Can’t work out if these symptoms are all down to perimenopause, older age, stress or just life?

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I’m now 50 but for the last 5 or so years I have been on a steady downward decline in my mental and physical health.
I can’t work out if the issues I have are actually down to perimenopause because I actually still have a cycle and have minimal hot sweats (although I have always been a super chilly person so not sure if that makes a difference) or if the fact I’ve had lots of family stresses, a death in the family and caring for a parent with dementia has a lot to do with it?
I have seen several GPs regarding this and they have put everything down to anxiety and won’t acknowledge that I may be in perimenopause despite my age. One even tried to put me off HRT by printing off some literature warning of the breast cancer risks.

So I am at a bit of a dead end. I can not afford to see a private menopause specialist and so am coasting along feeling like shit every day.

These are my symptoms, could most or all of these be caused or made worse by my hormonal system?

Anxiety - I have had anxiety most of my life but hitting my late 40’s seemed to unlock a level of anxiety I have never experienced before. It’s relentless, overwhelming and much worse during the first half of the day, I wake up feeling dreadful and feel shut most most mornings. I feel so low, cry at the drop of a hat and am spiralling into quite a depression

IBS and upper gut issues - again, something I have suffered from for several decades but it’s been super bad these last few years. Despite endless tests via gastroenterology all has been put down to IBS and functional dyspepsia. I have a bad tummy every day, nausea, acid, gurgling, bloating and gas. The symptoms even wake me during the night. This is one of my biggest issues and is very much getting me down but nothing I try helps (on a low fodmap diet, take IBS meds and meditate etc)

Sleeping issues - I am often woken by my tummy but also woken because I’m hot, or because I just don’t sleep deeply enough anymore, I wake so easily. I often wake from 3am - I’m knackered a lot of the time.

sore and dry I am often sore and dry down below and have what looks like a paper cut down there which flares up throughout the month and can be quite sore and itchy. I also have zero libido.

very dry skin dry skin all over unless I moisturise every day.

Periods up until last year I had very heavy periods, so heavy I ended up needing an iron infusion and uterine ablation. I now have a tiny light period which is every 28-30 days so obviously still having a cycle.

Aura migraine I suffer from aura migraines, not so much the headaches but the visual issues, these became worse since hitting 45 and have always been during my periods so must be down to hormones. Not sure if this means I could take HRT or not as I’ve never been allowed to take the pill due to the stroke risk.

Of course, none of these things could be down to the menopause and maybe lots of these symptoms are related to the amount of stress I have been under for the last few years and according to the GPs I’ve seen I’m not yet ‘there’ as my cycle is the same but I can’t help but think that surely I must be somewhere there? My mum was about my age when she went through it but she has Alzheimer’s so I can’t ask her but I do remember her being very low with awful anxiety and crying a lot at that age but she also lost her mum at 48 so I had put it down to that but who knows now?

Can anyone relate to these symptoms? Where they part of your menopause symptoms and what help you? The GP just wants me on antidepressants which make my gut issues so much worse.

I would be careful of thinking digestive issues are worse or changed by the menopause.

I've had a really low iron result and then A really high FIT result. Waiting for a colonoscopy now.

I could have written your post, almost identical symptoms .
I only recently put them all together and spoke to my GP. I’m 48 and have just started on HRT patch and pessary.
Ask your GP to start on the HRT, the leaflet in the patch packet has all the statistics on increased risks and it was reassuring rather than worrying.
Good luck.

If you decide not to go with hrt there are alternatives that can help. hyolauronic acid pessaries help vaginal dryness, and there are a number of foods high in phytoestrogens. Strength training for bone density etc.

All of those symptoms could be down to perimenopause. I think you should try HRT and see if they alleviate.

I have been very lucky with my symptoms, but have had some insomnia and aura migraines. Plus gut issues have worsened hugely - I did some research into it and this is common during perimenopause (like you I have always had IBS but now can't eat anything).

I have a friend whose anxiety became intolerable during peri. And as others have said you clearly have vaginal atrophy.

My GP also initially turned me down for HRT as I was having regular periods and my blood tests showed normal levels of oestrogen, even though I was 50! I ended up going private. Honestly, I think most of your symptoms would disappear if you went on HRT - surely it's worth a try?

Get blood tests for thyroid and coeliac to rule these out before assuming all is due to peri menopause.

Not everyone has erratic periods during perimenopause, some (including me) had a regular cycle all the way through. Yet many seem to think that if one still has a regular cycle, then they can't be in perimenopause. Indeed, quite a few GPs dismissed my assertion I was perimenopausal and needed HRT even thought I was suffering with every other perimenopause symptoms under the sun.

The other symptoms you list are all absolutely linked to perimenopause, with most being caused by the decline in oestrogen, and also by the decline in progesterone and possibly testosterone too.

For immediate relief for your pore sore vagina, ask your GP to prescribe Vagifem otherwise you can buy it from the pharmacist under than brand name Gina. It's used nightly for two weeks, then bi-weekly, indefinitely. It's wonderful stuff.

I was asked if I had anxiety and difficulty sleeping during a consultation for HRT. Yes.

I too have migraines, but they didn't ask if I had migraines. 🤔. I don't know if I have aura, if the tingling /numb left hand I get beforehand is one sort then yes.

I'm collecting my first prescription on Tuesday do I hope it's fine. Patches.

I think you really need to give HRT a go. I'm no expert, but I'd hazard a guess that most of what you describe is caused by, or least exacerbated by, peri-menopause.

It seems such a battle for many women to get HRT. I'm sure it's all down to funding. Women are supposed to just battle through their 'women's issues' and get on with it.

Print off the NICE guidelines about HRT, go back to your GP and stand firm. You don't need to suffer like this.

Though I'm many years younger than you but my periods stopped some time ago. My GP said they need to have stopped for two years under a certain age, and one year after to be confirmed as menopause. I don't know if that's accurate. Mine didn't fit the criteria neatly anyway.

Also, it's not for your GP to try to fob you off with an anti-depressant. Their are guidelines for this which they are in breach of. Read the NICE guidelines for Menopause and insist you are prescribed HRT. It's also worth asking at your GP practise if they have someone with an interest in women's health and menopause as they might be more familiar with all of this - sometimes, (and hopefully in your case), it's about finding the right GP.

I had a lot of these symptoms as soon as I hit my mid forties. The anxiety and disrupted sleep were particularly horrendous.

I was also going through some other serious stuff - bereavement, issues at work, financial issues - so I was also completely confused about what was going on.

HRT and a diet & exercise overhaul have all helped massively.

The HRT was my first line. It took about 3 months to kick in, but suddenly I was sleeping better, the anxiety was dialled down a lot and I felt lighter somehow.

I’m now addressing exercise and diet because I have the energy now to do that (didn’t before HRT).

I feel miles better. Not falling apart at the seams anymore!

Yes, this is absolutely correct, but few seem to know about.

It's two whole calendar years for those under 50, and one whole calendar year for those over 50.

For those under 50, it is advised to continue using contraception if still having periods, no matter how erratic they are because there is still a chance of pregnancy.

*there not their

I went to my gp earlier this year to discuss going on hrt and she wouldn’t as I’m still having regular periods! As I’be been on low dose of anti depressants for years she told me to double that and go for grief counselling (partner died last year but I don’t need counselling over it!) x I didn’t want to just double my anti-d dose so agreed to a 50% increase and I have to be honest it has helped with some symptoms. last week I went up to the suggested double dose and wait to see if any further improvements happen - don’t rule out anti depressants - they’ve worked for me but I still feel incredibly guilty for needing them as There’s still such a stigma attached to taking them.

You don't have to go on HRT for ever. I've taken it for a couple of years and am going to try stopping soon. It is like a magic pill. I had aches, swollen joints, anxiety (never had it before peri) , insomnia and migraines and the HRT
made them disappear. I thought I had general arthritis but it was mostly just the peri. ( I assume!).
I felt a million times better on HRT. It was like a switch when I started taking it.

My symptoms don't sound as bad as yours and I didn't have any complications of digestive problems or long term anxiety.

I recommend that you return to the GP but concentrate on physical rather than mental issues. I found that mentioning hot flushes and vaginal atrophy really made them sit up, even though by far the biggest issue for me was anxiety. Be very clear that you want HRT, including vaginal pessaries. Or buy the vaginal stuff over the counter.
At home, try a good multivit esp magnesium, as good a diet as you can manage, less/ no booze, and some kind of exercise like swimming, yoga, gardening.
I guarantee you will feel better than now. It might not solve everything as you have a lot going on, but you will definitely feel an improvement.

EarringsandLipstick I am encouraged by the lack of migraines, I was worried hrt could make them worse after being told for so many years the pill would exacerbate them.
tothelefttotheleft I’m sorry to hear that, hopefully the colonoscopy will come back clear. I had a colonoscopy and gastroscope 2 years ago then a pill camera endoscopy last year and 2 clear FIT tests within the last 6 months. My iron and ferritin levels have risen since I had the ablation so hopefully that was all down to my heavy periods. Good luck with your colonoscopy.
Thats good to know Rollerboots I hope HRT helps you.
Worldgonecrazy thanks, I will try those anyhow, can’t hurt to try.
SybilWrites have your gut issues worsened since taking hrt?
BreakingPointAgain I had a whole panel of blood tests last week and thyroid came back as normal. I’ve had several negative coeliac blood tests over the years and a biopsy taken 4 years ago which came back negative.
highfidelity thank you so much, I will get some of that today if I can and I will print off those guidelines as I have a GP appointment later in the month.
Good luck annahilly, I hope they work well for you.
YinYogi that’s very encouraging, thank you.
blobby10 can I ask what you are on? I have tried Sertraline and Citalopram but they very much exacerbated my IBS which is already a daily issue for me. I am currently taking an old style TCA called Nortriptyline to see if it will help my gut issues but currently not seeing much luck but I have only been on it for 2 weeks.
NextTimeItsOver I did say I’d like to trial it and if it’s not for me then at least I’ll know but it’s trying to get the GP to agree, hopefully the new one will be more helpful when I see her in a few weeks.

Thank you domesticslattern - this is the issue I keep facing. Our GP surgery have a huge poster stating ‘one appointment so please only discuss one issue’ which is understandable but tricky when I have a list of a whole host of problems so inevitably I end up discussing the most pressing which atm is the anxiety and gut issues and I never get to mention all these other problems further down the list so they always get overlooked.

I lost four years to feeling like shit because my gp was adamant that it was just mental health. See a different Gp.

I have an increased risk of breast cancer, but have made the decision to start HRT now I have a better GP.

Have a look at this;

bcrisktool.cancer.gov/calculator.html

And see attached.

Thank you for that gotthearse

Definitely try HRT!!! I've been on it for a year (I've just turned 50) sleep for me was the biggie which in turn led to lots of other issues including anxiety, claustrophobia (weird), aches and all sorts. It was like flipping a switch - definitely ask for a different t gp if your current one isn't providing you with the service you need.

Possibilitiesxyz I definitely need to ask, it seems to have helped so many on here.