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Menopause

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Please help - debilitating anxiety in perimenopause

140 replies

PopRay80 · 17/02/2024 06:44

Morning ladies. I’m 43 and going through this horrendous perimenopause. I feel like it’s ruining my life 😢
I’ve never had anxiety before but this was one of the symptoms that made me go to the GP to ask for HRT as I knew it was hormonal.
I’ve been off work for about 3 weeks now and don’t know how I am supposed to work with such crippling anxiety and tiredness.
I wake up at around 4am every morning and the anxiety hits. I have a really tight chest and my brain is in overdrive.
I have been on HRT (gel and utrogestan) for around 10 days (prior to that I was on Evorel Sequi patches for 2.5 weeks, which made me feel worse) and desperately want to know if anyone can tell me if this will help with this debilitating anxiety??
Please let me know if HRT will help with anxiety as I’m desperate.
I’m SO unhappy right now and can’t cope with this 😢

OP posts:
Foodaddict1 · 18/02/2024 21:41

I feel for you. I'm 48 and most definitely perimenopausal. Horrendous anxiety with intrusive thoughts also 🙁 I'm a bit scared of taking HRT as I have always responded really badly to the pill etc. the worst for me was the mirena coil. I was depressed and anxious all the time. Had it removed as a matter of urgency and the mood lifted within days.

I try to remain positive though because I had crippling anxiety after my first child 19 years ago and it managed to pass. I was given anxiety medicine but never took them (anxious about side effects).

I was much better after DC2 and still had a few bouts but felt so much more in control.

Do you still have periods? Does your anxiety fluctuate through your cycle or is it all the time?

Also have you had your ferritin levels checked? Low ferritin can cause anxiety/tight chest etc.

chittyshittyohffs · 19/02/2024 16:08

No advice but I'm in exactly the same boat and struggling to function. I'm still managing to work but it's a struggle.

How old are you OP? Perhaps you need a higher dose of HRT or a different delivery method?

Did you have anxiety before menopause?

chittyshittyohffs · 19/02/2024 16:09

Sorry just realised you gave your age.

ArchetypalBusyMum · 19/02/2024 17:14

Thought some of you might find this an interesting listen... It is a broad conversation but some is of direct relevance to this thread and all of it is interesting.
https://www.bbc.co.uk/sounds/play/m001w0z9?partner=uk.co.bbc&origin=share-mobile

In Our Time - Hormones - BBC Sounds

Melvyn Bragg and guests discuss the chemical signals that control the ways our bodies work

https://www.bbc.co.uk/sounds/play/m001w0z9?origin=share-mobile&partner=uk.co.bbc

StillCreatingAName · 19/02/2024 17:40

Also there is also a correlation between menopause symptom severity and adverse childhood experiences and this should definitely be taken into consideration when creating a menopause care plan for yourself, possibly with therapy.

@SallyGarozzo I’ve never heard of this, I would have assumed puberty (and later, perhaps conceiving, or struggling to conceive, IVF etc) could be a relative influence on how we feel in the years approaching menopause.
Are you talking about stress, adrenaline at an early age (pre puberty) having an impact on our hormone management for the future?
It could really help others on the menopause threads to hear more about it.

PopRay80 · 19/02/2024 20:08

chittyshittyohffs · 19/02/2024 16:08

No advice but I'm in exactly the same boat and struggling to function. I'm still managing to work but it's a struggle.

How old are you OP? Perhaps you need a higher dose of HRT or a different delivery method?

Did you have anxiety before menopause?

I had never had anxiety before! I have had depression for around 15 years, which I have taken antidepressants for and had lots of counselling.
I knew something wasn’t right when I started feeling very anxious at the end of last year and I recognised that it was my hormones causing it.
Thankfully, a lady at work told me to go to the GP and I did a lot of research on perimenopause and realised I had quite a few symptoms aside from the anxiety.

OP posts:
JT69 · 19/02/2024 20:27

Add me in too. The anxiety is ruining my life. The waking up , the 5am panic attacks. I’ve even had a complete meltdown at work. I’m on hrt but supposed to be seeing my GP this week but just can’t bring myself to do it. I can’t even talk about it without crying - I annoy myself. Interesting link to child hood stress -it explains why all my bad memories and triggers have surfaced.

Nevermindtheteacaps · 20/02/2024 06:48

Exercise and acupuncture are the only things that help me with debilitating anxiety OP, although not yet peri related. But if you can afford acupuncture, I highly recommend it

Kingsley81 · 20/02/2024 12:25

I feel your pain. I have been suffering terribly for the last year. I’ve tried various HRT and ADs but nothing seems to be working for me at all. I’ve been on Mirtazapine for the last 15 weeks and I still feel dreadful but feel too embarrassed to go back to my GP as I have lived there during her last year. I’m not sleeping past 4am and wake with the most awful panic/nervousness. I cry and cry and have lost all joy in my life. No appetite either, even though mirtazapine seems to make everybody else eat all of the time. I hope you find something that work for you. I am interested in seeing the other responses to see if there is something else I can try.

PopRay80 · 20/02/2024 16:00

Kingsley81 · 20/02/2024 12:25

I feel your pain. I have been suffering terribly for the last year. I’ve tried various HRT and ADs but nothing seems to be working for me at all. I’ve been on Mirtazapine for the last 15 weeks and I still feel dreadful but feel too embarrassed to go back to my GP as I have lived there during her last year. I’m not sleeping past 4am and wake with the most awful panic/nervousness. I cry and cry and have lost all joy in my life. No appetite either, even though mirtazapine seems to make everybody else eat all of the time. I hope you find something that work for you. I am interested in seeing the other responses to see if there is something else I can try.

So sorry to hear this. Make sure you go back to your GP, that’s what they’re there for. I’m sure they see lots of people over and over so don’t feel embarrassed to go back.

OP posts:
Reachingforchocolate · 20/02/2024 19:26

Hi. I’m 52 and was on HRT for just a few weeks - gel and utrogestan. Literally second month taking utrogestan I literally was suicidal. It was awful, like a switch had been flicked in me. It was utterly overwhelming. I just couldn’t work out what had happened to me, crying all the time and planning to end my life. After nine days, I just couldn’t take it anymore and I stopped completely, been on HRT for about five weeks in total. I’ve never felt so low. As soon as I stopped the HRT it started to lift.

That was about three weeks ago. I’m on antidepressants now and slowly starting to feel better - I haven’t cried today and that’s the first day since the middle of January. I only started HRT because of night sweats. Other than that I wasn’t too bad. I’m still very shaken and quite anxious, a bit of a wreck. (I’m a keen runner so I just keep running!)

My GP thinks I have a progesterone intolerance so no more HRT for me. Incidentally I had a dreadful time on the mini pill and the mirena coil was awful for me - non stop bleeding, migraines and then I got an infection, had to beg the GP to remove it.

I’m so pleased that HRT works for some people but it just doesn’t work for me.

Twoshoesnewshoes · 20/02/2024 19:31

I have anxiety anyway, and it was x 10 on HRT due to progesterone.
im off HRT now, take SSRI, anxiety not an issue now.

Purplecatshopaholic · 20/02/2024 19:43

I had this. Crippling anxiety that started from nowhere, got worse and worse (never been an anxious type of person in my life before) - being sick on the train going into work, to being sick before meetings, to having full blown agoraphobia and being unable to leave the house. I honestly thought I might never work again, certainly not in my job (senior, full time). I quit alcohol and started taking Sertraline and it’s really made a difference. Also on HRT now too.

StillCreatingAName · 20/02/2024 20:08

@Reachingforchocolate keep running through it, it will pass. It took me a few months before I felt like myself again- I walked for miles and miles, first thing in morning and some whole days at weekend just to recover (I have running injuries otherwise I would have been running like Forrest Gump). It’s such an awful experience to go through, progesterone intolerance is felt almost immediately on the tablets, I tried taking as a pessary too and the same happened, it just took longer to kick in😞 I had a bad time on the pill when younger, I wish I’d known it could be the same awful side effects too. Hope you’re starting to feel much better soon.

Reachingforchocolate · 20/02/2024 20:25

@StillCreatingAName thanks so much for this. Right now, I can’t imagine feeling normal again. I’m still so shocked that I was so overwhelmed with it and totally out of the blue. Sorry you went through something similar but it’s reassuring to hear that it’s not just me.

chittyshittyohffs · 21/02/2024 09:51

How is everyone doing?

I seem to be having a better day now that the dreaded AF has arrived so there's definitely something hormonal/peri related in this for me, it's a very physical anxiety I get.

Hoping you are all doing ok, this thread is very helpful and supportive

Twoshoesnewshoes · 21/02/2024 13:28

I guess HRT assumes we are defecit in those hormones? So if our own levels of progesterone have not dropped, or are fluctuating, the HRT will raise levels to an intolerable level.

Bookist · 21/02/2024 13:29

Yeah, but just......no. I am not medically qualified but I am far more knowledgeable about hormonal/reproductive depression & anxiety than most. I had to educate myself because none of the GPs I saw had a clue.

These symptoms of intense anxiety, agoraphobia, panic etc are caused by the fluctuations of oestrogen and progesterone. It is a chemical reaction. I'm sure fellow sufferers on here will recognise when I say it feels like you have been injected with a powerful dose of anxiety & fear. Nothing to do with your childhood, or traumas or any of that woo nonsense. It's chemical and should be recognised as such. Have therapy or acupuncture if you fancy it, but no amount of talking or inhaling hemp leaves is going to control this chemical chaos.

It's like suggesting that talking therapy is going to cure your diabetes.

Women who suffer in this way are severely progesterone intolerant. They cannot tolerate the fluctuations in their own progesterone, particularly when their oestrogen levels are fluctuating and ultimately diminishing. The highly synthetic progesterone present in oral HRT can be pure mental poison for progesterone intolerant women. For women who are hormone sensitive (and not all women are), good levels of oestrogen are vital for your mental health. Oestrogen is your happy, feel-good hormone.

Did you know there is a direct correlation between women who suffer with PMS/PNDD who then go on to suffer with PND and eventually end up suffering those same PND symptoms again, years later, during the peri menopause? It's a classic progression that is common to many women who are progesterone intolerant.

More women commit suicide between the ages of 48 and 52 than at any other time in their lives. This is the typical age of when peri menopause is at it's highest. This. Is. Not. A. Coincidence.

I suffered like the damned with peri menopausal anxiety and depression. I went from being outgoing, busy and full of life to a terrified husk of my former self. I had the classic progression from severe PMS to PND to peri menopause Hell. My PMS had been getting much worse and lasting longer since I turned 40, at the same time that my periods had got much lighter. Then in October 2014 the PMS didn't go away once my period started. It just got worse and worse and worse. I was only getting a few good days per month.

The next two years were incredibly difficult. I knew my problem was hormonal but every GP I saw told me I was far too young for peri menopause. I was 43 FFS. Not one doctor was prepared to recognise any connection between my PMS + PND and now peri menopausal anxiety/depression. Not one.

Finally through a lot of research and reading I found my way to Professor John Studd. At the time he was considered a world expert on menopause and was Chairman of The Menopause Society. He saved my life. He told me I the classic poster child for what he termed 'Reproductive Depression.' If any of the sufferers on here have a look at his website I think they will all recognise themselves in the case studies he writes about. I know I did. I read his website crying the whole time because FINALLY an actual doctor knew exactly what was wrong with me.

Prof Studd was a huge advocate of HRT. His gold standard was Oestrogel (as much as you needed to feel good again) balanced by as little progesterone (Utrogestan) that you could get away with. His doses were often much higher than anything a regular GP would consider. But in his own words "All women need different doses to feel good again." He liked his patients to have a p/mol level of 800 or higher of oestrogen, he deemed this a decent therapeutic level.

However, he also said that anti depressants can also have a role to play in women who are especially progesterone intolerant. He told me that the reason that ADs alone don't work well for hormonal anxiety/depression during peri menopause is because they need sufficient levels of serotonin to interact with - and that oestrogen plays a big part in serotonin production (I am paraphrasing what he said).

It took roughly 3 months on his HRT regime to fully recover. But there were definite signs of improvement within the first fortnight. Once I was stablilised he wrote a letter to my GP explaining exactly how to prescribe for me, on going, on the NHS.

So, sorry for the long diatribe. But I promised myself that if I ever recovered (and I did) I would do my very best to pay it forward and help other sufferers of progesterone intolerance. It's a terrifying and horrible condition that can ruin lives and wreak women's mental health to the point where suicide seems the only option. It's astounding that it is virtually unknown and unacknowledged among the general medical profession (yes, even in some supposed Menopause Clinics which are often staffed by doctors with no background in gynaecology or menopause).

But the right medication and help is out there for you. And you can and will recover from this.

BeretInParis · 21/02/2024 13:39

Nevermindtheteacaps · 20/02/2024 06:48

Exercise and acupuncture are the only things that help me with debilitating anxiety OP, although not yet peri related. But if you can afford acupuncture, I highly recommend it

This for me too.
Acupuncture has been a game-changer. I was going weekly, then every 10 days and now every 2 weeks. It's helped my anxiety and brain fog.

Bookist · 21/02/2024 14:47

Are you aware that you're not allowed to advertise your professional services on Mumsnet?

Bookist · 21/02/2024 14:52

"I absolutely understand that this may seem totally absurd, but please remember that we are all operating from different paradigms and this may be one that doesn’t make sense to your world view. But your world view is not the only world view that is legitimate. "

I'm sorry but this is just word soup.

PopRay80 · 21/02/2024 16:43

@Bookist Thank you for your informative post. I had read a lot of that before. So, are you saying, if we show signs of being progesterone intolerance we should take antidepressants with it?

OP posts:
Bookist · 21/02/2024 16:47

PopRay80 · 21/02/2024 16:43

@Bookist Thank you for your informative post. I had read a lot of that before. So, are you saying, if we show signs of being progesterone intolerance we should take antidepressants with it?

As I said I am not medically qualified, but Prof Studd told me that if you don't have sufficient oestrogen then ADs aren't going to be all that effective in peri menopause. And he said that in severe cases of progesterone intolerance that adding an AD to a good HRT regime might help.

PopRay80 · 21/02/2024 17:04

@Bookist Thank you. I reacted really badly to the progestin in the patches so swapped to utrogestan. Hoping when I take it in 9 days time it will all be ok 😬

OP posts:
Bookist · 21/02/2024 17:07

Keeping my fingers crossed for you. Thankfully I was able to tolerate Utrogestan quite well. Though Prof Studd had me only taking 100mg for 7 days a month.