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.

But the nurse keeps saying stroke risk, nothing about HRT raising blood pressure.

The speculum insertion is extremely painful for a smear test, they need to visualise the cervix to insert a coil, I could do it with gas and air but they offer nothing at all. I just can’t do it.

Years ago I had the contraceptive injection which made me suicidal, I’m reluctant to have anything like that again. (Stopped it and that stopped quite quickly, never had those thoughts again until now)

I know about pica hence me taking iron supplements. And no, no one has asked or questioned me further when I describe my periods, pica and dark thoughts.
The comment was…”oh, bless you”.

The prescription for antihypertensives was duly given, for 5 weeks HRT withheld.
I’ve probably had high blood pressure for years. It’s certainly NOT acute or due to HRT.

Have they offered antidepressants while you’re off HRT?

· Today 08:01

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. *

Ive had high blood pressure for years, not due to HRT.
I don’t think I’m a Dr, I’m challenging outdated, misinformed medical advice because I am living with the consequences of this lack of treatment and I suspect every woman who goes to my GP practice with similar issues is having to suffer like this too.

The waiting lists as you know in the NHS are horrendous, blood tests and ultrasound scans are a fight to get then a very long wait.
Im fucking knackered, I just don’t have the energy for it all.
My priority is to not get sacked.

No! I don’t need antidepressants, I’m peri menopausal, I need HRT.

I do not want drug after drug after drug to deal with the direct issues of perimenopause.

Everything improved once I started HRT, the insomnia, the moods, the anxiety stopped, the joint pains eased, the brain fog went away, I felt… normal, just normal, not better, just like a normal functioning person.

I was baffled by the new NICE guidelines. I wonder if the CBT suggestion comes from increased reluctance within the NHS to accept that female-specific health and hormonal conditions underpin the notion of biological reality. After all, if our femaleness is all in our heads, the menopause must be too. Trans identified males seem to think they get symptoms too, after all.

Over the counter Iron supplements will not be high dosage enough to get you back to the normal levels, particularly if you are having heavy periods. You need prescription dose iron supplements. But you also need this tested via blood sample to confirm it.

Okay, @MrsNandortheRelentless
This is said with the best of intentions!

Take control of this because your GP isn't.

If you can find £250-ish you can probably see a private menopause gynae within 2-4 weeks.

You need a blood test and treatment for your blood loss. The prescribed iron supplements are up to 100x what you buy over the counter. Long term anaemia is a serious thing and needs sorting asap. (Your GP could and should test you for that without waiting weeks.)

https://pubmed.ncbi.nlm.nih.gov/15823946/

The summary is this Conclusion: HRT use does not have an adverse gross effect on BP in hypertensive menopausal women who need it, although there may be an increased need for antihypertensive therapy during the 36-moth follow-up period of our study.

So, you either need to go back to your GP and show them this and other medical statements, or take it out of the NHS and find a consultant.

Look at local private hospitals and checking out their consultant gynaes. The other option is the BMS list of specialists on their website.

Painful smears etc- you sound as if you need vaginal estrogen (loads of threads about that here- one on Vagifem) which is the treatment for vaginal atrophy.

Thanks jingling, great practical advice there. And thank you for listening to me with this as there seems to be a complete lack of this out in GP land, it helps to be able to offload on folk that actually get where I’m coming from.

@MrsNandortheRelentless do update once youve made some progress with another HCP. Good luck.

Hi , I refused the coil for pretty frequent bleeding, which had given me very low iron. I ended up agreeing to take the progesterone only pill . My reasoning was I could stop taking it any time , if it didn’t agree with me , but a coil you need an appointment to have removed.

Have they given you vaginal oestrogen? A lifetime of agony with smears but since having vaginal oestrogen it's like a little miracle has happened.

No reason you can't have this regardless of BP - or you can just buy it yourself.

I also got far far better advice from a private meno specialist - just pick one from the British Menopause Society list. A lot work over Zoom/Teams so don't even have to go to a clinic.

https://thebms.org.uk/find-a-menopause-specialist/online-only-clinics/