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[AliBaliBee]

Hello everyone.

I’m new to the forum and have discovered it for a little bit of support and advice!

I am 41 and went to see a nurse practitioner a couple of weeks ago to ask about perimenopause. My periods have been all over the place for probably a year now, could be 25 day cycle, could be 35 day cycle, some really light, others really heavy (for me), number of days they last are fluctuating every time. I’ve been getting really moody, snapping at my family over nothing! And I’ll forget conversations I’ve had and repeat myself and forget words mid sentence. My husband says several times a month “you’ve already told me that”.

So I explained this to the nurse and she said “you’re only 41 so it is unlikely the menopause”. And I said “I don’t think it’s the menopause, I think it’s the perimenopause”. She asked if anyone in my family had early menopause and I explained my mum stopped her periods in her 50s, which she said was normal. (I know that, thank you).

Then she asked if my moods are every day to which I said no, not every day. She asked if I have low libido and I said it’s hard to tell because we don’t do it very often as it is 😂 (she didn’t crack a smile).

She said again that because my moods aren’t every day then it won’t be the menopause.

Granted, I’ve only had a few episodes of heart palpitations, one night sweats in the last 6 months that I’ve been keeping track of symptoms and cycles.

But she would do blood tests for lots of things to rule things out. She didn’t explain what she would test for. So she said for the hormone part of the blood test that when I started my period to phone up and book a blood test for day 2 to 5 and be adamant with the receptionist that this is when I need it done. The receptionist was going to phone me back after messaging the nursing team but never did so I called them again and again but was unable to get through so went in to the medical centre. I was told they don’t have the availability to get me an appointment at such short notice so said I’d have to book in at the hospital bloods clinic. Tried to book in there but they can’t offer anything until mid February.

Today I went to bed in between the school runs because I feel completely drained. I never feel rested even if my husband lets me sleep in at the weekends, which he does often (I’m very lucky).

I realise I’m rambling. But does this sound perimenopausal or something else?!

Thanks for reading ☺️

[Miss Sunshine]

The nurse sounds like she very misinformed.  Perimenopause can come years before menopause.  Yes you are probably in the very early days of it but it's still very possible.  Could you maybe book in with a GP or another nurse.  Have a look on here to arm yourself with information and then go back.  They can't ignore  facts when presented with them.  You need support and not to be made feel like you don't know your own body

[CLKD]

Again!  medics who have no idea 

   from where I'm sitting your symptoms are peri-menopause .  My periods waxed and waned for several years: regular bleeds, intermittent gaps ........ in late 2002 I realised that they hadn't presented themselves for months.  I knew it was The Change ...... and fortunately I haven't had too many aches, pains, flushing.

Do read the threads about bladder issues and vaginal atrophy.  Your Nurse probably wont' have any idea about that 1: 4warned is 4armed!

Some find that keeping a mood/food/symptom diary of use to chart progress.  In your position with such abismmly [sp] treatment I would be asking for a referral to a dedicated menopause clinic.  Not a gynaecologist!

As for getting a blood tests within a certain number of days, depts. should be more accommodating.  Though hormonal blood tests are reliably un-reliable!  Medics should be going on symptoms. What happens if a lady doesn't get a period for months?  Does she have to continue with symptoms !!! to prove a point 

A routine full blood count, VitD, thyroid function test can be done from the surgery.

Why does she consider 'moods every day' a symptom of peri.?  Most medics still believe that the loss of periods and a few hot flushes are menopause  .  Let us know how you get on.

[CLKD]

Tiredness may be due to thyroid function issues or low VitD levels.

[bombsh3ll]

It definitely sounds like perimenopause, however it is not possible to say you have nothing else going on as well.

It is not unreasonable to do blood tests for other things such as full blood count, thyroid etc but hormone blood tests are not always helpful in the diagnosis of perimenopause, and treatment should not be withheld form a symptomatic patient on the basis of a "normal" FSH.

It sounds like the nurse was determined it was not going to be perimenopause regardless of barn door symptoms, and believing that mood changes have to be present "every day" also suggests this is not her area of expertise.

I would try to find out if there is a particular GP at the practice with an interest in women's health and menopause, and make an appointment with them.

Even if not, it is probably still better to see a GP than an NP because they can at least refer you to the local NHS menopause clinic if treating you is outwith their scope of practice.

For those experiencing perimenopause at the earlier end of the age spectrum, the combined pill can often be easier to access (and clinically preferable in many respects) than menopause hormone therapy, so this is often a good option where a GP is unfamiliar with the latter. They will often be more amenable to prescribing the pill as long as it is medically appropriate (no migraines/blood clots/hypertension/obesity/smoking etc).

Especially when taken on a continuous basis i.e. no hormone free intervals, the pill can keep you bleed free AND hormonally stable, with a sufficient dose of estrogen to keep your bones healthy and address perimenopausal symptoms. This is worth considering even as an interim measure even if it is not your preferred treatment longer term.

[AliBaliBee]

I had my over 40s MOT blood test maybe this time last year and the only thing they flagged up was my cholesterol levels. I’ve since started eating better and have lost over a stone but declined to go back for the retest they wanted me to do.

[AliBaliBee]

Thank you for the replies CLKD, Bombsh3ll and Miss Sunshine. The wait to see a GP about it was that long that they said the NP would be able to see me as she’s trained in menopause 

I get migraines with aura so there is a pill I can’t take, I think that was the combined.

I just wanted information and advice from the NP as to my options if it were perimenopause because I don’t want to be affected severely by it. If that makes sense.

[CLKD]

Whoops I hadn't read that you were dismissed by a NP - sorry.   .  There4 I would be pushing for an app to a dedicated menopause clinic ; there are waiting lists in both the NHS and private sectors. 

Have the migraines worsened in recent years?  I believe that there is a new medication to ease symptoms.

If U can get the book: Me and My Menopausal Vagina: do buy it ;-).

[AliBaliBee]

I don’t get migraines very often to be honest, they were worst after my first pregnancy 15 years ago up until about 10 years ago. I’ve only had a handful in the last 5 years I’d say.

[CLKD]

Let us know what you decide?

[AliBaliBee]

So I got my blood tested finally!

My testosterone level is 0.3nmol/L. Serum follicle stimulating hormone level was 5.9IU/L and serum LH level 5.7IU/L. Bloods done on day 5 of my cycle.

The nurse said this is within normal range so won’t be the cause of my symptoms so not in perimenopause.

[bombsh3ll]

That's nonsense, perimenopause is a clinical diagnosis, not a biochemical one.

Whilst it is favourable that you have a low FSH - a high one would mean that you had been exposed to long term hypoestrogenism with potentially negative health consequences - this does not mean you aren't perimenopausal.

Given perimenopause can last 10 or more years, and the average age of menopause in 51, then mathematics alone tells you that someone in their 40's is more likely than not to be experiencing perimenopause, and treatment should be provided to symptomatic women.

You need to see someone with the relevant skills and training in this area.

Your testosterone is also very low and additionally should not be overlooked if you have symptoms of hypoandrogenism.

[CLKD]

Medics don't seem to understand peri/menopause.  They should know that perimenopause are those years prior to the final bleed = menopause proper - peri being when we feel 'odd', 'off' - my periods waxed and waned for several years and I knew it was The Change so wasn't worried.  Would miss several months, then bleeds would return  .  Then in 2002 disappeared but I didn't realise until late in the that year as I had been nursing 4 sick pets for 2.5 years   

Some find that keeping a mood/food/symptom diary of use to chart progress.  Because there are long waiting lists for dedicated menopause clinics I would get a referral ASAP, an appt can be cancelled if you don't require it.

Bloods can be reliably un-relaible  [pity I can't type] 

[AliBaliBee]

Thank you both for your replies. I’m not giving up just yet! 😂

[CLKD]

Please don't!  Keep asking.  Make notes.  This too will pass 

Let us. know how you get on.