38 vaginal atrophy and symptoms of menopause

[Bonnie21s]

Just looking for some advice really. So a year ago, I went to the GP due to some irregular bleeding, although I do have PCOS but this was happening after sex. After she examined me she said I had vaginal atrophy and started asking if I had symptoms of menopause. I went for scans and bloods. Bloods came back all fine and no changes to my scan since the last one. I have been struggling a lot with my mental health ove the last few years. However the past year my anxiety has crippled to the point I struggle to go out. I have really bad brain fog and lack focus, I have depression and have the worst mood swings. My skin is dry and itchy, my hair is going dry but roots are so greasy and hair is thinning. As I was told that my bloods etc were normal I didn't get any other answers or support and due to my mental health I didn't push any further. I had previously had ovulation induction using letrozole and saw that this drug could cause atrophy. However as my mental health is getting worse, I continue to have dryness and itching. I have asked about menopause and have just been told I am too young. I have now changed GPs and have an appointment on Monday but I'm scared to discuss it because I have been dismissed so many times. I have so many matching symptoms but even with my PCOS in the past I have been told it's not that bad but I have facial hair, weight gain, unable to conceive and drs have just told me that my hormones aren't too bad. I feel that they think I am a hypocondriact because my symptoms don't match my bloods.
I suppose I am just looking for some advice on how to speak to my GP about it, with them being new I am worried I'm just going to be fobbed off again due to age etc. I honestly feel like I am going insane.
Thanks for any advice given.

Hi, this is exactly what happened to me! At 38 I started feeling upset, emotional, uncontrollable rage (directed mainly at my DH 🤦🏽‍♀️) low libido and soreness during sex. My periods also stopped. I had been experiencing these symptoms for around 6 months before I went to the doctor. I also had itchy skin, hot flushes and fatigue. When I eventually got an appointment doctor examined me and told me i had vaginal atrophy and coupled with my other symptoms said I had the perimenopause. The bloods didn’t reflect this. She prescribed a vaginal pessary which has helped massively although I found the supplement ‘black cohosh’ alleviated most symptoms like hot flushes and fatigue. If you don’t get the help it sounds that you so need, keep pushing for a sympathetic doctor xx

Thank you for your reply. I am thinking it's perimenopause, I don't understand why it would be so difficult to believe, considering that menopause statistically starts from the age of 45. We don't just suddenly go oops your now in menopause. There is a lead up to it so why Drs are dismissive and say you are too young to be perimenopausal is beyond me. How was your experience when you finally got them to listen? Is there anything that I should say. I am just worried I'm going to be fobbed off again and I don't want it being left. I've had a few UTIs and BV and I know the atrophy will be causing it. Xx

Beg, steal or borrow some estriol cream. That will solve the uti/thrush-like symptoms of atrophy x

@Bonnie21s There are plenty of doctors who will believe you, you just need to find one. If your GP is useless, ask to be referred to a menopause gynae.

It's vitally important to protect your bone density as well as early menopause (before 45) and premature menopause (before 40) are a big risk.

I know without almost any doubt that my own consultant would offer you HRT without any problem, but they are a highly experienced gynaecologist.

You may have to go privately if you hit a brick wall and although this shouldn't be necessary, sometimes it's the only way to see an expert rather than a GP (who isn't) or wait a very long time for an NHS appt.

@blackandgold88 It's not clear from your posts if your periods stopped for good at 38.

If they did you should be using HRT to prevent bone loss and heart disease. This is mainstream treatment and recognised by all drs because prem menopause (premature ovarian insufficiency) is a disease.

Black cohosh won't support your bone or heart health.

I wrote a lengthy list of everything that was bothering me (mainly because of the brain fog!) things that I had never even considered to be peri related like the itchy skin, black floaters in my eyes, itchy inner ears, weeing more frequently, bloating etc. just keep impressing on the DR how you have never suffered from these new symptoms before with your PCOS and you know your body, this is not PCOS it’s something else, you believe to be peri. Explain how the atrophy has completely stopped your sex life. I also suffered fertility issues so it may well be that the closer you are to the end of your fertile years, menopause may creep up quicker? Good luck!!x

Did your dr offer you HRT or just black cohosh?

For VA you can buy over the counter oestrogen (Gina). It gave me almost instant relief (access to GP hard round here). Also stopped UTIs. But agree with PP: go back to GP. Sounds like peri to me.

You are definitely not too young for peri-menopause and I highly recommend you go to a private clinic. It is well worth it.

Gina is only available OTC for women over 50 who are post menopause. The pharmacist would use a check-list before selling it.

Shit, isn't it. So many of us have struggled with GPs, I had to fight tooth and nail for HRT even though I was 49 and had had a hysterectomy!

Having said that, you are on the young side and any GP worth their salt would want to rule out any number of other things like thyroid issues which could be causing your symptoms. If that has all been done then I would ask them to refer you to a gynaecologist, or to the menopause clinic if there is one in your area. If the GP has diagnosed you with vaginal atrophy then it would appear to be a no-brainer to prescribe Estriol cream. It has worked wonders for me, use it twice a week and no longer have the permanent UTI feeling.

Could you afford to pay to see someone privately?

Thank you all for the information. I do have an underactive thyroid alongside the PCOS and it is managed. My last levels were all fine. There is an endocrine history in our family and and a lot of hormone related issues. But things that have started over the past 18 months were not really an issue with my PCOS. For example, when I would have periods they would be heavy and last for at least 2 weeks and even though they are irregular almost non existent now, they are much much lighter and last like 5 days. I have anxiety and depression but this seems to be worse despite medication and actually became worse as I noticed other symptoms such as itchy dry skin, hair drying and thinning. Sleep is all over the place, get hot flushes, urinary symptoms, bloating and even though I've not had kids I have started having leakage when I sneeze or laugh, it not massive but that never used to happen and I do kegel exercises. I have new sensitivities to things, get sweats, brain fog, lethargy, bloating, more facial hair than I used to have, my mood is so up and down, have joint pain and muscle aches. List goes in. When I have looked at symptoms I have a lot of them plus the VA. I was previously a nurse so know there is something going on. All smears are up to date and clear along with my thyroid bloods. The only thing I can think is perimenopause. I may see if I can get some cream for now.
Thank you so much everyone. Xx

I get black cohosh off Amazon. The doctor only prescribed the pessaries

Do be careful with that.
If used long term it can cause liver damage. It's not regulated in terms of safety so you do need to be careful.

I'm not sure if you were just sympathising with the OP or were her age when you had symptoms. Or what age you are now and if you're still in peri. If you did have an early menopause, is it worth seeing your GP again to discuss the risks and maybe HRT?

@Bonnie21s From what you say you really need HRT.
Just ask for it and if your GP won't prescribe it, insist on a referral or go privately if you can afford to. None of this is going to go away so you do need to pursue it. All the best.