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[pawpawpawpaw]

Hi all.

I'm 52, have had irregular periods for a few years now - first very heavy and long, then quite irregular, most recently I have spotting and bloody discharge almost all the time, so much so that it can be hard to know what the start date of a period is.

In the last two years I've had back and hip pain, and in the last year abdomenal pain, all on the same side. Physio was no help, an MRI showed some arthritis and a slipped disc, an ultrasound of my abdomen showed nothing remarkable. I had some abnormal cells in a smear a number of years ago (maybe 5yrs?) and colposcopy (all fine) but everything since has been normal.

As the pain is ongoing and only partly explained by the slipped disc, I'd quite like to have any potential gynae cause ruled out. My GP is unconcerned and is suggesting a blood test, where I feel like a pelvic exam will at least show if my cervix looks healthy. To be honest, I have little faith in my GP (long boring backstory) and changing to a different surgery is the first thing on my list.

I'm thinking about what my next steps will be. I'm not from the UK and don't really understand how the NHS referral system works, or if anyone can just rock up to any gynaecologist and make an appointment. I feel very alone in this and no idea where to turn next. I'd be grateful for any guidance.

These are some of the things on my mind:
1) Why is my GP insisting on blood tests to determine if I'm perimenopausal?
2) Should I register with a new GP and ask for a referral or can I self-refer to a private gynae?
3) Am I overreacting for asking for a pelvic examination to see if everything looks ok?

Thanks for reading! Hoping to pick up good info on this site, which comes highly recommended. 

[CLKD]

Morning!  Is there a Practice Nurse you could chat with? 

As oestrogen levels drop muscles may become lax = aches and pains.  Do you take pain relief?  Also the body may become dry: inside and out.  Do read our vaginal atrophy and bladder related threads.  Make notes ;-).

Not many blood tests give a true picture unless they are specific as hormone levels rise and fall constantly.  Don't bother with a Gynae., who often know little about menopause.  A referral to a menopause clinic is the way to go, I think you can ring to make an appt. yourself?

Some find keeping a mood food/symptom/diary of use, to discuss at appt.s.   Let us know how you get on.

[pawpawpawpaw]

Thanks for quick replies.

Hi there and welcome to the forum.
No you?re not overreacting at all,you want to get to the bottom of this,gp's tend to go the most obvious route first,this may be slower but it's probably to rule out other things,be persistent is really my only advice,not sure changing your dr will help as dr's will rarely contradict another drs ruling. Your slipped disc can cause a lot of pain, I had one in my neck many years ago and this caused pain in my ribs hand and arm,yours is probably touching on the nerves that lead to your hips and abdomen,also if you've inflammation from the womb this can also cause it's own issues. I do hope you find some relief,let us know how you get on

I agree the disc can be the cause of the pain, but they can't tell me that it is the cause if you see what I mean, and there's the issue of the constant bloody discharge. There is some smell but I'm not really sure how normal that is, I mean body odours change with hormones don't they? I just want anything more sinister excluded.

Without going into the whole story, I don't have a good relationship with my GP and the surgery has a very poor reputation locally so I'd like to move for those reasons, not due to this one health issue. Because I don't trust them it's very hard to leave my health in their hands.

Morning!  Is there a Practice Nurse you could chat with? 

As oestrogen levels drop muscles may become lax = aches and pains.  Do you take pain relief?  Also the body may become dry: inside and out.  Do read our vaginal atrophy and bladder related threads.  Make notes ;-).

Not many blood tests give a true picture unless they are specific as hormone levels rise and fall constantly.  Don't bother with a Gynae., who often know little about menopause.  A referral to a menopause clinic is the way to go, I think you can ring to make an appt. yourself?

Some find keeping a mood food/symptom/diary of use, to discuss at appt.s.   Let us know how you get on.

Yes, I thought the NICE guidelines said that a blood test was inappropriate at my age - ? They did one last time I enquired about HRT.

I take naproxen when required - it's the only thing that helps - although I recently found an ELDOA stretch which helps a lot with the lumbar pain and has allowed me to sleep through the night for the first time in two years. Trying to avoid the naproxen as I also take iron and thryoid meds and organising it all is such a headache as they have to be separated. 

While perimenopause is a side issue here (ie it could be causing some of my symptoms) I'm mostly concerned about the pain and bleeding/discharge and I was wondering if a gynae appt would be appropriate to address that, to exclude any gynae issues that could be causing pain - ? I agree they're not automatically menopause experts though, I've heard that.

I don't have dryness or bladder issues. Thank heaven for small mercies etc 

Thanks again, I really appreciate having someone to knock this around with!

[CLKD]

OK - get yourself to an Orthopaedic consultant.  'they' will be able to tell you if a 'slipped' disc is causing your problems. 

Or - self refer to a physio.?   When did you last have X-rays of the cervical and lumbar spine? Important to take these with you, B4 starting any treatment. 

Also, as strange as it seems: what type of shoes do you wear ??  .  The number of women I see with bad footwear! who are staggering or struggling!!!  A good quality pair of well fitting shoes is important. 

As is posture.  How do you sit, sleep, seating position in the car ........ get comfy without slouching. [note to self  ]

As for odours, yep, I began a thread OOHHH ERRRR years ago  even though DH says he can't smell any alterations.  I certainly can! 

Thyroid function may go awry as hormones rise and fall, something toB aware of. 

You don't have bladder issues etc..   Yet ;-).  hopefully you won't!

[pawpawpawpaw]

Sorry CLKD, I meant to say I will ask to speak with the practice nurse. Maybe she will help me understand what to do next. I need to find a way to make my interaction with the surgery a less stressful experience, it takes me ages to work up the nerve to get in touch with them.

[pawpawpawpaw]

OK - get yourself to an Orthopaedic consultant.  'they' will be able to tell you if a 'slipped' disc is causing your problems. 

Or - self refer to a physio.?   When did you last have X-rays of the cervical and lumbar spine? Important to take these with you, B4 starting any treatment. 

Also, as strange as it seems: what type of shoes do you wear ??  .  The number of women I see with bad footwear! who are staggering or struggling!!!  A good quality pair of well fitting shoes is important. 

As is posture.  How do you sit, sleep, seating position in the car ........ get comfy without slouching. [note to self  ]

As for odours, yep, I began a thread OOHHH ERRRR years ago  even though DH says he can't smell any alterations.  I certainly can! 

Thyroid function may go awry as hormones rise and fall, something toB aware of. 

You don't have bladder issues etc..   Yet ;-).  hopefully you won't!

I have an appt with an orthopaedic surgeon (phone appt now due to covid), maybe that will shed some light on things. No x-rays, just an MRI in Oct. They have the images so hopefully will be able to tell me more.

Funny you ask about shoes, I developed plantar fasciitis this winter (my theory is that it was caused by my gait changing due to back/side pain) so can only wear Birks and supportive trainers with inserts. Much improved now, as long as I use arch support.

I saw a private physio before my GP referred me, nothing was much use. I admit to having weak glutes  but I do Pilates 2-4 times a week and my core is pretty good. The horse has bolted I fear, but no harm in staying strong, and as I said the ELDOA stretch (L5-S1) is a revelation.

I need to sort out an improvement in seating in my living room. I've got dining chairs which are very supportive and a sofa which isn't but both are too low I fear. It's hard to know if it's the seating causing the back pain or the back pain making it hard to sit comfortably if you see what I mean.

TFT is included in upcoming bloods, so we'll see if there have been any changes there. Last ones in Oct so not so long ago.

The odour thing is hard to gauge if you're bloody every day!

[CLKD]

All excretions smell  and I doubt if your blood loss will be noticeable.

OUCH Plantar fasciitis is PAINFUL due to a spur under the heel at the edge of the bone!  This can be treated with an injection 

Have a list ready for the 'phone call?  I have a back support thingy when I sit on the sofa or travelling in the camper van, or in the back of our small car which really eases back pain.  Time for a new sofa ;-)  

[pawpawpawpaw]

Gait change can cause pf apparently, and I deffo have been walking differently - leaning forward - due to the back/side pain.

I'm not sure what you mean by blood loss not being noticeable - ? What I mean is that I know smelly discharge is an important symptom, but I don't know how to characterise it because there is a smell, but who knows what's normal when your perimenopausal? It seems like all the things I'd normally talk to the doctor about - bleeding between cycles, pain etc - are considered normal in peri - ?

So what I meant was that I'm not sure if this smelly discharge is abnormal or not. It's abnormal for me, but everything is in flux now if you see what I mean.

It's a right pain in the arse too, all my pants are ruined.

[CLKD]

Get some pads?  If this is more than 'light' and continuous, there may be medication to stop it.

If you are outside the UK mayB familiarise us with how your health system works?

[pawpawpawpaw]

I'm concerned that the discharge, along with pain in my side, hip and back, could be cancer symptoms. But they can of course also be a normal part of perimenopause and unrelated to each other. So I want to figure out what to do next so a professional will take account of these (possibly unrelated) symptoms and assess if there is anything else that needs doing. I feel brushed off by my GP.

The inconveniece of bleeding is just inconvenient.

I'm in the UK but not from here. I've thankfully needed few referrals so I don't understand the procedure. Where I'm from I'd just make an appointment with the gynae and they'd do a pelvic exam if you see what I mean.

[pawpawpawpaw]

Just to update, I made a phone appointment with the practice nurse, who never rang but apparently bounced it back to a doctor, who will ring tomorrow. The receptionist told me there's no one in the surgery who has a special interest in women's issues. I feel so worn down by this whole thing, it's really getting to me.

[Foxylady]

hi pawpawpawpaw, welcome to MM! Have a look online & see if there is any groups etc locally for menopause support. GP's & other surgery staff are unfortunately (in my experience) rarely up to date or interested in women's health/menopause specifically. I now have a great GP although no real expertise in meno does consutant with local specialist on my behalf when I see him about any changes in medications etc. It is really important you read up as much as you can on this forum & the website to educate yourself to save a whole load of wasted time/treatments & heartache (unnecessary investigations, trials of medications etc). Keep a diary of your symptoms & you could try some things yourself dependent on your symptoms that might work diet/exercise etc. Hope you find someone you can build a trusting relatinship with who you feel reassured by & at least shows some interest in helping you. x

[pawpawpawpaw]

Thanks for your reply Foxylady.

I feel like I'm pretty on top of things, but it's getting someone to cooperate, as you say someone who shows some interest in helping me, which is the part I'm struggling with. Can you advise on how to find a local support group? I've done a dozen different searches and I mainly find old Meetup groups in the US. There's a local menopause clinic (I'll ask my GP to refer me) but I can't find anything that looks like a support group. This forum comes up again and again.

I talk to my doula friend who's about my age, I'm on another women's forum which has been informative and I've read a recommended book (Your Change, Your Choice). My understanding is that it would be good to try an oestrogen-only patch. I may have a slightly raised risk of bc (my mother and aunt had it, my aunt was under 35) so I believe that excludes meds that include progesterone? Wondering if it's even worth pursuing here in the UK as I understand these are the meds that are currently running short? Or has that resolved? This is obviously just to address the symptoms of perimenopause and not the current medical issues around bleeding, discharge, pain etc.

Since I last posted here my GP referred me for an ultrasound, and an urgent referral was recommended due to vascularity and thickened endometrium. Referral was made and rejected as not urgent, to be put on the general pile 'until Covid resolves' which is a piece-of-string length of time. They haven't bothered to explain why an urgent referral has been downgraded to non-urgent. I'm not worried as such, but I want to understand why one professional considers it urgent and the gynae unit doesn't. I'm very frustrated.