Can anyone clarify the 'over 45' cut off point?

[HighlandCowbag]

I am 45 and 3 months. Have had peri symptoms for the last 18 months, including erratic periods which are now coming every 2 weeks. Unexplained weight gain, poor sleeping, vaginal dryness, loss of libido, slightly stressed about silly things that would not have bothered me 12 months ago.

Booked a GP appointment and have been today. Despite me stating I did not want a coil that was offered 3 times. Said I wanted to try HRT. He said I needed a blood test first as I was very young to go on HRT and the bloods needed to confirm perimenopause.

I am having bloods done Friday and an appointment on Monday with a different GP (he was a locum). The sticking point was his definition of over 45 and my expectation that 45 and 3 months is over 45. The nice guidance says 40-45 should have a blood test, over 45 should be able to be diagnosed with symptoms.

Find a GP that isn't as fixated on blood tests. Do take the test. But if the result doesn't show a result that indicates perimenopause find a GP that is willing to prescribe based on symptoms alone. They do exist and you are over 45!

I knew I was experiencing peri at 35 (exhausted, achey, no libido, anxiety through the roof) but GP said I was too young. Reluctantly offered a blood test to look at other potential causes of symptoms too and the hormone level came back normal. “See, you’re too young!” They said. I felt like I was going mad and/or had some other undiagnosed malady.

Turned 40 and bam - periods stopped that very month and I’ve only had a couple in the year since. So I was definitely in peri but not even blood test could confirm it.

I know I am over 45, that was what was so frustrating. He didn't want to listen, just wanted me to have a coil which I don't want. He gave me a mini lecture on not being lax with contraception. I pointed out vaginal dryness makes penatrive sex very uncomfortable and painful, plus loss of libido, plus I'm on my period 20 days out of every 30 and spotting in between so contraception not really a priority.

But if I couldn't have hrt then would consider the pill to regulate my periods, so he tried to get me to have the coil instead. Knob.

I went a few days after my 45th birthday and didn't require tests - I now have a coil with estrogel. I think the other important issue is that the tests are not to confirm menopause but to rule out other problems which might cause similar symptoms e.g. thyroid issues.

@MarcelEtCeleste I know blood tests aren't conclusive as well, just a waste of time and money. Fuck sake. I might print the nice guidelines off and take them with me.

@UnaOfStormhold he has just put them down for hormanal tests I think?

Random question but is your username related to highland ponies at all?

You’re 45, not over 45. Given your symptoms started when you were under 45 bloods might not be a bad idea, along with checking your thyroid function and a full blood count.

You probably are perimenopausal and will benefit from HRT but it doesn’t hurt in younger women to check there’s nothing else going on. A Mirena coil isn’t a bad idea as not only is it contraception, it can control erratic bleeding and acts as the progesterone part of HRT should you then start HRT.

I had a similar problem. Told I'm too young at 45 and only offered the Mirena coil. Dr got very annoyed when I said i didnt want the coil. Despite having 11 out of 12 symptoms, as I still menstruate regularly (though my periods have changed) I was told it can't be menopause, coil or nothing. I'm currently struggling along with nothing.

My GP put me on HRT based on my symptoms at 44yrs 9m. Think it depends on the GP and how comfortable they are at managing menopause

Random question but is your username related to highland ponies at all?

UnaOfStormhold

I was thought skyrim

Agree with Sidge

My username relates to Neil Gaiman's Stardust.

I’m 45 and was referred at bang on 45 for a Mirena (I can only have under GA). As soon as it was in I came off the pill and onto oestrogel.
Ask for a woman Dr.

Do GPs get Megabucks for inserting coils? It was suggested several times to me as an option despite me asking not to be asked again as the very thought of it makes me physically sick.

ahh yeah, I forgot about Stardust.

At the risk of being a knob, out of interest and my ignorance why would you refuse a hormonal coil but take HRT and the pill?

@mumda i wonder if it’s because it’s a much cheaper option for the practice budget?

GPs just don't listen to women when it comes to menopausal symptoms, do they?

@BessieSurtees - I’ve just started hrt (gel and tablets) but hate the thought of a coil as it can fall out, migrate, cause infections (from recollection it’s strings act as a ladder into your womb) and you have to wait for appointments to have it put in and taken out. I don’t want to take anything that I can’t stop asap if I react badly to it.

I would do exactly that OP. Take the NICE guidance and, if it doesn't mention the pointlessness of blood tests, find a BMJ or similar article covering that too.

I saw a male GP who was very well informed and prescribed gel and tablets at 44y 4 mths without mentioning blood tests. Offered a coil but I said no and he didn’t push it.

You can stop the pill or HRT if it doesn't agree with you. Of 5 people I know who had the mirena coil, 3 had side effects which meant they wanted it removed early and all 3 had an absolute nightmare doing so, GPs just wouldn't agree until they felt that the NHS had its monies worth.

There would be zero chance of me agreeing to have something inserted into my body that the NHS would have to remove for me because women are never taken seriously

This sums it up totally for me. Plus the thought of having it inserted makes me feel very ill. I don't take the contraceptive pill though.

40-45 is your age bracket if you are taking a survey would you tick 40-45
or 46-50?

Given how much you are bleeding, Mirena coil would be a good option.

Those I know with one are all using it for the progesterone part of HRT and rave about it so much they should get commission.