Are these symptoms peri-menopause - or chronic fatigue syndrome?

[Walkingtheplank]

I am absolutely knackered. Constantly tired. Doesn't really matter how much sleep I have. I feel dizzy, can't focus or process work, have headaches, feel hungry frequently, am irritable, like I'm pre-menstrual. I've been like this for c.6 months. I'm also achey joint-wise. I feel decrepit

I started HRT c. 2 years ago. I went from anxious and not sleeping to feeling pretty good and sleeping OK within the week - but more recently I just feel awful.

My first GP wanted to prescribe me anti-depressants, but I declined as I'm not depressed, so she suggested blood tests which have largely come back OK although I have high bilirubin which I've known for years and it means I probably have Gilberts syndrome which is not a major issue apparently.

I had to see a different GP for next steps. He hadn't even read the notes despite the surgery asking me to to come in to discuss the results. The result of this conversation was a suggestion of chronic fatigue syndrome but he also wants to rule out liver issues. He wants more blood tests.

I feel that the fact that I'm a 51 year woman is being ignored.
I've been offered anti-depressants (like so many women) which I feel is just to numb what I'm thinking and to shut me up.
If the issue is chronic fatigue syndrome then there's no treatment for that so that's just giving me a diagnosis (that is mostly a diagnosis for women).

What do I do? I don't feel that either GP has heard what I've said - or am I just not hearing what they're saying and this is not hormonal?

Has anyone had similar and what was the best way forward?

Yes I'm still working. But not to the best of my ability. I literally forget what I'm talking about or key vocabulary. Not helped by being one if the oldest so living up to their perception of me as a dipsy old woman.

It's beyond frustrating when you lose your train of thought or can't find a word.
I would consider going private to optimise your HRT, then at least that part of your system will be working as best it can. I recommend the FB group The HRT Truth Collective for good information.

Rest is important, is there any way you can get more rest?
A temporary reduction in hours at work or maybe they have a menopause policy that might help
Or reducing how much you do at home
I realise it's not easy to get more rest as a busy working mother but pushing through can often make things worse.

I was at the sister practice to my usual GP surgery just now and asked the receptionist if they had any GPs who specialised in menopause/HRT - which they don't. I explained that the GPs at my own surgery are unwilling to discuss my HRT prescription. When you think about it, isn't it strange that any GP would not discuss a prescription? Anyway, she says she couldn't help so I asked if she had a list of private practitioners which she didnt. Anyway, as a woman of a certain age, she obviously took pity on me with my morose face and said I could have a phone appointment with their nurse practitioner who knows about HRT. Which almost made me cry!

Your GP is rubbish. Maybe look at the nice guidelines on menopause to see what service you should be able to get from your GP.
I suggest go private if you can afford it, once you get the right dose you can go back to your GP and get them to just continue with it.
I would chose a private practitioner based on recommendation.

I'm perimenopausal and have CFS. Getting my HRT right took almost a year, until I found the type and dosage that worked for me and that made me feel somewhat more human. A lot of random symptoms cleared up, leaving me with fatigue and much less brain fog. I truly felt I was losing my marbles before then.

I agree that CFS isn't an easy label to accept - there was a clear development for me so I'm confident my diagnosis is accurate, but do look for alternative explanations. Have you tried adjusting your HRT? I had to resort to going private but that meant I was also prescribed testosterone, which does seem to help.

Had the appointment with nurse who has had no training but has been through the menopause (that was her only qualification).

She told me to look up the Menopause Charity and look up what Davina McCall has said and work out what I need.

She said what I probably needed was a referral to one of 2 menopause clinics (not my local 1) so I've got to go back to my useless GPs for that. She was shocked that no one had so much as taken my blood pressure yet 2 years into taking HRT and wanted me to explain why I was on the prescription I'm on - how do I know? Why dont doctors leave case notes?

I guess if you wait long enough you've passed through the peri-menopause by the time they'll discuss it.

I cant believe how much time im spending on this. I just need a doctor to speak to me.

You don't need a GP referral to a menopause specialist if you go privately.
I'd stop wasting so much time with your GP practice if I were you.
Look at the Facebook group I recommended instead! The answers are all there.

Did she take your blood pressure OP? I went to Dr feeling tired, sore joints and utterly shit thinking I needed HRT - I'm 54 . My BP was high so I've been on a low salt, low sugar diet and within a week my BP had started to go right down and I feel like a new woman. More energy, able to concentrate, tendons and ligaments and joints feel better. My BP had been fine before but apparently low oestrogen affects how salt affects your BP. There's hidden salt in everything. You probably need your HRT reassessed but on the off chance it might be BP getting a check might help. Your GP sounds shit you are going to have to insist on a referral and if they are still shit send in an emailed complaint to the practice.

"I do have the test results as on the NHS app.
My Serum TSH level is 1.59 (normal range 0.27 - 4.2) - so I think that rules out thyroid issues."

This in itself is not sufficient to rule out problems with the thyroid gland being either over active or under active.

Comparing signs and symptoms of thyroid conditions – Thyroid UK

I would also concur that your GP practice is utterly awful. Would register with another practice in your area.

Going to a private menopause clinic will be the best money you've ever spent, and I wouldn't touch antidepressants. They are absolutely not recommended to treat menopausal issues and your GP should know that.

My blood pressure has always been low and I had mine taken at a work event around Christmas time and us was low again. Nurse appointment this morning was by phone so no testing. The practice has probably not tested my blood pressure since I registered a long time ago.

There has been a development though. I was first prescribed HRT by my original GP. Lovely older man who I trust. However he has been off for a long time, I think with cancer. I rang the surgery this morning to ask if there was any timescale for his return, and they said he's back next week. So I've got a Tuesday appointment. If he's no help I'll go private but I'm hopefully he'll be willing to help.

My strategy with my GP is to do my own research and then then tell her what HRT I want to try and why and if I'd like any specific tests eg testosterone level.
If you do some good online research it's not hard to reach a higher level of knowledge than most GPs have on the subject. My GP is very nice and sensible but doesn't have much knowledge about menopause even though she is the lead GP on the practice on this area. That's pretty normal unfortunately.
Even a lot of consultants often don't know much about HRT. That's why a good specialist private practice is a wise use of your cash.
It shouldn't be like this but 🤷‍♀️

@Walkingtheplank “CFS is a label given to women who are tired and the NHS is not capable of solving it”.
Whilst it’s true that the nhs has no treatment or cure for cfs, cfs is a genuine disease with significant genuine symptoms, with unfortunately not enough money invested by the government or pharmaceutical companies into causes and treatments. This is where the problem lies, until there’s a huge investment in research nothing will change.
I don’t agree that it’s a label given to women who are “tired”, this devalues the experience of men women and children with cfs/long covid as it is really much more than feeling a bit “tired”.