Could she be peri?

[SpongeBobcircle]

My dear friend has asked me for advice and I said I’d ask MN for a wider view. She is 37 and for the past 8 months or so has started having very irregular periods, intermittent bleeding, increased anxiety, low mood and depression, hot flushes day and night- they wake her regularly, insomnia.
DF has a copper coil fitted - had this changed 1 year ago as the previous one had run out and worked well. Has always suffered with PMDD so periods of low mood before/during/after periods but was manageable and would come out of it for the most part. Whereas now the low mood has lasted continuously for months on end. She does all the right things like eats well (for the most part) and is very active at the gym for her MH’s sake as well as physical health.
Has had the usual blood work done at GP for thyroid etc and all levels normal. No TSH or hormone levels as 2 GPs have stated not old enough to be perimenopause. She has felt very dismissed and describes feeling as if she’s going mad. The only thing offered to her is antidepressants which she is reluctant to take as feels the symptoms are hormone related.
What do you think? Is it possible it could be peri? Any advice or suggestions of how I can help? I hate seeing her struggle so much.

Yes, there’s a really wide window. Average is mid fourties’ BUT swings 10 yrs on either side, so 35-55.

Mine started at 43 and my GP said although 45 was the “start point” for prescribing HRT, she’d let me try it and see if it made a difference. It did so I stayed on it

my GP said although 45 was the “start point” for prescribing HRT

I hope you (and she!) realise that is not the case.

There is no age limit (young or old) to start HRT. There is no guidance to say that so not sure where she got it from.

Some women with POI (very premature menopause) start HRT in their 20s and 30s.

@SpongeBobcircle Many GPs know nothing about peri or menopause. Diagnosis is made on symptoms and blood tests are unreliable.

Your friend has a couple of choices- see a different GP who is clued-up, pay to see a private consultant who knows about menopause, or ask her GP for a referral to an NHS menopause specialist for another opinion (but to be honest the wait could be 2 year s for non-urgent gynae things.)

Thanks everyone.
it’s so difficult for women to be heard sometimes, especially when two middle aged female GPs are stating it’s too early and whilst the internet does not make anyone a doctor or qualified, it doesn’t take a genius to know it CAN be earlier.
The ease at which antidepressants are pushed on women esp when their issues are hormonal is a worry. Surely trying to stabilise these would be better.
I’ll see if DF can try the private route but I’m thinking not and otherwise explore with another GP if that’s even possible. I just hate seeing her a shadow of her former self

Can she try a different GP? I was having most of those symptoms by about 39 and they ramped up in severity by the time I was 41. I have a great gp and she prescribed hrt immediately at 41. It does seem to be the luck of the draw whether you get a supportive gp or not.

Just to point out, seeing a private consultant is around £250-£350 depending on location. BUT they will write to your NHS GP and recommend whatever ...in this case, HRT. So that comes from the NHS.
Obviously there is the option to continue with a private specialist but that depends on affordability.

GP said start point as in prescribing guidelines are that if a woman presents with peri symptoms and is 45 or over, can prescribe HRT no question. If younger than that, other investigations may be necessary first. But she was happy to let me try it. I’d assume that my GP knows what NHS prescribing guidelines are.