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[Dorothy]

The good news is that my new GP, having first refused to believe I could be peri, has now decided I am.

The bad news is that she thinks the birth control pill is 'too dangerous' a way of treating early meno and wants to come off the pill so they can do blood tests to see 'where I am' and then put me onto an appropriate form of HRT which she says is 'safer'.

It's a bit frustrating as my previous GP was quite happy for me to stay on the pill until 50 and then go onto HRT if I needed to, but this one is worried about breast cancer risk. 

So, if I do come off the pill, how long will it take for it to leave my system sufficiently not to affect the blood tests?

Is there really any benefit to changing to HRT from the pill?  Part of me is thinking that if I go along with what she wants, she might create less fuss over renewing prescriptions in future.  But I'm also worried about coping with the change from one to the other, and also, if my blood test comes back normal, that she might refuse to give me anything at all!

[Cassie]

Not sure how old you are, but there is no reason not to keep on the pill, I went into early meno in my late 30's and the only reason, I swopped over to HRT when I was just over 40, was because I was forming a fibroid and I was convinced, it was from the pill and when I went onto the transdermal HRT, there was no more mention of the fibroid, but my Dr had told me it is quite safe to stay on the pill well into my 40's, cannot imagine why they would want to swop you over. Nonetheless, if they do insist, the bio identical transdermal patches or gel are great and you can then take a separate progesterone, if you still have a uterus.

[Dorothy]

I'm 42, started getting symptoms at 35 and was diagnosed at 39.  Last GP was lovely and so helpful, but since moving, I'm back with the 'you can't possibly be menopausal until you're 50' brigade!

I am actually wondering if once I was transferred to HRT, she'd decide that was 'too high risk' too and try to stop me having anything.  Every time I go, she talks about the 'extremely high risk' of breast cancer, in spite of the fact that I tick all the boxes for being low risk.  Doesn't help with the health anxiety of course.    I dread going as I know I'm going to stress about my health for days after!

[dangermouse]

They're very different animals in that the pill (or very high strength HRT) is meant to dampen down your own cycle (handy if it's very erratic) so you just feel the exogenous hormones.

Low dose HRT is more about adding hormones to your own to enhance how you feel.

Try HRT and see how you go but you should be able to switch back until you're  at least 50 if your cycle is too erratic to benefit from the more targeted HRT.

[Hurdity]

Hi Dorothy - you are so young! Which BCP are you on. As others have said I thought 50 was the age at which stopping BCP was recommended? How about trying a compromise and using one of the types that are like HRT - ie QLAIRA or ZOELY? The oestrogen in these is estradiol rather than the strong synthetic ones. The progestogens would be different from what you are used to though. They do control the cycle eventually although the doses of oestrogen are lower than BCP - higher in Qlaira - but variable throughout the month. Also what about your choice? And also again - I understood that some gynaes prefer to prescribe the CCP for early meno rather than HRT?

Here is the information on this website:

https://www.menopausematters.co.uk/contra2.php

The pill' is a highly effective method of contraception at all ages and is used by 8% of women over the age of 40. It may have special advantages for older women by helping heavy or painful periods or preventing ovarian cysts. It contains a combination of the two hormones, estrogen and progestogen which are given in a high enough dose to suppress ovarian function, preventing egg release. Women may continue with 'the pill' up to the age of 50 years provided they are fit, slim, non-smokers and have no risk factors for heart disease or stroke but in women who smoke, it should be stopped at the age of 35. 'The pill' must be prescribed by a doctor and the woman will need to have her blood pressure checked regularly. 'The pill' will not suit some women. It may be associated with a very slightly increased risk of breast cancer and should not be prescribed for women with migraine. Using 'the pill' in the long term protects a woman against both cancer of the ovary and of the lining of the womb(endometrium); a reduction of at least 50% in the risk of ovarian and endometrial cancer with combined pill use has been suggested, and this reduced risk continues for 15 years after stopping.

HRT type estrogen containing pill

A new combined pill, Qlaira is now available which contains natural estradiol valerate as the estrogen component, rather than the synthetic estrogen ethinylestradiol. Ethinylestradiol is the usual component of the combined pill whereas estradiol valerate is an HRT type estrogen. This is a useful option for women in the perimenopause when it should control menopausal symptoms while providing contraception and good control of bleeding.

If you are keen to carry on then I would do some homework, print off anything you need to take to your doc and be assertive if you can!

Let us know the outcome please!

Hurdity x

Oop pressed the wrong button before I'd finished!

[Dorothy]

Thanks Hurdity!  I think I'll stick with what I've got as it works for me and I don't want to rock the boat.  I'm just getting fed up with having to fight/argue every time I go for a repeat prescription, and all the panic from them about increased cancer risk really does not help the health anxiety!  Listening to her last time, you'd have thought I was guaranteed cancer if I didn't come off the pill immediately!  I thought if I went along with what the GP wanted, it might be easier.  But thinking about it, if I changed to HRT she could decide next time that HRT was too dangerous for me and I shouldn't take anything!  So I'll stick to what I know works for now.

[Hurdity]

OK - good luck with that!

I know what you mean about GPs and cancer scares. My GP told me I should not be on HRT at my age as it can only lead to cancer ( when I complained about an abdominal pain a year or two ago) and "Let's hope it hasn't already". Needless to say I have never returned to this doc and always go to her job share GP! Nice eh?

Hurdity x