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!

Dear OP, I hope you manage to transfer to the surgery with the good, female GP. With time you may be able to build a relationship where you can discuss smears. Record your blood pressure several times a day whilst you’re eating for an appointment.

I’m 58 and have just started HRT patches. My (amazing, female) GP did ask some questions about breast cancer in the family etc. She explained in a very sensible manner the risks, but also the very many benefits.

I no longer think about suicide, several times a week (not joking).

Good luck to you x

So, I’m wondering if anyone else has experienced muscle pain due to oestrogen. Used a patch on my bum and got severe muscle pain/deep ache in my flutes, like I’d done a serious session at the gym. Changed to oestrogel on the inner thigh, now have terrible muscle pain in my thighs. Tried on arms, same muscle pain. The pain goes away within hours of removing application of oestrogen to the particular area. Absolutely localised. And no, it’s not skin irritation. Anyone else experienced the same thing?

That should obviously say glutes! Damn you predictive text! 🤣

Thank you all for the further thoughts and support.
Just to clarify, I wasn’t going to do a BP reading straight after a cup of coffee, I said “then chill for a bit” but that might not have been clear enough that I was going to relax for a good while then do the reading.
I am inputting the readings into the NHS BP checker, which has a nice little colour coded chart, so yes, I do know what I am looking for.

Readings so far have been in the Orange pre-high zone, so I have to recognise there might be a problem there. I will chart them for a fortnight as I am away next week and it will be interesting to see if there is any difference when I am on holiday and properly relaxed.

I will see a GP about BP. Current one or new practice with meno specialist depending on how quickly the latter can see me. Iwill not be seeing that ‘expert’ NP again. Any push towards smear tests will be met with a polite “No” from now on until I feel I can consider one. I haven’t ruled out taking DH in with me, which is bloody ridiculous in 2023 that an adult woman feels she won’t be listened to unless a man is with her.

@7eleven I know exactly what you mean in your last sentence. Like, what is the point of waking up if I have to watch the world pass me by.That isn’t me, perimenopause has done this and I want to get back to Me again. I hope I get to experience considered, knowledgeable care like you did

Sorry, I didn’t realise I was on another thread. Apologies 🙈

No problem @Genty , if anyone wants to answer you on here that’s fine, but I can’t advise as I’m not allowed HRT yet
Or you could start your own thread, that might get you more answers.

I’ve just worked out how to start a new thread @SpamhappyTootsie, I’m new here! 🙈 I sincerely hope that you get back on track soon, one way or another! It’s a tough old gig, that’s for sure! X

They need to follow the rules of the formulary. The NHS is letting you down. I understand why you may go private, but please remember the practice is letting you down. You shouldn't need to pay!

@SpamhappyTootsie That sounds like a sensible plan with regard to your BP. I really hope you can get your HRT, I only started 2 weeks ago and wish I had started it sooner. Please update with how you get on.

The smears thing is rubbish. As another 'no smears' woman, my GP practice do raise it with me but in a half-hearted 'I see you have never had a smear' kind of way and quickly give up.

Even though my GP menopause appt was disappointing, he did not raise the smear issue at any point and was quite happy to prescribe the wrong stuff

I had a private video appointment and the doctor was delightful, smears did come up but she was very experienced at deally with women with trauma and incredibly understanding.

@SpamhappyTootsie Just popping along to your thread again to make one comment.

The dont use metal speculums now for smears. They use clear, plastic ones. These are more comfortable (IMO) as the aren't so cold. They can also choose one that is smaller which they would use on a young girl.

If you've not had one for years you might not know this. Also, they don't use a wooden spatula to get the sample- it's small brush.

I've read on here that if you are very nervous some practitioners will allow women to insert the speculum themselves to 'get it going'.

It's 100% your choice, but I know so many people with pre-cancerous changes (close friends) and even further down the line with CIN 2 etc, that I would say it's worth trying to have one if you can.

OP, have you had any more success?

I’ve been back and forth with the BP thing @7eleven 🙄. After 10:days of home readings they averaged it and…..it’s fine. Pre-high levels but nowhere near medication. I was offered the chance to make a new appointment with the Nurse Practitioner but declined. BP nurse also went on and on about smear test, so got a polite but short “Birth trauma PTSD, it’s not an option”
I didn’t want to approach any other GP or menopause specialist with high BP but now I will enquire.

My blood pressure is in the pre-high stage too (130s) and that's despite running, swimming and doing outdoor fitness classes and probably being around the fittest I've ever been in my life. No way am I taking medication with possible nasty side effects. I'll take my chances with the other health risks.

I don't need HRT yet but it's annoying that they gatekeep like this. You shouldn't have to pay to go privately because the NHS GPs and nurse practitioners are gatekeeping. The blood pressure thing I get a bit (though not if "pre-high") but the smear test thing is irrelevant in this context. Why is it always women who get told they can't have medication?

Before paying out OP, I'd speak to reception again and say you want to speak to a GP about HRT (and ask them to put on your notes that you will not be persuaded to have a smear test at this stage).

I read a post on LinkedIn this week about a woman who'd been on HRT for two years and now her GP practice has decided she doesn't need HRT but needs ADs instead. So refused to prescribe any more HRT! Even though it was helping.

Thanks @lieselotte . My BP is low 130s too, although I’m nowhere near as fit as you! I do walk and hike a lot and I’m going to get my BMI down because tbh, that has crept up again after losing 3 stone over the lockdown period. It’s difficult when I’m measuring out my energy levels due to fatigue, but it’s doable, no excuses.
Apparently, my initial BP as taken by the Nurse Practitioner was 172/103. It has not been that high in the 2 weeks since, because no one has tried to force me into a smear test.
The GP practice as a whole has been obstructive in the past. Brilliant when my DS was small, excellent for my DH, but a bit shit for me. Offered ADs for everything apart from a mole removal. There are other non private options I can try.

On the continent we buy it OTC, just to put this farce into perspective. My 14 year old DD gets it for me on the way to school. About 15 euros a month.

I tried at the doctor about 6 years ago and was offered ADs,so I walked out (politely)

Gel and vaginal pogesterone 10 days every month. No risks with this.

Wow @adriftabroad , how easy is that! The Boots service mentioned upthread is the nearest to that system, so that’s another possibility, now I know my BP is ok. The antidepressant over-prescribing really pisses me off.

On the continent we buy it OTC, just to put this farce into perspective. My 14 year old DD gets it for me on the way to school. About 15 euros a month

That sounds amazing, although I thought that it can be quite hard to work out what works best for an individual woman? Can you just go in and say "that's not working for me, can I have x gel or y patch instead"?

I had an early menopause 44 ish. Asked on here and got amazing advice. Read, read read about it. Went to docs (as worried for bones) then had an appt at hospital, all well... no need for HRT. Have ADs. I disagreed. But I was dismissed as a stupid Englishwoman.

Came back on here, spoke to (a frankly brilliant) lifesaving poster (and others) went to the pharmacy and got the gel (every day, 2.5 pumps a day equivalent) and the ustrogen (vaginally) 10 days a month. Worked a dream. Now 52 and have upped Oestrogen gel slighly, put it on my thighs every day after a shower.

No risks and my decision 100%. I definitely knew reams more than my old, Spanish, male, doctor.

Research is key with bloody everything I have found.

If I miss 3 or 4 days of gel my mood simply plummets. Never had hot flushes. All my symptoms crept up on me.

Simple.

Oh, and I look young still!

My daughter could go in and get me as much as she wanted!

I send it to my Dsis when she runs out in UK

My ex H bought viagra. Did they ask about his blood pressure? NOPE.

I just thought I’d update, mainly to encourage anyone whose GP isn’t following NICE guidelines on menopause (at the very least) to look for other options if possible.
It took me a year, for Reasons but I registered with the practice that has 2 menopause specialist GPs, very proactive across the practice wrt women’s health. Had my initial appointment this week and it was fantastic. I walked out with a prescription for gel and body identical tablets after a really long and unhurried chat about all the options.
Smear test was addressed at the end because so overdue but I have booked an appt. That I can stop at any point and try again another time if necessary. Bloods also booked, but again, not linked to menopause particularly, just part of a general healthcheck.
I just feel so…..hopeful now! Like, even if the HRT combo has side effects or needs tweaking, that I’ll be listened to.

I'm so glad you got the help you need. I had a disastrous appointment with a GP where I referenced the Nice guidelines about HRT (for menopausal anxiety) and she started down the road of me having health anxiety 'because I read up on stuff'.

Anyway in the end I decided not to take HRT and got my anxiety under control in other ways but I felt unhappy with the consult.

How did you get on with the meno weight issue? I ask because from what I read it's important to increase protein intake, reduce cortisol levels and use weights rather than decreasing calorie intake hugely and doing lots of cardio.

Anyhow I'm delighted you got the help you need.

@SpamhappyTootsie Thanks for your update. Great news! I hope HRT helps

Well done! Hope you feel great soon.