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as she kept reiterating how it raises the risk of bc (yet so much I read on info sites like Dr Newson say that’s outdated info) and really didn’t seem happy to talk peri yet they all hand out prescriptions for antidepressants like they are sweeties.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

@Septemberintherain have you got an update? Just read through and really hope you have concluded everything and are feeling better?

Completely relate @Septemberintherain & sympathise. It’s shocking & disgusting treatment.

FWIW I think the minute you have anxiety &/ or depression on your records & prescribed antidepressants - they over ride EVERY health complaint you may have & make it impossible for any GP to take anything else seriously.

The patronising & gaslighting that goes on in the medical profession is just horrendous.

It’s taken me 4 different GP’s to even consider prescribing me micronised Progesterone with all trying to fob me off with synthetic progesterone. Laughed at by male GP when I asked, while a second overplayed the risks of HRT & tried to persuade me to increase my antidepressant “where there are no risks”. Makes my blood boil. Antidepressant withdrawal & the harms caused by them are very real & also completely downplayed by the profession (despite changes afoot as stated in NICE guidelines on prescribing & tapering).

I’m yet to start it because GP won’t prescribe without a polyp being removed first - which is all well & good but a 12mth wait for treatment. I can’t wait that long!!!

Hope you get somewhere at your appointment. Keep us updated 💐

Just to mention on the having depression already point- not in all cases. I have a long history of depression since 17 years old and GP is so far taking me seriously about perimenopause. Doing hormone tests etc.

Sometimes on the GP websites it will say about different GPs and which ones specialise in women's health. This could be a plan, to see one of these. Mind you this is a big city practice with quite a few GPs.

Sadly, I’m not getting too far atm.
Its an uphill battle just getting a gp appointment at my surgery, 6-8 week waits are the norm.
I have an appointment coming up in the next few weeks. It’s with a locum gp as I’ve just discovered mine has left.
I am hoping I will get somewhere with this one as tbh, I am feeling just awful. Every day. It may or may not all be peri related but I am 50 next month and now have a myriad of seemingly peri symptoms.
If I still draw a blank with the gp I will have to use my savings and seek out the advice of a medical professional with menopause knowledge. I don’t want a GP to reluctantly prescribe me HRT just because I’ve come in with all of the NICE guidelines, I want someone who will support me. I haven’t been receiving that from my gp and it leaves me feeling medically gaslighted, she is putting everything down to anxiety and over looking every other symptom, when I tell her I don’t want to continue with the antidepressants she has just become angry with me.
That is not support imo.

How did you get on with the nurses practitioner back in Nov? You really don't need a face to face with a gp, I understand you may want reassurance but they don't really have the time for lengthy explanations and analysing presenting concerns. They should but they don't. Keep it concise, tell them what you want.

'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.'

This. Take control read up ask for a telephone consultation if the NP in Nov didn't prescribe, say you've read the NICE guidelines and want to try body identical hrt. Say you will then ring for a review in 3m.

@Septemberintherain near me, lots of the GPs are setting up a menopause practice alongside the NHS practice.

So it's not as expensive as a menopause clinic with meno specialists, it's still GPs but instead of a 10 minute speedy consultation, you get an hour, plus follow up appointments whenever you need them.

Might be worth looking for if you don't get anywhere with the locum.

Its been a nightmare trying to get seen, for various reasons. The nurse practitioner appointment in November was cancelled due to staff absences, I was given another appointment in January but unfortunately I caught a virus so had to cancel. I now also need a gp appointment due to my digestive issues and the receptionist is insisting that due to the lack of availability with appointments I need to book an appointment with one or the other and as I need the digestive issues sorted it will need to be with a gp! It is so hard to get an appointment at this surgery.

@Septemberintherain just to echo what others have said - you may need to stress (or ham up) hot flushes (even if you’re not particularly bothered by or having them as am I). They seem to trump all others symptoms - from both male & female GP’s IME, so maybe play on those along with sleep disturbance & the impact of this on your functioning.

Otherwise a woman, already on antidepressants complaining of mood swings & heightened anxiety (& other “somatic” complaints) is just being hysterical & neurotic (regardless of her age & the potential for hormones playing a part).

Hot flushes not being commonly associated with MH difficulties I think reassure them that hormones are responsible.

Which is completely shit bcos if you do already suffer with anxiety or depression (or have been put on antidepressants when hormones may have been the cause all along) perimenopause can make it significantly worse!!

When I asked about hormone testing to see if they could be ruled out for why I was feeling so bad, at 47 I’m now 50) I was shot down & told they’re completely unreliable & that I’d need a year without periods & unmanageable hot flushes to be eligible for HRT & for any hormone test to be conclusive. This from a female GP in her mid 40’s. It’s hard not to wish her a truly horrible, life altering, job threatening, menopause. I know that’s horrible but I think it’s really hard for some doctors to appreciate how desperate the person in front them can actually be. Even if you tell them that.

If hormone testing is so unreliable how come when an NHS male endocrinologist tested mine (for a different (yet related IMO issue) his hormone tests were capable of confirming I’m in perimenopause then? And HRT may indeed be worth trying - mainly for my disrupted sleep (at the time) than anything else.

It just highlights the ongoing ignorance & lack of interest when it comes to mental & menopausal health. And resistance from the medical profession to genuinely want to collaborate with the patient & practice patient led care.

I know not all GP’s are like this but it’s hard not to feel otherwise when it’s your repeated experience across the board.

I’m concerned you’re having to go in to discuss two issues however - digestive & HRT - as this may prove too much for the time strapped locum in front of you to be able to deal with. Even if you have got a double appointment.

FWIW I wouldn’t tell them the history & that no GP has prescribed you to date with HRT despite your repeated requests etc & instead present a very straightforward request based on….hot flushes.

Good luck 🤞

I’m so sorry you’ve been having such a battle for treatment @Septemberintherain. It’s so unfair when your symptoms sound very clearly hormonal.

I was lucky and my GP prescribed HRT without much fuss (I was 47 and still having very regular periods!) - but I went to a menopause cafe recently and one of the women I met there mentioned that Superdrug now offers online GP appointments, so could be a way to get HRT. I don’t know any more than that but it’s worth a try.

www.superdrug.com/healthhub/onlinedoctor

Please keep fighting, you deserve so much better and HRT can work absolute wonders - it has for me.

I’m horrified by stories like yours @SayyestotheDog. As I mentioned above my periods were still regular as clockwork when I went to my GP aged 47, and no hot flushes - I had anxiety and insomnia and a feeling of joylessness which I now know is a classic symptom of the perimenopause. Very few if any physical symptoms! I realise now how lucky I was that I was prescribed HRT when I asked for it (although the - young, male - GP did do blood tests first to rule out any other issues).

It’s infuriating that many GPs seem so ill-informed about the menopause, and it’s awful to hear these stories of women having to fight for treatment at a time when their mental and physical health is already under duress.

Get it online for now. Transdermal.

Wow, a lot of parallels, the headaches, the polyps, the heavy periods, but my gp at local women's health clinic (i'm in ireland) put me on progesterone only back to back pill for a year to finish my periods and then put me on hrt. Just on it two weeks. I didn't have to 'beg' in anyway and she was reassuring me that the risks of cancer with hrt have been disproven! because I was worried about cancer. She told me not to worry.

ps, only on it two weeks but i've been sleeping better so so far I recommend it. I hope you can get it.

oh wow, is that what causes a sore tongue. I never knew this.

Heartening & encouraging to hear more positive experiences ladies - not to derail your thread@Septemberintherain.

There are good ones out there - fingers crossed 🤞

Sore tongue for me in peri was a folate deficiency

Something I have done in the past- not for menopause but for a different medical condition- is

Ask the surgery for your 'named GP'. It says who is mine on my online access account as well

Write a letter or email into the named GP with the Nice guidance attached and asking for what you would like to happen.

I found that they perhaps have to respond and mine then wrote back saying they agreed with the Nice guidance and to bring this letter in for annual reviews (that was not menopause btw but a medication I should have had regular health screening for but wasn't)

I had the same problem with my GP, so I've gone private. It's really a disgrace - I'm expected to work till 67/68 and they don't want to treat a routine part of ageing properly...

It's expensive but dropping a day a week from work because I felt so bad, would also be. If you need to go private and get the proper treatment, it's probably something worth exploring

It shows you do have to be assertive. My gp at women's health clinic initially tried to push the coil on me, but I said ''no, now way, never'' and my hand gestures supported how far uphill she'd be pushing water with that suggestion. She quickly said ok back to back progesterone only pill so!

I think paying does change the dynamic slightly. It's normal to pay in Ireland, well, when I had a medical card because my income was so low and I was a single mother I did go to the gp with a default setting of grateful which is crazy because the gps still get paid, but by the government, so I should have been just as assertive.

But when You're paying which I am now, and I've also chosen a women's clinic rather than regular gp, there's that background knowledge of I'm the client.

Not that they don't all have long waiting lists. But anyway, if somebody had tried to push anti-depressants on me, I would have reported them. A 49 year old woman with obvious meno issues, it's tone deaf to fob her off with the much more easily available anti depressants. I feel bad for the women who go away like lambs taking anti-depressants they don't need that won't help them.

@silentpool just out of curiosity how much is it to go private in the uk? my apt at women's clinic to see menopause doc was 60 euro and then the estradot and utrogestan 100 were the bones of 100 euro for three months supply. I could have paid one month at a time but I wanted to buy them all as I keep reading about supply issues.

you're so right about the ageing. we're expected to work forever but have to fund all of this inevitable ageing process ourselves........

Thank you everyone.
I will try again with this new appointment but if I don’t get too far I will go privately. I appreciate that I need to be more assertive but right now I have a huge amout of stress going on in my life and with all of my physical and emotional issues too it’s compounding the peri issues and I just don’t have the strength and confidence to push further.
Tbh, I would rather pay privately and have someone actually listen to me, during a longer appointment which isn’t rushed.

@Septemberintherain practice beforehand. I have a friend who's not getting the same support from a gp. And I think it's because the gp knows/thinks ''I can talk her in to the coil for a few years at least''. We are same age (ish) same symptoms.

Anyway apologies for talking about myself here but happy to report that after 12 days on hrt I have finally lost half a kilo. I've been trying to lose some weight for AGES. 4 weeks of eating so healthily and so mindful of portions too................. but not one gram departed from my gut.

Is it possible the hrt has given my metabolism a bit of a shake

Well if money isn't tight then it is your choice. But tbh I think it's terrible that private practices are profiting from GPs inability to handle the most simple request.

If money is tight then please revisit the nurse practitioner appointment. Have a phone chat and say you want body identical hrt and will review in 3mths.

While you're at it discuss the digestive problems you have, ANPs practically have the same ability as GPs regarding ordering tests, prescribing and monitoring. You don't need to wait weeks for a face to face with a Dr who will tell you exactly the same as a nurse practitioner. Good luck

xJoy brilliant to hear it’s having some positive effects for you.
Janiie I will call on Monday and see if I can change the appointment although I need a referral to a hospital consultant (for another ongoing issue!) so not sure if a nurse practitioner can do that? My practice doesn’t allow more than one appointment running at the same time.
Tbh, I’d rather just use my 50th birthday money to see someone privately.
Not ideal, I know but there really is nothing I want for my birthday more than to feel better!