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[MrsStacey]

Hello, all I'm 45 and I have a mirena coil fitted and am on number 3 with no bleeding for the last 10 years BUT in the last 6 months, periods have returned and are really painful.  I am soooo tired all the time, cranky, irritable, headaches, head fogs as well as hot and cold flushes.  Along with being very anxious this has not helped the high blood pressure they are now trying to treat - can anyone tell me is High BP linked to menopause at all - I  keep being told to stop but when I run my own business that is not easy to do. The  GP wants me to see a private consultant in Bristol but wanted some advise from those in the know first if this all could be linked? 
This sounds like the biggest moan out but I am normally fit, well and full of beans but just give me a fire and a duvet and I am happy these days 

[Hurdity]

Hi there Mrs Stacey

 

Not sure about BP and meno - but there are lots of ways to control this without medication eg losing weight if you are overweight, improving diet, taking more exercise, reducing salt, no smoking, reducing alcohol etc http://www.bloodpressureuk.org/BloodPressureandyou/Yourlifestyle

When was you last Mirena coil fitted? If it is less than four years ago then you could start HRT in the form of oestrogen only patches which should help your flushes if due to the beginnings menopause. However if your periods have re-started despite having a fairly recent Mirena - then it could be that you're at the last stage before peri-menopause when periods become closer together and sometimes heavier? Also if you are also having cold flushes too then maybe you could have blood tests - for thyroid etc - as a baseline and to rule out other conditions? Feeling cold (as well as fatigue) can be an indicator of underactive thyroid.

What - your GP is suggesting you go to a private consultant - about what exactly? They certainly should not be advising this!  Surely the NHS should be able to help you either with menopause or blood pressure depending on who s/he is referring to!

Hurdity x

[MrsStacey]

Hi Hurdity,

Thanks for all the info... i'm a little over weight but still a size 12 at 5'2" not too bad! Cholesterol is very good and don't smoke or drink to excess.

Coil was fitted Sept 2015 and was not the easiest of fitting's - going to go the Family planning next time!

Blood tests all come back fine but don't think he tested for menopause or thyroid. 

My GP is wanting me to see a menopause specialist at the Nuffield in Bristol, Dr Annie Evans but I want to explore all avenues before contacting her. He will not let me have anything HRT wise unless I have seen her, which I am happy to do but not convinced now about symptoms....

Thank you f or your time x

[Hurdity]

Heavens - I am amazed that you GP has suggested you go to consult a private menopause specialist! He is quite wrong not to think about prescribing HRT until you have had a gynae consultation - if you are peri-menopausal. If he is not confident in treating women with menopause ( and he should get up to speed pretty quickly since it affects rather a lot of his patients!) then he should send you either to someone else in the practice who does have this expertise or to a NHS menopause specialist. If there isn't one in Bristol then depending where you live I suspect Oxford or Southampton would be the nearest or else Bournemouth or Plymouth?

The other thing is Annie Evans returned  retired about 18 months ago so I don't know why your doc is referring to her anyway!! This does not instill confidence - that not only does he not know about menopause and HRT but also doesn't know who the practising gynaes are.....

You should absolutely NOT be asked to go for private treatment when you can get what you need on NHS!!!

However be that as it may - in your situation I would insist on blood tests for a whole range of things - but if you are bleeding heavily and experiencing proper periods after 10 years of no bleeding and with a fairly recent coil - I would want a referral/investigation too if necessary. It could just be the heavy bleeding of peri-menopause (and anovulatory cycles where the womb lining builds up) - and the progestogen in the coil being insufficient to stem this. However in your position I would actually want to have this investigated too just to make sure nothing else is amiss. Are the periods regular or is it just random bleeding?

Please go back to your doctor.....and ask your receptionist for a print-out of your blood tests (or maybe you can look at them online?).

Hurdity x

Edit - apologies for very misleading typo above!

[Mary G]

MrsStacey, if your GP is giving you the chance to consult Dr. Annie Evans at the Bristol Nuffield then I would grab the opportunity with both hands, she has an excellent reputation and is very knowledgeable on all things hormonal/menopause.

My local GP practice often sends patients to the local Nuffield hospital and they pay the full cost - my mother had her hip operation there on the NHS. 

Speaking from personal experience, I had a Mirena coil in the lead up to the menopause and it started causing problems when my oestrogel levels dropped.  Too much progesterone (in the coil) coupled with very low oestrogen levels is not good news but it is very easy fixed.  I tried using oestrogen patches with the coil but didn't get enough oestrogen out of them so I would strongly recommend Oestrogel, I think it would work much better and it is very dose flexible making it easy to adjust the dose up or down as required.  I wish I had tried that combination myself but unfortunately by the time I was introduced to Oestrogel, my coil had been removed.

I hope that gives you something to think about and run past Dr. Evans. 

Good luck with your appointment!

[Hurdity]

Hi again Mrs Stacey

Apologies I made rather an important typo (and I read all my posts too).   What I meant to say was Annie Evans retired 18 months ago (I'll correct my post). This is what comes of not wearing the right glasses! Sorry about that. If I'd written it correctly then Mary G would not have said what she said! I don't know if anyone else now takes the menopause clinic at Bristol.

If they are going to refer you to a private clinic and foot the bill (because there isn't an NHS one) then that's fine of course -  I wasn't aware that this could happen  and I was concerned that your doc is expecting you to pay for private treatment because he doesn't know enough about it, which is quite wrong!

As I said - just to reiterate, I do think it is important to be checked out (by your doc through referral if necessary) - if your periods have restarted despite a recent Mirena coil, not having had one for 10 years - although this may well be due to menopause, as well as having blood tests for thyroid function etc. You can then think about HRT if indicated and all is well - as patches or gel as I suggested.

Hurdity x