Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: honorsmum on January 27, 2015, 09:52:55 AM
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I'm 45, married with 2 children (11 and nearly 9).
In a nutshell - my cycles started to become irregular last year, ranging from 21 to 28 days. At the same time, I started to get unpleasant ovulation symptoms and worsening PMT, so I saw my GP in October and she ran blood tests - standard, plus thyroid, ovarian cancer and FSH. All came back normal.
At the same time, I started to notice I was getting palpitations - mostly in the day when I was lying down, but also in the middle of the night when they would wake me up. I also started having occasional night sweats at the same time.
I saw a different GP, who referred me to cardiology for further tests, which I had last week. Then, in December, I ended up in a&e for 7 hours, with a heart rate of 130bpm and badly dehydrated (I have Crohn's and had been feeling so anxious that I had been struggling to eat or drink enough and hadn't slept properly for weeks). Again, blood tests were fine, apart from dehydration.
I've since been back to 2 different GPs because my symptoms have been increasing. At times, my anxiety is high and I can't find any motivation to do anything. The fatigue can be overwhelming, and I either feel too sick to eat, or (as last week) I need to eat every couple of hours throughout the day, and sometimes in the middle of the night.
I haven't slept through a night for maybe a couple of months. I get to sleep ok, but then wake up repeatedly and generally wake up with a start at around 5am, sweating, heart racing, adrenaline pumping, thoughts racing and then I'm pretty much awake until the alarm goes off.
My skin has got very dry, as has my hair - which has gone white at the temples since August.
There have been times over the last few months the that I have felt like I am losing the plot - I just don't feel like myself at times. My moods swing dramatically, sometimes even minute to minute. My libido has gone AWOL.
What I don't understand is why all the health professionals I've mentioned all this to dismiss any thought that it's perimenopause - it's as if they don't recognise anything except actual menopause. I keep being told I'm too young!
My regular GP keeps trying to insist it's simply anxiety. She prescribed Cerazette initially, when I complained of ovulation pains, but it made me depressed in the first month so I stopped. She won't re-test my FSH because she says there's no point after it was checked in October and she seems happy to ignore my symptoms, saying that as long as I'm not missing periods, there's nothing to act on.
I'm thinking of finding a specialist (probably Annie Evans), because I don't feel supported in my doctors practise.
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I forgot to say - the GP who is trying to insist it's pure anxiety was the same GP who misdiagnosed my Crohn's as IBS caused by anxiety 5 years ago. She stuck me on Citalopram and sleeping pills, and prescribed diazepam (which I didn't take) when I got more and more ill. It took 8 months to finally get diagnosed by a gastroenterologist.
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Hello Honour :)
Oooooh, I feel so angry at your GP I feel like shaking her.
I am 44 and suddenly started with episodes of anxiety and very low mood this time last year. There was nothing in my life to cause it. It just came out of the blue - but at the same time I did notice my cycle was getting shorter (went from 28 days to 25/26) and my periods were getting a lot lighter.
I thought I was going mad. Within days I went from being Mrs Outgoing and Optimistic to being scared of being alone, and incapable of finding pleasure in anything. I then started to get random insomnia which I had never experienced before.
I kept going back to my GP because I felt so wretched and just didn't recognise myself anymore. But just like you, my GP never once suggested anything to do with hormonal issues. Just sent me off with a prescription for ADs. I tried another GP who was just the same. Neither asked me anything about my menstrual cycle, ever.
I took the ADs but noticed the anxiety/insomnia still came back each month. I finally saw a third, male GP, who agreed there was a chance my issues could be related to my menstrual cycle and referred me to a PMS/Menopause Clinic.
I saw a lovely gynaecologist who reassured me that I wasn't going mad. She assured me that she saw dozens of women just like me every week, all with similar symptoms especially the anxiety/fear. She was dismissive of an average GP's ability to recognise or diagnose hormonal problems in 40-something women. She said far too many women (like you and me) ended up on ADs for the whole of their 40s and 50s when really all they needed was hormone therapy.
I am currently waiting for a prescription from her for HRT. She offered it to me before Xmas but I foolishly turned it down because I had had a 'good' 6 weeks and fooled myself that I was somehow better. I then went on to have awful, awful PMS over Xmas and realised I wasn't any better at all.
Have you read Professor John Stubb's website? He is a leading authority on hormone related depression/anxiety. I recognised myself so much when I read his website. It was a light bulb moment for me. You might have to fight for a referral, but your GP can refer you to a specialist clinic, but you need to demand it.
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Thank you for your reply - you have reassured me no end!
I don't think I will go back to that particular GP, actually. She's a similar age to me, which makes her attitude towards this a bit baffling. I can't seem to get through to her that this all feels like a chemical change - I just feel like something in my body/throughout my body has/is shifting. That's the only way to describe it - it is as though I am literally going through a change!
Anxiety is definitely among the symptoms, but is NOT the cause. It is too much of a coincidence that my periods have gone from alternating 24/25 days to being all over the place, and that's when the palpitations started, the worsening PMT, the fatigue etc.
My mum says she can't remember exactly when she went through the menopause, because it didn't cause her any trouble, but she thinks it was around about 50 - which makes peri for me at 44/45 seem perfectly reasonable.
My older sister is 10 years older than me and now post meno in the last year or so, but started peri about 7 years ago, so again close to the age I am now,give or take a couple of years.
My good days are totally normal - I have just been away with friends for the weekend and even though my period appeared on Saturday (day 22), I felt good all weekend and was able to walk up mountains for hours, stay up late, enjoy food and company, sleep pretty well etc...but the bad days make me feel horrible and desperate.
When I asked my GP about having tests done privately, she said that that was something I would have to deal with on my own - she would not be prepared to treat me on the back of any results they may give, as it may not be within her range of expertise. I actually don't think she likes me taking control of my own health. :-\
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Hi
As i explained in another post to you I was the same as you thought I was going off my head all the heart, thyroid tests etc. luckily my Fsh test showed peri meno or I think I would have been given ADs. Although my GP still insists anxiety is nothing to do with meno, :-\ she did insist on me trying HRT as I was 42 at the time, now 44. First HRT didn't agree so I left it a few months and then went back in April armed with info and got Femoston. She was great that way would have gave me anything. I had never suffered anxiety that extreme before peri meno and it has settled a lot since starting HRT. You know your body and things are changing if not text book I still think GPs should be more understanding that we know it's out hormones. I do hope you get things sorted. I really think you need HRT.
X
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Hi honorsmum
I did respond to you on the other thread but I just wanted to say "hi' again.
My sister has Crohns and when she was on HRT she found it was less aggressive. Many woman find their IBS is better when on HRT as well.
If you can afford to see Annie Evans then I really think you should - I hear she is fab and what you are describing sounds so typical for peri menopause. Your GP is wrong about them not being able to give follow up treatment after seeing a gynae privately - I went to see a gyane privately last autumn and he simply wrote to the GP and told them what he wanted them to prescribe - he also asked for them to do blood tests after I'd been on HRT for 2 months.
A private gynae rarely gives any unusual treatment that cannot be ongoing or monitored by the GP.
Keep us posted. DG x
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Thank you, Millykin.
I agree - I wish GPs would balance blood test results with symptoms, instead of just going by blood tests, as a lot seem to do. It seems really bizarre that they are happy to diagnose anxiety and depression in the first instance, even though they are 2 conditions for which there are no blood tests! Talk about moving the goalposts!
My GP actually told me she would not take into account anything I might read on health forums on the internet, after I questioned her on accepted thyroid ranges. She said that even if blood tests showed thyroid antibodies, she would not treat me until my actual thyroid levels demanded it.
Actually, the more I write of her attitude, the more I think I need to find another GP.
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I think you sum it up well.
Taking control of your own health!!!
I too feel that was the main problem with my Doc too.
Without trying to start a debate I also think its the general lackadaisical attitude out there to peri and meno.
So many people have convinced us that we are not suffering from an illness and we should just "get on with it" , its a natural process!
Unfortunately that leads to a lack of care before in our peri years which are now seen as more important in terms of help, treatment and prevention.
Good to hear that Milly is being helped in this way.
And in our immediate meno years which again are now being seen as a key time to help us for the longer term too.
Its about time people made up their minds what it is.
Many organs in our bodies start to falter and fail as we get older and most are put down to illnesses.
Why then when it comes to our ovaries starting to fail we've suddenly got to put up with it as a natural process or ignore us till we go away.
I hope you and others can go to another doc that will take more care of you and help you start your own journey in a more caring way.
:-*
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It iss crazy world out there where some GPs are concerned. My daughter was feeling really unwell few years ago age 21 I kept taking her up to GP saying something wasn't right and they kept saying hormones sending her away, without going into too much detail she had clot to kidney high BP resulting in brain swelling coma and having to relearn her life.
Good discussion on this morning about meno and what your going through Honorsmum
X
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Thanks DG.
You are right - hormones have a big impact on the digestive system, as does anxiety, so anything that balances them out has to be a benefit. Sadly, my gastro consultant is also insisting that my symptoms (including IBS) are caused by anxiety - he sneered when I mentioned perimenopause, and told me that the FSH result clearly proved it wasn't the cause.
Can my GP actually refuse to treat me on the recommendations of someone like Annie Evans? She did say that if I wanted to go privately, she would not be prepared to then treat me on the basis of any tests results - because she was a "conventional" doctor and I should look elsewhere if I wanted an alternative approach.
If I were to see Annie Evans, would I need to gave had blood tests for ostregon and progesterone overshadowed I went - or would she prescribe based on symptoms alone?
I really feel that I may need some kind of low-level HRT to level things out, but I don't have confidence that anything my GP might be persuaded to offer will be right for me personally, given her apparent lack of insight into menopause matters.
Peegeetip - all too true, seemingly.
I was horrified when my sister told me she has struggled for 7 years and is only now thinking about seeing her GP, post menopause, because things are so bad. GPs shouldn't be seen as a last resort, but my experience is that women of a certain age (ie 14 to 90!!) are seen as neurotic.
Even though my GP is well aware she misdiagnosed me 5 years ago, she is still very quick to ask after my "psycho-emotional" state every time I see her. Another female GP in the practice told me that 90% of appointments were due to mental health issues.
My own GP actually had a go at me for taking vitamin B supplements!
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Glad I could reassure you HonoursMum
I completely empathise with what you are suffering. I could have written much of it myself. I very much suffer in private though as all my friends see me as being very cool, calm and collected. They don't realise I am often a nervous wreck these days suffering with random anxiety that makes me suddenly scared of the flipping dark, or scared to be alone.
And then I get days where I feel perfectly normal. But it's getting to harder to relax into those good days and enjoy them because I know just around the corner there will be more anxiety and bad days.
Sorry but your GP sounds like a pompous arse >:( Even worse that she is your age and should at least have an inkling of sympathy. Sadly the female GP who treated me was much the same. Insisted it was just regular anxiety and that all my other symptoms like insomnia, lighter periods and worse PMS were 'just what we ladies have to deal with at this age'.
Well thanks a lot for that ::)
I think some GPs have a God Complex and have a chip on their shoulder about patients being knowledgeable about their condition. I think they can also get a bit sulky when a consultant basically tells them what to prescribe. They really need to get over themselves. Consultants train and study for roughly an extra 7-10 years more than GPs and they know SO MUCH more.
What infuriated me was later finding out that my female GP had been treated by the same gynaecologist for menopause issues, I ended up seeing! To this day I don't understand why she didn't correctly diagnose my peri menopause symptoms when she'd clearly suffered herself?????
I think you definitely need to see a new GP. Definitely.
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"I think some GPs have a God Complex and have a chip on their shoulder about patients being knowledgeable about their condition. I think they can also get a bit sulky when a consultant basically tells them what to prescribe. They really need to get over themselves."
Love those comments GypsyRoseLee :) ;D
My Docs back went up so quickly when I explained what I wanted to do (after being palmed off to read this site). I wanted to go on the 3 month cycle HRT and got told it was for post meno ???
Still think doc put me on monthly cycle to try and put me off HRT - as my periods we widely spaced but not quite at 1 year point.
If we feel ill and goto the doc feeling ill looking for some help and relief, then its unhelpful that some say things are not an illness.
If it looks like a duck and quacks like a duck then its a duck ;D
:-*
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It iss crazy world out there where some GPs are concerned. My daughter was feeling really unwell few years ago age 21 I kept taking her up to GP saying something wasn't right and they kept saying hormones sending her away, without going into too much detail she had clot to kidney high BP resulting in brain swelling coma and having to relearn her life.
Good discussion on this morning about meno and what your going through Honorsmum
X
Oh my word, your poor daughter! That's shocking. Is she ok now?
I had a slightly similar situation with my own daughter. I really struggled when she was born - she wouldn't feed, never slept etc. I kept being told I had pnd, was an anxious first-time mum etc,until my son was born a couple of years later. He was so totally different from her - the sort of baby I'd expected. Again, the health visitor said I must be depressed, not coping etc and that my daughter's behaviour was a reaction to having a new brother.
Fast forward to her first year in school - teacher called me in and asked if I had any concerns. I blurted them all out and she nodded in total agreement - my daughter was eventually diagnosed with ADHD.
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Honorsmum
Yes thank you she is doing well, lots of hospitals, rehab we are just lucky she is here and mental state not affected. It's a long story for a private area, instead of hijacking your thread and totally diverting from your symptoms! ;D funny how that happens, get so caught up like a wee coffee morning x
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Ladies,
I could have written your posts with regards to anxiety, perimenopause and drs views on it all.
I am shocked in this day and age that many drs are so misinformed and dismissive about perimenopause and the symptons it can cause.
I recently completed a trial for low dose hrt. Whilst I was doing this trial, the hospital that was treating me did quite a few blood tests that showed I was in perimenopause. When the trial finished I went back to my own GP to ask if she would take over the prescribing of my HRT. I was told that I wasn't further enough into menopause to warrant hrt, and that when I got breast cancer I would sue my doctors!
Needless to say I am now looking for a new Dr. Xx
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Oh, and another thing HonorsMum, your gastro consultant is talking out of his bum too.
Blood tests and FSH levels are notoriously rubbish at diagnosing anything being wrong with your hormone levels UNLESS you are very near, or post menopause. My gynaecologist assured me that I was definitely peri menopausal BEFORE she commissioned my blood tests. She also told me that she fully expected they would probably come back as near 'normal' because that's typically the case with peri menopausal women.
You are reacting to the very rapid and often quite subtle changes in your hormone levels - even though those hormone levels might still be within a 'normal' range. She told me I would need a blood test done several times a day for at least a whole month to get any kind of handle on what was genuinely going on.
She told me that typically women presenting with the classic peri menopause symptoms e.g. unexplained anxiety, insomnia, feelings of dread, palpitations etc are 'clinically' diagnosed which basically means you are diagnosed on the basis of your symptoms and your previous medical history REGARDLESS of what your blood tests say.
Some GPs (and your gastro consultant) should really STFU rather than spouting off about stuff they don't actually know much about.
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I agree and sympathise with all of you suffering through the peri menopause, GPs really do need more training in dealing with the problems of women at this stage and the humility to accept if they can't hellp they need to refer to a specialist. Would just like to add that there is the same ignorance and lack of support for those of us who are a few years post menopausal and still having problems with sweats, anxiety etc.My GP is very easy to talk to but will not accept that hormones can still be responsible for feeling the way I do. She has prescribed ADs and yes they have helped but I still feel the cause is hormones. Various studies I have read show that many women are still experiencing menopausal symptoms up to 12 years post menopause, they tend to suffer in silence and GPs either don't know or won't accept this evidence. Didn't mean to hijack the thread, sorry, hope everyone gets the support they need.
Thorntrees
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Please don't apologise, anyone, for hijacking the thread - your replies make me feel so much better, by reassuring me that I am not an isolated case when it comes to struggling to have perimenopause symptoms recognised by health professionals.
I am really quite stunned by some of what has been posted - it's depressing to think that such a major part of a woman's life can be given such little regard by doctors.
I am lucky to be in a position that allows me to pay for an appointment with a private specialist, even if it means travelling to see her - but what about the many women who can't? Why shouldn't we expect to get decent care from our own doctors, or be rendered to someone who can, as Thorntrees suggested?
My worry is that I will see a specialist and everything will be fine...until care is taken over by my GP.
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Hi honorsmum
You asked about whether your GP would give you ongoing treatment for menopause symptoms if you were to see Annie Evans. Annie Evans is a well known and eminent gynaecologists so will certainly not be offering 'alternative therapies' or treatment that your GP could not continue. The comment by your GP that he/she only offers conventional treatment means he/she is simply not understanding what the menopause involves. I'm not sure whether your GP can refuse to prescribe on the instructions of a consultant gynae but it would be sheer arrogant stubbiness not to and would certainly not be in the best interest of their patient.
If you do see Annie Evans then she will probably take a proper history, full range of blood tests and assess you based on your symptoms to get the full picture. She will then write to your GP to advice them what she is recommending. If you tell her that your GP is refusing to offer any support regarding any treatment she is offered privately I am sure she will advice you about your options. I must warn you that going privately isn't cheap but I have found it money well spent if you see the right specialist. Sadly we are living with a health system that is simply not designed to help with these quality of life issues. Unless you are lucky enough to have a good GP many women do not get the right treatment.
I am fortunate as I'm seeing a GP at our practise who is open to discuss all options and when I said I wanted to see a gynae, who specialises in treating the meno, privately she approved and is now following his instructions.
I would seriously think of changing your GP if you can.
I'd make that appointment - you may have to wait for a while as she is very popular. Good luck.
DG x
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Hi Bracken
so glad your taking positive action.
Recent updates are saying that we should manage our peri to ensure we head off the problems that can cause issues later in life.
The main one I think is the problems we can have in terms of heart and circulation.
Recent studies show that we can protect that more by starting to protect ourselves earlier in peri.
Rather than leaving it till we're well into meno when a lot of the problems are already underway.
You could apply the docs "Sue us" statement to any medicine in their Cabinet.
Perhaps you should ask them for that in writing! As I'm sure thats not even allowed.
By their own oath's they are supposed to treat us, not avoid treatment based on some hollow assessment.
If you have an illness or symptoms then they must treat those to your request, not to their whim.
On a positive note did the Trial help you?? I wish I'd had the chance earlier too.
:-*
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Thanks DG.
To be honest, I'm not sure exactly what my GP's issue is. It was very much a case if "if you can't accept my opinion on things, without question, maybe you should find another doctor or a consultant." My main concern is that she won't discuss the possibility of perinenopause at all - she only mentioned HRT, prior to blood tests, in case they showed I was menopausal, and even that came with the warning of "needing a serious talk" (as though it would not be something to be taken lightly).
She has basically suggested that my normal blood results confirm her diagnosis of anxiety. I couldn't even get her to agree to repeat the FSH test.
We have 3 other female GPs at the surgery, and I have to say, I'm not keen on any of them - maybe a male would be better?
On the subject of going privately - can I expect a need for several appointments? I can find the money, but it will involve travelling and sorting out the logistics of all that entails, eg school pick ups etc.
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It is horrifically depressing that in this day and age peri menopausal women are suffering the agonies of the damned in silence, because their GP has poo-pooed their symptoms, and they feel there are no other avenues to turn down.
I am so lucky that I am capable of arguing my corner, even with stubbornly ignorant GPs and that I could use the internet as a useful tool for help and advice. Lots of women out there must just meekly accept their GPs decree and go on to spend years and years in misery, or taking ADs which they don't need and which have their own unpleasant side effects. So very sad and worrying :(
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Oh sounds like she does have a God Complex HonorsMum, she really needs to get over herself.
I studied alongside plenty of junior doctors at university, and have several friends who are GPs. They're really not all that. And, they're really NOT Gods, very far from it.
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Hi Honorsmum
the alternative is this. Single Phase (Monophasic) Contraceptive pill.
The main benefits ladies! ITS FREE and your doc cannot stop you taking it. Just head along to your family planning clinic.
This is an alternative to full HRT till nearer the peri/meno crossover time.
I like a lot of people did my utmost to get off the pill earlier but seems that the regularly hormones might have helped me through till later in my peri to nearer that crossover point.
Don't try a multi phase contraceptive pill, as they tend to have 3 or 4 different dosages during the month so might not have as good a stabilizing effect.
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0016409/
check the plain language summary right at the start. Single or monophasic is the same dose of estrogen and progesterone each day of the month.
Hope that helps
:-*
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I'm not sure if the trial helped or not really. It was a very low dose of hrt. I never got the chance to try it at a normal dose as that is what we were hoping the Dr would prescribe. X
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Hi Honorsmum
Sorry to hear about your experience with your unhelpful doctor - yet another disappointing case.
Regarding contraceptive pills - personally if I was beginning to experience menopausal symptoms at your stage and the pill seemed like a good idea, I would only choose one that was very similar to HRT. Most contraceptive pills contain very high doses of synthetic oestrogens and progestogens.
I don't know about all the brands of pills but one that has been discussed recently is Qlara which contains bio-identcial oestrogen, which you would be given as part of HRT. It only has two pill free days so avoiding some of the dramatic fluctuations in other hormones. The downside is that for 3 weeks in the month you need to take a progestogen - which may be fine if you can tolerate it but could cause side effects in some women.
I hope you manage to sort out a good option to enable you to have the right hormone treatement and eliminate your hormonally induced anxiety and other symptoms - most likely caused by reduced oestrogen.
Hurdity x
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I have been on monophasic pills before - Microgynon and Dianette, both of which were great. However, since having children, I have had very occasional migraines with aura so had to come off them.
I've tried Cerazette twice, but it didn't suit me - it made me depressed in a weird, cold way.
Also, having Crohn's does mean I have some absorption issues, and I know that certain HRT is better suited to sufferers than others for this reason.
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Hi honorsmum
If you suffer with occasional migraines then transdermal HRT would be your best choice.
Again, this is something a specialist Gynae like Annie would be best placed to advice you on. Yes, you may need a couple of visits with Annie Evans but I expect if, when you make the appointment, you explain you have to come quite a distance then they will be able to advice you about their procedures. When i first went privately to a meno clinic in London they were able to do the blood tests there and then, gave me a prescription and then rang me with the results. I just went back after 3 months for a check up and chat about how I was doing. They should tell you all the charges etc up front.
I have to say I am appalled and angry that so many women have bad GPs who simply won't support them. Good luck Dg x
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I have been on monophasic pills before - Microgynon and Dianette, both of which were great. However, since having children, I have had very occasional migraines with aura so had to come off them.
I've tried Cerazette twice, but it didn't suit me - it made me depressed in a weird, cold way.
Also, having Crohn's does mean I have some absorption issues, and I know that certain HRT is better suited to sufferers than others for this reason.
Hi Honorsmum, don't let migraine with aura mean you immediately write off the pill if that's what you want. My GP has agreed to let me try Qlaira (a kind of pill meets HRT ideal for 40 something's in our peri situation) despite the fact I have migraines with aura. Obviously there is a risk, but a measured one. It's about weighing it up against potential benefits. I am generally happy with HRT but am still suffering the effects of fluctuations, so may need something to suppress my cycle. The only reason I'm still not convinced is that it's a four phase pill - not great if fluctuations are an issue - though she won't let me try any other COP (Qlaira is assumed to be slightly 'safer' because of its more natural estrogen).
Really hope you find some relief soon x
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Hi Briony - Sadly Honorsmum is having so much trouble with her GP I doubt she will be able to get them to prescribe anything hormone related as they feel her symptoms are nothing to do with hormones!!!!
Do let us know how you get on with Qlaira as this is relatively new for treating meno symptoms and I know there are many women out there interested in how well it works.
Good luck Dg x
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Sorry - my fault for reading the posts backwards ::) xx
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Yes honorsmum you're right that if you have absorption issues because of Crohns then transdermal HRT is also recommended ( as well as for migraine sufferes) as it will give a more consistent dose straight into the bloodstream.
Hurdity x