Meg Mathews: 'Most GPs don't get menopause training - here's how I learned to work the system'

Since 2018, Meg Mathews has been one of the UK’s foremost menopause campaigners, determined to use her profile to end the stigma surrounding it. In her Stella magazine column, she reveals what she’s learnt. This week: how to get the help you need from your GP.

Last week I spent some time reading and answering comments on my column and I really enjoyed it. One important question was, ‘How do I get the right help from my GP?’ So I wanted to cover this today.

When I first visited my doctor in 2016 I burst into tears. I knew something was wrong but I had no idea that it was the menopause. I couldn’t sleep, and was struggling massively with anxiety and a foggy brain. I thought it was a mental health issue so when the doctor prescribed antidepressants I didn’t argue.

I don’t blame the doctor for not picking up the menopause – but sadly, at the time I felt there was a stigma connected to antidepressants. I took them but didn’t tell anyone as I didn’t want to be judged. I now talk openly about this as I feel nobody should feel shame or embarrassment about antidepressants.

I was feeling anxious and uncomfortable in my own skin. I went to my safe place, which was my weekly AA meeting, and shared what I was experiencing thinking I was going crazy. At the end of the meeting one lady tapped me on the shoulder and told me it was the menopause. I couldn’t believe what I was hearing. The menopause hadn’t crossed my mind – I thought it was something old women experienced. Looking back, I was clueless on the topic.

I spent some time thinking about what she said and eventually plucked up the courage to call her. We spoke for hours and she told me about the NHS clinic at Chelsea & Westminster, she told me where to get testosterone and how it helped her, we discussed HRT and so much more. She taught me everything about the menopause. She saved me from feeling like I was going mad.

The next day I rang my GP to make an appointment but they didn't have anything available for over two weeks as it wasn’t an emergency. In desperate need of support I called Dr Sara Matthews, my gynaecologist. This was a private appointment so it did cost me money, but she had studied every area of the menopause and had answers to all my questions. I walked out of the practice with body identical HRT. This was an estradiol gel and Utrogestan progesterone, which is derived from the yam but regulated in a laboratory. When my blood results came back 24 hours later Dr Matthews prescribed testogel (testosterone). My night sweats went after four days.

Two weeks passed and I went to my GP appointment with everything in my bag from Dr Matthews. My GP looked at me in astonishment. She had no idea what most of the products were. I asked her to type each one into the computer to see what was available in the UK on prescription. Everything was available except the testosterone gel so I asked to be referred to a menopause clinic so I could access this going forward.

It was a huge help going armed with information to my GP appointment but I know this is a luxury that not every woman has. I decided to eventually go down the NHS route so I could make notes of the process which would allow me to help other women taking this route. I then shared my findings on social media and in press interviews – always offering advice and inside knowledge any chance I could to help other women. Through campaigning for menopause awareness I’ve now spoken to some of the leading doctors, gynaecologists and menopause specialists at events and various talks.

The first step when accessing help via the NHS is to ask the surgery if they have a menopause expert when you call to make your appointment. Take a look on the British Menopause Society website to see a list of who is accredited and if they are connected with your surgery.

The majority of GPs don’t get menopause training at medical school, which is ridiculous given it affects all women eventually! This is why it’s so important to write down your symptoms – I learnt quickly to keep a list of everything. It’s easy to forget some of them when talking directly to a doctor. Every woman experiences the menopause differently, so it’s useful for the doctor to know how you are feeling so it can help them check any underlying issues that may not be menopause related. Brain fog really affected me, so being armed with a list when visiting the GP was so helpful.

Don’t be afraid to ask for what you want. Doctors can’t read your mind. It’s OK to ask to be referred to a menopause clinic too – the doctor won’t be offended. Just be aware that there is a low number of menopause clinics in the UK so there is no guarantee that there will be one near you. Luckily for me, living in London this was easier.

If your doctor prescribes you antidepressants, rather than considering HRT, you should ask why. Likewise, if they prescribe HRT ask them how that will help and make sure it’s right for you. HRT helped me greatly but that doesn’t mean it’s the right choice for you. If you feel uncomfortable with the prescription offered, it’s OK not to take it. You might want to gather more information first or read up about the treatment offered. You can then go back to your GP armed with information and what you believe is right for you.

There are excellent doctors and nurses out there who really know their stuff but if you don’t find the right one first time, please don’t be afraid to ask for a different GP, or if necessary change surgery. We’ve come a long way from the days when we were expected to just soldier on!

Remember, the menopause can increase the risk of other health problems such as heart disease, depression and osteoporosis, so it’s important that you are satisfied with the level of support you receive from your GP. If you are anxious or nervous, take someone with you for support. They can ask uncomfortable questions for you.

I have my bloods tested each year just to rule out anything that isn’t menopause related. This gives me peace of mind. You can pay £500 for a blood test privately but this is also available on the NHS if you ask for it.

Some doctors are hesitant to prescribe HRT, which is often due to a lack of menopause training. Most doctors only get three hours of menopause training (if any!). Menopause specialists and private clinics are much more willing to discuss the benefits of HRT and alternative treatments. Look up NICE guidelines – they detail HRT, CBT (cognitive behavioural therapy) and other treatments available. Make notes and take this information with you to your appointment.

The most important thing is that you can have an open conversation with your GP and that you leave feeling empowered. Good luck!

Read more: Meg Mathews: What I want men to understand about the menopause

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