Perimenopause - mid cycle bleeding + other symptoms

[Ceravera]

Hi, re-posting here as I originally posted on the wrong subforum!

I want to preface by saying I have a GP appointment booked in 2 weeks but would love hear from others on this, and also maybe have an idea of what I should say/be asking for. Here is the lowdown:
I'm 40

Cycle length has gone from 28 days to 24 days over the past few years

Have consistently had 1-2 days of spotting pre-period for years (anything sinister has been ruled out with ultrasound). Now, averaging 4-5 days of spotting before my period. This month I have begun spotting 3DPO.

Have consistently always had 1-2 days breast pain before period. Now breast pain starts after ovulation and continues up until period starts.

Other symptoms - hormonal spots on my chin and cheeks, weight gain (around half a stone, cannot lose it whatever I do)

Google is suggesting possible low progesterone. Apparently it is very hard to convince Gp to prescribe progesterone cream

Bloodtests I hear are notoriously unreliable at detecting hormone changes - sometimes things can be missed if the day it is taken isn't quite right.

Honestly I dont know what I need to ask for. Do I need progesterone? Do I need topical HRT? Is this nothing to do with peri....
Has anyone else been here!?

Hi - this is my first time on here and desperately seeking help myself. Your post caught my eye.
im almost 50 and have started bleeding every few days as well as normal cycle which is 3 weekly. I’ve had blood tests which say normal - tummy is like a balloon and back pain, always tired. Struggle to lose weight. Very fed up! Am awaiting a call back from the gp to discuss next move as can’t carry on like this x

Interim bleeding with blood clots. I’m definitely peri as told this a few years ago but decided to manage myself. Last 5 weeks I’ve been bleeding every few days and if I have to strain on the toilet fresh red blood comes (from vagina). Had some blood tests and awaiting to discuss with gp but say normal on my nhs app. Tummy is always very bloated but more so this week. Just feel horrendous.
any one had similar. It’s all come out of nowhere x

If you are still bleeding and have a uterus, you cannot have progesterone 'unopposed' - which means you need oestrogen as well. I can recommend 'Spiced Pear' and the British menopause society to find out more.
However, a member of the BMS advised that peri women tend to seek out female GPs who then tend to know more than male GPs. Often there is a practice nurse with a speciality in HRT.
My advice and experience suggests:
initial GP consultation - they will then do bloods and scans if necessary to rule out anything else. They will then be willing to have a conversation about HRT. Bear in mind this includes the mirena coil which helps control bleeding. However - this is not suitable for women who have been hormone sensitive in the past (eg on depo/implant/pill). It also does not help with vasomotor symptoms like hot flushes or night sweats. It can also be an issue for anxiety or depression and make these symptoms worse