Recommendation for a good Bangkok OB/GYN

[BuddyPish]

A lady near and dear to me seems to be having all the symptoms that a layman might associate with perimenopause.

These include: 
Extreme tiredness/fatigue
Heart palpitations
Bone pain
Hot flashes
Vaginal dryness
Frequent urination

 

In her efforts to determine what's wrong with her, she's

1. Had a curettage that removed a benign polyp,

2. Had a pap smear that was clear,

3. Commissioned a urine culture that was negative

4. Had a thyroid check that was fine and

5. Had kidney function test which was normal

 

The last three were done at a reputable lab in Bangkok. 

 

I suggested she might be perimenopausal but she's skeptical because she still has periods. Obviously, I've tried to explain that perimenopause is the transition to menopause and not the "haven't had a period in 12 months" that menopause usually refers to but she reasons that none of her similarly aged female friends have encountered her symptoms so it's probably bunk.

 

Anyway, she is currently relying on the inept administrations of a hack OB/GYN at a state hospital somewhere in Bangkok. He's ordered an x-ray of her lungs and an ECG saying that her palpitations and her hot flashes warrant an immediate check of those organs but he hasn't even considered prescribing a low dose course of HRT.  

 

Does anyone know of a decent OB/GYN in Bangkok who doesn't charge too much and would at least consider her age (49 in July) and her symptoms as warranting some sort of investigation into perimenopause? I know there are no definitive tests to diagnose this challenging condition but a woman her age uttering these symptoms to a GP in the UK would hear the words "peri/menopause" and "HRT" more or less straight away.

Thanks for any help.

 

 

[Sheryl]

I will assume "bone pain" is not really bone pain at all but just her way of saying muscle aches and pains

 

There are in fact blood tests that can help identify if a woman is at the start of menopause, but they need to be conducted at exactly the right time in the menstrual cycle

 

Urinary frequency,  if it has persisted after the myomectomy, needs further work up especially if accompanied by dysuria.

 

There is a menopause clinic at Chulalongkorn hospital's Women's Health Center (7th Floor Phor Por Lor Building). Last info I have is that it was Mondays from 1:00 p.m. - 4:00 p.m. and Fridays from 8:00 a.m. - 12:00 p.m. but this is old so should recheck by calling 02-576-6529. (Number is also old, if it does not work can call general number 02-649-4000 but may be quicker to just go in person to inquire)

 

Other options are the various anti0aging clinics but these are very expensive

[BuddyPish]

On 2/20/2024 at 2:18 PM, Sheryl said:

I will assume "bone pain" is not really bone pain at all but just her way of saying muscle aches and pains

 

There are in fact blood tests that can help identify if a woman is at the start of menopause, but they need to be conducted at exactly the right time in the menstrual cycle

 

Urinary frequency,  if it has persisted after the myomectomy, needs further work up especially if accompanied by dysuria.

 

There is a menopause clinic at Chulalongkorn hospital's Women's Health Center (7th Floor Phor Por Lor Building). Last info I have is that it was Mondays from 1:00 p.m. - 4:00 p.m. and Fridays from 8:00 a.m. - 12:00 p.m. but this is old so should recheck by calling 02-576-6529. (Number is also old, if it does not work can call general number 02-649-4000 but may be quicker to just go in person to inquire)

 

Other options are the various anti0aging clinics but these are very expensive

Thanks Sheryl

She received the hall-clear on her lung x-rays and ECG. 
The hack reiterated his opinion that it couldn't be menopause and ruled it out completely.

 

I advised her to go to MedConsultAsia clinic in sukhumvit. They're inexpensive and reasonably competent from what I've experienced.

 

Instantly recognised perimenopause. The doctor's own mother is going through it right now so it was all familiar.

Prescribed some valium for sleep because the insomnia and resulting fatigue is the most debilitating symptom. Some amitriptyline for anxiety/depression and some oestrogel. No progestin though

[Sheryl]

2 hours ago, BuddyPish said:

Thanks Sheryl

She received the hall-clear on her lung x-rays and ECG. 
The hack reiterated his opinion that it couldn't be menopause and ruled it out completely.

 

I advised her to go to MedConsultAsia clinic in sukhumvit. They're inexpensive and reasonably competent from what I've experienced.

 

Instantly recognised perimenopause. The doctor's own mother is going through it right now so it was all familiar.

Prescribed some valium for sleep because the insomnia and resulting fatigue is the most debilitating symptom. Some amitriptyline for anxiety/depression and some oestrogel. No progestin though

Progestin may make symptoms much, much worse.

 

Natural progestetone on the other hand may help....and is advisable when using estrogen.  In Thailand available only in micronized oral form (Utrogestan) and would ususlly take foe the last 10-14 days of cycle.