'I'm 43 and a doctor diagnosed me as being in 'early menopause'. He was wrong.'

I had a doctor’s appointment last month and was diagnosed as postmenopausal, which, considering I’ve just turned 44, would put me in the Early Menopause category experienced by five per cent of women. 

I have been ticking off perimenopausal symptoms for a year or so now, and my periods have been absent for months, but I was still shocked. Postmenopausal? That didn’t sound quite right.  

When I managed to find my words again, I asked about HRT. He said I wouldn't need hormone replacement therapy because menopause is "a natural process". 

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I needed a second opinion and arranged a Zoom call with Dr. Linda Dear, a registered Menopause Practitioner who also runs the website MenoDoc. 

How do you know it’s menopause?

“Menopause is when you haven’t had your period for one year or longer. You then have to track back to the date of that last period and this is your Menopause moment - everything that happens after this date is then called Post-Menopause” – MenoDoc website. 

I discovered “postmenopausal” is a slightly premature call for me. It’s certainly likely I’m experiencing an early menopause, but officially your periods need to have stopped for an entire year to be considered postmenopausal. Only then can you say you’ve definitely gone through the menopause transition. 

I’m on day 233 with no periods. It’s likely, but not official just yet. 

The average age for menopause is 51, but any time between 45 and around 55 is considered normal.

“Menopause under 40 is POI (Premature ovarian insufficiency), compared to menopause 40-45 which is a grey zone really,” explains Dr Linda Dear.  

“It’s often not recognised by women or by doctors. Because that’s often a period of your life where there can be so many other things going on. It’s usually quite stressful,” she says. “The vague symptoms can lead people astray, including doctors.”  

To make it more difficult, the symptoms seem less classic in early menopause. You might not get the typical hot flushes or night sweats. It could just be trouble concentrating, brain fog, or mood changes. 

“It’s more likely to be misdiagnosed, or just missed,” says Linda.     

What do the blood tests mean?

I was given a couple of hormone-related blood tests for FSH levels and I asked Dr Linda to explain how tests like these are helpful and what they indicate. 

For a start, she wanted women to know, perimenopause – the stage before menopause – can’t be diagnosed with a test. 

“There is no test for perimenopause at any age,” says Linda. “It’s a snapshot in perimenopause. It doesn’t tell you anything.” Hormones fluctuate too much during perimenopause for tests to be useful.

Blood tests for hormone levels, such as FSH, can be helpful for confirming early menopause in women under 45 and in women whose periods are absent because of the type of contraceptive they’re on. You would need at least two high FSH levels a few months apart. Even then it isn’t straightforward.  

A very high FSH, such as 100, is quite a clear indicator of menopause, but levels around 30-50 are more vague.  

“They’re very rarely that dramatic. It’s only simple when it’s really extreme,” says Linda. “A lot of the numbers we deal with as doctors are like that. There’s this big grey zone.”

If you’re over 45, you don’t need a blood test to show you’re in menopause. Symptoms are usually enough. “The body does tell us, just not with numbers,” says Linda. “It’s holistically telling us with symptoms. That’s how the body talks to us mostly.” 

“We get taught at med school, treat the person not the numbers,” explains Linda. “That’s true with everything including in menopause, but because doctors are busy and stressed and we don’t know everything, we’d love things to be simple sometimes too. But it’s not that simple,” she says.  

What about HRT?

Many doctors, and women, are still reluctant to use Menopause Hormonal therapy (MHT), or Hormone Replacement Therapy (HRT) as it’s also called. The research linking HRT with “breast cancer risk” that came out in 2002 scared people, but it was a flawed study. 

New studies have shown the risk for breast cancer is actually lower with HRT than from obesity or drinking a couple of glasses of wine a day, and has the same risk as being on the combined hormonal contraceptive pill. 

Menopause specialists are now not only comfortable recommending HRT, but find it life changing for many women. 

Dr Linda Dear says an HRT trial can be really helpful in ruling out hormone-related symptoms, for example, if you’re experiencing memory loss and are worried something is happening in your brain. 

“If you try HRT for your symptoms it isn’t going to fix anything else [that isn’t hormone related]. So it kind of proves you haven’t got dementia because HRT can’t fix dementia or a brain tumour,” she explains. “Sometimes while you’re waiting for a specialist you can do an HRT trial and see if you feel better.”  

How can you prepare for your doctor’s visit?

You can’t always rely on your GP to know much about perimenopause or menopause, which is why it’s important to be informed and well prepared. 

“We don’t get taught enough at med school [about menopause],” says Linda. “Because it’s not a disease and we’re so busy and overwhelmed with diseases and I understand that.” 

Linda knows it can be hard to access menopause care, which is why she went into private practice specifically as a Menopause Practitioner, on top of her regular GP work, to help fill the gap. “This does need love and attention from doctors as well,” she says. 

Listen to No Filter, On this episode, Mia turns the mic on herself to talk openly about her experience with perimenopause. Post continues below.

So how can you prepare? 

• Track your periods for six months if you can. 

“Tracking periods is useful even though it’s not a requirement to have any change in your periods whatsoever (in perimenopause). You can be in the throws of perimenopause and your periods are still coming like clockwork,” says Linda. 

• Fill in a symptom questionnaire, like the one on Linda’s website, and print it off to bring or write down your symptoms. 

• Book a double appointment if you can.  

• Be informed. “Read something that’s not nonsense,” says Linda. “Arm yourself with some good knowledge.” 

• Pick someone interested in women’s health, preferably interested menopause. You can always consider doing a virtual appointment with a menopause doctor.  

“I probably do more virtual appointments than in-person ones. It does lend itself to virtual as most of what we do is talk to each other,” says Linda. “The vast majority of what we need to do is with our ears with menopause as doctors.”

Dr Linda Dear is conducting a large menopause survey which you can be a part of. Take part in it here. 

We've brought in the best peri-experts in the world for the Very Peri audio series to share the most up-to-date advice and info. Everything you need to know to face perimenopause with confidence. Listen now. 

 Feature Image: Getty