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.

Just for a bit of balance, I love my Mirena and I like the idea of having the hormones delivered where I need them rather than systemically eg via a pill or patch. I’m 48 and definitely getting more anxious, but it’s holding off other symptoms (or I like to feel it is 🤣)

In a similar position and have been threatened with the coil. Over my dead body. Last time I let them do THAT (reluctantly), the GP perforated my uterus and I had to have an MRI and GA/surgery to remove the bastard thing. NEVER AGAIN.

GPS were encouraged to fit coils and they got paid for meeting targets.

It wasn't a huge amount and the scheme has ended, but there was this massive push to encourage GPS to do this, and there's a lot of reporting that this was done quite forcefully and despite what views women had previously stated.

Basically GPS weren't listening and it was a systematic push to do something which didn't really engage with women properly.

I'm going through similar at the moment and went to the Drs. Dr 1 said to have all my bloods done - they took loads, also mentioned having HRT 2nd Dr phoned me back to say nothing unusual bar one test in the results but that blood tests can't determine whether peri or not. The only confirmation I'll have is when I've gone through menopause (no period for a year). No mention of HRT.
Just had another set of bloods done and waiting results.
I'm suffering from quite a few symptoms but the last nurse I spoke to has said she'll discuss HRT in a couple of months if I'm still feeling the same. I've had a lot of stress and change in my life recently so she wants to make sure it's hormonal and not induced by all my change in life.
I feel so bloody crap at the moment and literally just want to cry most days. Luckily I have a very supportive DH.

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I literally had a speculum hanging out of me and they were still trying to push it when I went for my copper coil.
There is definitely something in it for someone.
We constantly get told there's no incentive, but it's hard to believe when it's pushed so hard despite some women reporting awful symptoms

Exactly why I won't have a coil. Also the thought makes me feel weird. And I have a tilted uterus which makes smears painful. And had 2 elcs so no natural birth to open my cervix. So nah to a coil. And I'd already told him I didn't want a coil. So why he suggested it 3 times I don't know.

I'd tick 40 - 45, but if I was asked am I over or under 45 I'd say over because I am 45 and 3 months. I don't object to the bloodtest, but it only shows the relevant hormones at certain points of your cycle I think and I have no clue where in my cycle I am cos fortnightly periods. I think I am ovulating when I come on as its the only time I have a libido. Which is no good really as I am also either doubled up with cramps, have the shits or am bleeding like a stuck pig.

Thanks for everyone's comments and sorry other people go through this. I was hoping the recent spotlight on the menopause would have made things a bit simpler. I don't think the risks associated with HRT are as great as they thought they were, and the osteoporosis and heart disease prevention certainly appeals. We don't have breast cancer in our family history but we do have heart disease so for me I definitely think the rewards outweigh the benefits.

@HighlandCowbag - I think you have to have a list of symptoms as long as your arm and be prepared to fight your corner. I wanted to try hrt a couple of years ago (I’m now 47, but definite peri back then with periods close together etc) and asked the nurse about it then, when I went for a smear, hoping she’d talk about the benefits and suggest something, but she said ‘oh you’re much better carrying on without it if you can.’

Having been told recently about the Davina documentary I watched that with a notepad (brain fog!) and wrote down every symptom that I also had and what Davina took (I also read some stuff on the menopause board here). When I had the telephone consultation I listed everything - and she said ‘oh if you’d only had one or two symptoms I’d say to carry on for a while longer (totally against what the davina experts said) but as you’re having a lot now then it’s worth trying it, but you can only be on it for 3-5 years (I ignored this as I thought I’d fight that battle later). She said she’d send me some information to read to look at different types, but then because I said I already knew what I wanted to try she arranged for me to talk to the prescribing pharmacist a couple of days later.

It’s not been a 100% magic cure (the progesterone gives me bad period pain type pains for a week and depression on day 7 🤷‍♀️), but I feel much more with it and better for taking it overall. It’s also oddly enough helped things I hadn’t associated with peri, like my plantar fasciitis which can be linked to menopause and dropping oestrogen!

Good luck with getting a dr to listen to what you want and help.

Same with me. I had dreadful periods all my adult life and was getting anaemic. I am actually sterilised but the coil has been amazing for me. Am 49 now and it's been 3 years. Not had a period until this summer and now getting them regularly again but nothing like without it.

From another perspective I know 3 women who had a mirena fitted to take them through menopause and one who had been through, come out the other side and had it removed. All raved about it. The one through it said that Mirena basically stopped all
The peri symptoms and now she's through menopause symptomless.
I had a mirena for 7 years, apart from the first 3 months of sporadic bleeding, it was a godsend. And I'm not exaggerating.

No doubt GPs are getting kickbacks or whatever but it helps a lot of women.
A copper coil saved me from my Ashermann's syndrome which was killing me.

I'm now 49 and only now have missed a period. I am symptom-free otherwise but I won't hesitate to get a mirena again if it all kicks off.

The thread is about the doctor not listening to a woman. People are talking about fiercely not wanting a coil and the doctor pushing it.
A load of people come on raving about the coil. Seriously? Bit tone deaf?

I'm not 46 until next year and have just been prescribed HRT patches based on my age and symptoms. She did do blood tests but that was to double check other things such as thyroid etc, not confirm if i might be peri-menopausal. Her words were "at your age we go off symptoms as diagnosis".
I also refused a mirena as I've had one before to treat heavy bleeding and it had the opposite of the desired effect!

Have nothing much to add except that I am so fed up of bloody Drs offering the coil. Quite persuasive and determined sometimes.

I am slightly younger but have awful periods and would welcome the menopause. I have campaigned for a hysterectomy for a decade now as I don’t and have never wanted children. Every single time they try to push the frigging coil. Like no, I don’t want anything up me. Every.Single.Time.

Exactly this @mangoontoast I do not want a coil. Its not that I doubt how effective it.is in the majority of cases. I just don't want it inside me. Even thinking about it makes me feel.odd.

Anyway had bloods taken today. Dr has only ordered the hormonal one, not a full blood work up. So a complete waste of time and money. It won't show anything useful re hormones and won't exclude thyroid issues etc. I did ask the nurse if she could ask for a full blood count and she said she could not.

Am making a list of symptoms for my appointment on monday and taking it with me. And also going to ask why no full blood count. And why bother with a hormonal one at a random point in my cycle.

Download the Balance app then you can log symptoms daily and it’ll give you a report and how frequently you log each which you can use to show your GP.

Update

Went for 2nd appointment following blood test and saw a female GP. She was completely different to the male GP. Said I shouldn't have had to have a hormonal blood test, maybe a blood test to rulle out other issues. She listened to my symptoms and prescribed HRT patches. Said mini pill probably won't help regulate periods and would still be without oestrogen, and would miss the benefits of that so may as well have HRT.

Soo am trying it for 3 months and then if things don't settle down a bit I can increase the dosage.

And she confirmed the age group thing, over 45 is anyone who has had their 45th birthday.

Glad to hear you got someone to listen to but ridiculous that GPS aren’t all aware of the guidance for such a common problem.

Yup you would expect every GP to at least be aware of the issues that affect 51% of the population wouldn't you? Not like its niche or anything. Especially considering the campaigning that has happened recently for more awareness.

We shouldn't have to specify a female GP to address these things. Male GPs should be as informed as their colleagues, it's not like they only get paid to deal with male problems.

It also probably costs the NHS more money. I had a blood test and a 2nd appointment that were both unnecessary. I was probably lucky to get an informed GP. Which should not be the case.