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[Suki2]

Hello

Visited before but first time commenting...sorry for this long rant!

Believe started peri 6-8 years ago.
First experienced joint pain, brain fog, fatigue, sleep issues, anxiety increase.

Then followed hair shedding (twice).

Then random blood pressure drops, hearing more sensitive, bouts of dizziness - one occasion couldn't get out of bed for 12 hours so nauseated. Globus, random reflux. Suspected hiatus hernia.

From this January more spectacular results:

Shoulder pain, facial neuralgia, lumbar pain/tightness, silent reflux, skin crepeing at an alarming rate. Feel quite weak physically. Constipation.

Changed GP in January.

 Dentist referred to Oral Maxillo, suspected TN.

Shoulder pain resulted in frozen shoulder. Managed to see Consultant who was furious with NHS for letting my shoulder get this point. (He will be operating on it soon!)

GP put me on Estradiol 25mg and 200mg Utrogestan (taken over 12 days per month) in April 2023. GP queried why my previous doctor not tested me for PCOS (i have suffered with acne for 35 years now). Doctor not happy. Referred me for ultrasound which was rebuffed by Hospital stating "as this lady in Perimenopause we cannot scan"!
Where now?

I have been on HRT for 5 months now. Dont feel any different. Getting to end of tether with it all.

Ps. Previously tested for Testosterone level twice. Both were 0.1. Barely neglible!

Next steps? I just dont know. I know HRT not always the panacea but Im so depressed about it all. I do feel a lot of these health issues related to Peri but what to do?   

Thanksall.

[CLKD]

Morning.

U mention that the Surgeon blames the NHS - so what's he/she going to do about that, considering that many are on strike again  .  However, what does peri/menopause have to do with not doing an ultrasound?   Wonder what NICE guidelines might be and what was the GPs reaction?  Did he/she recommend physio for example?

Welcome.  Browse round, make notes.

How R your periods behaving?  It mayB that the HRT isn't the correct 1 to ease symptoms 4 U, or your dose may require a hike.  Some do require testosterone in the mix, it's not long been recognised that this hormone is important to both men and women.

HRT can help a lot, it's not a cure by a 'replacement' for the hormones we are losing.  It shouldn't be such a battle to be heard !

Let us know how you get on.  Hopefully some1 will be along with knowledge of your current regime.

[sheila99]

I would start by increasing oestrogen. 25 is a low dose, I started on 50 in peri and am now on 100. Have you seen any improvement at all? Do you have symptoms of low libido?

[Suki2]

My GP was good in that he requested an MRI of my neck to rule anything out there - that was fine.
My consultant told me that he says countless cases every week with preventable frozen shoulder. He stated he keeps begging the NHS to alter the way they refer but has not seen it implemented yet.  The day I saw him I was the fifth NHS patient with such a problem. I was referred to Physio by GP but within two months of doing exercises it became frozen.  My consultant stated that had I received an injection earlier the frozen shoulder could have been avoided.  I keep hearing frozen shoulder is common amongst peri/menopausal women - hey ho!  BTW: high praise for the NHS - they do a sterling job but I’ve got to the point now when I am fed up feeling so ill.

I have not spoken to my GP re rejection of Ultrasound referral - but have today emailed NICE to see what their guidelines are.  My GP was quite furious and wondered why no GP had previously referred me over the last 35 years!

No improvement with any of my symptoms whatsoever with 25mg of Oestrogen.  No libido either!
You would think a reading of 0.1% for Testosterone on two occasions would motivate - but no!

Up until this month almost regular monthly periods but very heavy for first two days now.

I’m thinking of seeing a specialist but I’m guessing none of them are available via the Choose and Book scheme via the NHS?  I have also speculated whether I should in fact see an Endocrinolgist (either/or).  My family have a history of under active thyroid (I was tested for this and told it it was “normal”).

PS.  Any tips on constipation - my lower back is killing me!

[CLKD]

Frozen shoulder is indeed, as is hiatus hernia, common as oestrogen levels drop.

GPs are reluctant to refer patients with ' normal thyroid function ' results, even when they continue to complain of symptoms!  So an endocrinologist might be 1 way to go to get that checked out and treated if necessary.

Let us know how you get on.

[Suki2]

Thank you CKLD and Sheila99 for your help!  Will keep you posted.
Booked an HRT review for next Monday!

On the hunt for an Endocrinologist!

PS. Can Menopause specialists be seen via the Choose and Book NHS arrangement?

Thanks again! 

[CLKD]

It's worth a try - accessing any menopause specaislits: not a gynae: sometimes GPs seem reluctant to refer for any speciality  . Let us know how you get on.

Your GP should be able to refer U to an endocrinologist too. 

[sheila99]

You can get a referral to an NHS menopause clinic though the wait in my area is a year. The nhs don't do a comprehensive thyroid test. Can't remember what it is they don't test (a search should tell you) but I got one done by medichecks that showed I have Hashimoto's, something the nhs test didn't uncover. It also showed I was deficient in vit d in summer even though I spend a fair amount of time outside.
 If you're not on testosterone I think the blood test is a bit useless as levels in women are so low it barely registers. They usually prescribe based on symptoms but it'sbest to sort out your oestrogen levels first. If you haven't been tested for other causes of fatigue it's worth doing. To me your symptoms sound like oestrogen deficiency but there may well be other factors too. I'd have expected at least a little improvement even on a low dose.