When exactly to go to GP?

[CoffeeeLove]

When is the best time to visit the GP to get treatment (HRT)? I'm 46 and think I could be in the early stages of peri, although I can't be sure. My period is late (not pregnant) - could have missed one - and I feel like I've been having a few episodes of hot flushes. I'm in a ' could be something or nothing' state of mind. Any thoughts?

I would wait see how you go. Everyone is so different some find flushes plateau then tail off, others find they escalate and become unbearable.

Imo the time to get medical reviews amd prescriptions is when the issues associated with depleting hormones start affecting the quality of your life but work on the basics first cool bedroom, lots of activity to help sleep, lose weight etc.

I would however suggest getting vaginal oestrogen pessaries sooner rather than later if sex becomes painful. Atrophy is very common and vaginal oestrogen is a no risk fix.

When you feel like it!

If it isn't bothering you, then you are perfectly OK not to go.

However if you have had one hot flush and it's driven you nuts, then go.

Everyone's menopause is different.

I'd go now. The NICE guidelines state that you're eligible for HRT on the basis of symptoms alone (i.e. no blood test needed) from age 45. You could also read around possible symptoms and see whether anything else might fit.

The fact you are asking the question means there might be something to discuss, but I would agree it’s when mental and physical symptoms are taking over your life.

You go to the GP when you feel unwell and need help. You may be lucky and not need any help. But many of us feel like we’re dying or going insane, and we need treatment to feel normal again.

The NICE guidelines state that you're eligible for HRT on the basis of symptoms alone (i.e. no blood test needed) from age 45.

You are able to get HRT at any age if you have symptoms, but women under 45 may be asked to have a blood test. This is mainly to confirm it's an early menopause and therefore HRT is medically advised anyway. It's more about women over 45 not needing blood tests because it's just a waste of time and money.

@CoffeeeLove I'd wait and see how you go. I was early 50s when I started on HRT, periods pretty much over. I only asked for HRT to help with sleep and my hot flushes were hourly - hard to cope with at work.

If you’ve had hot flushes, you’d really know about it! Sounds like it’s not bad atm so maybe wait a bit?

Have a read on the www.menopausematters.co.uk/ website about the various treatment options (lifestyle, over the counter/complementary, HRT and prescribable non-HRT medications). If there is something you would be keen to try that requires prescription then give your GP a call.

I haven't had a period for over 4 years now but no definitive symptoms that i need help with hence no visit to GP. Everybody's different.

It's very personal. I didn't have any of the 'big' symptoms of hot flushes, night sweats, anxiety, but I did have a combination of other symptoms that were adding up to a picture and making an impact on my life. I had joint and muscle aches, hives/histamine issues, bad sleep,. migraines, some brain fog.... All in all 17 symptoms from a list of 34 so.i figured enough is enough. Started HRT a month ago and beginning to feel the effects.

It's a very personal thing though. If you feel it's affecting your life, go for it . But don't be like a boiled frog and let the symptoms mount up!

If your symptoms are manageable then maybe no need to go yet, though I'd add two considerations that might make you go earlier. Firstly some symptoms can creep on gradually and it's quite common for people to report that they hadn't quite realised how badly they were being affected e.g. by poor sleep.

Secondly, you may want to start HRT as a precaution if you have osteoporosis in your family or have had any unexpected fractures yourself. I started HRT at 45 not because the symptoms were unbearable (though I sleep so much better now which makes a huge difference!) but because I have osteoporosis on both sides of my family which shifted my risk calculation significantly.

One final thought is that getting some weight bearing exercise (strength training is fantastic) is a really good investment in your health at this time - it helps slow bone loss but also counteracts the way women lose muscle at a really accelerated rate during peri, which can become a vicious circle of finding it harder to move and thus moving less.

@UnaOfStormhold - great post, really well informed, thank you.

When is the best time to visit the GP to get treatment (HRT)?

The best time to get heart protection is to use HRT within 10 years of your last period. (Drs call it the 'window of opportunity'.)

So, you've bags of time on that score.

As PP says, family history is important BUT GPs will not prescribe HRT for a protective effect IF you have no meno symptoms (well, some might, but it's against the guidance, although consultants are usually happy and able to.)

I think if I were you @CoffeeeLove I'd wait. The 'guidance' is for HRT to be used if your quality of life is suffering, to a point where it's hard to get through a day or night. I'm not minimising your symptoms but they are very minor.
Most women using HRT have started when they felt they couldn't do anything else (lifestyle) to try to help.

I disagree with this. I wouldn't wait or advise people to wait until "your quality of life is suffering, to a point where it's hard to get through a day or night". There's absolutely no need to wait until you're at a breaking point! My symptoms are affecting my quality of life but definitely not to the point where I couldn't cope and hadn't exhausted all lifestyle changes either. But neither me, my doctor or the menopause practitioner that I spent 45 mins discussing this with (from Peppy) thought I needed to put up with symptoms I had either. Plus it's so much easier to make lifestyle changes like exercising when you're sleeping better, have more energy and aren't aching.

I also disagree that women should wait until they can't go on any longer - I've read about women leaving their careers due to menopause symptoms, and I'd want to be trying to fix things before they got anywhere near this level.

Davina McColl's book about menopause is very good.

What I meant was that the OP is having minor symptoms.
If she had more symptoms, she'd probably not be asking the question about when to start HRT.

No one is suggesting a woman waits until she has to change careers or has to get to 'breaking point.'

I said if symptoms were affecting quality of life enough to know HRT was worth trying.

Fair enough, @JinglingSpringbells 🙂.

@Coraline353 I wasn't at breaking point either. But hourly hot flushes and not being able to sleep within 2 hours of going to bed were affecting my life enough.

I'm not disagreeing with you. I think you have misinterpreted what I posted.

I think you phrased it more strongly than you probably meant. Still though your level of symptoms were pretty awful. Mine were much, much milder but I wasn't willing to get bad so onto (a fairly low dose) of HRT I went

@Coraline353 Yes, you're right. Badly worded.

I didn't put up with my symptoms for very long- possibly a couple of months or so. I was 'lucky' in that peri was almost unnoticeable. my symptoms started immediately when my periods stopped ( almost 53.)

Thanks for your replies, everyone. Yes, I will wait and see. I had also been very tired/had lower mood, but perhaps I was just a bit burnt out with work and life.

Must admit i seem to be permanently tired no matter how much sleep i get. Wonder if it's the menopause 🤔