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[JS79]

My OH is almost 54 and periods stopped roughly 3yrs ago but it's only knw that I'm going through perimenopause that she realises she was having symptoms and is still effected by brain fog especially. She came to my original HRT appt and heard about the health benefits for bones and heart . She is now worried about what's to come for her and is wondering if she should start some HRT now? Any advice to pass on to her before she goes to GP.

[CLKD]

How is she feeling overall?  I never required HRT other than treatment for vaginal atrophy.  My periods waxed and waned for years then stopped 21+ years ago.  Initially I had itchiness which didn't continue although occasionally I get areas of my skin that is really annoyingly itchy due to loss of oestrogen. 

Whilst HRT can protect bones and heart, I personally don't see the point in taking any medication unless symptoms are over whelming.  Because I feel OK I never consider that I should ask for it.

Whilst going through school we had lots of exercise: hockey, cross country, which is good weight bearing to protect bones from an early age.  Also we ate a wide diet including dairy.  MayB she should think about her overall diet whilst growing up as well as how much exercise i.e. cycling, walking, swimming, jogging ...... because many schools sold off fields for buildings!!! = less access to sports.  Plus the inclination not to eat dairy 

Perhaps look at your diets and make notes for 3-5 days/nights: food and liquid intakes.  Is there anything that you could gradually alter/improve upon? 

Hobbies?  Exercise?  Cooking together ?

Brain fog may simply be general aging.  The 'what did I go there for' scenario which is within normal limits for most of us!

[JS79]

She has difficulty sleeping but it's mostly brain fog. She is doing her masters at the minute and is getting so frustrated because she can't retain info and since meno has become very analytical of herself and lost lots of confidence.
She was sporty growing up but not so much now between 12hr shifts(she's I the ambulance service) and family life, including having to step up as I've been so rubbish health wise this year. Diet could be so much better, especially on shift when you eat what you can when you can, and if you can't eat then it's haribo in between jobs lol. Non smoker, non drinker.

[bombsh3ll]

It might help for her to download a menopause symptom checklist such as Louise Newson's or the Green climacteric scale and tick off those that apply.

Sometimes this can help people identify symptoms they hadn't connected or had just been putting down to age or general life stress.

Also because natural menopause is gradual, symptoms can creep on insidiously and it is only after starting treatment that some people realise how bad they had got used to feeling.

It would also be helpful to think about any risk factors for osteoporosis, eg family history, especially parental hip fracture.

If she wants to try hormone therapy, I would recommend asking for it directly rather than beating around the bush hoping the GP will guess what she wants.

If there are outcomes that she would not find acceptable, for example being offered antidepressants instead, she should politely but firmly decline, and leave any prescription that isn't appropriate in the room, so they are clear it hasn't been taken and will cancel it off the record.

Taking someone along for moral support is always a good idea - this helps to slightly rebalance the power dynamic, and reduces the chance of being fobbed off or facts being recorded incorrectly.

Being familiar with the relevant NICE guidelines and having a copy either printed or easily accessible on your phone can also help advocate for the treatment you want.

[CLKD]

Sometimes symptoms ramp up after the last period because hormone levels R still active. Let us know how she gets on!

Could you batch cook for the freezer so that she can grab a box to take to work, ready to dip in2 between calls?  Something easy on the digestion as shift work can take a toll on both digestive transit and sleep patterns.  I always said when working in the NHS that 'they' would have us on commodes! 

[olive]

My OH is almost 54 and periods stopped roughly 3yrs ago but it's only knw that I'm going through perimenopause that she realises she was having symptoms and is still effected by brain fog especially. She came to my original HRT appt and heard about the health benefits for bones and heart . She is now worried about what's to come for her and is wondering if she should start some HRT now? Any advice to pass on to her before she goes to GP.

JS79 the advice from the other lovely ladies on here is excellent as always. The starting point should always be a look at lifestyle, diet etc. and what you can improve if anything. It's good to be able to show your doc you have thought about it and gone through some kind of process of elimination. However I would add that if she's post-meno, her hormones are no longer fluctuating so push for a blood test as a minimum so she has a benchmark and so ammunition to try HRT to see if it helps her brain fog. I agree with the principle of not taking meds if you don't need them, but she has nothing to lose by giving it a go. Don't let GP fob her off! If GP won't play ball, try a £75 consult with the BMS specialists at menopausesupport.co.uk who will give her the time for a proper discussion, inform her of the options and will send a letter to GP if you want. Good luck x