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[BrightLight]

Forgive me if this comes out in an emotional 'rush' - I needed to write here.   

My GP informed me late January (after one period with extended spotting) that my FSH and LH levels were post menopausal and as I am under 45 would need to consider HRT asap.  Advice was to repeat the tests within 2 weeks and talk to him about HRT.

I took advise from here, from a private GP and others and managed to somehow 'go against' my need to just trust the GP and follow his lead and made my mind more open to the fact that things change and his summarisation was a little too black and white.  That perhaps I was on the journey to menopause with more change on the way and not as he described as a 'done deal'.

My brain has been mush trying to make logical sense of limited menopause symptoms - according to my GP - yet a 'diagnosis' of post menopause and my emotions have been all over the place.  I really needed to trust this GP at this point, thinking I was facing a decision to take HRT etc To me, this was a milestone situation.........

Anyway I had the repeat blood tests last week, I waited 6 weeks and not the 2, to see if my cycle was changing, by chance I had the test during a period (I had just skipped my first one), so it was on day 2.  The first test was perhaps on day 25, afterwhich I did infact miss my first period. 

The Dr retested FSH and LH plus a FBC and electrolytes and white cell count, hymoglobin and other words that I didn't hear the receptionist clearly on.  All routine I think.  Anyway I didn't ask for numbers except the FSH and LH.  His notes said "normal ranges - No further action required)

January tests FSH 83.1 and LH 35 (post-menopausal range)

Last weeks tests FSH 5.7 and LH 11.2 (normal range)

I am aware that the FSH/LH ratio in this last test is not 1:1 and that can sometimes indicate PCOS but at this point I am not going to think about that, and hopefully not worry.  I don't believe it indicates anything else and am preparing to close the chapter on thsi horribly confusing situation.

As is repeated here very often - do not take a one of FSH blood test as anything other than a one off blood test.  Reading on patient.co.uk Drs are not supposed to diagnose menopause on FSH results, they diagnose on symptoms and then if necessary take TWO blood tests to help confirm.

I am going to try and get my head and emotions to catch up with all this now. 

[rosebud57]

Sounds like you're still peri to me.  Your hormones are obviously up and down like a yoyo.  It can be a very long time from 'missing' a period until they stop.  Could be years yet.  Follow your instincts, it's you body so take your time before you decided on HRT or not.

[BrightLight]

Yes, they are up and down and that's OK with me for now - it was just the scare that the Dr gave me about risks of this and that due to early menopause and get on HRT straight away.  He would not even entertain the idea that they would be up and down.  Yes, I'll trust myself a bit more now.

[Dancinggirl]

GP stands for 'General Practitioner' - they are not specialists and frankly the menopause should be dealt with by specialists because it will be different for every women and treatment will vary accordingly.  Well Women Centres with specialist doctors and nurses are what we need.  DG x

[BrightLight]

Absolutely DancingGirl - the GP practise that I am switching too at least has a Practise nurse you can see for well woman things - it says so on the website   It even says the word Menopause.  I was sold.

[Hurdity]

So sorry you had to go through all of this worry through a doctor saying something he shouldn't have - and through lack of knowledge - at least you have read up a huge amount and to some extent know what's coming, although not necessarily the details of how/when it will all happen to you.

Now you can concentrate on doing everything you can to make sure you are as healthy as you can be (I expect you do that anyway!), and you can think about HRT perhaps when you are further along the journey, or if your symptoms become unmanageable despite your lifestyle interventions and de-stressing techniques.

Hurdity x

[lancashirelass]

It.is.better to do fsh alongside oestrogen levels.  Just fsh isnt full picture. 

[Dancinggirl]

If Well Women Centres were set up properly then perhaps women who were having problems with their meno, right from the early stages of peri, could go along and it would be routine to do a series of blood tests to look at oestrogen and FSH levels over, say, a 6-12 week period to get a better picture of what is going on.  Each women could be given a questionnaire that listed typical symptoms they might be experiencing and an area where they could write down their concerns.  Then advice can be offered accordingly.  Women would then feel they have options depending on their needs. Many may go away to see how they cope and perhaps never come back while others may return in 6 months realising they really need something to help. These centres would respell all the taboo and allow women to open up to help and support in the same way Family Planning Clinics do. 
Hey, why not just extend all the Family Planning Clinics to include the Menopause? The Menopause Clinic I used to attend in North London did just that - so no extra set up costs just a bit of extra training for staff.
Sorry was I sounding sarcastic?  DG x

[BrightLight]

I didn't think you sounded sarcastic. Dancing girl

I guess in some ways I have less info and more worry since I went to my GP. I'm pretty sure things suggest perimenopause but at the end of the day I actually went to GP for spotting and a pain in my back that I was concerned was a cyst/fibroid. He latched onto my FSH levels and hasn't really discussed bleeding etc.

A centre would be able to advise me properly and take away all the mystery and personal guesswork which has only led to confusion for me. I even feel a bit silly being on this board now as I am so confused.

I have no pain since the period in January, a missed period and a normal period, although it was heavy for first two days. It's ended up being down to me to assess my own health and although that's fair to a point I really feel unless you go backwards and forwards questioning, you don't get a full picture taken of your situation.  I have has no clear explanation from any medical professional for my strange bleeding pattern and acute pain. Now trying to stop working it out but there is still background concern. I hope that will fade.

Extending family planning clinics is a very simple solution. There is zero financial incentive though

Thank you Hurdity, as you can see I haven't quite let go of the 'worry' and just move forward trusting there isn't anything untoward going on

[BrightLight]

 I'm pretty angry about the service actually GP's are indeed general but I do think jumping about trying to direct your own healthcare, guess whether you need tests or not and reminding them of your symptoms as the diagnostic process goes on is all a bit much. I have however learnt a lot and am trying to accept healthcare has changed since I was young and its very self directed now. I'm just not handling it very well

[Dancinggirl]

I personally think there are a lot of financial benefits to having Well Women Clinics. 
Firstly it stops the numerous visits to the already overloaded GPs and secondly it would keep women working and productive for longer.  Think of the benefits to the families of the women suffering with bad meno symptoms - apparently only 10-15% of women actually seek help for meno symptoms and it is known that 50% or more suffer quite sever symptoms.
How many unnecessary tests and procedures are done before its actually decided its the menopause to blame. 
The savings to the NHS and society could be enormous.  DG x

[BrightLight]

DancingGirl - I didn't express myself properly, I totally agree with you that it makes financial sense, but at the moment the NHS strategy isn't directed in this way, no funds put into it.  GP's get bonuses for spotting dementia or other conditions rather than anything else.  If money could be spent setting up clinics it really would save them a lot of money in the long run.  The whole area needs a revamp

[Dancinggirl]

I wasn't implying your were wrong Brightlight - sorry if it sounded like that.  You are absolutely right about these incentives payments. I just get so angry about the lack of logic and common sense.
I've had experience of trying to get a project up and running within a local authority for special needs educational.  It would have saved the borough a lot of money and hassle but there were so many egos in the way and not nearly enough logical practicality. They wasted so much time and money finding ways to block the the whole project. It did eventually get set up but not in time for my son. I fortunately managed to find an alternative placement for him that was very good but I spent 3 years trying to set this project up(along with many other parents) so I hope there are kids benefiting now.
More high profile women are speaking out about menopause issues now so hopefully it won't be long before appropriate provision will be available across the country.  DG x

[BrightLight]

It's OK DancingGirl I didn't think you were implying that either

I too have had experience of working with the local authority to set up a school - managed to secure a big Government grant, presented it to the council, who said no.  A year or more of effort, clear benefits to be had, a disused building put to good use etc etc  I am glad to hear your project eventually led to something, even if it wasn't in time for your son.  I have had my fingers burnt in the commercial world, the not for profit and now I feel the NHS is following suit - I am rapidly turning into a grumpy middle aged woman   ha

Aside from the operational angle, I just want to know if I am healthy or not! That's the upshot and really am angry that things still feel up in the air - I am contacting the Private GP that I saw, to update her and talk through whether I need to investigate the 'abonormal' bleeding further, seeing as it doesn't seem so straightforward as menopausal - even though I am certain it's hormonal.  I just want peace of mind and haven't found it quite yet and will not be setting foot inside my GP's surgery again - he's only confusing me.

[honorsmum]

The whole situation is really pretty tragic.
Surely at the very least, GPS should be trained to be able to interpret things like FSH test results - to tell a 44 year old woman that she's post menopausal before she's missed a single period is just bizarre.
We have a  situation where some women are being refused HRT, despite suffering horrendous symptoms, while others are having it thrust upon them at the mere mention of wonky periods.

I'm on another menopause forum where a 51 year old member who hasn't had a period for 11 months asked for HRT because she is suffering horrendous anxiety, among other symptoms. Her GP told her that they only gave HRT to women in their 30s to protect bones, and certainly wouldn't give "a cancer-causing drug" just for anxiety.