NHS menopause clinic

[Dog2030]

I'm 42 and started having peri symptoms at 39. Hot flushes, night sweats needing a change of clothes and impacting on sleep, bad anxiety, obsessive thoughts, formication, really itchy vulva on the outside and perineal area (this is not all the time but gets worse before my period), very dry skin all over my body, very dry eyes, headaches, and bad PMT which I've not had before. My periods were always very regular, but they went to anything between 18 and 42 days.

My GP said I was too young for peri. My mother and maternal grandmother were menopausal in their late 30s.

After two years of GP visits I was referred to an NHS menopause clinic. In the mean time I went private and am on oestrogen patches and utrogestan which I take vaginally. This has helped with the hot flushes and night sweats in particular, but my mood is still all over the place. My skin is less dry but still very itchy at times.

I want to ask the menopause clinic to continue my HRT prescription. However I'm wondering if I need something else for the itching and mood, and if so what I should ask for.

Would it not be best to contact whoever first prescribed HRT and ask their advice?

It sounds as if you may just need a higher dose of estrogen. Women of your age often need up to 4 pumps of gel a day. What dose are you on?

Have you not had a review with the prescribing dr? My HRT is private and I usually have a review every 6-8 months(ish) to discuss.

The NHS clinic probably won't offer anything any different and sometimes the medics there are less qualified and experienced than other specialists.
(I have read accounts of some women being very disappointed with the NHS clinics.)

Thanks for replying @JinglingXmasbells - your advice on this board is really useful.

I'm on 100 patches so equivalent to 4 pumps. I have a review in a couple of months.

That's frustrating to hear about the menopause clinics sometimes being disappointing.

I've spent 2 years feeling fobbed off by my GP so was hoping the clinic would be more helpful. (It got to the point where I was asking my DP if I was just making up all the symptoms because I was being dismissed). I also thought my GP might be more likely to follow their advice.

I'll update on how it goes.

I'm 41 and got steroid cream for the itching/soreness, seems to have done the trick. Have also been referred to gynae, I think I'm peri too, haven't raised it with gp yet but will mention it at gynae appt.

I don't want to be negative @Dog2030 but many menopause clinics have less to offer up their sleeves than other specialists. I know of at least one woman (on another forum) who was forced to stop HRT at 60 by the NHS clinic, despite no health issues on it and that had a very detrimental effect. (she was able to resume hrt later.)

Have you thought of other things to try- maybe exercise and diet? Sorry if you have, but it's worth considering the benefits. MIND has a lot of evidence on exercise for mood, on their website, and you might benefit from increasing Omega 3 in your diet (which can help people with eczema and other skin issues.)

I usually do a lot of exercise and lift weights which does help. I'm recovering from having Covid again several months ago and not able to exercise as much as before.

I take magnesium and vitamin supplements and have just started taking probiotics. Will start omega 3 as well. I have had eczema for years although it goes away at times.

Some positive feedback from the menopause clinic!

I had written down all my symptoms before going, as well as a log of the number of days between periods over the last year or so. My usual cycle is very short, so a gap of 42 days is effectively missing a period, and this happened multiple times.

I saw a consultant who said my symptoms were clearly perimenopause-related. He will continue the Evorel and Utrogestan, has prescribed a cream for the vulval cuts and itching, and also suggested testosterone gel for low mood and brain fog.

I feel more optimistic about it all already (clearly placebo effect 😀) just from having been listened to, and not having my symptoms dismissed. I am also speaking to my manager at work about just working my hours for a while (juggling a senior job and several young children has been really challenging recently).