Should I see my GP about manageable perimenopause symptoms?

[HazelHedgehog]

Do I need to see doctor about perimenopause? My symptoms are totally manageable, had got flushes and sleeping difficult. Periods are irratic. I don't think I need too but worried I should be on HRT or something

You don't have to put up with symptoms, but even if you had no symptoms, hrt protects against osteoporosis and heart disease.

yes, it has some long term health benefits even if your symptoms are manageable.

I went to GP recently after a thread here about shrinking labia to get topical estrogen (it's on prescription in Aus)

I'm also peri but have manageable symptoms. I asked my GP about taking HRT and she said I didn't have to but to do things like weight bearing exercises for my bones.

I think I'm waiting for terrible symptoms? I'm not against HRT, just don't feel I need it yet.

I’m not sure why so many women are martyrs when it comes to the ‘manageable symptoms’ of peri or menopause. I say that a a former martyr who had horrible hot flushes and very erratic periods and extra anxiety and sleeplessness…

all of which are actually debilitating in the long term! My ‘bar’ was when my hair started to fall out and even then I was reticent. Because of the scare tactics surrounding HRT? Or the ‘mystery’ of menopause, what with it not being a male complaint and therefore underreported and under researched.

Anyway. Short version of all that is from the first day/night I took it my hot flushes stopped. Then the knock on effect of less anxiety and better sleep and when I actually looked into it there are many benefits to taking it, not least mitigating the effects of osteoporosis.

So threads like this I find strange because why wouldn’t you take something if it’s going to help you - if only to sleep better, which we all need!

I feel my jury is still out even though I’ve done it!

I had what seemed pretty minimal symptoms. I kept starting an e-consult form to request a GP appointment but kept pulling back again, unsure if the symptoms were bad enough. In the end I booked in with a private clinic just to avoid feeling guilty about taking the time to talk about it. But not surprisingly, I came out with a hormone prescription.

I don’t really trust the motives of private medicine, but have used it anyway. I’m quite struck by the changes in my symptoms tbh so on balance I’m glad I have done it. I’d say it is more than reasonable to talk it through with your GP.

As Nice Menopause Guidelines state treatment (systemic HRT and/or topical estrogen for vaginal atrophy/GSM) is based on symptoms with personal risks and benefits taken into account. It’s personal preference - if you feel you mght benefit then make an appointment with your doctor. You could also look at lifestyle measures like diet and exercise for future health.

This booklet might help https://menopausesupport.co.uk/wp-content/uploads/2025/07/Menopause-Support-Booklet-V2.pdf

I'm no martyr. By manageable I mean my period no longer comes regularly, I can't tolerate alcohol the way I used to, and before I started magnesium, nightly waking at 3 am.

If I was having hot flushes, night sweats, and crippling anxiety then of course I'd take HRT. Who wouldn't?

@PermanentTemporary do you mean your symptoms increased and so you were glad you had HRT?

I didn’t take it because I had zero symptoms. I’m not taking anything that’s not needed. As for preventing heart disease, that’s laughable. I take regular blood tests and no sign of heart disease or osteoporosis. I’m not lining the pockets of big pharma

It depends, if you don’t want to be on HRT then there’s probably no point. Saying that I do believe there’s a new drug been approved in the last couple of months to help with menopause symptoms for those who don’t want or can’t have hormonal treatment. If your symptoms are very minor and you’re against taking medication then crack on.

For me the hot flushes were unbearable, I felt shaky and ill, like a wave of doom rushing over me. My anxiety was through the roof and I’m not normally anxious. I didn’t want to take hormones but it was so bad that I was begging for HRT. I feel a lot better.

If you do nothing else I would say educate yourself on the symptoms of genitourinary syndrome of the menopause and at the first sign of any symptoms get topical estrogen from your GP and don't take no for answer.

It depends on how your symptoms affect your quality of life. AND how far into peri you are. It will change when your periods stop - you may have no symptoms are many more.

I've used HRT for years - over 15- and started because hourly flushes and insomnia were awful. I was very tired and work was difficult. I'm many years post meno now and when I've had a short break from HRT the symptoms are still there.

In all honesty if your symptoms were bad you would probably be on HRT now - you'd have reached the end of your tether!

What I mean is if your sleep was affected so much you weren't functioning day to day, and longer term a lack of sleep affects our immune systems , heart health, weight, and brain.

There is a difference between waking up once in the night and getting back to sleep , or having bad night sweats and insomnia so you're exhausted.

I agree that HRT protects the bones and heart BUT it's not licensed as prevention (except for women who already have some bone loss diagnosed with a DEXA scan, or with a family history of osteoporosis.)
So you can't 'demand it' for that without other symptoms.

I'd see how you go with it all.

@BloodyRoses no I mean I think I was minimising the symptoms to myself, or at least I was very unsure which of them could be menopause related. Incontinence, sex drive and sleep were the big ones for me but I’ve also been bereaved of my mum this year, my relationship is now getting more settled, and I’ve had continence issues for years and years so I wasn’t sure whether HRT would help at all. It seems to have helped all three really significantly.

@UniquePinkSwan Not sure what you mean by 'laughable' re. heart disease.

It's established that HRT reduces women's risk of heart disease if it's taken with in 10 years of menopause. At menopause, women's risk of CVD rises quickly to the same risk as men's, because estrogen protects the arteries by keeping them flexible and less likely to become narrow and blocked.

HRT is not licensed for CVD prevention but it's a 'good' side effect if used for menopause symptoms.

The same applies to bone density- it is licensed for the treatment and prevention of osteoporosis, where it's been diagnosed.

If you're in the UK no one gets regular heart / blood tests unless they have risks or established disease . Women don't have bone density scans as prevention (unless high risk factors.) Obviously all of this is available privately, of course if anyone wants to do that.

This is really important and is barely talked about !!!!

100% agree!

Women don't need to use HRT if they don't need it.

But if they do use it, it offers a reduction in heart disease and osteoporosis.
1:2 women develop osteoporosis and without a DEXA scan no one knows if they have it or not. (There are no signs of osteoporosis until a fracture, or back pain from broken vertebra.)

I remember being a year on from my last period smugly congratulating myself for sailing through the menopause with no symptoms and no hrt. Thought that was that. And about a month later all the symptoms hit me like a train 🙈

before I started magnesium, nightly waking at 3 am.

@BloodyRoses So Magnesium has made a big difference to your sleep? I was going to post today asking for advice about waking up in the early hours, because it's just started with me and it's SO annoying!

I suspect that I'm moving from peri into full menopause as I 've just missed my first period after always being regular (I'm nearly 52). Luckily no other major symptoms yet aside from a slightly upset tummy...I expect they're around the corner. What a lovely time in our lives!😂

No, you do not need to take medication just because you are going through a normal phase of life.

HRT is not an option for me given my medical history. I have to find other solutions to any problems that develop. Bamboo pajamas and cooling sheets are very useful.

Thank you everyone. I think because I feel totally fine other than occasionally symptoms which are not impacting my life I would be wasting doctors time. I think I may book appointment and get some advice and guidance, especially around HRT.

I didn’t bother. My symptoms were completely manageable and some non-existent, plus it was around lockdown so pretty much impossible to see a GP about anything.

I am all for taking medication if you need it, and I’m for not taking it if you don’t.

Just have a Google op. Plenty of info out there and lots on this board. See a gp if you decide to go down HRT route and need a prescription.

GPs vary hugely in their expertise on HRT.

If you're not having enough symptoms to need it, there is no point seeing a Dr.

You could read and research it online -Menopause Matters is a consultant-led website and other dr-led websites.

I saw that @over50andfab left a link to a menopause site which is pretty sound with its advice.

(Ignore any written in the US as they tend to have a different attitude to HRT.)

(Ignore any written in the US as they tend to have a different attitude to HRT.)

@JinglingSpringbells Yes, no one has mentioned HRT to me here. I did mention it to my doctor a while back and she wasn't dismissive, but I don't think it's as widely used here. I wonder why that is?

I'm not 100% sure but it's possibly because one of the oldest studies on HRT (WHI study) was done in the US (around 24 years ago) and was shown years later to be flawed.It overstated the risks partly as the women in the trial were not typical of women starting HRT (they were older and many were overweight and used types of HRT not often prescribed now in the UK/ Europe.)
It may be that many women in the US still believe the old research and don't ask for HRT so much.