How do I know I’m in menopause and how do I ask for help. What help do I ask for because I’m clueless about this thing which I really should know more about!

[Vevevoom]

I’m reaching out as I need some support and help with how I’m managing things here.
Maybe around December I kind of stopped having my period. Since then I’ve I’ve had a streak of blood occasionally at different times of the month - which I assumed were my cycle time - alongside sore breasts, back pain and mood swings. The his month, I had a full on period with 3 day bleed after sore breasts and back ache. This followed a very low mood.
Two months ago I went to see the gynae to do a series of tests, Pap smear, and other blood tests. Frustrated is being kind. Doc says I’m post menopausal. But it hasn’t been a year of no period. I’ve come away with nothing, yet I feel frustrated and am suffering. Low mood, aches and pains, forgetfulness, no flashes, feel like I can’t mange anything, have lots of dots in the air, but nothing being connected. I feel like I’m meandering through a maze that I don’t know how to get out of.
visiting the gynae was my way of seeking help. I feel she didn’t know what to tell me or give me.
any advice of what help to ask for from the doc and medication that can help. Any natural things too.
I need to feel normal and not feel so out of my depth. I struggle to study or to retain info or to retrieve. I need to feel normal again. I’m in my 50s and feel like I’m having a midlife crisis which I’m clearly past.

What I need:

• Advice
• What I need to look for about my situation
• Coping mechanisms
• medication
• What do I ask the gynaecologist for? (I know that they should know, but clearly don’t)

your help and guidance will help will be appreciated

What country are you in?

In my experience GPs (male ones in particular) know very little about menopausal symptoms and often have an attitude of 'It's one of those things, you'll just have to put up with it'. If you continue to ask for help they then tend to diagnose you with depression instead, ffs.

Don't be fobbed off. Keep going back until you get the support you need. Practice nurses are often far better and more sympathetic than the doctors, to be honest.

It sounds like you are perimenopausal. Do you want to take HRT? It would sort your symptoms out.

You can fill in a symptom checker on line and take that in with you.

Everything you need on this website https://www.drlouisenewson.co.uk/knowledge

I'm sort of thinking you're not in the UK as it's not usual to 'go and see a gynae' for what you had done- smears etc. Most done on the NHS ever 3- 5 years.

LIkewise in the UK if you chose private treatment with a gynaecologist you'd do your homework and choose a menopause specialist if that was the reason for seeing one.

Yes, not in the UK. GCC country.

I’m reluctant to go onto HRT yet as my mom was on that and that was a contributing factor to her condition.

Nevertheless, I went to see a female gynaecologist who was meant to be good, but alas, I went away frustrated. I will go back to see another armed with blood test results and more questions. I was frustrated because I expected her to know and to guide me after I explained the stage I was at. She kept saying that I’m post menopausal despite it not quite being a full year.

is HRT safe and how does one stay on that for? I’ve heard people say it’s a game changer. Will it take away brain fog and all of that? Anyone been on testorone? I heard that some people have.

I’m a bit reluctant on the HrT. Where would I find this or a symptom checker?

I’m sorry you’re going through this. It sounds like you really need some proper guidance and support. I think it would be worth seeing another doctor or menopause specialist and explaining all your symptoms clearly. You can ask about whether hormone therapy or other treatments could help, and what checks you need. Keeping a simple record of your bleeding, mood, pain and other symptoms may also help. Most importantly, don’t feel like you have to figure it all out alone.

If you are reluctant to go on hrt or even try it, then I don’t know what else you can do except get through it without medication.

Could you do some reading for yourself? Get a book out of library or book an appointment with a menopause specialist consultant. These are available online now.

Thank you

I have done loads of reading, listened to podcasts, tons of research, but I suppose once I went to see this doctor for help, I felt like I was coming away with nothing. Now I have to see another. I’m thinking of alternatives to HRT.

im just trying to get myself together.

What happened to your Mum?
(Sorry I don't know what a GCC country is.)

Regarding asking if HRT is safe etc, there is loads of info online, so putting your questions into a search engine will bring up lots of info.

You need to focus on medical sites (not insta, tik tok & other stuff by 'influencers')

Look at Menopause Matters, the Women's Health Concern, the Dr Louise Newson app.

Thank you. Sound advice

Your just need to Google menopause symptom checker. There is one on the NHS website.

I just read your initial post and it sounds like me. I'm mid 50's and had my last period 2 years ago. I've learned Menopause symptons will vary, each woman is different. In my case it's extreme fatigue, anxiety and low mood. No hot flashes, no brain fog, body pains and I sleep well, weird I know. My NHS doctor was very reluctant to give me HRT so I ended with a low dose of SSRI citalopram and some sort of hormonal cream to put in my "bits" just for sex activity (which doesn't happen often as my libido has taken a dive into the abyss).

My point is: if you get this sorted through NHS depending on your symptons they'll give you one thing or another, but they don't put everyone on HRT 'just because'.

'is HRT safe and how does one stay on that for? I’ve heard people say it’s a game changer. Will it take away brain fog and all of that? Anyone been on testorone? I heard that some people have.'

Yes, bioidentical HRT is safe. You can stay on it for as short or long a time as you want to. Yes it's a game changer for lots of us. Virtually all of my symptoms have either stopped or massively improved over the last 2 years on HRT. It's giving your body and brain what they need - no different to taking thyroxine if you had an under active thyroid gland

HRT involves oestrogen (and progesterone if you still have your womb) in the first place. When stable on them, you may consider adding testosterone. There are no reliable blood tests for perimenopause - they are supposed to diagnose based on your symptoms. There's a v useful app called Balance - you can use it to track your symptoms, bleeds, sleep, nutrition, exercise and mood - helps you to build up a picture of what's going on for you over time

In your position I'd just be requesting HRT, not asking for a medic to diagnose me. In the UK fortunately it has now become the case that if you are in your mid 40s onwards and you are experiencing the sort of symptoms that you are, you just ask for HRT and most (decent) GPs will prescribe them. In my view you have nothing to lose and a lot to gain from trying HRT. Typically you can start on a low dose so it doesn't need to be heavy handed. For low mood/brain fog and generally not feeling like myself progesterone was the real game changer.

Your GP is out of touch.

My NHS doctor was very reluctant to give me HRT so I ended with a low dose of SSRI citalopram

ADs are not prescribed for menopause- since 2015 (NICE) unless there is existing depression etc.

Also it's not a case of what you are given but what you want!

If you want HRT you need to ask for it.
Don't accept ADs.

And estrogen cream for your vagina is not for sex. It's not lube.
It's to stop vaginal atrophy and old ladies in their 80s and 90 use it (even if they are not having sex.) It needs to be used regularly, for life- 2 x a week at least.

Your GP sounds clueless.

(OP is not in the UK - she's in the middle east.)

Are you a doctor?

@bitontheobtuse this was my experience with a female doctor. Took me two years of horrendous bleeding before she finally sent me to a gynaecologist. Had the coil and no periods for 3 years....bliss.

Hi, I’m in my 50s too. During perimenopause, our hormone levels fluctuate and this transition affects some of us more than others. I have erratic periods, hot flushes, and moods that come and go.

Balance is a useful app with information about the menopause, HRT and lifestyle changes. It’s also handy for keeping track of our symptoms.

You might also find the International Menopause Society website helpful for reliable information about menopause, including symptoms, treatment options and women’s health: https://www.imsociety.org
Just remember that this information shouldn’t replace advice from your own doctor.. The website can also be translated, so you can read it in your preferred language.

I hope you find something that helps you.

@toiletpaperthief No. I'm quoting medical NICE guidance.

If you want to see the evidence, look at the NICE menopause guidance, it's all online. The guidance as far back in 2015 said ADs were not first line treatment and only to be used if women had an existing diagnosis of depression of MH issues.

In very rare cases some women may need both but not as first line treatment,

You do not have to have hot flushes etc to be prescribed HRT if you have other menopause symptoms.

You can read the facts about ADs and why they are not to be prescribed on the web. Dr Louise Newson has written on this a lot- do a search and you'll find the articles.

I do have many years of personal experience of HRT with a consultant.

There is masses of advice online about not using ADs and the correct way to use vaginal creams.

OP it’s important to know that HRT has changed over the years so the medication you would be prescribed now is different to the medication your mother was prescribed ( assuming this was 20/30 years ago ). It’s also useful to know that it’s a combination of medications so there are many variations. I have a patch and an oral tablet, a testosterone gel applied to the skin and even a “ring” I have which is inserted vaginally for 3 months. If some aspect does not work for me it could be the combination needs re-jigging rather than the whole thing throwing out.(I met someone with horrible symptoms who was complaining that HRT doesn’t work but she’d only taken something for a couple of weeks before giving up.). I think the symptom checker is more valuable than the blood test because those can vary from day to day. The symptom checker will incorporate all the mood measures as well as libido etc which is a much broader measure than merely periods and hot flushes. I think you need to specifically ask about HRT even if you’re not certain that you want to take it. They can take your mothers medical considerations into account. Good luck.

HRT can literally be a life saver. Looking back I wonder how I functioned without it! As others have said, there is a wealth of information on line. You really do have to do your research and know what you’re asking for. IME expecting medical staff to know and guide you is not helpful. Sadly most (not all I’ve had some brilliant GPs) are almost clueless about menopause and what you need. You really do have to advocate for yourself and approach it by saying what you want.

@toiletpaperthief

This might be useful for you if you go back to your GP.

https://www.drlouisenewson.co.uk/knowledge/antidepressants-and-menopause

This is part of it

Can antidepressants be prescribed for menopause symptoms?
Menopause guidelines are clear that antidepressants should not be used as first line treatment for the low mood associated with perimenopause and menopause. This is because there is no evidence that they help improve psychological symptoms of perimenopause or menopause.

Antidepressants are not effective for the low mood and anxiety associated with perimenopause and menopause as they are not treating or addressing the underlying cause of low hormone levels.

How should hormonal low mood be treated?
Because mood changes during perimenopause and menopause are caused by altered hormones, the most effective treatment is to stabilise hormone levels with HRT, often with testosterone too.

Thank you everyone to everyone of you who have taken the time to respond and provide support and guidance.

I hear you, but the NHS and Dr louise seem to have a different approach to menopause symptoms. I'm not a doctor so not sure who is in the wrong and who in the right, all I know is I have a history of depression and anxiety and the menopause has made it 3 times worse. I have no hot flashes, I sleep well and have no joint pains. A low dose of Citalopram seems to have mellow me and I feel much calmer, but that's me and my personal experience. I'm not on HRT and if citalopram continues doing it's job I may never go into HRT, but ask me in two years :-)