What kind of foolishness is this because it just doesn’t make sense.

[MrsNandortheRelentless]

Awful perimeno symptoms gradually worsening over the last year.
Age 53, still having THE most horrific periods.

Saw meno specialist nurse at GP practice. Got me some patches. Hooray!

Feel better but by no means wonderful, certainly not a miracle but coincidentally, periods stopped for 3 months.. thank fuck!
went for HRT check, blood pressure checked, extremely high.

Stopped my HRT straight away, prescribed blood pressure pills.

Wont let me have HRT until blood pressure controlled. It’s their guidelines, so absolutely will not let me have HRT patches back.

So.
Joint pains back
Insomnia out of control, awake from 4am every night.
Anxiety symptoms taking over, imposter syndrome looming all the time
Forget words, brain fog bad (worried I’m going to lose my job)
Feeling very very low, suicidal thoughts

Bleeding through period pants and super night time pads through my good work trousers.
Period pains stopping me mid conversation, it’s so severe. Paracetamol does nothing for the pain.
Fatigue, utterly utterly washed out and shattered all the time. Zero energy.

What the hell can I do? I’m suffering, I’m miserable, so so miserable.

That sounds miserable. I’m sorry for you. Could you have fibroids? I think they’re easily treated

You can see where they are heading:

https://www.bbc.co.uk/news/health-67438995

Have they offered you a Mirena coil, which might help with the horrendous periods, but is very low-dose so should be OK with the blood pressure?

I had one in my mid-40s when my periods were starting to get erratic and much heavier, and the mirena stopped them almost immediately. It wouldn't necessarily help with your other symptoms, but would take one thing off your mind, and would reduce the risk of anemia. Have they checked you for that? Some of your symptoms like fatigue etc could be down to anemia, which is a likely consequence of really heavy periods.

@MrsNandortheRelentless How often are they monitoring your BP? Most people on BP meds find they work very fast- within a week or so. BP meds work really quickly. You should in theory be able to get back on hrt in a week or two if the meds for BP are correct.

HRT if it's transdermal doesn't usually affect BP so I wonder if your BP was always high?

The other thing is, did they ask you to take your BP at home for a week?
Are you and they sure your high BP wasn't white coat syndrome?
Most GPs won't make a call on BP on a single reading done at the surgery.
I feel concerned they are not managing the readings and the treatment properly.

The answer to the heavy periods is a Mirena coil but it won't work immediately. Meanwhile your GP should be prescribing Tranexamic acid to reduce the flow.

I'd go back and ask a lot of questions, about your BP, and also push for treatment for the heavy bleeding.

I was advised to get my own BP device so I did. They have now doubled my antihypertensive drug after 4 weeks of slight drop but still really high.

I don’t understand why they are so adamant that a patch (I have NO oral HRT at all) can increase the risk of stroke.
When asked, the nurse was adamant that their guidelines are in fact up to date and that patches should be stopped if hypertension persists.

I absolutely refuse to have a coil fitted as I can barely tolerate a smear test, I find them excruciating, as there is zero pain relief offered for this invasive procedure, I know I will not be able to tolerate it.

TX acid might help with the heavy blood loss and no, unsurprisingly, not one person has suggested anaemia or checking bloods for this despite me repeatedly describing my periods as torrential with very large clots along side fatigue and low energy. (Also eating bag fills of ice each week).

Its just utter utter utter shite.

I do take oral iron as I figured that I must be anaemic or at the very least iron deficient due to my symptoms but it’s like trying to fill a fucking leaky bucket due to the volume of loss each month..

@CesareBorgia yes that's slightly concerning ......
I don't believe all this 'in addition' business, I think we can all guess that the NHS thinks we're all taking too much hrt and want to tell us cbt is the real cure for menopausal symptoms.....

.....yeah cos cbt is going to REALLY help the old paperthin fanjo, crippling depression and osteoarthritis ain't it😱

We all know cbt is a load of absolute bollocks half the time.

Especially if what you need is your fecking hormones!

@MrsNandortheRelentless your practice sounds moronic with the decision they've made. I was told by mine that if my BP coincidentally became high on transdermal hrt, it wouldn't be stopped, they'd just give me the BP pills as well! I use oestrogen gel on thighs and utro up me vag, so no chance of it causing high BP!

If you can afford it, I'd book yourself in to see a specialist like a menopause gynaecologist. The BMS has a list on their website. Opinions vary so much with treatment (not just for menopause) and as you feel so terrible, and aren't getting much further with your GP, I'd look beyond that.

This is from a fact sheet by Dr Louise Newson

Can you take HRT if you have high BP?

For most women, it’s perfectly safe to take HRT if you have high blood pressure or you’re taking medicines to lower your blood pressure. Your doctor will simply need to keep an eye on your blood pressure and adjust your medicines if needed.

There is a lot of confusion around HRT and blood pressure and some women have been needlessly advised against HRT. However, a review of the evidence showed that postmenopausal women with normal and high blood pressure had a very low risk of a rise in blood pressure with all forms of HRT, and in fact their blood pressure was often lowered.

Estrogen taken as a tablet has the potential to raise blood pressure but taking estrogen through the skin as a patch, gel or spray allows your blood vessels to widen – so it can lower your blood pressure rather than raise it. Progestogens have different effects and while some could raise blood pressure, the newer type, called micronised progesterone, appears to have no effect or even lowers blood pressure. Women with raised blood pressure can still usually take HRT and it is safe to take blood pressure lowering medication with HRT.

Thank you for the info.

Lets hope that by the time our daughters are at this stage in 30-40 years from now, things are better.

Its piss poor and makes me so angry that unless I pay for it, I have to suffer.
My blood pressure is higher I’m sure BECAUSE of my awful menopause symptoms not being treated.

I absolutely refuse to have a coil fitted as I can barely tolerate a smear test, I find them excruciating, as there is zero pain relief offered for this invasive procedure, I know I will not be able to tolerate it.

It's really not a big deal. It's over in a second and the relief of having no periods to deal with is immense.

I eye-rolled hard when I heard this on the news yesterday. Thing is it doesn’t make a lot of sense from a cost control side - HRT is cheap and therapies like CBT are expensive in comparison. Really not sure where they’re going with this.

Ice eating is called Pica and often a sign of anaemia. Ask for blood tests and a pelvic ultrasound to rule out anything else.

@Sparehair me too.

But what I'm confused about is how CBT and it's associated 'journalling' etc etc will help my night sweats, or hot flushes, or as PP above, vaginal atrophy.....

I did look for a thread on this yesterday as I'd assumed everyone else would have been bemused and slightly appalled too!

OP good luck seeing a meno specialist. I'd totally ask for another opinion elsewhere.

The CBT thing is because it's "all in your mind". I was raging when I heard they are proposing this .

Yes, this.

Have you told them about this?
I'd agree with the others - they're giving you piss-poor attention.

Like you'd be able to see anyone for CBT without paying for it anyway. You'd just be added to another long waiting list.

Can you afford to go private? You shouldn't have to, I agree, but you're not being treated as an individual (with what sounds a horrific group of symptoms) but as a category and I feel they're being really dismissive of the way you're suffering.

It sounds horrific.

Have you told them about your suicidal thoughts? Have they blood tested you for anaemia and thyroid levels?

I really, really feel for you. Aching joints stopped me from doing the hobby I loved but a year of HRT gel really helped with that.

Go private. You'll get the medical attention you deserve. I'd say that this, for you, is a matter of urgency

And on the very unlikely chance you live in the South Wales area, contact Carolyn Harris MP for Swansea. She has made the treatment of menopausal women one of her campaigns.

The thing is, that by refusing a Mirena coil, you are refusing something that could probably reduce/stop a lot of your problems.
I was told by a gynae consultant that the best way to control bleeding from the uterus is progesterone in the uterus, ie a mirena coil.
I had one fitted and it was better than some smears I’ve had. I had a hysteroscopy recently, it was a breeze. Sometimes youve got to try these things yourself, rather than listening to what others say.
For your joint pain - good quality omega .
Insomnia - magnesium glycinate.
Brain fog - magnesium L Threonate.

I’m sure you’d be the first to complain if you have a stroke or TIA. I wish people would stop thinking they’re doctors and try to understand that these decisions are made based on evidence. If you read Dr Nelson’s leaflet extract properly it’s saying that the risk of HRT raising blood pressure is low - but this HAS happened to the OP, which is why her GP has stopped the HRT.

By the way, Dr Newson advocates use of HRT in women who have had breast cancer, so she is going against medical evidence there. Using phrases like “perfectly safe” is unwise - no drug is “perfectly safe”.

What are the alternatives to a Mirena coil? I had one fitted around 6 years ago and it was awful. I felt suicidal. I’ve lived through lots of crap from a young age yet I have never felt so depressed as I did with the mirena. Obviously I was told it “couldn’t possibly” be as a result of the coil. I had it removed after 5 or 6 months and my mental health improved in a very short space of time.

I’m in the early stages of peri so I don’t really know yet what/how bad my symptoms may or may not be. But if I do end up suffering from heavy periods etc are there alternatives to the Mirena?

Having the coil fitted was the only thing that stopped my ridiculously heavy periods. I used to have to change my pad, knickers, pyjamas bottoms every half hour. Ended up sleeping on puppy pads so I didn't stain the bed. It was honestly the best thing I did. Plus the menopause actually happened while I had the coil in. There is a very good pre menopause vitamin in Holland and barret. It really helped with the brain fog. Good luck 🍀

@sorrynotathome
The medical profession does not have 'one voice'- there are lots of shades of grey and other opinions.

If you read all of the extract, she does also say that some types of HRT lower BP (and that's the case with Utrogestan, which is why it's taken at bedtime as it can cause dizziness from low BP.)

However, a review of the evidence showed that postmenopausal women with normal and high blood pressure had a very low risk of a rise in blood pressure with all forms of HRT, and in fact their blood pressure was often lowered.

In other words, HRT isn't likely to raise BP even if it's high already.

As for prescribing HRT to women who have had BC, it's not against guidance. There are many other specialists who will prescribe, based on individual risk and symptoms. One of the UK's leading breast surgeons ( Prof Michael Baum) does, (he's on a BMS video discussing why.)