Blood pressure and HRT

[TheNeighbourOfTheBeast667]

Hi has anyone had any experience with blood pressure and HRT, specifically reducing Oestrogen patches (Estradot) and blood pressure increasing ? I also take testosterone gel prescribed by a consultant, the last blood test I had showed that my free androgen index was a bit high (I think 6 but I need to double check this) this has often been the case even though I am taking it at the prescribed dose because my SHBG has always been low.
I had reduced my patches by 25 mcg about 3 or 4 months ago and did this very gradually as I thought that the bloating I was experiencing was caused by HRT when the consultant swapped me from Evorelle to Estradot. This was due to me not absorbing the Evorelle very well and despite using 200mcg I was still experiencing symptoms. My blood levels were about 300( they had dropped from 460 the previous year when I had been using Estradot but had to change when I couldn’t get hold of them.)

The consultant hadn’t told me to reduce my patches, but I knew that I absorbed the Estradot much better than Evorelle.
I realise that blood tests are not routinely recommended however I have another condition that cause similar symptoms and it’s very difficult for me to tell which is which.

I think because of the testosterone they will carry out blood test to make sure it’s still within female levels once per year. I have had quite a lot of stress going on this year, but my blood pressure had been more or less stable at 125/80 ish, however over the last few days when there isn’t very much stress going on, it’s been 137/88 or even 140/88 at times even when resting nothing else has changed I am not overweight although I could do with losing some weight around my tummy but I found that very difficult to shift (I can’t exercise due to disability) I’m also wondering whether this could be the slightly higher testosterone levels, I don’t drink at all or smoke or have caffeine.
On another routine blood test I had also noticed that my haemocrit levels are slightly raised and I understand this can be due to higher testosterone. I have had the bloating investigated for ovarian cancer, et cetera, and had a scan and CA125 blood test.

I think this is something you need to ask your doctor.
estrogen is beneficial to the heart but reducing a patch should not automatically rise your BP.

Is this an NHS consultant or privately? If it's NHS were you referred because of complex issues?
If you see a private consultant I'd suggest making an appt to see them and discuss all of this - otherwise see your NHS consultant whenever you can.

Next question- what's making you test your BP?
Is that something you'd normally do? Do you have a BP problem?
Are you testing it properly? It should be 3 readings and take the average of the 3.

TBH I'd put the dose of estrogen to one side, and as you say blood tests are not accurate. (My consultant won't do them and never has.)

High BP can be caused by all sorts of thing but it's worth thinking about diet and exercise. BP rises with old age but doing exercise and changing diet can help. If you can't exercise at all, that is going to increase the risk of high BP.
Are you able to say what your disability is? Are you able to walk, swim, exercise at home in any way?

Also being anxious about your BP and testing daily can make it higher!

Once a week is enough (advice from a cardiologist for someone in my family with high BP and on meds, who was testing too often.)

@JinglingSpringbells Thank you for replying. I see an NHS consultant due to complex issues but they signed me off last year back to my GP. I test my blood pressure from time to time as I’m inactive and been disabled for years and my husband is a paramedic so it’s something that he’s quite aware of.I don’t want to say what my disability is due to possibly identifying myself but I am very very restricted with walking or any physical activity. I used to be very active physically before this and I don’t like not being able to exercise. I do exercises from a physiotherapist, but this is more about muscle strength rather than cardio health. I’m very careful with my diet as well.
The other reason I check it is because I had an irregular heartbeat I saw a cardiologist and this turned out to be ectopic beats caused by stress(I had a 24 hour monitor last year) this has improved but I occasionally still get them but I’m not worried about them now. My BP has occasionally been raised in the recent past, but there has been a huge amount of stress going on for a few years now since lockdown. I had to do a safeguarding on a family member due to a sibling abusing them, this has just been horrendous and it’s had a big effect on my health. The person is safe now, but it has ruined my relationship with one of my parents and meant they don’t see their grandchildren(their choice).
I’m 60 I realise that blood pressure is going to increase with age.
I completely agree that being anxious about testing is not going to help!

I have also been suffering badly from anxiety recently and I am wondering if the reduced oestrogen has anything to do with this as I understand that it takes a while to take effect if you reduce or increase it. I’m seeing a counsellor for the family issues which does help. I haven’t had any other symptoms of low oestrogen like over heating but the worst symptoms for me were mood and mental health related initially and HRT really helped with this. I felt like my old self again

Might be best to increase your estrogen back to what it was. No point reducing it if you've got some symptoms back like anxiety.
Are you using any progesterone?

Only you know your limits with exercise but being sedentary is not going to help.

I don't mean that as a criticism.

The Blood Pressure charity has lots of advice and tips.
Blood Pressure UK

Sorry to sound pedantic- a family member sees a cardiologist for high BP and theirs was increasing with 'home' white coat syndrome. They too are very anxious. They got a reminder to only do it once a week.

If yours continues to be high you obviously need to see your GP and discuss medication if you can't do any exercise.

Thank you. Yes, I’m thinking about increasing the patch again however I’ve got issues with trying to find it because I’m on Estrodot and there is a UK wide shortage, it’s been a nightmare. I’m starting to get stressed about it now because I’ve only got four weeks supply and can’t find it anywhere. I was using Evorelle before, but it wasn’t working as well.
No progesterone as I gave a Mirena.

I will start taking BP only once a week and I’ll get my Husband to check it. I know exactly what you mean about whitecoat syndrome that always happens whenever I’ve had it done at the Doctors and also with ECGs.