Cannot get a GP to take me seriously

[StresHed]

I had a hysterectomy 4 years ago when I was 40. I kept my ovaries at that time but was told they usually fail in 5 years

I have every symptom of perimenopause and I’ve been asking for a year if I can try some oestrogen gel to see if it helps.

I have no bleeding as no womb so I can’t go by periods. And can’t have any tests during a menstrual cycle as have no cycle.

My last FSH came back normal, so that’s that apparently! But I pointed out to GP that it can fluctuate that’s only one reading from one single day, so it can’t represent a complete definitive decision that I am not peri, right? Because I am not testing my FSH at any other time, and no one knows when I ovulate because I have no cycle

I am constantly sleep deprived as I am sweaty all night, tossing and turning which isn’t like me - I usually sleep great, and solidly

My vag is dry and itchy a lot
Lower libido
Grumpy and tired
More headaches than usual

I feel like FSH is such a pointless test for me but told I must have another one! Why?

I asked female GP today if she understood what I was saying or trying to explain about the risks to me of osteoporosis if leave this too late. I could go through my whole menopause and not know about it and under 45 has higher risks later on. Have some antidepressants or sleeping tablets she said

And no I can’t afford to see anyone privately

Hey. So I'm now almost 44.
I had a hysterectomy leaving my ovaries and cervix 8 years ago so I was 35 when I had it done.
For at least a year I've been suffering with the same things you list.
I tried to take perimenopause vitamins and for a year they worked. Until they didn't.
I went to see a female gp armed with this list of My symptoms :-
Night sweats
Hot flushes even when I'm at work (air conditioned building)
Migraines that cause black spots in my vision
Pins and needles/numbness in my hands especially at night in bed
Struggling to sleep even when I'm clearly tired
Mood swings can be crying at something ridiculous like a TV advert. Or raging mad at something that i dont really need to be mad about. Full on rage over the top.
Getting aggravated by simple things like kids being too noisy in the shop I work in.
Forgetting things all the time.
Brain fog, can't concentrate properly on things most of the time.
Restless legs especially at Night
Get so overwhelmed with the amount of things I have to do at home (ie housework) that I just don't do anything or the bare minimum. Zero motivation
Completely disinterested in sex, the most touch I want from my husband is a cuddle, can't remember the last time we did.
Had to use lube for many Years now.
Struggle to climax
Back pain, leg pain, arm pain
Boob pain, sometimes for weeks

She immediately put me on estrogel.
I've been on it since December and in April started testogel because my sex drive still hadn't come back. 3 months later and my sex drive is returning, I feel much more like myself and have no more menopause symptoms really. I suspect I'm not peri and I'm full considering I had no womb for 8 years. Blood tests aren't a definitive way to diagnose peri/menopause. They need to go on symptoms.
Please try and see another gp. I'm sorry your gp isn't being helpful. I got lucky I know that.

Can you take a man with you to sit by your side in the appointment. Every time you get ignored he can repeat your question. I guarantee you’ll get the medical treatment you need.

It baffles me that there is now so much information out there about menopause and the fact that women aren't taken seriously or listened to about their own bodies, yet so many GPs and other clinicians still completely ignore this. Are there other GPs at the practice who you could ask to see? Can you go in armed with written information from reliable sources and not budge until they refer you to a specialist? Write to the practice Manager outlining your concerns and that you're not being taken seriously. I don't know about any specifics but didn't want to read and run. It's awful and you really shouldn't have to battle for basic tests and healthcare or be fobbed off with anti-depressants. It could also be something other than menopause so you really should be listened to. Sadly I feel you'll have to keep fighting and find the evidence and information yourself. Good luck and sorry you're going through this.

I was going to say the same! Sad but true...

GPs tend to specialise in things I have discovered - have a look on their website or phone and ask the receptionist if there is a GP who specialises in reproductive health or the menopause and see if you can book in to see them. They may have a better understanding than the one you saw.

demand to go on HRT immediately, they are stringing you along! I am fed up how they always make us feel guilty for asking for HRT. I had emergency hysterectomy age 25 (endometriosis & fibroids strangulating my internal organs) I was put on HRT age 30,felt like a new woman, was brilliant, moved house new Dr constantly bullying me about coming off HRT, came off for a few yrs as I did not have the energy for the constant fight every time I need a repeat prescription, such a huge mistake, within 2 yrs I developed crippling arthritis, kept falling down stairs, knees giving way, had to sell up move to a bungalow, then walking stick, then wheelchair, finally new dr gave me HRT but damage to bones is already done, so 2 x knee replacements later.... get your HRT asap!!!! biggest mistake I ever made coming off it due to bullying from Dr

Keep ringing your Doctors daily do not let them tell you that you can have antidepressants & sleeping tablets, your not depressed & sleeping tablets are addictive! They will not stop any of your symptoms you have now! its your body only you know how much you are suffering, insist you try hrt treatment for 3/6 months to see for yourself how you feel then.Dont give up 4 years i fought for HRT by then the anxiety depression had set in bad, dont let that happen to you, they would rather get yoj addictited to medication than treat your symptoms where is Doctors duty of care gone these days its disgraceful good luck

Look up the NICE guideline for perimenopause and take them to your appointment. The doctor should follow these guidelines.

They state that diagnose should be based on symptoms alone and not blood tests. It also supports the use of HRT for a first-line option to treat menopause symptoms.

it also goes on about how to treat specific symptoms like vaginal dryness.

The most useful appointment I’ve had with a doctor about perimenopause/ME/CFS which I’ve been dealing with, was when I actually took my husband with me. I said he didn’t need to say anything unless he could see that they were not listening or answering my concerns or generally trying to fob me off. The first and probably only appointment where that didn’t happen.

Also, if you’ve had a hysterectomy, especially before any perimenopause then HRT should have been an automatic conversation and treatment plan surely!?!?

I knew from the thread title this would be gynaecology related. It always is!

I don't have any answers. I only got a reverted to my gynaecologist after 10 plus years of complaining that something was wrong, by sitting in my GPs office and refusing to leave without a referral.

If I were you, I would document all systems in an email and ask for a written response as to why you are being refused.

My FSH was normal too but i had so many symptoms, some i hadn’t even attributed to peri. I said i wanted to try HRT (I was 41 at the time) but my Mum went through early menopause. The GP didnt even argue and said I could try the combined patch. It has helped with a lot of things, some are still an issue.
Go back and see a different GP, if they also refuse then ask them to note in your records they are refusing your request to try HRT. The guidelines suggest now to go off the symptoms.

It took me 8 years to get my womb removed only after seeing 3 gynaecologists and being permanently on the verge of blood transfusions did they agree to operate on me.

My mum is also housebound from osteoporosis as she didn’t take any HRT. I have all the same symptoms and she was before 50 too.

GP said what do you want from today? I said I would like to try oestrogen gel. I said I think I am peri and it would maybe help me now and help protect me long term

I listed my symptoms and she has offered me:
migraine prevention tablets (which I have tried and don’t want or need)
anti depressants
sleeping tablets
Another blood tests

After telling me that zopiclone?!!? can make me drowsy and should be careful of driving, then that antidepressant can help with my ‘anxiety’ I left with no medication and blood test is end of July.

This is a different GP, I’ve seen 4 now and none of them will give me anything.

Im going back after my blood test and I will demand to know why they are NOT giving me the medication I am requesting, I want them to look me in the eye and tell me the reason. Or refer me.

I am so upset. I’ve had to fight for so much. All I want is a decent nights sleep and to not get osteoporosis, I don’t think it’s too much to ask. I can fall asleep just fine. I am not staying asleep

So sorry you’re going through this. Is it worth asking for a referral to the consultant who did your hysterectomy? Or another consultant if you’re in a different area now. Whatever they recommend for you to your GP will then have to be prescribed on the NHS. I take on board what you say about the cost of private care, but it is well worth the £250-£300 it may cost you to see a gynae consultant, and get the right advice and treatment. Good luck.

No one tells you this but if you keep your ovaries, no that’s it you on your own. You don’t need HRT at the time of you op, but You get no follow up just left with no checks, no periods anymore, no idea when your ovaries will fail, and then when you do think you are peri, no one listens to you either!

I will have the blood test and go back with the NICE guidelines to give them another chance. I am a very nice patient, I am always open to listening and I am always polite but I am traumatised from years of this and it’s not even male doctors, it’s females they are always worse and my worst experiences have been with female. Today she was female and younger than me. The gynaecologist I had who wouldn’t operate was female. I might ask for a male GP. My gynaecologist was male and he was great and took me seriously

This

if you can’t afford to go privately take your DH, or any available man, and say he’s your DP. Doesn’t matter if he is or not. Get him to tell the GP how it is affecting him. (Give him a list to memorise)

It’s shit but it works
I was fobbed off by GP and went privately.
she told me I couldn’t have any HRT as I’m too fat, and should consider weight loss jabs instead. When I said I knew what I wanted, mirena, oestrogel and estriol, she gave me a prescription for vagifem tablets. and told me to call the local STI clinic for mirena, who turned me down as it wasn’t for contraception.
privately I was seen in 3 days and mirena fitted and on oestrogen by the weekend. And it’s been a few months, but I felt better after just 2-3 weeks.

Do you have a wellwoman clinic near you?

My gynaecologist was a fantastic surgeon, so much so that I haven't needed further operations and my symptoms, while still flare up regularly have never been as severe since.

However, after going through chemical menopause for a while, my hormones, skin and mood were all over the place. A friend recommended wellwoman and I'll never forget being told there "you were lucky you had one of the best surgeons but he's no good with the easier problems". They recommended numerous things that solved all the other issues with 6 months.

I've always found wellwoman brilliant (they also do the best & most comfortable smear tests if there's such as thing as a nice smear test!) .

I think they are worth a try.

@DoYouReally no I don’t seem to have wellwoman near me. I don’t have smears as I have no cervix.

My skin is also horrible lately

I have booked a GP follow up a week after my blood test, when I will have turned 45 and the NICE guidelines state that post 45, the FSH doesn’t count as a way to measure perimenopause and blood tests are not needed. I will present this plus also no one has ever measured my FSH 4-6 weeks apart, which was also the guideline so it can’t be a diagnostic when I was under 45

I feel a bit better standing my ground now.

The guidelines also state not to just offer women antidepressants 😒

Yes ,lay on the lack of sex ,husband unhappy, risk of divorce, blah blah -could work

I believe that even if the ovaries are retained, it's accepted that they can be less efficient at producing oestrogen or fail earlier.

https://www.liverpoolwomens.nhs.uk/media/4515/gyn_2018-164.pdf

I was going to say the same thing. No interest in sex, husband deeply unhappy, causing serious marital disharmony - this is unfortunately likely to be more effective than any other symptoms (which women are generally expected to just tolerate).

Feck posts like this (too fecking many of them) make me sad and angry. I’m sorry you are going through this OP

Sorry you're having such difficulty. Next time you contact the GP surgery, try asking for which one of them has a special interest in menopause, any of they say none of them, ask them to refer you to a local GP who does. Use one of the symptom checker type websites - this site is good

Balance - Balance app https://share.google/o29tLz99SSrpUds7O

And as someone else said, print off the NICE guidelines and have a good read of the website

Recommendations | Menopause: identification and management | Guidance | NICE https://share.google/3Wu3D8ZvoPiq4FWEB

Even if you had a uterus and your periods were normal, they should go by the symptoms and prescribe HRT

Good luck. Don't let them fob you off. Say that you'll be working to the CQC.

Having said all of that though, my worst symptom initially was anxiety and waking in the night worrying about everything (completely out of character for me) so I went on Sertraline which worked wonders, then started HRT a few months later to help with other symptoms. The GP I spoke to (COVID times - all over the phone) was great and discussed all my options and it was my choice to start with the Sertraline.

What you want is either a male doctor or a female doctor who is perimenopause age or older.

Also focus on the symptoms that scream menopause rather than ones that let the doctor wander off down a side quest eg migraine or anxiety. Just go with hot flushes, itchy vag as your number one symptoms even if they aren't.