I saw a menopause specialist at 46 and wished I'd done it sooner - here's what happened

I've often heard women refer to menopause as a time they 'just didn't feel right'. But ask them to go into more detail, and many can't seem to pinpoint a reason.

I am no different. In my early 40s, I noticed feeling off, not quite myself, but with no idea why. Nothing in my life had changed. I just didn't feel like myself. The fiery Aries I have always had in me was surfacing more and more regularly, and without much provocation.

At 42, I made a doctor's appointment to discuss feeling this way, and, long story short, was prescribed antidepressants. I didn't question it then. I just wanted something to help ease the sense of confusion I felt. But as time went on, new symptoms arrived, and I started questioning whether I was actually perimenopausal.

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Years went by, and the medication wasn't really helping. I had countless more GP appointments to try (and fail) to explain this. It all led to a huge amount of frustration at what felt like a lack of wanting to acknowledge that my symptoms might be something other than depression.

So I contacted the team at Menopause Care - the UK's leading menopause clinic, founded by Dr Naomi Potter - who invited me in for a consultation with Dr Eloise Elphinstone. After just 45 minutes with her, I felt a sense of validation, relief and hope that I'd been so desperate for up to that point.

Here, I explain exactly what happened during my consultation, the cost involved, and other options available if it is not within budget, and why I wish I had done it sooner.

The appointment

Arriving at the Menopause Care clinic, I was met promptly by Dr Elphinstone, who immediately made me feel at ease with her warm and inviting nature. We went into a consultation room. It was modern, comfortable and relaxed, despite the more clinical elements of the room, which included an examination area. Whether this area is needed is entirely dependent on individual needs. In my case, blood tests and physical exams weren't necessary, but had they been, everything Dr Elphinstone needed was on hand.

The appointment was called a 'new patient consultation'. It lasted approximately 45 minutes and cost £295. During this time, Dr Elphinstone asked me why I had decided to see her. She then just let me talk and listened as I explained the uneasiness of not feeling right, and a level of rage that often felt unwarranted for the situation.

The whole time I was talking, she smiled supportively and nodded along. I knew she understood what I was saying, and so I felt comfortable being open and speaking without any judgment. She knew what I was going through and, more importantly, she empathised.

As we continued, Dr Elphinstone would occasionally ask for more details, including any physical symptoms I was having, but what I really noticed - and appreciated - was the clear importance she placed on my mental wellbeing as a result of perimenopause.

"I don't know if this reassures you, but what you are saying is really common. I think so many people talk about hot flushes, which is definitely a symptom for some, but actually, the emotional side of things, whether that be mood, anxiety, irritability and rage, is a really big part of it. It's probably one of the most common symptoms that people don't talk about."

This response, honestly, where she told me everything I was feeling was real and true – and all part of perimenopause – was a huge relief. She helped me join the dots, validated my feelings and told me to stop blaming myself. That alone would have been worth the time and cost of the appointment, but there's so much more to gain from seeing a specialist.

Understanding what's happening

After a good 30-min chat about my physical and emotional symptoms, Dr Elphinstone was able to reassure me and spend time clearly explaining exactly what happens during menopause. It gave me a newfound understanding of why I had been feeling such confusion and discomfort.

To finally know what was happening in my body, and how that was responsible for a lot of my symptoms, has allowed me to not only worry less, but be so much more patient with and kind to myself.

But why is it so difficult for some women to get this clarity or a diagnosis? Surely this is something a blood test could help with, I asked Dr Elphinstone.

"The guidance is that if you are above 45, it's a clinical diagnosis. So because in perimenopause your hormones fluctuate, you could do bloods when your oestrogen level looks quite good, and they can look completely normal," she explained. "Do it at a different point, and it would look completely different.

"The other point is, when we do blood tests to diagnose menopause, we look at hormones called the FSH and the LH as well as the oestrogen. They are what the pituitary gland in the brain produces to get the ovaries to work. So when you are having normal cycles, the brain doesn't have to work that hard. The ovaries produce the eggs, and the eggs produce the oestrogen. So if you've got lots of eggs, you're producing lots of oestrogen, your brain doesn't have to do anything.

"As you have fewer eggs as you get older, you have less oestrogen, so the brain thinks you need more, and so the FSH and the LH go up, and your body responds initially. It goes 'okay, we need more oestrogen' so the oestrogen goes up. The brain's done its job. Those hormones come back to normal, and if you do a blood test at that point, it all looks normal.

"It's only as later down the line that the FHS and the LH go up, but when there are no eggs there to produce more oestrogen, they can't respond. It just goes up and up and up, so it's only at that point that you might see something on a blood test. And you can have symptoms of that for quite a long time, and the risk of using bloods, and I've seen this a lot, is GP take bloods and everything looks fine, and that's because of that reason."

Tailored treatment & follow-up

The latter half of my consultation discussed the treatment plan I should start. Dr Elphinstone talked through and showed me various options. Once we had decided which treatment to go for, she advised me to monitor how I feel using a journal or symptom-specific app.

Using a diary to log symptoms during this phase can be incredibly helpful for doctors and other medical professionals to get a holistic picture of what is going on. It can also help with medication and treatment that might be needed. The Flo app is a popular choice, and the one I use to log my daily symptoms now.

The prescription you get from a menopause specialist is not available via the NHS. It's a private prescription, so it comes with a higher cost. The medication I was prescribed would have cost £100 to buy privately. However, Dr Elphinstone advised she could send notes to my GP, and they could write the prescription, which would then incur the usual £9.90 NHS prescription fee. This is the option I chose and had no issues. Dr Elphinstone's notes were promptly sent to my GP, and just 48 hours later, my prescription was being sent to my local pharmacy.

For the last three months, I have been taking the medication Dr Elphinstone prescribed. It has been a huge help with some of my most troublesome symptoms. The dosage is something I am in regular discussions with my GP on, but the difference it has made has been remarkable. I also have better conversations with my GP as they have detailed insights into my symptoms and situation.

I chose to do follow-up appointments with my GP due to cost. However, follow-up appointments are available via Menopause Care - usually three months after the initial consultation. The cost of a follow-up is from £225, but within that time, patients are able to email or call in with any problems, side effects or questions.

Additional support

A new patient consultation at Menopause Care costs £295, and 30-min follow-up appointments are from £225. Not every woman can afford private healthcare - and that's a problem. If seeing a specialist is not within budget, or you are unsure about the support you need, the good news is that there are other avenues you can explore.

During my time at Menopause Care, I also caught up with founder Dr Naomi Potter, who very kindly shared some resources. Below is a summary of Dr Potter's advice for anyone needing further menopause-related support:

• Be clear on what you want when going to see the GP. You have very little time, and so having an agenda the GP can work with will help. I have recently downloaded the Flo app and have been tracking my symptoms to help both me and the GP understand where I am going forward.
• If you don’t feel satisfied after an appointment, try another doctor. A GP Registrar is a fully qualified doctor, in their final year of training to become a GP. Dr Potter explained that these doctors often get longer appointment slots and tend to be more up to speed as they have just come out of training.
• Ask for a referral - some areas have local menopause services, some areas you could ask to see an endocrinologist, a gynaecologist or sometimes a menopause team.
• Women’s Health Concern has a lot of helpful, trustworthy advice, including where to find a menopause specialist in your area.

Menopause is something every woman will go through, and it takes more than a 10-minute GP appointment to provide and determine the best care – which every woman deserves. Seeing a menopause specialist has made a huge positive change to my life, and so I would highly recommend, if budget allows and you are experiencing symptoms, to look into specialist healthcare professionals in your area.

If budget doesn't allow, or you are not quite sure whether a specialist is what you need, the information above will help.