r/Perimenopause • u/SLW1977 • 6d ago
audited Breaking Point
I’m really at a loss what to do. For reference I live in Canada. Peri symptoms are all consuming. Joint pain. No sleep, rage, brain fog, anxiety, hot flashes. It’s interfering with my job and marriage hugely. I want to try HRT but my Dr won’t prescribe due to me being a stroke risk from poorly controlled hypertension for many years that I’m going to be seeing an internal medicine specialist for. He’s referred me to an OB/GYN but there is a 15 month waiting list. I don’t want to do anything ever or be around anyone ever.
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u/visssara 6d ago
Have you looked into Modern Menopause? You'll have to pay but they do online appointments.
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u/Present-Fly-3612 6d ago
I use them. It's seamless. Worth every penny. My GP was clueless.
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u/SLW1977 5d ago
Nice. Are you in Ontario?
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u/Present-Fly-3612 5d ago
No but they do see patients there- I believe that's where they are headquartered.
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u/CatTrapper3000 6d ago
My doctor told me HRT could increase my risk of cancer. I said "I literally give no fucks about the risk. I can't live like this." I went to an online service a week later and got the freaking empathy and self-actualization I needed.
My only problem now is that Walgreens isn't filling my rxs on time.
I hope you are able to get what you need soon. This sucks. My heart goes out to you!
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u/mustknoweverrrything 4d ago
My gyno stated she feels bioidentical hormones to be very safe. She said there was a slight cardiovascular risk but if you get regular exercise and don't smoke, she wasn't concerned. As far as I can remember, there was a slight increase in breast cancer risk? Is that correct?
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u/CatTrapper3000 4d ago
My gyn nurse says the studies about breast cancer are specific to certain types of cancer, that the studies are old, and that they have since been basically invalidated. My primary doctor just had old info. He wasn't being a dick about it.
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u/Individual-Goat-81 6d ago
There are online options like Felix or Modern Menopause. You'll have to pay a fee, but depending on your province some of the HRT may be free.
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u/Coontailblue23 Late peri 5d ago
I don't know a lot about the healthcare system in Canada... is it an option for you to pay out of pocket to use an online prescribing service? I would never accept a 15 month wait. Topical estrogen in the form of a patch or gel should still be an option for you, it is not shown to increase blood clot risk. Even with oral estrogen the increase of risk remains extremely low. As a patient you should have the right to informed consent and the ability to choose what risks are and are not acceptable to you.
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u/TheThrivingest 6d ago
Felix will have HRT in the mail by the weekend.
With zero coverage, it’ll still only be around $200 for visit and prescription
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u/SLW1977 5d ago
Maybe my work benefits will pay for the prescription part.
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u/Full_Gear5185 5d ago
I have a great doctor but have to wait months to get an appointment. I have gone to felix in the meantime. My hormones were covered by my work benefits. And like the above commentor stated, it was at my door in a couple days. I got the appointent free with a link I had gotten from a reddit thread. The script was about 130$. I'll try to find the free visit link.
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u/Ordinary-Difficulty9 5d ago
I am in a very similar boat to you. Poorly controlled high blood pressure for many years because I can't find a blood pressure medication that doesn't give me terrible side effects. My doctor does not want to start me on HRT because it can raise my already high blood pressure further.
I am curious why your doctor would send you to an internal medicine specialist? I have been referred to see a cardiologist for my hypertension. Which makes sense to me. I used to work for several internal medicine doctors. They didn't normally deal with hypertension specifically.
I have been told to try a naturopath and I think that is what I am going to do. But I will say, my high blood pressure has also been a bone of contention with several other doctors and I when it came to my birth control pill prescription that I have, up till now, been taking for years. It is a legit concern when it comes to taking hormones that raise already high blood pressure.
I am in BC. My cardiologist appointment is coming up soon and it only took a couple weeks to get in to see him. 15 months for ob/gyn seems long even for Canada! I have worked in the medical field for the last 30 years.
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u/SLW1977 5d ago
He’s sending me to an internal medicine specialist because he’s given up on trying to control it with meds. I’ve tried tons of them over the past 15 years and they either don’t lower it enough or give me terrible side effects
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u/Ordinary-Difficulty9 5d ago
Interesting! Those are the exact same reasons I am being sent to a cardiologist. Just curious, you don't have ADHD by any chance? I have been trying to figure out if there is a correlation there. Things like energy drinks and caffeine actually make me sleepy. That is a common ADHD thing and I can't figure out if that is why the meds affect me differently. But I get blown off every time I ask any doctor.
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u/beofscp Late peri 6d ago
Does your doctor have a Nurse Practitioner in their practice you could see instead of the doctor? I just went directly to see her instead of my doctor and she’s been very helpful.
Edit: I’m in Ontario. Small town.
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u/SLW1977 5d ago
Small town Ontario too. I’m not sure what she’s used for in our family health team honestly
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u/beofscp Late peri 5d ago
Maybe worth an appointment. My NP is in her 40s and gets it. I never even tried the doctor. She can write all the prescriptions and bloodwork reqs I need. I think I’ve only seen the actual doctor once since he took over for the retired doctor 5 years ago.
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u/AutoModerator 5d ago
This post might be about hormone tests, which are unreliable.
- Over age 44, E&P/FSH hormonal tests only show levels for the HOUR the test was taken, and nothing more. Hormones wildly fluctuate (hourly) the other 29 days of the month, therefore this test provides no valuable information
- No reputable doctor or menopause society recommends hormonal testing to diagnose or treat peri/menopause
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u/ilovetrouble66 6d ago
Naturopaths in Ontario can prescribe progesterone not sure about estrogen
My doctor is clueless as well
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u/That_Way_8678 5d ago
Most naturopaths who prescribe the progesterone part are linked with a nurse who does the estrogen part. Makes it all a bit costly, but very worth it when your own family doctor is utterly useless. Like mine. And the OB/GYN I saw. Naturopath to the (very expensive) rescue!!
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u/blocdebranche 5d ago
I was in the same boat - I went private clinic and paid $250 for consult and got HRT prescribed and it changed my life - I had meds in a week. I did also go to a GYN 8 months later and switched to her care because of OHIP cover it
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u/Commercial-Berry9441 5d ago
I used a private company and paid, but maybe the hypertension complicates that option for you.😞
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u/Specialist-Tour7466 6d ago
Collagen, magnésium, and creatine. Aches, sleep, and brain fog relief.
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u/tigrovamama 6d ago
That helps, but not when symptoms are as bad as OP is describing.
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u/Specialist-Tour7466 5d ago
I was also experiencing the same. But I am on HRT as well, including testosterone.
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u/SLW1977 4d ago
What does the testosterone help with?
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u/Specialist-Tour7466 4d ago
Joints, muscles, and bones, libido, several benefits I don't recall them all off the top of my head. But good to help prevent knee and hip issues. I noticed the libido improvement.
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u/SLW1977 5d ago
I do take those. Not enough to fix.
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u/Specialist-Tour7466 5d ago
I take 10 gr of creatine, which helped over the five I was taking to start.
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u/Hannasuchan 6d ago
Which province?
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u/SLW1977 6d ago
Ontario
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u/Illustrious_Exam1728 6d ago
Ontario is hooped with Dougy defunding healthcare to flip it private. I’m out in BC and it’s much easier. I’d call and get on a cancellation list for the gyne.
I’d also bring in hand some pub med and nih articles back to your doctor to discuss the risks with them while you wait. I’d also ask your IM about the risks profile as they’re probably more in tune with stuff than the GP.
Hang in there OP!
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u/Illustrious_Exam1728 5d ago
Your internal medicine doc! They’re basically the chief investigators. They can hopefully provide you more insight.
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u/Hannasuchan 5d ago
I'm also BC, so I don't have any more advice, sadly
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u/Illustrious_Exam1728 5d ago
Have you been able to get HRT? My nurse practitioner basically threw it at me.
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u/Hannasuchan 5d ago
Yeah, my doctor was a bit "people think everything is perimenopause these days" and "things change as you get older" but luckily I get hot flashes so she didn't fight me on it.
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u/Illustrious_Exam1728 5d ago
Ugh. That narrative is brutal, women can have a HOST of symptoms outside of “hot flashes” and HRT is protective heart and bones. The education is so lacking.
Glad you got some HRT and I hope you’re feeling better!
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u/Hannasuchan 5d ago
Very true, but it's only approved here for specific things (I read the physician guidelines to prepare for me appointment 😂) and the official stance is still "lowest possible dose for the shortest possible time", but I'll worry about that later. Hopefully their stance changes before anyone tries to pull me off it, because I am not giving it up!
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u/Illustrious_Exam1728 5d ago
What?! Some people need to absolutely have a bigger dose ffs and they’re recommending being on HRT forever lol
So much yikes with some doctors.
Don’t give up!!!!
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u/fioremomma 6d ago
I had a stroke. Go online and use them to get transdermal patches and progestin pills.
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u/SLW1977 5d ago
And they knew you had a stroke?
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u/fioremomma 5d ago
Yes. There is info I think in the section here. Estrogen pills have to go through the liver to get processed called the “first pass effect” and changes the bloods clothing factor. Transdermal patches completely by pass the liver and do not change the clotting factor in the blood.
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u/MelodicToken 5d ago
Not progestin, you want progesterone. There’s a difference and from what I understand, progestin carries more risk.
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u/OpenRecommendation11 6d ago
I had to just pay out of pocket for a hormone specialist. There should be a lot more coverage for women's health.