Advice on Perimenopause, Appt with Dr, what do I want?

[InWaves]

Pls help I feel extremely fortunate to get an appointment with a Dr I have previously experienced as very sympathetic. I thought I'd have to wait weeks, so I'm quite unprepared (TBF I'd probably be unprepared anyway). I'd be so grateful for any reading recommendations or advice.

My symptoms aren't awful yet, from reading the experience of others. But I have already had to rearrange my life around migraines so my perception might be skewed. There's definitely something happening though because my periods are suddenly very erratic with long gaps. Also noticing slightly decreased libido which really bothers me as that side of life had been brilliant.

I'm only 45, if I start hrt now does that mean I stop at 50 and then essentially get everything bad back at once? Is it better to delay a bit? I've realised I know so, so little!

I'm generally not a person who takes lots of prescription drugs - I'm quite sensitive - and I also really didn't get on with the progesterone only or combined pill so haven't taken either for a decade. But my reasons for wondering about hrt are aforementioned libido (although the pill was awful for that!), plus history of osteoarthritis in my family.

There's no reason you'd be stopping HRT at 50 if it works for you, you don't have a five year limit.

I'd write down all your symptoms in a list so you're prepared for your call, as well as any concerns you have.

If you do decide you want to try HRT, your doc will prob ask how you want to deal with it (patches vs cream) and also the progesterone aspect (tablets vs mirena coil) etc.

If you do decide on HRT, they normally start you off low and review in three months.

My top tips…

Avoid antidepressants! I was prescribed them when I should have been put on HRT but hopefully your GP will be more up to date - antidepressants obliterated my libido!

Don’t hesitate to try the Mirena for progesterone - I’m 58 and had my first ever fitted last week. I’ve had bleeding with utrogestan for 18 months - wish I’d tried the Mirena earlier, particularly as the gynae consultant told me it’s the best way to protect the lining of your womb (my sister died from womb cancer) but GP originally put me off it.

Thanks both. I'd be really disappointed if they offered ADs. I've also had a very negative experience of them albeit a very long time ago. But it was enough to make me wary of prescription drugs in general.

I always assumed I'd not want hrt but my concern about bone health is pushing me the other way.

Following with interest, I have my first GP appointment today to discuss HRT. It is a male doctor and I know I shouldn't make assumptions but I'm not expecting anything miraculous 😬

Symptoms aren't massive, periods same as normal. Complete inability to stay asleep, low energy, low libido, irritable, premenstrual rage, thinning hair, aching joints, itchy, dry eyes. It's the lack of sleep that's pushed me into making as appointment.

Let me know how you get on @InWaves 🤞

plus history of osteoarthritis in my family.

Is there a chance you're confusing this with osteoporosis?
HRT doesn't really help with arthritis (although it can help keep joints a bit more supple.) If it's osteoporosis, that's different and it will help as long as you take it and for some years after stopping.

Don't confuse the mini pill with HRT, as they are completely different products.
Most HRT now is made from yam and is identical to our own hormones.

How did you get on?

Hey, following this post. I have recently done a at home menopausal test. It came back positive. I have also done the online menopause checker (as advised by my GP's receptionist) again that come back as premenopausal. I have an appointment with the nurse on the 25th October! am 41. My mum went through the menopause early too. Worried now my GP will fob me off. i have spoken to them before but I keep getting told am to young to be going through it. Interested to know how you ladies get on with your appointments. Keep us updated and fingers crossed for you both.

I had a really reassuring appointment; if I had wanted to, I could have left with a prescription right then. (This seems to contradict the experience of friends but I'm wondering if being 45 opens doors with this? I have several friends who started hrt at a younger age BUT had to fight for it or go private.)

Lovely Dr's view was that every woman in their 40s has fluctuating hormones and is therefore perimenopausal, but that individual symptoms vary wildly. She said these days most of the women she sees starting hrt are now mid 40s. This is a change from the past.

I'm going to sit on the decision for a bit, now I know I won't face opposition in my choice! My symptoms don't seem anywhere like as serious as those of some of my friends and I do still have a general reticence towards medicine in general.

When I decide I want to start she advised lowest dose oestrogen patch and then the necessary progesterone to balance. A much lower dose than the combined pill. I know the combined pill would solve my migraine problem BUT it kills libido, so I suppose I'm looking for a sweet spot in between!

And yes I was confusing the osteos, and yes the Dr strongly advised hrt as preventative for osteoporosis.

A much lower dose than the combined pill. I know the combined pill would solve my migraine problem BUT it kills libido, so I suppose I'm looking for a sweet spot in between!

That sounds like a good appt.

The only thing to remember is that HRT is not anything like the Pill.
The Pill is a large dose of synthetic estrogen +progestins that prevent ovulation etc. This means the hormones are not identical to our own.

HRT is body-identical, so the estrogen is identical to your own and so is micronised progesterone. It's made from yams.

So, bearing in mind you try to 'avoid medicine' although HRT is regulated and prescribed, it's nothing like the contraceptive pill.

At 45 all you're doing is replacing your hormones, like with like.

Pleased you had a good appointment@InWaves

@Mairzydotes mine was okay. The GP was understanding (though did briefly mention SSRIs and when I looked askance said that they have proven effectiveness against hot flushes and night sweats - neither of which I have 🤔). I'm having full bloods to test for a thyroid issue and then if nothing shows up will have to go back to discuss HRT options. So all in all, fairly promising, not quite the fight I was expecting, but still not yet sorted.

Thanks JinglingSpringbells that's useful info

Hi, looking to see is anyone else is suffering from really low mood? I can't seem to snap myself out of it. It's affecting my family life 😞. Coupled with the obscure paranoia, it's not even that am paranoid my partner is cheating. It's over something really stupid but when we talk about it we argue. I feel like am losing my head. I do have a GP appointment coming up but the last time I went they told me I was too young (41) and put me on AD's. Does anyone else have a bout of depression and paranoia going on?

I did and things that helped were sleep, mindfulness/CBT, avoiding sugar, evening primrose oil, carbs, exercise, tracking my mood so I know if its coming. Last resort low dose antidepressants. The main thing is just learning to notice and not react to it. I'm sure HRT fixes it but I can't take estrogen.

that's what am struggling with, I can't seem to notice it at the minute. I've caused my partner to stop being friends with someone because of how I am. Because I was paranoid they didn't like me. It doesn't even matter whether they like me or not but geeze it's played with my head! I am already on Antidepressants, it's what I was given when I went the docs the first time. When I went the second time they increased my dose. 3rd time lucky... hopefully.