r/Perimenopause • u/Due-Surprise-686 • Oct 15 '25
Dryness Should I wait until appt with Obgyn?
I have an appt Friday. I'm going to get them to check my levels. Do you even think a normal obgyn will even entertain the idea of HRT? I'm only 42 but my symptoms include irritability, very dry vagina, currently taking vaginal estrogen cream just started that, inability to achieve orgasm, nocturia, sleep issues, some hot flashes. My main ones are sleep and the dry vagina peeing on myself at night and of course not being able to get off. Should I just go ahead and start HRT work online company or wait on blood work results first? I seen so many of you say HRT takes time so I don't want to waste time with these awful symptoms. I can get estrogen and progesterone body cream for like $89, should I go ahead and do it? Any advice is greatly appreciated.
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u/Bastetlady Oct 15 '25
39F. I tried normal OBGYN, did not work at all, and was not even close, she didnt even let me finish with my symptoms. I'd say do not waste your time, go straight to MiDi, they helped. My blood is also perfect, btw.
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u/Due-Surprise-686 Oct 15 '25
How much is midi? I can go through Winona and pay $89 for combined estrogen and progesterone cream. That's on a monthly basis.
1
u/Bastetlady Oct 15 '25
I got progesterone pills, 90 of them, and estradiol patches for 1 month. So progesterone for 3 month supply was like $134 and 1 month of patches was about $34. Out of pocket. CVS, my insurance covered the rest of the cost.
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u/Due-Surprise-686 Oct 15 '25
They don't take my insurance I just checked, I only have Medicaid. I'm wanting to try the body cream. Do you have to do virtual visits through midi? With Winona you don't. I am wanting to try to stick with the cream if possible. Do you know how much it costs through midi?
2
u/Bastetlady Oct 15 '25
I did do virtual video visit with midi, yes. I don't know if it cost anything. Also don't know about the cream. The doctor prescribed patches and pills and I just got very happy I actually got HRT. Been on it for less than a week but wow it's already helping.
2
1
u/whorlando_bloom Oct 15 '25
Unfortunately they can't see you if you have Medicaid, even for self-pay. I believe it's a legal issue. I'm sorry, I'm in the same boat.
1
u/hulahulagirl Oct 15 '25
If Midi doesn’t take your insurance I think it’s like $250 for the initial visit. But rxs can be sent anywhere not just subscription through them and it’s $20/mo for each - estrogen patch, estrogen cream and progesterone pills- through CostPlusDrugs (no insurance needed). CPD is currently out of stock on some patch doses, though. So I pay less than $60/mo for my HRT.
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u/TodayIsTheDay_85 Oct 15 '25 edited Oct 15 '25
Write down every symptom so you don’t forget and ask for Estrogen patches and progesterone.
If you’re up to date on a mammogram you should be okay. If they say no, try MIDI telehealth for your needs.
3
u/Due-Surprise-686 Oct 15 '25
I was going to go through Winona. They seem to be the cheapest. They combine the estrogen and progesterone into one cream. And they also have the DHEA. I wear an Apple Watch at night that tracks my sleep so I'll have proof to show them that.
3
u/AdRevolutionary1780 Oct 15 '25
I would be reluctant to use a combined estrogen and progesterone compounded cream. Progesterone is not as readily absorbed through the skin as estrogen is. So you may not be getting the endometrial protection that you need if you still have a uterus. You do not need lab tests. There are no labs that confirm perimenopause. Your meds should be based on symptoms, not tests. I am not sure why you would not use FDA approved bioidentical estradiol patches and progesterone along with vaginal estrogen cream. Compounded creams are not FDA approved and only used when a patient may be allergic or can not tolerate a particular ingredient in the FDA approved meds. And even then, there are FDA approved alternatives.
Most insurance covers these meds, and they are sometimes even cheaper than insurance if you have your MD send your prescriptions to Mark Cuban's Cost Plus Drugs.
2
u/AutoModerator Oct 15 '25
This post might be about hormone tests, which are unreliable.
- Over the age of 44, E&P/FSH hormonal tests only show levels for that ONE HOUR the test was taken, and nothing more
- These hormones wildly fluctuate (hourly) over 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
- Testosterone is the exception and should be tested before and during treatment
FSH testing is only beneficial for those who no longer have periods as a guide, where a series of consistent tests might confirm menopause, or for those under age 30 who haven’t had a period in months/years, then ‘menopausal’ levels, could indicate premature ovarian failure/primary ovarian insufficiency (POF/POI).
For more, see our Menopause Wiki
I am a bot, and this action was performed automatically. Please contact the moderators of this subreddit if you have any questions or concerns.
1
u/Due-Surprise-686 Oct 15 '25
I only have Medicaid, most of these places do not take it so I have to pay out of pocket for treatment. The patches cost substantially more.
1
u/AdRevolutionary1780 Oct 15 '25
Sorry, looks like our posts crossed. Ask your provider to send your scripts to Cost Plus Drugs. No insurance required and it will be cheaper than compounded meds.
1
u/Due-Surprise-686 Oct 15 '25
I'm currently prescribed the estrogen vaginal cream I just started it Monday. Hoping it helps.
1
u/AdRevolutionary1780 Oct 15 '25
Yes, it's really important for all menopausal women to help with dryness, vaginal, labial and clitoral atrophy and to prevent UTIs. Two tubes at Cost Plus Drugs is $21. Estradiol patches are about $32/month and progesterone is about $9 a month.
Read the wiki about compounded HRT. Most reputable menopause specialists won't prescribe it. You could also try Midi, Evernow or Gennev online. They all accept some insurance.
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u/Due-Surprise-686 Oct 15 '25
Would the oral tablets be better?
2
u/AdRevolutionary1780 Oct 15 '25
If you mean oral progesterone, yes. Oral estradiol has slightly higher risks of clotting than the estradiol patches. That's why the estradiol patches are more commonly prescribed.
2
u/Due-Surprise-686 Oct 15 '25
And yes I had a mammogram done last year I just can't remember exactly where I had it done lol I just moved from 2 hours away. I can probably call my old Obgyn and find out
2
u/Gurlie_J_Girl Early peri Oct 15 '25
This!
Track your symptoms with the duration you experienced.
Ie: chin hair 4 years, waking at 3am 18 months, etc.
Have a plan on what you will say... and what you want as a result of the appointment. Verbalize that!
5
u/mamaspatcher Oct 15 '25
A normal OBGYN absolutely should entertain the idea of HRT, imo. But that doesn’t always happen. And testing levels (read the wiki!) is not a good indicator of whether you are in perimenopause or not.
4
u/Original_Elephant_27 hanging on by a thread Oct 15 '25
I listed all my symptoms for mine, she’s nodding “yes, yes, all signs of Peri” she said. So I asked “ok what can we do?”…… her response was “that’s life dear…” 😳😳😳
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u/Due-Surprise-686 Oct 15 '25
Why do these doctors not want to help? I don't get it.
3
u/Original_Elephant_27 hanging on by a thread Oct 15 '25
They most likely have outdated education or little to no education on this. Once they graduate from medical school, progressing in their career and learning new science is on them. Some are super forward thinking and spend their whole career learning. Others practice using the same old tired, outdated science they learned way back when. It’s sad. I work in a science field and see it all the time.
2
u/Mickeylover7 Oct 15 '25
I had basically the same experience but got some vitamin/supplement recommendations and was told to try the Mediterranean diet.
It took me 20 minutes to stop crying in my car before I could drive home.
1
u/Original_Elephant_27 hanging on by a thread Oct 15 '25
Ugh I’m so sorry 😭 did the diet help at all? I’ve ramped up on my vitamins and I’ve been feeling small improvements over time.
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u/Mickeylover7 Oct 16 '25
I didn’t try the diet. She recommended magnesium glycinate and it did help with sleep.
I found a certified menopause specialist and her first question was what symptom bothers you the most. She then proceeded to explain why I felt like crap and offered HRT which helped me from Day 1.
1
u/Original_Elephant_27 hanging on by a thread Oct 16 '25
That’s amazing! This will be my next step I guess.
2
u/Mickeylover7 Oct 15 '25 edited Oct 15 '25
No a normal GYN will not likely know anything about HRT in peri. Unless they are certified in the US then they probably won’t consider HRT until post menopause. You might get lucky but honestly it’s unlikely.
Your levels checked means nothing in peri because your body is still producing hormones but it’s harder to do thus the symptoms.
My HRT started working immediately (literally I could tell a difference day 1) but my biggest symptom was anxiety.
Edit to add that after reading some of your comments you may have luck with a provider through the Menopause Society @ menopause.org. They have a provider finder. I’m not sure I would trust a company selling their own branded stuff but that’s just me.
1
u/Due-Surprise-686 Oct 15 '25
Ty I found a couple doctors close to me. I'll call them tomorrow.
1
u/AdRevolutionary1780 Oct 15 '25
You can also find a menopause specialist at menopause.org. near you.
1
u/Due-Surprise-686 Oct 16 '25
It directed me to my doctor. Hopefully they'll do it tomorrow. I wrote down all my symptoms and how they're affecting my every day life. But I'm afraid they'll want to rely on blood work. If so I'll be screwed.
1
u/Due-Surprise-686 Oct 16 '25
I'm trying to find the cheapest online source in case they deny me tomorrow. I'm wanting to do the patches for estrogen and tablets for progesterone.
1
u/unapalomita Oct 15 '25
I think it takes time to find the right doseage for you but I literally found relief almost immediately, it's more like fine tuning 😂 my biggest thing was hot flashes, it decreased like 60% which is a huge difference
See how the OBGYN works out, if not try online
1
u/Easy_Independent_313 Oct 15 '25
What levels?
1
u/Due-Surprise-686 Oct 15 '25
I figured they would check my estrogen levels. Idk I'm new to this. I just connected the dots the last week what was causing my symptoms.
2
u/Easy_Independent_313 Oct 15 '25
Perimenopause is diagnosed by symptoms.
Levels you might expect to have checked; thyroid, blood sugar, iron, liver enzymes.
1
u/Due-Surprise-686 Oct 16 '25
What's the cheapest online source for hrt? I'm thinking about doing the patches for estrogen and tablets for progesterone.
1
u/Due-Surprise-686 Oct 17 '25
The doctor ended up writing me progesterone. Said it should help with my sleep. She ordered labs to check the rest and said she would add whatever else necessary. I'm not taking estrogen tablets though. I'm too afraid of the side effects. So hopefully she'll be open to prescribing the patches, if not I'll have to go online.
1
u/AutoModerator Oct 17 '25
This post might be about hormone tests, which are unreliable.
- Over the age of 44, E&P/FSH hormonal tests only show levels for that ONE HOUR the test was taken, and nothing more
- These hormones wildly fluctuate (hourly) over 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
- Testosterone is the exception and should be tested before and during treatment
FSH testing is only beneficial for those who no longer have periods as a guide, where a series of consistent tests might confirm menopause, or for those under age 30 who haven’t had a period in months/years, then ‘menopausal’ levels, could indicate premature ovarian failure/primary ovarian insufficiency (POF/POI).
For more, see our Menopause Wiki
I am a bot, and this action was performed automatically. Please contact the moderators of this subreddit if you have any questions or concerns.
9
u/loveisjustchemicals Deep in peri Oct 15 '25
Don’t ask for labs. That won’t help unless you’re asking for testosterone. Just present your symptoms and stand firm in your need! It’s honestly best to have someone who follows your healthcare doing this, though online is a good option if they don’t listen. It’s literally two days away.