July 29 2021
By Dr Radhika Vohra - NHS & Private General Practitioner in Surrey, Educator & Medical Trustee to The Menopause Charity
Thankfully, everyone is talking about menopause! If you know you are suffering with symptoms such as hot flushes, sweats, brain fog, tiredness or anxiety, you may be wondering where to start when trying to get some help. Many women suffer for years with perimenopause and believe they just have to put up with the 40-odd symptoms of menopause. NO, NO, NO!
Please don’t wait until you are desperate and at breaking point as it usually makes the process more frustrating. I work as an NHS and Private GP, so I very much understand the challenges GP surgeries are facing and the struggles that patients are having. So, I’m going to share some advice and tips that will allow you to get the most from your consultation with your health professional.
Who to speak to?
It’s not essential that you always speak to a GP about perimenopause or menopause. GP surgeries are changing, so practice teams are made up of multiple health professionals including: nurses, paramedic practitioners, nurse practitioners and junior doctors.
Non-GPs are dealing with all sorts of problems, so it’s important to try and speak to the right person… I hear you sigh in exasperation… please wait! There are lots of ways to find this right person:
- have a look at the practice website – does anyone have a special interest in women’s health?
- look at the practice social media and pop a query there if you feel comfortable
- most practices are offering e-consults (usually called Footfall), where you can fill out an online query form in detail and this is passed onto the appropriate health professional – this will save you and the reception A LOT of time
- speak to the receptionist – it’s a good idea to avoid the busy times such as morning and early afternoon
- consider seeing a doctor who is training; most training practices will have GP trainees. This will be a qualified doctor who is on a 3-year training programme to become a GP. Menopause education is a HOT TOPIC so quite often they will be interested in learning more through patients and will have longer appointment times.
Making an appointment?
So now that you know who to see, bear these tips in mind when making an appointment:
- try to get a ROUTINE appointment rather than urgent, either on-line or by phone.
- try to book a double appointment as this will give the health professional more time to spend with you.
- be prepared to try a few times as most surgeries release staggered appointments every few weeks to cope with demand.
- do your research before making a private appointment with a menopause specialist. Taking a look at testimonials, motivations and professional credentials will be reassuring for you and will often work out better in the long run.
Homework before an appointment?
If you have not already done so, download the FREE Balance App (balance-app.com). It will provide you with a symptom tracker, information and group chats that provide immense support. You can download the Health Report from the app which will be a summary of your symptoms and also your periods (if relevant). Many women find this alone is hugely empowering and gives them control.
Preparation in the run-up to your appointment is ESSENTIAL. No one will know your history or health like you.
- Periods: What are your periods doing? Have you missed any? Are they getting longer or shorter? Do you regularly feel unwell at certain days of the month?
- Contraception: What contraception are you currently using? Is it making you feel worse? For example, many women on the progesterone-only pill find that vaginal dryness or mood maybe worse.
- Past medical history: Have you had any fertility care? What hormones have you had in the past either as treatment or contraception?
- Family history: What is your family history? If you don’t know, ask! It is important as it clears up the unknown. Pay particular attention to any history of heart disease, clots, breast cancer, ovarian cancer or dementia. If you have anyone with a family history of breast cancer, find out three things: the age they were diagnosed, type of breast cancer and their oestrogen receptor status (they can find all of this at the top of a hospital letter, usually in bold)
Look at your lifestyle?
Your lifestyle has an impact on your entire health – from your mind to your body! Take this opportunity to have a CLEAN UP!
- do you smoke?
- do you drink above the recommended amount of 14 units/week (1.5 bottles of wine)?
- do you exercise regularly?
- how much caffeine per day? Decaffeinated and green tea still contain caffeine!
Going to the appointment?
Go in calmly and, if you have done all the above, you should be brilliantly prepared and the time should be used to focus on YOUR NEEDS. It is not supposed to be a battle but a shared conversation of risk and benefits for your health. For example, if you don’t exercise, drink 3+ coffees and 7 units of alcohol a day, then expect lifestyle changes to be a crucial part of your consultation. However, if you’ve learnt all of this from the Balance App and made changes beforehand, the conversation should be much more comfortably focused on treatment options, including hormone replacement therapy (HRT).
Being self-aware about your own health and lifestyle is CRUCIAL and if you make healthy lifestyle changes, they will benefit you in all areas.
If you start HRT, don’t forget/be forgotten – make sure you follow up?
Once you start to take HRT, it is important to:
- not miss doses – ensure you have plenty prescribed and ask for a 3-month supply
- keep a bleeding or side-effect log
- stick with it! It usually takes around 3 months to get a good idea of how it suits you.
- have a REVIEW at 3-6 months.
Menopause and perimenopause are the consequences of HORMONE DEFICIENCY. We have plenty of evidence that replacing the hormones using body identical HRT (available on the NHS) is SAFE and BENEFITS most women. I hope this information helps you to find and consult the best health professional for you.