Help me not get fobbed off for a third time please

[Maltybiscuit]

So this week marks my third visit to the doctor's for what I believe is perimenopause symptoms.
On the previous visits I've been told "I'm too young " the symptoms aren't perimenopause related , "take these antibiotics for a UTI even though the dip test and lab test were clear , "maybe you need antidepressants "

So here are the facts and , im seeing a nurse on Thursday as can't get a doctor , do my symptoms sounds like perimenopause?

Aged 44 (45 in three weeks )
Shorter cycles used to be 28/29 now 24/25
Severe anxiety especially the week before period
Night sweats and hot flushes
Urinary urge incontinence
Little or no sex drive at all
Fatigue and exhaustion
Not sleeping
Crazy itching both vaginally and anal
Some feelings of UTI before period
Brain fog
Forgetfulness

I really really need some help this week and if I can't get any answers I'm considering I will have to see someone privately.

I've looked at the NICE guidelines and I believe at 45 they have to listen , I know thats literally a few weeks away but I need help now.

I had hormone blood tests and thyroid done in December and they told me all was normal.

Any advice from you wise people?

Good luck @Maltybiscuit. It makes me SO ANGRY hearing stories like yours, and there are so many women having the same battle for treatment.

How did the appointment go @Maltybiscuit ?

Hi all appointment update.
I saw an ANP nurse today , she listened and listened which immediately made me feel better.
We went through all of my symptoms , she did say that sometimes an antidepressant could be an option and shouldn't be ruled out but she could tell by my face that really isn't the way I want to go.
Anyway ,.I'm having more bloods done tomorrow morning at 7am to check if there's anything else going on , she also did a swab as this intense itching perineum and anus is really getting me down , she did say it all looks inflamed ! We did urine test height weight , blood pressure etc and she scanned my own notes on to her computer on my file and then made me an appointment for next Tuesday with a female doctor who can look at all the results and evidence and hopefully prescribe something or rule anything else out.
I hope I'm on the correct path now and I can get sorted although it really shouldn't be this hard to be listened to.
Fingers crossed for Tuesday.
And I wish this intense itching would go away !!!!

@Maltybiscuit I had the itchy too, went away with HRT, however, I used an antihistamine every day until It kicked in, it helped quite a lot.

I'm glad you feel you've been listened to; that's a great start. Fingers crossed that things begin to fall into place now x

@Barelyable was it anal itching you had ??
I'm so itchy and sore which she saw today when she did the swab, I've tried sudocrem , thrush creams , anusol , I only wear cotton pants , haven't changed my washing powder or anything like that , only use water to wash.
Did you take the antihistamine in the morning or at night ? Was it citerzine ?

Thanks

@Maltybiscuit VERY long thread here about vaginal itching and soreness.

www.mumsnet.com/talk/menopause/4719854-uti-soreness-are-my-bike-riding-days-over

It's quite likely that you need topical estrogen. So many women have their time wasted having swabs etc when the reason is often very obvious.

Regarding the itching and urge urinary incontinence, low oestrogen can affect of all the genitals, including the bladder and urethral tract, vulva, vagina and anus.

While waiting for next week’s appointment, try using an emollient ointment like Epaderm or Hydromol (in a tub, there are others), available OTC from pharmacies. It can be used as often as needed and can also help with vulval skin splits. It’s really thick and protective and if you hold a little between your finger it will soften.

@JinglingSpringbells thank you x yes I've been keeping up to date with this thread , I think the op mainly talks about vaginal itching rather than anal which is my main complaint.
It's so uncomfortable I don't know what to do with myself.

@over50andfab thank you for this , I have zerobase at home but non of the others you've talked about. I will go and purchase something tomorrow and hope it will see me through until Tuesday.

Zerobase might help too. Emollient ointments have less ingredients than the creams and can be longer lasting, however it’s also personal choice. They can also be used to wash with and protect as water can be drying on irritated tissue.

I’d probably buy some oestrogen pessaries and try them. If they help then you have evidence to get them on a repeat prescription.
All women with a UTI history should be on oestrogen pessaries from peri and stay on them.

Gina estrogen pessaries are only available at a pharmacy to women over 50 and 1+ years after their last period plus other health screening.

OP have you tried cortisone cream for the itching? Helps me, might be worth a try.

I actually changed doctor practices to get heard! I suffered with irregular periods since 2013. Went 4 months without one. Dr said that was weird, but no investigations would take place unless I was trying to get pregnant and I definitely wasn't. Said I was stressed (I was to be honest at that time due a family death and job losses). But the symptoms went on and on when I wasn't stressed.

I am 47 now. I've been on hrt since September 2021 and feel loads better.

I feel that the covid pandemic and not being able to see a Dr did me a favour. I filled in an e-consult form and wrote all my symptoms down. Blood tests organised. HRT given out. Everytime I'd seen a doctor in person, they saw my symptoms as different illnesses and wanted to deal with each thing separately, the headaches, migraine, the digestive issues, mood swings, irregular periods, sleeping issues, fatigue. Strangely no hot flushes until I'd had 2 covid jabs 🤔

Please keep pushing OP. It's time that this 'you're too young for.... attitude' and was stopped!

You mentioned using only water to wash but the advice I have had from both GPs and a gynae is that it's better to use an emollient (I use Epaderm) to shower with and it can also be put in the bath plus used as a moisturiser. Though it may be better to avoid baths as they can be quite drying. Use emollient as a barrier when washing your hair in the shower to stop shampoo irritating it, don't wash face in shower for similar reasons.

Avoid anything scented down there, wear white cotton pants (bamboo also seems to be ok for me).

Topical oestrogen would probably help with urinary symptoms and soreness and possibly the itch too. It might be worth them examining you for atrophy if they haven't already.

It also may be worth getting checked for lichen sclerosus as that can result in itching of any or all of vulva , vagina, anus, plus can cause splitting. Though most GPs IME aren't that knowledgeable about LS. (There is an excellent facebook group for LS if you do have it or suspect you do).

I switched washing powders from a non bio to a non bio with no perfume (these are quite rare) which I think helped a lot. Also bamboo loo paper is great if you feel as though you are sandpapering yourself when using the normal stuff.

Hi all just thought I'd update and thank you all again for bearing with me.
I've had all my bloods done and some swabs for the itching.
All results were clear and I actually saw a doctor today who has listened to me , she listened to every single detail and I feel better that she knows everything.
Anyway we talked about what I could try and I have been prescribed Ovestin 1mg cream to help with the itching and the urinary issues which I can start straight away and Evorel Sequi patches which I will start on my next period in about 8 days time, I then have an appointment for 3 months from now to see how I'm getting on but can go back sooner if things go haywire for whatever reason.
So I feel a little happier and didn't have to bang on about being 44 and 45 in a few weeks blah blah.
The only downside is I had to pay three prescription charges so I purchased a three month certificate.
I heard things are changing after April 1st for HRT scripts ?? Or did I hear wrong.
Onwards and upwards I hope

🎉🎉🎉 hoorayyyy. That sounds very positive and hopefully means you can mentally relax a bit knowing you're not being dismissed. 👍

That's great news. Yes, I believe that from April it should be possible to get a prepayment certificate for HRT which would cost about £20 for a full year. It has been a while coming so I will believe it when I see it but I know that they're trialling the system now.

Well done.

It's rubbish that we have to psyche ourselves up and tie ourselves into knots to get this treatment from the doctor. I really hope you're feeling better soon.

Glad to hear you have the chance to try the HRT!
I have intermittent itching around the anus - never linked it to hormones though, keep thinking it's threadworms or something awful like that. I have Ovestin that I haven't used so think I will try it again just in case!

If you do t mind paying either book an online appointment with Superdrug- pretty cheap alternatively I got a prescription for Oestrogel and Utrogestan from Boots bypassing theGP entirely. You could also book to see a menopause nurse privately- I did this after crap GP experience and she was great.