Perimenopause anxiety

[EatenTooMuchChocolateAgain]

I’ve been on hrt since last year:-
everol 75
testosterone
vaginal estrogen

No progesterone as I had a hysterectomy 8yrs ago (kept ovaries though).

The hrt has sorted all my perimenopause symptoms except anxiety. It’s like a low level anxiety that comes and goes, but it’s for no real reason if that makes sense? I’ve got nothing to be anxious about! I’m finding I’m more anxious when I’m driving too, again for no reason.

Has anyone else had this? If so how have you managed it?

A very long time ago I had PND and had fluoxetine and pregabalin, which worked but I hated the side effects of the pregabalin. I’m reluctant to take it again, but I don’t know if there are any alternatives.

It would be great to hear from anyone else who’s had this please?

Yes, I had horrendous anxiety that would come and go, even on HRT. I found the thing that actually helped was giving up alcohol- even a glass or two and I’d be fretting in the wee small hours, or full of anxiety the next day. It wasn’t why I gave up, but it’s a very welcome side effect!

Bio identical progesterone helped my anxiety and panic attacks within a week. They took me off it after 6 months because I was on a synthetic progesterone so I didn't need the utrogestan for womb protection. Within a month my mood had dropped and the anxiety was creeping back up. Started the utrogestan again and got happy again. No doubt in my mind which bit of the Hrt had the biggest effect on anxiety and mood for me.

Yes, I’ve gone on beta blockers which have massively helped

I think progesterone will help you

Here’s a podcast from Louise Newson explaining why

https://www.drlouisenewson.co.uk/podcasts/natural-progesterone-what-mental-health-benefits-can-it-bring

@Overanddun thats a good point about alcohol - I had a glass of wine last night and feel so anxious this morning; it’s not worth it!

TBH I think anxiety is normal and doesn't need medicating unless it's so bad you can't function day to day.

I am far more anxious now than i was in my 20s. I just accept it and don't fight it.
It's not something I'd want to medicalise to take drugs for. I'm on HRT anyway but it wasn't for anxiety.

I think it's partly an age thing. Most people I know including men feel more anxious in older age.

CBT might help so you can learn to control the feelings a bit better. There are some good self-help books and online videos.

Yes I get so anxious about messing up my work (self employed). It’s always been a worry but it’s definitely got worse in menopause. Whenever someone leaves me a phone message I steel my self for it being a client saying I’ve messed up. Hate it! On hrt which has been brilliant for the physical symptoms. Any tips welcome !

I agree anxiety is normal, but I think anxiety in my peri years is NOTHING like what I’ve experience in previous years.

Being on HRT - body identical hormones - is NOT medicalising: it’s not drugs.

If someone still has anxiety and it’s bothering them despite being on HRT, it might be worth looking at increasing Estrogen dose… Dr Noor on instagram has some excellent videos on this topic - her insta handle is @ askdrnoor

Sadly women have been largely denied these treatments for a generation, and many docs are still misinformed, so we have to push for our own education on this x

I didn't say HRT was medicalising (I'm on HRT) - OP asked for other treatments as she is already on HRT and I suggested CBT. Or of course upping the estrogen.

my anxiety was off the scale - I have always had anxiety issues but this felt completely different.

saw an amazing meno doctor who explained it is your body pushing and pushing and spiking your estrogen, and when that drops there being too little progesterone to cushion the fall.

I am on BD HRT, I take a shed load of vitamins, and I’m on sertraline. I changed my anti depressants.

now feeling great but it took a while to get there.

Snap. Even a low dose of propranolol was enough to make a massive difference.

Oh glad you found that was the cause and a solution. I don’t drink alcohol, but I’m hoping i can find a relatively simple “cure” like that!

Agree a certain level of anxiety is normal, and I definitely don’t want to medicate if not necessary. But it is impacting me day to day, I’ve lost all my confidence, dread the phone ringing, and ive bitten all my nails and all the skin around them (both of which I’ve never done before 😩😬).

I will look at CBT etc too.

Thanks everyone. I didn’t think i needed progesterone since I’d had a hysterectomy. I didn’t tolerate progesterone in contraceptives very well before I had my hysterectomy. I’ll look into it though as it seems like progesterone has helped a few of you.

Good to know, I’ll bear that in mind. I’m glad you found it helps you

I found ditching caffeine helped.

Hi @EatenTooMuchChocolateAgain
anxiety is one of my worst per symptoms. I started on 50 patch and then went on 75 and now I am on 100(over 3 years) Each time my anxiety came back, I upped my patch and it went away again, so for me it was upping my patch that worked for me. I am also in cyclical utrogestan x

Can I ask if current anti depressants Setraline massively helped?

NICE guidance from 2015 said not to use ADs but to optimise estrogen doses and then offer talking therapies.

Thank you.
Im starting CBT for my anxiety, my GP is refusing HRT as im 42 and not getting hot flushes but other symptoms. So wondered if I should medicate which ive been reluctant to do but my anxiety is increasing.

See another GP?

You are not too young at 42 for HRT. Many women use hrt at that age.

Your GP is ill informed :(

Many women need estrogen in their 30’s let alone 40s, and for many (including me) mental health changes/anxiety was the first symptom - periods still fine, no hot flushes etc

Please find a specialist menopause Gp - if not at your current surgery, then many good providers do online consults - recommend the Newson clinic

Please could you share which vitamins you are taking thanks.

Vitamins do not address peri symptoms. Most of us get all the vitamins we need from a healthy diet. Everyone should supplement with Vit D ( NHS advice- from October to April) but other than that you shouldn't need any.

You need to talk to your GP or find another one.
Menopause can happen at 45. 3 years in peri not too early.

i take a methylated multi nutrient (BioWare), vit d, and magnesium glycate.

Thanks for posting this @EatenTooMuchChocolateAgain. I’m experiencing the same, particularly at work and it’s miserable. My confidence is on the floor. I’m sorry you’re suffering but it does help to know that I’m not the only one.

I’m making note of the suggestions from other posters (although horrified by @LemonSnail‘s recommendation to give up caffeine - one of the few remaining joys in life 😭). I guess I need to find the courage to talk to the GP again.