NHS or private for perimenopause?

[casseroleofnonsense]

I have a private healthcare service through work which I’ve hardly ever used but I’m getting to the point that I think I really need to see someone about perimenopause symptoms because I’m feeling like I’m falling to pieces. Has anyone any experience of AXA private healthcare - I don’t want to waste my NHS GP’s time so i wondered if this might be a better approach.

Main symptoms are exhaustion (wake up feeling tired even after 8 hours’ sleep), no sex drive at all, low mood nearly all the time shot through with bouts of red-hot fury especially for about a week before my period, forgetfulness/brain fog etc etc. All the usual fun and games.

(Also, last time I went for a smear the nurse was really hyping up the mirena but I am completely terrified of having it put it so I’m worried about that being the suggested route.)

I would just really like to feel human again. I used to be a fun, cheerful person but now I’m a miserable old husk.

Forgot to say I’m 45 and also hypothyroid (but supposedly adequately replaced on 125mcg levothyroxine).

Check your AXA entitlement but when I checked with them was no menopause support offered on my policy. I don’t think there’s a GP option on mine. NHS GP route is so hit and miss- I saw an older female GP first and was fobbed off with antidepressants then found out we have a menopause specialist (senior nurse practitioner) at our surgery and she’s great. Maybe find out what is on offer at your NHS GP practice as well as checking with AXA what they can offer? Either route, download a symptom list and make a note of everything you’ve experienced (past and present), how it’s affecting you and have a think about what you want- it doesn’t have to be mirena! It seems that being informed before you go in can be very useful.

Oh rats, hadn’t considered it might not be covered. Need to do more research clearly. Thank you for the tips!

I have Bupa but just went to the GP first and I had bloods. Probably helped I had palpitations but they took me seriously. I said I’d return when I was ready. 6 months later I went back to get HRT

We’ve AXA through my husbands employer & it is covered for us but not til you’ve been trying the nhs gp for 12 months.
however we have doctor at hand and I had an excellent consultation with them & they prescribed HRT for me. I had recently had lots of general blood tests to rule anything else out.
also have underactive thyroid gland ( on 175mg) but it’s proving to be an exhausting combination

No insurers as far as I know will pay out for menopause.

Thanks everyone. @YourAzureHedgehog i’ve made an appointment with Doctor At Hand so fingers crossed - thanks for suggesting it.

Insurance will usually pay for any appts and investigations that are not yet diagnosed as peri or menopause.
So for example, odd bleeding or heavy periods.

But for 'normal' menopause they won't.

You can of course, money allowing, pay for private consultations outside of having health insurance.

My bupa policy also excludes menopause cover .
I got offered HRT after a phone consultation with nurse , and routine blood tests

Hopefully they will be helpful🙏🙏🤞

You won't be wasting your GP's time. The NICE menopause guideline (NG23) says that over 45, perimenopause can be diagnosed from symptoms alone without blood tests, so an NHS appointment with a written list of your symptoms is often enough to start the HRT conversation. It's worth asking reception whether one of the GPs has a special interest in menopause.

The Mirena is one way of getting the progestogen you need alongside oestrogen if you still have a womb, but it isn't the only one. Progesterone can also be taken as a capsule or tablet, or come combined with oestrogen in a patch, so you can say no to the coil and still have HRT. NG23 also says HRT should be considered for low mood that comes with the menopause, and CBT is another option for mood and sleep.

As you're on levothyroxine, mention it to whoever you see. Oestrogen taken as a tablet can change how much levothyroxine you need, so thyroid levels are sometimes rechecked after starting.

For AXA, check the policy wording or ring them before booking, as some work schemes exclude menopause care. If you go private you'd usually pay for the prescriptions privately too.