Dismissed by GP having to make private appointment

[Poppins17]

I went to my GP in the summer presenting perimenopause symptoms. I had a blood test and when the results came back she dismissed perimenopause staring at 41 I was too young and instead referred me for talking therapy which I am not stating until later this week due to delays in system.

Since then my symptoms have declined and have resulted in me feeling exhausted and burnt out.

I went back to my GP today but she still refuses to agree to me trialling HRT and has instead given me Sertraline.

I’ve decided not to take it and have instead been researching a private specialist. I’m hoping to get something booked in over the next couple of days.

Has this happened to anyone else and did the private specialist confirm your thoughts or am I wasting my time and money and should I just take the Sertraline?

Not a doctor so cannot advise on medication.

But if your symptoms are being caused by lack of estrogen, SSRIs will do the square root of fuck all. I was prescribed them twice when I needed HRT but was older than you at the time. It is definitely worth seeing the specialist and asking for her opinion.

Have you had bloods done to rule out other issues like underactive thyroid?

I was 44 when I got HRT.

go see the private people

Different angle - symptoms have a huge overlap. Blood results suggest not perimenopause.

Sertraline will help if it’s depression and won’t make much difference if it’s not. It’s also more straightforward to dose and has fewer complicated side effects than hrt. So worth a try first, if doesn’t change things then that’s another reference point to feed into plan on what next.

In the meantime, a symptom diary may help future discussions either way.

You are young for menopause so don’t be so quick to put down symptoms to that. It’s sometimes an easy peg to hang a hat on

of course lots of women are perimenopausal at 41 and you may well be so a private appointment would probably be ideal for you as your GP is so dismissive

just keep an open mind that your symptoms could be being caused by something else

The HRT specialist at my GP surgery told me the only way to know if I’d benefit from HRT was to try it. I started at 43 but wish I’d started at 42. If it was me I would try the private specialist before starting on SSRIs.

Remember hrt has negatives too. If the blood test didn’t show low hormone levels they won’t prescribe

You are quite young to have markedly low oestrogen but it does happen to some people.
Are there lifestyle factors worth exploring that are making you feel exhausted and burnt out?
I doubt that sertraline is the answer, unless you are severely depressed or anxious.

Please listen to Emma Barnett’s podcast on bbc sounds called time to talk, she is very early 40’s and is going through peri, she was also offered anti depressants, it’s way more common than you thing to have early peri symptoms

Thanks for all the responses.

Should have added that I was a very early starter (primary school) and have also had fertility issues (never had a baby) and only one functioning ovary so lots of issues that I think my GP hasn’t taken into account, even though she knows about them.

Thanks for all the info - I shall take a look and listen to podcast and hope I can find a specialise who will be able to help me, even if that’s to rule out perimenopause by someone who is an expert.

I’m slightly older than you (not much) and after suffering for a year I finally went to the GP.

6 months of jumping through hoops and being passed around, loads of tests.

I flat out refused venloflaxine because of all the symptoms I did have, depression/low mood wasn’t among them.

A few MNers helped me with links to NICE guidelines (sorry I don’t have it anymore but Google will probably bring them up…) because it’s clear they don’t need blood tests and should be diagnosing based on symptoms and not automatically doling out anti-depressants.

Eventually GP conceded there were no other underlying causes for my symptoms and agreed to try low dose HRT.

I’ve been on gel + progesterone tablets for 6 weeks and it’s been a revelation.

Keep pushing and wave the NICE guidelines at them.

If you do want to go private - Newsham Clinic is the gold standard!

Antidepressants are nor sweeties. Sertraline has literally dozens of side effects and it can be very very difficult to give up. I'd say it's the other way round - your GP should rule out a physical cause before prescribing mental health medication.

You are doing the right thing by looking for a health professional that will listen to you and consider your symptoms.

Modern HRT rarely has negatives unless there are other factors present. It is mostly positive.
the scare stories are about old style HRT.

blood tests should not be relied on if there is a possibility the woman is perimenopausal.

the OP needs a menopause specialist to guide her through this.

Thanks all - I feel the anxiety and low mood are a symptom of what I’m physically going through, not a cause of my problems.

If specialist does say it’s perimenopause what happens then? Do I stay under their care for HRT or do I do I go back to my GP?

The specialist im considering can administer HRT but obviously not at NHS prices.

If the symptoms are brain fog and exhaustion then see if you can get a thyroid blood test first. I was pre-hypothyroidism for ages but the symptoms were so bad they eventually gave me medication which did mostly improve things. (I was also pushed onto sertraline before they worked out it was thyroid so maybe ask for them to rule a few things out first)

My thyroid, B12, vitamin D etc etc have all been tested and come back ok.

I'm the same age as you and was also fobbed off by the GP/nurse as too young for HRT. I have anxiety which is definitely perimenopausal. I have heard if you go private they are much more keen to prescribe HRT.

Go and see the specialist and get your HRT once you’ve found a combination of Hrt that suits you get the specialist to inform your doctor to prescribe it for you. That’s what I did.

Blood tests are not accurate.

The test is to use HRT and if it works, you needed it.

There are no negatives to using HRT in your early 40s if you have menopause symptoms.

It's not that private drs are 'more keen' but they are specialists and GPs are not.
Many GPs seem to not recognise early menopause.

41 is not too young for peri. It's early-ish bit not that unusual.

Normal range of periods stopping (for good) is 45-55.
And the wind down can start years before that.

As a guide, women whose periods stop before 45 are classed as having an early menopause and medical advice is to use HRT till at least 51.

I am sure it's frustrating @Poppins17 that your GP is putting obstacles in your way. NICE has made it very clear in the guidance that SSRIs are not to be used for menopause except with a clinical diagnosis of existing depression.

You might like to make a list of all your symptoms including if your cycles are irregular. You should get around 45 minutes with a specialist so don't be afraid to discuss all your medical history and symptoms.

Try the private specialist. I went private at 44 after my gp told me to meditate on Saturday mornings as I just had a busy life. HRT has been amazing

Sorry, you don't know what you are talking about. I should know I was desperate to go on HRT but neither my GP not the private clinic would prescribe it (see below). It's great that most women can ask for and receive it but it's irresponsible of you to say there are no negatives because that is not the case.
Do not prescribe hormone replacement therapy (HRT) in women with:

• Current, past, or suspected breast cancer.
• Known or suspected oestrogen-dependent cancer.
• Undiagnosed vaginal bleeding.
• Untreated endometrial hyperplasia.
• Previous idiopathic or current venous thromboembolism (deep vein thrombosis or pulmonary embolism).
• Active or recent arterial thromboembolic disease (for example, angina or myocardial infarction).
• Acute or active liver disease.
• Pregnancy.
• Thrombophilic disorder.

Prescribe HRT with caution in women with:

• Acute porphyrias.
• Diabetes mellitus (increased risk of heart disease).
• Factors predisposing to venous thromboembolism.
• History of breast nodules or fibrocystic disease — closely monitor breast status (risk of breast cancer).
• History of endometrial hyperplasia.
• Hypophyseal tumours.
• Increased risk of gallbladder disease.
• Migraine or migraine-like headaches.
• Increased risk of breast cancer
• Endometriosis — seek specialist advice due to the potential risk of disease reactivation and malignant transformation.
• Uterine fibroids — may increase in size.

That list you've posted is contraindications. It's what a dr would check before offering HRT.

The posts by the Op weren't about pre existing (if any) medical conditions and if they would mean no HRT. She said her GP refused to accept she was in peri.

Negatives (which is the word you posted) would usually means side effects, or taking time taken to establish the dose and type of HRT.
.