have been on HRT for 4 months now.

I don't know if it's making me feel better or not (hard to judge), but my partner says it has made me 'less irritable'. I still cry at everything though. And my libido has just disappeared which is worrying.

I can tick, tick, tick every symptom you listed. I don't understand why your DR can't see this. Mind you, even my Mum refused to believe I was going through it (she never did; had a hysterectomy).

I would suggest printing off a list of peri (or just) menopausal symptoms for your next appointment and just saying you have every single one.

I think I am very fortunate that I have a GP who agreed that I needed to start HRT as soon as possible. There is also lots of support online. I also have another medical condition (which I have twice daily medication for) which made him delay for a couple of days to check that the meds wouldn't interfere with each other.

Really hope you get some more useful help for your next appointment.

oestrogel and utrogestan and I will submit a review in 3months time

Exactly what I am on; had my 3-month review 4 weeks ago. GP asked me what I wanted to do, I said keep on the same and review in a further 6 months. I am aware of the risk of breast cancer etc if I carry on for more than a few years but we're taking it one year at a time.

Don’t go privately, just make an appointment (can be on phone) about HRT and say you read the info and you want to try it.
6 mins into a consultation is well in as it is 10 mins and they need few seconds to bring up your details and write what was said. Physically getting someone out of room and next person in can take 2 mins at times.

I found I had success getting HRT when I wrote a list of all the symptoms I was experiencing in my phone and read them out to the GP and said 'I'm 46 years old, I have all these symptoms and I want to try HRT'.

So if that's what you want OP, don't beat around the bush. You're almost 50, you're peri-menopausal, no doubt about it. You have umpteen symptoms (including burning tongue, which is a recognised symptom), so just be blunt and given your previous experiences I'd also tell the GP that you don't want to be fobbed off with antidepressants. I hope your next appointment is better and I'm shocked and saddened that this is STILL happening to women who are clearly asking for help with obvious and clear symptoms.

ArcticSkewer in retrospect, I think what I am doing wrong is going in with a written list of symptoms. I always list my anxiety, depression and awful digestive symptoms as the most pressing (because they are), then the very heavy (albeit, regular) periods, the zero libido and dryness, the mood swings, hot day and night sweats and headaches (but only a week before period) etc. They always say that as my periods are regular and I do t have regular sweats then I am ‘nearly’ but not quite there. This has been quoted to me since the age of 45. I can seem to get them to understand that I know anxiety, I have suffered from childhood yet have managed it well with exercise, CBT and yoga etc but since my mid 40’s this anxiety is different it is on another level that I never knew existed and is beyond overwhelming (and antidepressants just don’t help at all). This feels driven by something else but it’s hard to articulate when I’m in the consulting room as I feel like I’m wasting there time.
Janiie I have asked the receptionist if the nurse practitioner can call me, I will ask her if she can help.
NotRainingToday Sadly, I can not afford it but if I get nowhere with the nurse practitioner I will use Christmas money to pay to see someone privately.
I definitely need it GreenFingersWouldBeHandy I am sure my dh would love for me to be less irritable, even the kids are beginning to say I’m so miserable these days. I need it for all of us.