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[Jeps]

Hi
My sister who is 48 is suffering big time with anxiety, stress, and all other things menopause related.  I've finally talked her into seeing her GP about HRT and he said today that she would need to wait a year without any periods until he would consider HRT.  I'm furious. 

She's currently on the pill and was told by a nurse a few months ago that she's getting more oestrogen on the pill anyway so HRT probably wouldn't work. Again, I'm cross as it's clear the pill isn't the right thing for her as her anxiety is through the roof (which was one of the reasons she went on it).  I've suggested that she should try the same regime as me which is mirena coil and the gel. It's made a big difference to me.  I guess she'd need to come off the pill first - but not sure how long she'd need to wait until she'd be able to try HRT.  Has anyone else been in that position?

Anyway, thought I'd share and see if any of you wonderful, educated women have any advice I can give her.  Apparently a female GP is going to call her tomorrow so I'd love to get some tips as to what she could say - or examples of anyone in her position who is now on HRT so she can share that story and hopefully get not he case with it.  It beggars belief that the menopause will affect 50 percent of the population and yet so many doctors know nothing about it.  My friend, who described feeling really low, stressed and anxious once a month (er, hormones right?) and is 45 has just been put on antidepressants and wasn't asked once about anything relating to menopause.

Rant over... really really hoping someone can share some experiences that might help her out..
Thank you !

[Jeps]

Thank you for the reply, I'll pass that on to her about the NICE guidelines.  I asked my doc about the pill v hrt and she agreed with what you just said about it obviously not being the right thing for her.
I'm so surprised that so many GPs are not aware of the symptoms.
Thanks once again
Jx

[CLKD]

GP obviously knows nowt about peri-menopause then 

Ask for a referral to a menopause clinic, not a gynaecologist which is probably where she will be sent.  Gyanes don't know much more than GPs!

[Mogster71]

I hope the female GP is a little more sympathetic (and clued up). Thanks to you lovelies and this forum I can go in to see mine with the right info

I do understand that anxiety and depression will be present irrespective of hormonal issues but it's a bit mad that her age wasn't even picked up on. I am nearly 48 and my (male) GP gave me HRT straight off the bat, then when I went back afterwards to ask about a different regime with the female doctor, the subject of stress came up and I was offered anti-anxiety meds rather than repeating HRT.

it's a bit of a lottery with GPs. I hope your sister can get something to suit her and the GP is good on the phone. x

[Hurdity]

Hi Jeps

Do you know what type of Pill your sister is on? If it is the CCP then theoretically this will be suppressing her cycle, preventing ovulation so she shouldn't get menopausal symptoms.  However if she is taking it convetionally with 3 weeks on anD a pill-free week - she could be getting terrible pms symptoms!  (Some docs I gather recommend back to back pill dosing to avoid this problem). In fact the pill is often recommended by gynaes in younger peri-menopausal women for this very reason, because HRT does not suppress the cycle so some mood swings can still occur - depending where you are in menopause and the dose/type of HRT.

I would suggest if she wants to remain on an even keel she thinks about trying one of the newer CCP types which contain estradiol - the same oestrogen as in HRT (as opposed to the stronger synthetic ones of conventional CCP). There are two called QLAIRA and ZOELY. Qlaira I think only has two tablet free days and has variable doses of oestrogen to mimic the natural cycle. Progesterone is taken on 22 days if I recall correctly. ZOELY has the same dose of prog and oestrogen throughout but 4 tablet free days (again if I recall correctly).

What is it with these doctors and their anti-depressants. "Go away and take this magic pill and all will be well!" 

Hurdity x

[Jari]

My GP said to me that hrt is good for flushes/sweats but not for moods etc. Not sure if this is correct? X

[Hurdity]

Hi Jari - that is too simplistic a reply from your doc and not universally true! If you are peri-menopausal then HRT may not necessarily control the extremes of mood swings although by giving a basic level of oestrogen will prevent oestrogen levels from falling to rock bottom at the end of each cycle. Many women are indeed helped though HRT given at this point. Low oestrogen is one of the causes of low mood. When you are post-menopausal and no longer have a cycle then provided you are OK with the progestogen component of HRT it will keep both hormones on an even keel as they are constant  so any mood swings will not be hormonal.  Even on cyclical HRT in late peri or post-meno the chnages in progesterone (ie increase and then withdrawal) is not as extreme as the changes which occur during peri-menopause when hormones fluctuate wildly. In any case NICE Guidelines say that ADs should not be given for anxiety/low mood conected with menopause, but HRT instead - and the Guidelines are evidence based.

It all depends on your own individual circumstances how you will react...

Hurdity x

[Jari]

Thanks for the info Hurdity!

I guess it's all about trial and error in getting the balance and doses correct throughout the changes.

X