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[Henners]

Hi everyone,

New to this and would love some advice.
Bit of background, I'm 51 and started 1 pump of estrodial gel and 1 Utrogestan per day for just under 3 months. Periods ended naturally  a year an a half ago.
Went for my review 2 weeks ago and my bp readings were 164 162 and 154 over something.  Was told to stop hrt straight away. Didn't know any better so did what I was told. ( just to say I'd done a bp reading at home 3 days before and they were all no higher than 124 over something). I was also highly anxious in the surgery.
I was told to monitor my My blood pressure at home For one week And the average was about 133 over 88.

The thing is I've now spoken to an actual menopause specialist at my GP surgery and she said that she's happy for me to restart HRT and it never should have been stopped. but ever since I have I have been really anxious in the morning with some palpitations that take me up until about a midday. I'm sweating again at night and sometimes during the day.  The specialist I spoke to advised if my BP goes over 160 over 95 to let her know. My BP is currently averaging 135 over 88 right up to 155 over 92.
I panick in the morning and night when taking my bp. Just thinking about it makes me soo anxious. It's mainly the anxiety for no reason that's worrying me as well as the average bp. Sorry to ramble. Not sure what action to take now.
If anyone has any advice would truly appreciate  xx

[bombsh3ll]

I'm sorry this has happened to you.

Blood pressure readings taken in a clinical setting when someone is stressed and anxious are unhelpful and not reflective of a person's typical blood pressure.

This is exacerbated when the person is made to feel that ongoing access to much needed treatment is contingent upon getting a certain BP reading, which often happens with women and hormones.

I am glad you have now received appropriate advice that raised blood pressure doesn't necessitate stopping hormone therapy - if you were 35 would they have immediately given you a lupron injection?!

Abruptly stopping hormone therapy can in fact be harmful and can precipitate BP spikes as transdermal estrogen and micronised progesterone have blood pressure lowering properties.

What I would do is make sure you have a good quality BP machine with a cuff that properly fits your arm, and get really comfortable taking your own BP at home in a relaxed state.

Take 3 readings each time, ignore the first and average the other two, and keep a record of this for about 2 weeks, morning and evening.

Your GP practice may have a BP diary sheet for this, or you could use a free app such as kardia.

If you are regularly seeing readings of 130/80 or over, speak to the well informed GP about ways to manage this which can include lifestyle changes and/or medication.

[Tinkerbell]

It will be anxiety that is spiking it, something I am  a slave too.My target BP set by GP is 135/85, I am on systemic HRT.

Get a upper cuff Omron monitor, basic is fine if you haven't already got one. I have always been told to ignore first reading, my second is normally lowest but if I go for a third it is often higher, anxiety again!

Practice 4-7-8 breathing as I find that helps.

[Henners]

Hi bombsh3ll

Thanks so much for taking the time to reply.

Yes I'm definitely going to keep recording as you say for another week and see how I go.

The only other thing that concerns me is having to stop hrt again to take bp meds when my estrogen levels are low but I guess I have to do what's best.

I have no other health issues but I did have lichen sclerosis last year post meno and had successful treatment x

[Henners]

Hi Tinkerbell

Thanks for your reply.

Yes think that happens to me as well. Because I've just restarted hrt I've been told to take a bp measurement once per week to give my system time to adjust to it.

 I've also often got the lowest reading when I give in and have a 'don't care what the next reading says' attitude  .    I've historically never had high bp readings so this is all new to me. I have a boots bp monitor. My husband also uses it so I know it works. It's the squeeze before measuring that gets me every time. Will practice more breathe techniques x

[bombsh3ll]

The only other thing that concerns me is having to stop hrt again to take bp meds when my estrogen levels are low but I guess I have to do what's best.

Nobody needs to stop HRT to take blood pressure medication. Ever.

If you are on HRT and have genuinely high blood pressure that isn't responding to lifestyle measures, then you just add in blood pressure medication.

If you were premenopausal and had high blood pressure do you think you would be sent to gynae to have your ovaries removed?

[Tinkerbell]

I have been on BP meds for a long time, since my son was born. There is no reason why you can't use systemic HRT, they prefer transdermal so patch or gel, once you have controlled BP on medication. A couple of years ago mine went high with a load of stress but I didn't have to stop HRT GP just added in a new BP med.

[Henners]

Tinkerbell and bombsh3ll,

Thank you both so much for the reassurance.
I really feel a lot better not having to think about stopping and starting hrt again. Think I'd give up otherwise!!!

That analogy you have bombsh3ll makes perfect sense x

[joziel]

Low estrogen often causes high blood pressure.... So the mind boggles why you were told to stop it.

I am really fit (so says my Apple Watch  ) and work out 4-5x a week, do 10,000 steps a day blah etc.... And I'm slim. I've NEVER EVER had blood pressure problems in my life.

Suddenly, with all this peri-menopause crap, I began to get very high blood pressure spikes. Not consistently, but randomly. One night I laid awake ALL NIGHT (with my low estrogen symptoms - including palpitations, inner tremors, heart beating hard and fast) and then went to A&E the next morning as I was worried I was having a heart attack...

ECGs were always normal. But my blood pressure at the hospital was 183/90 which was ridiculous. Like you I was told to monitor it for a week. It was normal every time I happened to take it, because I wasn't testing during one of these spikes.

I am now on high dose HRT and my estradiol is around 850pmol with a generous amount of progesterone and regular testosterone doses. My blood pressure is completely normal again.....

[Henners]

Thanks Joziel,

I've been back on estrodial and Utrogestan every night for just over a week now and think that my body is starting to adjust again

Will.keep an eye on bp once per week  to make sure it's okay.

Glad to hear it all worked out for you in the end. The body does put us through a lot sometimes