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as she kept reiterating how it raises the risk of bc (yet so much I read on info sites like Dr Newson say that’s outdated info) and really didn’t seem happy to talk peri yet they all hand out prescriptions for antidepressants like they are sweeties.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

DontEatAnythingWithoutAFace maranella Hopefully, I’ll have more luck with the nurse.

'They always say that as my periods are regular and I do t have regular sweats then I am ‘nearly’ but not quite there'

But this is madness, women start hrt when in peri with periods all the time. I would just throw in night sweats even if you don't have them tbh if that is their magic word to get the green light. Start with 'I want hrt' though, then say as you have anxiety, insomnia, no libido and vagjnal atrophy. I wonder as you say if you list a myriad of symptoms that could be attributed to many disorders whether the GPs aren't seeing the wood for the trees.

At this point I’d just use the symptoms they accept and get it

There is a great fb group that was recommended on this board called Totes merry peri. It has a pinned post at the top about how to approach your GP. It's really good advice. I downloaded the balance app and input my info and did the ticky box list of symptoms. You can then either print a copy of the results or email yourself a copy. I could only get a telephone appointment with the gp but I was straight to the point, I simply said that I suspected that I am peri menopausal, that I had downloaded the balance app and have all the symptoms and that I would like to trial HRT to see if it improves my symptoms.
I think arming yourself with the info prior to your appointment is really helpful. I have read that if you're over 45 then you can have hrt, no blood tests are needed as your hormones are all over anyway so blood tests can be unreliable. I said that I had read the NICE guidelines too. The gp said normally she would give ladies info to take away and read but that I seemed to have done my research and I have a face to face appointment tomorrow to take my blood pressure and be prescribed hrt.
Try to be succinct and to the point, and confident. Fingers crossed for you.

.

It's such a worry the different experiences everyone has with this and it seems to be complete luck of the draw. I asked for a phone consultation with a female GP and she explained that she would follow NICE guidelines step by step. First offering was anti-depressants which I declined. After assessing risk factors I was prescribed Oestrogel and Utrogestan. My own GP did an initial follow up and said he could also prescribe me Testogel off licence if I would like it, so I've taken them up on that too. I have had to do my own research on daily dosage amounts for the Testogel (not the whole tube once a week as I was advised !) and I'm not sure the follow ups are as frequent as they should be but despite this I feel like one of the lucky ones.

I wish you lots of luck with your next appointment, there's been some good advice on here. It's also completely rubbish that you've had so many visits with such a poor outcome. I hope you feel better soon.

It's worth considering that your B12 results can be considered borderline deficient:

en.wikipedia.org/wiki/Vitamin_B12_deficiency

The NHS parameters for deficiency are extremely low. Definitely worth supplementing with a good supplement in the interim and increasing your consumption of meat, fish, eggs etc. Have you been prescribed any proton pump inhibitors for your reflux? These can also interfere with B12 absorption.

I was given hrt at 44 a year ago after extensive lists of symptoms, repeated Gp visits and had had main symptoms for 3 years.

I still had regular periods (give or day a two.)

I think my Gp had got on the Newson band waggon as she actually had her book and even knew I could have it while still breastfeeding my toddler. (It got so much worse when we stopped feeding and I had to double my hrt.)

However, I'd been in and out for years with random ailments and joint issues and no one considered peri. Soooo many diabetes and b12 tests thanks to tingling burning fingers. I now think that's linked to Raynauds and fluctuating hormones. (I'm hypothyroid too which doesn't help.)

It should be a battle at your age, according to Nice. Definitely print of the guidelines and go in armed with those.

SHOULDNT! Be a battle!

What a shame a female GP can be so dismissive.

Last year having similar issues with hopelessly inaccessible GP, I wrote a polite letter to the practice manager quoting the NICE guidance, and was phoned the next day offering me a telephone appointment the following week. GP was suddenly much more amenable!

She needs reporting for that comment alone, disgusting.

Fancy going into a caring profession and talking to people like that??

I'm beyond angry on your behalf

Testosterone will be your missing link there.

As an interim measure to going private, can I suggest a private GP appointment through Babylon or similar? Find a GP with a specialism in menopause and try them. You might have to pay for your first prescription but it will be on your record and you should be able to get your GP to take it over.

greeandorange Her attitude to my response really upset me, it felt like she took my comment in such a flippant way as though I was saying it just for effect but I really was not, I even told her how scared I am of my dark thoughts. Tbh, her response just confirmed what my mind was already telling me which is that I’m a nuisance.
PastMyBestBeforeDate I have been considering this. I have enough money put aside for just one consultation with a specialist but have been umming and ahing as to whether it should be a private gp or a private menopause expert but as you say, maybe I can find a private GP with an interest in women’s health and menopause?

@Septemberintherain as a stepping stone to private, I've ended up getting HRT through the boots online doctor service. They are now able to offer HRT to women that are still having periods when before they weren't able to. I'm on oestrogel and utrogestan to try for 3 months and for the 3 month supply it cost me £90. It's not ideal at all but trying to get a GP appt for this was proving extremely difficult so I decided to do it this way. So far I'm incredibly pleased with it and it's made a massive difference to how I feel.

I know you said you've made another appointment, and I presume it's with your GP again. You may want to ask at your surgery whether there is anyone there that specialises in menopause support and switch your appointment to them instead.

At my GP surgery it's a practice nurse, and she is utterly fabulous, really listens to me about what's important to me in terms of managing symptoms and in treatment options. Her recommendations for prescription go to another member of staff and come through in a couple of days. I found out she was the person to ask because when I had my smear, I asked the nurse who did it who was the best person to talk to about menopause and she recommended her colleague - in fact she made the appointment for me on the spot!

I really hope it continues working well for you ticktock19
funnelfanjo The appointment I have is with the nurse practitioner (can’t get a GP appointment for another 5 weeks). I will ask and check if she’s knowledgeable about menopause though.

@Septemberintherain thank you, I hope you can get sorted out as soon as is possible

That's probably a good start that it's with a nurse practitioner and not your unhelpful GP. My surgery runs specific "menopause review" appointments, so you could ask how your appointment has been classified? When you've only got 10 minutes per appointment, if the clinician knowns what it's about before you've come into the room you've saved some time to talk about symptoms etc!

Fingers crossed you start to get some helpful support soon.

Wow. That's awful. By complete contrast I found it very easy to get HRT. A quick phone consult and then weight and blood pressure check. Had the pills the following day.

It's so frustrating isn't it. I'm currently experiencing a difficult time too. I've seen 3 GPS over a year. The last 2 were from a new surgery I changed too thinking I'd get some help.

I was put on the pill and I ended up with chest pains and stabbing pain in my legs. I was put on 2 different antidepressants and got awful side effects and seemed to be worse.

All gp's have said I'm not peri, they said they've done blood tests and I'm definitely not. The last gp put me on cleanmarine for women, not the menopause one. I was also put on folic acid. I don't seem to be any better.

I'm getting awful night sweats where I have to change the bed during the night, gp said to get a lighter duvet and no heating on, I don't actually use any covers or heat due to sweating. My mood is appalling, I'm like the antichrist. In the last 2 months I've developed extremely bad joint pain in my neck, shoulders, knees and feet, a burning, stabbing, tingling pain.

I was told to come back when my periods start easing off or stopped. From reading this thread I'm thinking this isn't right? I'm 50.

This is such a common story and it's terrible so many of us have been through it.

I had a hysterectomy at the age of 44 about 6 years ago and the surgeon warned me that it might mean menopause sooner rather than later. 2 years later the sweats started. And then two episodes of intense anxiety/depression which saw me bursting into tears at the GP and leaving with scripts for antidepressants. Repeated UTIs.

Finally - and mostly through reading threads on here and through people like Davina McCall and Louise Minchin talking about it - I joined the dots and realised I wasn't losing my mind, I was going through the menopause. First GP I saw was just awful, refused HRT, gave me a prescription for folic acid (?) and recommended mindfulness. Second GP in the same practice was SO much better, agreed that I probably was in the menopause and was happy to prescribe. Both men, both of a similar age. But when I asked the (middle aged, female) receptionist whether there was a menopause clinic, she looked at me as if I had 2 heads and said "what would we need one of those for?"

Things are getting slowly better and awareness is increasing but it's a bloody scandal that this is being driven by a couple of outspoken media personalities and not the medical profession.

Ferritin ferritin ferritin. Not anemia. Iron deficiency

I see endless threads like this on mn. Educate yourself on the nice guidelines, go in informed and politely demand what you want. Don't be fobbed off.