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[Kittycat50]

A male friend recently declared he was surrounded by menopausal women and in our conversation I asked if his wife was taking anything and perhaps HRT might help.  He said he didn't like that idea as there were a lot of risks and that it was just the odd hot flush after all  .  Thankfully I'm married to a man who is a little more understanding 

You said what the husband said? What did the wife say? Or was he one of these AH's who speak for their wife? (AH= awful husband in case anyones imagination takes off - opposite of DH).

Yes that was what he said - I honestly don't think he's an AH, but like many of us woman don't realise we're in the line up (when we are), I think a lot of men don't understand the full complexities either.  I've not yet spoken to the wife.  And it has to be said there is so much misinformation about women never mind HRT

[honeybun]

Try explaining to your husband then would be my suggestion. They can be surprisingly understanding given half a chance.
If we dont tell them then how on earth are they expected to even understand even a little bit.

It's like pregnancy.....they can't experience it but they can support and empathise.....even suggest things if they are interested enough.

Honeybun

[Dorothy]

Hi

"once they have ruled out all other serious conditions"

Sorry why would we do that for just peri?

Sorry, peegeetip, I didn't mean to upset you by that comment and I certainly wasn't suggesting putting women through months of 'extensive, intrustive tests'.  I am just going by my own experience, where my GP asked me a lot of questions and ran blood tests to rule out some other possibilities, rather than just assuming hot flushes = menopause.  I felt much happier knowing she had listened to all my symptoms and then said 'well it does sound like early menopause, but let's just run a blood test to make sure it's not...' 

Obviously it would be daft to test for something that 1 in a million people get before treating for menopause.  I just think it's nice to have a GP that doesn't either assume every woman with 'problems' needs HRT or assume that someone in her 30s or 40s is too young for the menopause. 

[honeybun]

It's funny how quite a lot of us agree that we actually like the fact that GPs will rule out other things first.

Excluding of course the tests for TB and pneumonia 

I think that some GPs are given a really hard time. They are supposed to know a little about a miriad of illnesses. I really don't think they can be expert in everything.
Mind you I have a great deal of admiration of the medical profession rather than thinking they are useless.

I do think more emphasis should be on the hormonal difficulties that some...but not all women ...suffer from.

Yet again I will state my point.....I'm sure it's getting hard reading though 

Rule out the life threatening things....or maybe just thyroid things before handing out HRT....like Limpy said......oh like sweeties .

If just one woman's life in say 100, is saved by a GP doing "unnecessary tests " then that is good enough for me.


Honeybun
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[Briony]

I agree,  Dorothy. Checking for the nasties is really vital, obviously, but a broader understanding of hormonal issues is important too. My new (female, 40 something) GP immediately saw tingling. the chills, nausea, pains, fatigue  etc as potential peri signs, despite my younger age. My previous GP refused to explore a  hormonal cause  as I was too young and not having hot flushes. He did agree to lots of other tests, which I am grateful for  (including a finger where I didnt want it on my 40th birthday of all days  ) but I do regret that he didn't look more closely at my hormones too. Once everything else was clear, he basically said, 'so it's all in your head; take some ADs'. These GP  practices are a few miles apart - yet so different in the way they handled me.

That said - I do fully accept the pressures GPs are under, especially with training budgets and crazy targets  and dont criticise them per se. It's more 'the system', I guess?

[peegeetip]

Hi HB

I think your maybe a doc in disguise but handing out HRT like sweeties where ? If you read the stats docs spend far more and dispense AD's like sweeties. I agree with you though "more emphasis on hormonal side". 
I don't think they get a hard time, most of our GP's are all part time as they are being paid so much these days.
Back in the late 80's and 90's we could get a GP on a saturday and in the early evening where I lived. Now you can't see them for dust much later that 6pm and mostly just half the day. If they don't know medicine then perhaps they shouldnt have taken it up. I think a lot of posts say how doc's seem to be constantly on some web search, I've seen that myself and find that worrying as I could have done that myself. Perhaps we'd all have more time with the doc's if the resources were used better in the first place.

Hi Dorothy

Not upset at all, I think its just having to counter so much disagreement on the simple concept in regard to simple symptoms and simple tests. I certainly didn't think that pointing out that often our docs are left either unaware or wanting on such an important stage of our lives.

Thanks for the response. I see your point and agree that its better to have a doc that listens well. All I'm adding to that is for them to review patients properly over a period of time. I've seen this recently with another member of the family and each time they saw the doc it was like having to start over again. Little reference to previous visit was made. Just an example of how simple checks can go a long way.
Given they use computers they could have a pointer / reminder in front of them to give time vs number of visits and previous symptom/ailments over last years. Given the information held this could be simple and effective way of giving doctors more without them having to review pages and pages of notes for nuggets.
This might help spot other ailments not just peri and meno.

Now that I'm on the HRT path its funny but they seem to want me to see them very regularly. Not sure that this is for good intention or still trying to scare me on the HRT path I've taken. I kind of phase out when they do their speel on the path I've taken.

Perhaps they should lecture me and others on alcohol or tobacco or casual/unsafe sex in same way as I'm sure all of those can do far more harm than my lowly HRT. But lifes often unwise and unfair all at the same time

The jury is still out on when they will leave me to a yearly checkup

[honeybun]

A doctor...I don't think so  .

I think you will find I quoted...or perhaps misquoted Limpy when she said HRT should be given appropriately and not dished out like smarties.

I don't think being a GP is such a great job these days....a couple of my friends are full time GPs. We have only one part time GP in our practice. They have two late nights per week and one very early start so I can't complain at all but I live in a quiet part of the country.
It's surely not a case of not knowing medicine. They have a working knowledge of so many things ....that's why they are called General Practitioners

Honeybun

[Limpy]

I think your maybe a doc in disguise but handing out HRT like sweeties where ?

PGT - Sorry but you did post the following, I think it was in relation to you developing sudden onset headaches.

"If I'd stuck with BCP then I'd have avoid all the visits plus expensive tests (and all the worrying)
For the sake of continued BCP or HRT at 40p per day I could have saved the NHS thousands!!"

It did sound like you think hormones, be it the BCP or HRT are the only way forward. They do help massively but they wouldn't have been the first thing any Dr (Phd or MD) would have thought of as the treatment of choice for severe headaches.

Yes HB - I did say smarties 

[honeybun]

Sure it wasn't wine gums Limpy.....now there's a thought....wine on prescription.

I could go for that 


Honeybun
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[peegeetip]

Read my posts again Limpy. If your not seeing my point then your not reading them properly.

I'd rather my ovaries did not pack in half way through my life.
I'd think most people with diabetes think in the same way about their pancreas.

If that means that BCP or HRT would have kept me healthier and happier through my 40's then brilliant. With someone like yourself perhaps we should just keep that to ourselves and just let a few lucky people enjoy it. Perhaps its all just a conspiracy

You certainly seem to be against even a glimmer that docs might have been wrong to pull people off their BCP early.

I'm certainly not HRT pro and would love not to need it if my ovaries broken as they maybe.

But if you don't see how many appointments, tests, cost, resources and worry would be saved from what currently happens then I can't open your eyes to that. The BCP would not have masked any of the problems mentioned by those posting so I really dont understand why its a bad thing to at least let ladies have a choice.

Perhaps the establishment want the status quo as it keeps a steady stream of ladies from their mid 30's on. Funnily enough at the time when most doc's are so keen for us to ditch the BCP. Why would we want to continue having sex ? I'd rather not have had the worry pregnancy or whether I'd gone ectopic (thankfully it wasnt). Had I still been on birth control then this would have been unlikely to have been an issue or worry. Not to mention the awful periods whilst I went through peri once I'd stop the stability of BCP.

I could go on but I believe I'm wasting my time with some on the forum.

 

[peegeetip]

Again your talking about a minority of ladies that encounter a hidden loss of fertility whilst on the pill. A minority of ladies encounter blood clots however no correlation to their work or situation is ever tied into that.
Recently a horrible story of a lady starting on BCP was run blaming the pill for her blood clots. However the article also mentioned she'd just returned from a long haul trip. Helllo? long haul DVT anyone!!! Even sitting at a desk at work can cause more blood clot issues that taking the pill. However its all a matter of knowing and understanding rather than just going with scare stories.

You also make its out like everyone needs ivf if they take the pill too.

I've not encountered one friend thats been in the situation you explain.

Again what you have mentioning also is a lack of education of ladies on the bcp.
And a failure of the health profession to take peri seriously.

"I'd love it if all GP's could wave a magic wand and make things right, but that only happens in Utopia."

I'll rephrase your statement to my view.

"I'd love it if all GP's to use the tools and education they have to make things right, and that doesnt need Utopia (just hard work)!"

In terms of the BCP the standard at the moment is to stop ladies who smoke using it after 35.
However docs tend to try and stop all of us after 35. Again an over reaction to what ladies actually need or want.
I remember the spin that put on my relationship with my husband and the worry of unwanted pregnancy, all down to a skewed viewpoint.
I've never smoked and had no problem with the pill for years, like the majority who take them.
Apparently being on it was good for my ovaries from recent studies too? You could not make this up.

Its not just my point of view, its ignoring the facts that there is the problem here with simple diagnosis and recognition.

[Limpy]

If your not seeing my point then your not reading them properly.

Re - Not seeing your point - It's not "not seeing" it's more not agreeing

Its not just my point of view, its ignoring the facts that there is the problem here with simple diagnosis and recognition.

You are very selective regarding the facts that should be taken into consideration

[Briony]

Sorry to be the party-pooper on this occasion, but I think we've kind of gone away from the original gist of this thread?

Given that it's a thread about peri, and without getting involved in either side of the debate that has since ensued, I would not want new members reading this to feel the BCP isnt a viable option during peri menopause. In fact, for many of us (see other threads) it's been significantly more helpful than HRT was, simply because it's more controlling.

Previously, the BCP over 40 was generally seen as a no-no. However, recent guidelines state - assuming there is no other risk such as being a smoker - women can stay on the pill until 50 with no greater risk than aged 40. This is partly due to the newer generation of lower dose pills such as Qlaira, Zoeley, Femodette, Eloine with less than 3.5mg of estrogen (some of these are bio identical too). Eloine is very new and only has 3 blank pill days.

I dont actually like taking the pill and, ironically, refused to take it when I would have been more fertile, but for now, it seems to be the best option for me and many others in my situation. It's definitely worth considering. Yes, there are risks, especially of blood clots, but these risks are lower than those for a pregnant lady (have copied the fsrh notes below - basically it goes from something like five in 10,000 for non pill users to ten in 10,000 for pill users).

Hope this is of use to those ladies in the 35-49 age group who may not have considered the pill as an option.

B

http://www.fsrh.org/pdfs/ContraceptionOver40July10.pdf

VTE (including deep vein thrombosis and pulmonary embolism)
The risk of VTE in women of reproductive age is approximately 4–5/10 000 woman-years in
those who do not use oral contraceptives.61 This is higher than figures quoted in previous
Faculty guidance.1 The reasons for the apparent increase in the background prevalence of
VTE over time are referred to in a recent consensus statement on COC and VTE.63 It is
postulated that the increase may be due to a true increase in incidence (perhaps due to
changing demographic trends such as obesity rates), increased clinician awareness and
better diagnostic precision, or a combination of these factors.
The risk of VTE amongst COC users is approximately twice that of non-users [9–10/10 000
woman-years (average across all brands studied)].6




Although use of combined methods has been shown to decrease with age,4 CHC can be
used up until the age of 50 years, providing there are no risk factors that would restrict use.
After the age of 50 years, women are advised to consider an alternative method.26,191 No limit
is given as to the number of years a woman can use a combined hormonal method.
Guidance on stopping hormonal contraception at the menopause is available within the
FSRH guidance entitled Contraception for Women Over 40 Years.191

[Limpy]

You are correct Briony - Guilty as charged, sorry for going off topic GRL.

Totally agree the BCP can be very helpful for ladies in the 35-49 age group.
I took it till I was 54, on Microgynon till 50 then started on Loestrin 20. I had no idea that I was anywhere near the menopause, I was still getting withdrawal bleeds. When I stopped at 54 a blood test to find my FSH found it to be 103, it seemed that I was already post menopausal! Six months later my FSH came out at 108 confirmed it, well that and having no periods whatsoever after stopping the pill. 

It was only when I stopped the pill that meno kicked in for me.


 

[honeybun]

Thought this made interesting reading. As my young daughter is on the pill it was relevant to her too.


http://www.dailymail.co.uk/news/article-2550216/Deadly-risk-pill-used-1m-women-Every-GP-Britain-told-warn-threat-popular-contraceptive.html



Honeybun
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