Disappointing menopause appointment

[SpamhappyTootsie]

I follow the threads on here and I thought I was all prepared for an appointment with the Nurse Practitioner this morning (my first).
Had the usual gatekeeping oh you need a smear…..hmm, you haven’t had your bloods done for a while……blood pressure a bit high, buy a monitor to use at home and come back in a week or so
She would not listen to anything I said so now I’m a menopausal sobbing mess at home because I can see my 50s just vanishing in a fog of forgetfulness and joint pain. I’ve already turned down a fantastic job because of my energy levels. I have to choose what social and leisure activities I do because of the joint pain and fatigue.

Give me a kick up the arse, please. I’ve just spent £62 on a blood pressure monitor so I can play along with her stupid game, but I feel like next time I go there will be some other hoop to jump through.
Do I go private? Change GP ? How to combat the White Coat Hypertension because if HRT is riding on some magic number in her office then how will I ever get past that? HRT is proven to lower blood pressure ffs!

and a smear isn't relevant, unless you're due one anyway. Private won't give you a smear unless you need one!

My last smear was 15 years ago, under general anesthestic. It was done, coincidentally, during an operation to repair the colossal damage done through negligence during the birth of my son. At a hospital totally separate from the one where the staff caused the problem in the first place, because I couldn’t set foot in there again.
So talking about it unexpectedly in an appt I thought was unrelated was bound to raise my blood pressure. She wouldn’t listen.

The BP monitor will come in handy, I suppose. DH can use it too.

I'd just do a Boots online menopause consultation then you can get started with no hassle. I've found them to be super helpful, and the prescriptions aren't expensive and they are quick to respond to any queries

If you can't lower it with diet and exercise then meditation is the only other option as far as I'm aware. It comes to us all op.

Sounds to me like she’s trying to give you a bit of an MOT while you are there, nothing wrong with that. And it’s fair enough that they have a baseline before you start medication. You are entitled refuse, and they will document that.

They don’t seem to understand the correlation between high bp readings and stress at their approach.
The nurses at our practice wanted to take my bp just before they inserted a Mirena coil. I said no and made them use my home readings. Did they really think they’d get an accurate representation at that moment?

@KangarooKenny yes, she said “we can’t proceed with HRT discussions until you have had a smear”. That took me totally by surprise, so I explained the PTSD as above. She just repeated No HRT without smear, HPV test not acceptable instead.

Then I’d be asking where that is written in their policy or SOP.

Why are you so against the meds? Not everyone can control HBP by lifestyle.

I was looking at that earlier! Do they not require the same BP checks or up to date smears? I saw you have to choose which type you prefer, so I’d have to do a bit more research into what each one consists of.

I don’t need an MOT. I need whatever the automotive equivalent of HRT is! Oil change, onboard computer reboot
If you have a clapped out old banger sat in your garage you don’t just take its tire pressure and change its spark plugs,then shrug and say it doesn’t meet some unrelated requirement for repair.

What was your bp out of interest?

I know that, but I would like the chance to try, with HRT to make it possible in the first place. If it’s still high then, I’ll happily take the medication.
High BP is a symptom of menopause.

OP i would def go private. Go online today and find someone with an appointment this week. Doesn't have to be local though that helps.

I went to for an asthma review with the practice nurse and mentioned I wanted to go onto HRT. She took my BP 3 times and finally got a normal reading, I was stressed and have never had high BP reading before. I am almost due a smear and she has booked me in a few months early (every 5 years). Also got weighed and measured. Had a mammogram last year.

When I spoke to the NP she did look to see if everything was up to date before prescribing me the HRT I wanted. Don't GP's have to hit some sort of smear target rate? I think this could drive the eagerness for the smear.

I didn’t ask. She did it twice, entered it into my records and I could see where the appt was going (even more downhill). I will do one later this evening at home, when I’ve calmed down a bit. Then one as soon as I wake up, although menopausal anxiety is sky high first thing.

Oh, they definitely have smear targets. I just didn’t know they could use them to gatekeep other treatment

I would complain to the practice manager about the NP.

Bupa do a menopause appointment for £250. You can then get a private prescription for what ever you need. Don't recall being asked about a smear. If you can take you BP before the appointment it would help.

I did this as my surgery's menopause specialist has a you've just got to get through it without HRT mentality.

I now have an NHS prescription for the medication BUPA prescribed and am much much better.

Also, although I would not do this, what’s to stop me making up average readings at home? Is that what she half expects me to do?

and of many other things....I'm surprised you didn't ask what it was. No sane medical professional will prescribe you HRT with already high BP and just brush it off as "being caused by the menopause". i think you're being a bit unrealistic here.

Just to add..

If you do decide to go privately, many consultants are able to offer video consultations, so you can choose anyone, anywhere if you want to.

Please be choosy over who you see. Unfortunately many doctors have jumped on the meno bandwagon and are not especially well qualified.

My personal advice is to choose a consultant gynae, whose website specifically talks about helping with menopause.

There is nothing to stop you doing this if you are willing to gamble with your health.

I think GP's are happy to accept home BP readings as that is the action plan my husband is on to try and reduce his before they prescribe medication. Try and do a week or two of readings and see how your BP is in a less stressful setting.

I am on BP meds and am allowed HRT which i am on.
My GP asks for readings over a week, so twice a day, take two readings and note the second one down.
Mine really spike at surgery.

Smear no. BP well you don't want to start someone on HRT if they have uncontrolled high BP but doesn't sound like this is the case. I might not have started HRT first appt but would have discussed it and arranged review

@MrsGhandi I have already said I will not be doing that. It just makes a mockery of “can’t prescribe HRT with high BP”.
Also, why would I ask what my BP was? I had been forced to explain PTSD associated with traumatic birth, to the point of tears. I’d be surprised if it wasn’t high! White Coat Hypertension is a thing.