First appointment and don't know what I want!

[Purpletreetrunks]

Sorry this may be a long one, trying to get my thoughts straight!

I'm 43 and have booked an appointment with my GP as I'm fed up with feeling so rubbish.

I'm currently on the mini pill (desogestral) as I became fed up with increasingly heavy periods. I'd been on it previously and didn't go want to go back on it but periods were really making life so much harder. However the mini pill crashes my libido and makes me feel utterly flat. I hate the way I feel on it. Within days of coming off it previously I felt so much better, sex drive came back etc.

Over the last four years I've really struggled with sleeping, it's got worse in the last year. I wake at 2 or 3 and that's it. I'm exhausted for the rest of the day. I overheat at night despite living in a freezing old house and using a summer tog duvet (it's never above 10c!). And I'm angry ALL the time. I'm slim, fit, do lots of exercise and eat well.

I suspect it's perimenopause but I've put off speaking to a doctor until now. I don't really know what I want though. Should I be on HRT? Is there a different type of mini pill I can take that won't have the same side effects? I don’t want to have the mirena for various reasons... had emergency c sections as my cervix remained firmly shut, I struggle with smears as my cervix is very posterior and difficult to access - I think insertion could be horrendous. I was also told after my last section that my uterus was paper thin, I worry about a perforation.

I just feel a bit lost in terms of what to ask for!

It's good to think about what you want but on the other hand, if you discuss your symptoms, your dr ought to come up with some ideas.

Some younger women use the combined pill Qlaira as it's a natural estrogen and can be almost as good as HRT.

You will still need to use contraception, even on HRT, so you need to have a think if you prefer barrier methods or hormonal.

Thanks Jingling. I want something that'll manage my periods without making me feel utterly flat. And something that'll sort out the sleep problems, brain fog and rage. But I want it to be something other than Mirena really and I have a feeling that's what they'll want me to have as part of it.

Interesting about the combined pill though. Will keep an open mind though I was taken off it when a teen due to a possible blood clot (and family history).

The contraception bit I'm less bothered about, I can live with condoms if the rest is sorted.