Menopause Month: Dr Zoe Williams answers another question from a reader on menopause in week two of our series during October’s Menopause Awareness Month.
For many of us, menopause and its many symptoms appears to have snuck up on us and despite the fact that one half of humanity, that is, most woman will likely experience it at some stage, we can’t help but wonder why it is so difficult to easily find the right support on how to manage symptoms.
Doing their bit to raise awareness is Issviva, a digital hub that seeks to build a better menopause experience for women everywhere. Melan Magazine has partnered with Issviva and their medical ambassador, Dr Zoe Williams, in a weekly series during October’s Menopause Awareness Month to answer readers’ burning menopause-themed questions.
I went to see my GP a little while ago because I was having irregular periods and feeling a little down with low mood. My GP suggested I might be peri-menopausal, but he offered me anti-depressants instead of testing my hormones. I refused them at the time, but could they help if I am menopausal?
Dr Zoe: So, let’s break up this question. The main symptom here that seems to be bothering you is low mood and we’ve established that you also still have a period. So that means you could be peri-menopausal, and the low mood could be associated with that. Of course, it’s also possible that your low mood isn’t related to the menopause at all. There are many, many different causes of low mood from menopause to mental health conditions like depression, and we should also consider other biological factors like iron deficiency, your thyroid gland might not be functioning properly etc.
“Medicine is never as clear and simple as it requires a bit of investigative work.”
The NICE guidelines don’t recommend that we use a blood test to diagnose perimenopause or menopause. Usually, the reason is that during perimenopause the blood test may come back as normal because it looks for a particular hormone called PFS. If your PFS levels are above 30, that suggests you might be menopausal. But if you’re perimenopausal, it’s quite normal for your PFS levels to fluctuate and you might catch it at a time when it’s normal.
So, if somebody presents themselves to a GP with symptoms that are suggestive of perimenopause, the most effective treatment is going to be HRT.
My suggestion would be to try HRT for three months and if your symptoms improve, then great. However, if HRT doesn’t make a difference, it might be a case of going back to the drawing board and actually digging down a bit deeper. The cause of this mood dip could be clinical depression so I would suggest trying an antidepressant for a few months. Again, if it doesn’t work, you can eliminate it. Medicine is never as clear and simple as it requires a bit of investigative work.