Anxiety and Perimenopause

[EmmaL21]

I have had chronic anxiety since 2016, but I have always managed to keep it at bay with medication/exercise.

in August 2023 things started changing. Anxiety was consistent. I do have a lot of life stressors inc family, work, moving. 
Periods slightly started changing but nothing too serious. I had been to the dr and he told me it could be perimenopause. I dismissed it thinking I was too young. I did eventually start medication for 4 weeks and it made everything worse. So I stopped and went to another Dr. August I changed my medication as it wasn’t getting any better. Slowly started feeling better. However September came and things started going south again. Periods have started changing shorter, sharper, pain in my right hip, and every 2/3 weeks chronic anxiety attack that can last up to 1 week. Waking up in panic almost each morning. I have to take medication when needed to stop the panic. Does anyone have anything similar? It’s getting really tough and not feeling like living anymore. My 3 kids are the only think keeping me going. 

[Eagle Ray]

Hi EmmaL21,

It’s so hard to know for sure isn’t it. According to people like Dr Louise Newson and my hormone specialist doctor, hormone testing is not considered an accurate marker as it changes so much in perimenopause and often will be normal at the time of testing. So they tend to go by symptoms alone and then see if HRT actually works. 

For me I could tell the anxiety and depression was outside the box of anything I’d experienced before coupled with sudden, severe insomnia and intrusive thoughts. So it actually felt pretty weird. The testing a GP ordered was at the end of a particularly bad episode and oestrogen was pretty low so it was easy to establish a link.

I guess just see how you go and hopefully things settle and it’s really good the waves of panic are over.

Take good care,

ER

[Eagle Ray]

Hi seashells,

I totally agree. The lack of awareness is shocking. Hence people like ourselves get to perimenopause and don’t know what’s hit us. I honestly thought I was going mad until it dawned on me it was hormones. I then started reading about women with identical symptoms after doing some searching for info. But it’s weirdly still kind of taboo. You don’t see that with other topics like heart disease or diabetes etc. They’re regularly discussed all the time. While all these women are struggling on alone, many of them totally lost and confused.

With regard to the HRT I had a GP who told me just start whenever. I have heard conflicting views on this. I just started it because he said it was ok but it was when one of the hormones was already in its high phase. So I actually got an extra boost of that hormone by starting when I did so the results were quite dramatic. I went from a barely functioning mess who hadn’t slept for many weeks to feeling incredibly alive almost immediately - like I suddenly had superpowers. I immediately slept well, like after the first dose, and woke up feeling like a normal person without the debilitating despair that had been plaguing me every time I woke before. I honestly had never felt so strong and well. Not everyone has such a dramatic response and for others it’s much more gradual. After two weeks though I had a bit of a crash as he also advised to start both hormones together as I was doing one of them cyclically to begin with (2 weeks on then off). Looking back, based on my cycle, I should have started one and then introduced the other two weeks later. But, honestly, getting clear advice on this seems difficult. Overall my understanding is though that your cycle falls into sync with the HRT which is what happened to me. It became very regulated. I soon went to taking the hormone that was cyclical continuously instead which is often more recommended in the late perimenopause/menopause phase and that was better and more stabilising for me.

I’m limited in what I can say specifically as we aren’t allowed to name specific meds here. But if you join the balance-menopause app you can ask questions as much as you like about meds and you will get answers from others. Even there you might get some contradictory advice but you can at least talk about meds freely. 

I really hope you experience some benefit. It’s probably good to know it takes longer for some than others to start to feel the benefits so don’t be discouraged if it isn’t immediate. The dosages can require tweaking over time too. I have just restarted one of the hormones (the one that doesn’t trigger histamine intolerance for me) and it already feels it’s helping with mood and sleep. 

Take care and all the best,

ER

[seashells]

Hi Eagle Ray,

I chatted with you once a couple of months ago. Ive been struggling with what works and what doesnt tried the HRT worked for a couple of days then no good so stopped doing that. Stopped smoking and took every herb i could naturally but this is a roller coaster up down all around. Initially i was so scared and anxiety levels through the roof. No libido, no interest in anything, really looking for some miraculous answer or miracle. Well atm i guess accepting this is the new me is a start. Breathe and pray for a brighter future and hope this passes soon. WTF happened to me!!!!! How has your progress been? Have you found anything that has been benificial since we last chatted.

Seashells

[Eagle Ray]

Dear Seashells,

I just wanted to let you know I will reply to you most likely tomorrow when my brain is fresher as I can feel I’ve hit a wall of tiredness tonight.

But I thought you may like to know that BB have a webinar on tomorrow on the topic of perimenopause and menopause and the effects on mental health which you can see the details of at this link:

https://www.beyondblue.org.au/get-involved/events/the-menopause-mind-field 

Take care and speak soon,

ER

[Eagle Ray]

Hi again Seashells,

With the HRT, when you say it stopped working how long did you take it overall? I was one of those people who was helped immediately and some women do report that, but for others it often takes 3 months before they get a sustained improvement. So I’m just wondering if persisting would help, unless you are getting bad side effects? The Balance app is quite a good place to ask questions and that is where I found a number of women reported it was 3 months to start getting benefits. It really is variable and the HRT (or MHT as it is being called now) can require tweaking over time. As I mentioned above, I stopped it because of a histamine intolerance reaction that eventually became so severe I had to. But many women never get that.

At the moment I’m trying a supplement from the Chasteberry plant (Vitex Agnus-Castus). It has a brand name but I’m reluctant to name it as I might get into trouble for mentioning a med on the forum, even though it’s a supplement and not a prescription med. I think it may be helping. It’s a bit hard to tell as I’ve been through a lot in the last 5 weeks or so grieving a loss so my emotions are already out of the ordinary. I’m in an unusual space. I would say my hormonal symptoms are actually better at the moment as far as I can tell.

I completely understand the WTF just happened feeling. Were you able to watch the webinar today and get anything from that? I didn’t see it myself. But I have found it reassuring seeing and reading things that help explain what’s going on. I think feeling some support, care and understanding definitely helps even if not a total solution. Is there anyone in your life you can share with for some support?

I think accepting the reality of it can help. It really is outside other experiences isn’t it. Feel free to post here anytime if it helps to chat or just vent. If it’s any encouragement, I do feel the hormonal side is improving for me at the moment. I also have a complex trauma history and I think my level of hormonal dysregulation is tied to that as well, so I’ve found processing trauma experiences with my psychologist has helped as it has taught my nervous system how to kind of rebalance. That in turn I think does have a balancing effect on hormones and the immune system too. I’ve had a lot of healing just in the past few weeks in the context of grief processing which sounds like a paradox but it’s what has been happening. So for me releasing emotions and going through emotional healing I think has also been helpful with hormonal issues.

Take care,

ER

[seashells]

Hi Eagle Ray

thankyou. I'm dealing with complex grief too. coming up to 6 years. And just last 2 years my parents having to put them into aged care. So very emotional times in the last 6 years. so possible post traumatic stress then add this perimenopause to it and WTF. I just want to keep checking in and see if either of us find something that works or see if we hopefully ride it out asap. I have been reaching out to God and asking for help and praying. Pray we both find an answer.

take care. 

seashells

[Eagle Ray]

Hi Seashells,

That’s really tough dealing with the complex grief and putting your parents into aged care too. It seems to be the case that so many women go through perimenopause as they are caring for aged parents and many also for teenage children at the same time, and sometimes younger children which can be exhausting when struggling. I don’t have kids, but I was a carer for both my parents in my 40s while the perimenopause process was underway and it was a hard combo to deal with. My worst hormonal symptoms have been since 2022 though and I really hope the worst is over now.

I do feel like I’m experiencing some improvement at the moment. I feel like emotional processing of past life issues does seem to be helping a bit. I was talking to a friend about my age a few weeks ago and she was saying how for her these hormonal issues bring up all our life’s emotional stuff to process and I do feel like that has happened for me. It’s like anything I might have been able to suppress in the past I can’t now. But it’s like releasing certain emotions is helping.

That’s lovely you are praying for some help and answers. While I’m not part of a formal religion or church, I’m definitely a spiritual person and I’ve felt very spiritually connected over the past few weeks in particular and it’s really helped me. I think the feeling of being supported by something bigger can be so incredibly helpful and healing. It’s kind of like a feeling of being held whatever may be happening with those challenging hormonal symptoms.

If I learn of anything particular I find beneficial I can let you know. Things like the supplement I mentioned above are always good to run past a doctor or knowledgeable practitioner for advice. I try to look for things with some evidence base behind them.

I hope you have a lovely week this week and you take care too,

ER

[Eagle Ray]

I’m having an horrendous day today with how I’m feeling with hormones. I just need to express how I feel. I seemed to be doing ok hormonally for a while but crashed badly this afternoon. I can feel when oestrogen suddenly falls which is often dramatic for me. It’s like going off a cliff into the most horrific anxiety that then morphs with depression. It’s like feeling beside yourself it’s so bad. And I’ve tried so many things now. Hormone medication worked best but caused severe side effects with histamine intolerance. So just feeling really lost with it right now and I feel over researching it to find answers. When I feel I’m in a hopeful stretch I just get crushed again. Trying to stay positive but hurting 😞

[Annas1]

Oh ER, it's really not fair how this stage in our lives continues to test us. And you've applied yourself to the causes and possible solutions with care and diligence. So, definitely it can feel unfair and distressing; I hear you.

I have a very similar experience of putting in lots of effort to manage the physical and psychological experience of anxiety and depression only to be tipped over/blindsided by hormonal changes. It really undermines my sense of capacity and worth sometimes, even though this is just low-ebb thinking that I try to counter with gentle wisdom. And sometimes its just 'emergency self-care' time, when the discomfort/angst/despair is overwhelming and I need to make my wellbeing priority 1. Perhaps this is 'emergency self-care' territory for you ER? If so, do what you need to do in order to tend to your discomfort and low feelings. This is important and kind. This might be a few days, or a bit longer, but whatever is needed. When the intensity and overwhelm are reduced then it will be time to think about solutions to this recurring experience.

I know that replacement hormones have been important in maintaining my own wellbeing, but I am also aware that I may not always be able to use them. A little part of my brain is trying to be ready for this eventuality, which would mean trying the non-prescription herbal and mineral supplements. I think there is some usefulness in these, and understand that magnesium and calcuim are particularly helpful. It also might be worth a second opinion/revisit of the range of hormonal options available so that you don't unnecessarily exclude treatments that could be tolerated. It could also be a dosage issue? I'm definitely not qualified at all to give medical advice, but know how I would be feeling in your shoes.

You have managed your life so well over this time, and I commend you for the effort it takes to work out what's going on, deal with the symptoms and carry on as best you can. I believe there will be something that can reduce some of your symptoms, or maybe it's a matter of a whole toolkit of things. I'm getting a lot of benefit from regular exercise, including cold water swimming/immersion. I hope you can count on good social support too, which goes a long way in holding up our self-esteem and confidence.

I wish that this wave of hormonal hijacking resolves asap, and that you can see your tremendous strength and value.

Take good care

[Eagle Ray]

Dear Annas1,

Thank you so much for your kind, thoughtful words. I did start to feel quite a bit better in the late afternoon and went for a walk and I still feel improved at the moment, with the anxiety at a lower grade so to speak. Yes, I think I do need to kick into 'emergency self-care' at such times. I did call Lifeline last night as it really was distressing but I think the person who sounded young didn't know what to do with the situation. It's like having to just endure through it somehow.

I appreciate your understanding and I'm sorry you've had to go through these issues too, but glad you have got the definite benefit from the hormone medication. I am going to continue with it tonight myself. So far I have no side effects from last night. I'm going to stay on a low dosage and see how long I can continue, hopefully without developing the same issues as before. Depending which medical people you listen to, some say you can stay on the hormonal medication for life and others say it should be time-limited. I hope when it gets to the time you may be considering whether to come off it, that there will be clearer and more consistent advice on it. I have been trying an alternative supplement over the past few weeks, but I don't think it's made much difference in that I still plummeted down to an extreme low yesterday.

That's really interesting about the cold water swimming. Recently my hot water system broke and I was without hot water until the new system was installed. So I was having daily cold showers which I actually don't mind too much. I honestly felt much better for the rest of the day than I do having a warm or hot shower. It really does shift something in the nervous system. I have access to a nice swimming beach so I have no excuse. I need to be doing some cold water swimming.

Hormonal hijacking is a good description for it. It's really like being taken over isn't it and I find it can happen very fast. Only the day before I was walking by the river in the sunshine feeling really good in my body.

Thanks again for your kindness and understanding 🙏

ER