One of the most common questions that crops up in my Facebook group is about how to get the right menopause support from your GP. Now there are some amazing GPs who really take the time to understand the impact of menopause and the role they play in supporting women. Unfortunately this is not always the case. GPs do an amazing job that can be incredibly challenging and many have very little education around menopause. We need to feel empowered to ensure we get the best support possible from our GPs.
Sometimes you can feel misunderstood by your GP, brushed off or that the treatment you’re being recommended doesn’t feel right to you. You don’t need to just put up and keep struggling when it comes to your symptoms. I want to share with you key things to help make it easier to prepare for your appointments and get the help you deserve. This includes:
- Don’t wait
- Read the guidelines
- Prepare notes and questions
- Take a friend for support
- Ask for a longer appointment time
- Be aware of the treatment options that may be available to you
Appointments are often rushed so if you go in unprepared you might forget some of the things you wanted to say and questions you wanted to ask. It’s also worth remembering that your own GP may not be familiar with the most up-to-date information on menopause. Unfortunately the knowledge can vary from GP to GP – some are incredibly knowledgeable but this is because they’ve take an specific interest in educating themselves.
You have a right to ask as many questions as you like and not just accept what you are told as a fact. In examples where a GP provides amazing support for their patient, it makes such a huge difference on their life and the patient outcomes.
As an example: I had a woman aged 49 saying her GP told her “Your blood results aren’t bad enough for HRT”. Now there are several things wrong with this statement.
- The NICE guidelines on the menopause created for GPs state blood tests shouldn’t be used to diagnose menopause if a woman is over 45 and presenting with symptoms.
- Blood test results should not be used to decide if HRT is the right course of treatment for a woman.
So what should your GP do?
Preparing to get menopause support from your GP
- Be clear on your personal symptoms and how things have changed for you. You know your body the best and you know “your” normal.
- Use a symptoms tracker so you can provide specific information – this can be as simple as a notebook or you can download my free tracker “What’s My Body Trying to Tell Me?” which you can use as a summary to help with your next GP visit.
- Do your own research! Take a look at the NICE guidelines – https://www.nice.org.uk/guidance/ng23
- If you feel you may struggle to get your point across or take on information, take a friend or family member with you, it can be great to have support
- List any questions you have about treatment, symptoms – it can be easy to forget things once you’re with the doctor
- Give your doctor time to find out if they don’t know – GPs aren’t given a lot of training on menopause as standard so this may not be their area of expertise.
- You can ask for a longer appointment – many GPs actually appreciate this as they can take time to understand your symptoms. Deciding on the right course of action for your menopause is very difficult in a 10 minute appointment
What Should Your Doctor know?
- The average age for reaching menopause is 51 but for many women peri-menopause symptoms often start in their 40’s
- Your doctor should have read and applied the NICE guidelines on Menopause.
- Surgical menopause affects women who have been through a hysterectomy and it is recommended these women receive HRT (when appropriate) to protect their long-term health
- Premature menopause affects 1 in 100 women under the age of 40, 1 in 1,000 women under thirty and 1 in 10,000 under twenty. It is very important that women in premature menopause are counselled about the importance of hormone replacement therapy (where appropriate) to protect their long term health.
- Symptoms are not just hot flushes and changing periods. As we know many women experience mental and emotional symptoms before physical symptoms start
- Additional physical symptoms on top of hot flushes and period changes include palpitations, feeling tired or lacking energy, feeling dizzy or faint, headaches, joint pain, itchy skin, hair loss, vaginal dryness, increased urinary tract infections and loss of libido.
- HRT is the first line of treatment for menopause symptoms. The NICE guidelines state “Do not routinely offer selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs) or clonidine as first-line treatment for vasomotor symptoms alone.” Too many women are diagnosed with depression and treated with anti-depressants when menopause should be considered
- Women who still have their womb must be prescribed oestrogen and progesterone to protect the womb lining.
Have questions ready when speaking to your GP
These are taken from the NICE guidelines for patients and making a note of a couple of questions most relevant to you should help you have a constructive conversation on your treatment:
- What types of treatment are suitable for my symptoms?
- What are the benefits and risks of different treatments?
- Are there any complementary therapies that could help?
- I use complementary therapies for my symptoms – are these safe to take alongside other treatments?
- If I already take an antidepressant, will that affect any treatments I can try for mood changes during menopause?
- Can you tell me why you are recommending hormone replacement therapy (HRT)?
- If I don’t want to take HRT, or can’t for medical reasons, what other treatments are there?
- What type of HRT is suitable for me?
- How quickly will HRT improve my symptoms?
- Can I still become pregnant on HRT?
- How and when do we decide I should stop taking HRT?
- Might I have problems when I stop taking HRT?
- Are there any serious side effects from HRT?
- Are there any long-term effects of taking HRT?
The most important thing is that you get the right support and you don’t suffer in silence. If you feel you are not being heard, you can ask for a second opinion. As well as the NICE guidelines, Women’s Health Concern (the patient arm of the British Menopause Society) is another great place to find up-to-date information https://www.womens-health-concern.org/help-and-advice/factsheets/
Where to get more help …
If you’ve got any questions please come and ask it in our Facebook group or join one of my weekly Q&A’s.