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[GypsyRoseLee]

Hi dazned, thanks for asking. Funnily enough, even though I felt really sleepy after taking the Mirtrazapine last night U found it really hard to fall to sleep and don't feel I slept that well. Woke very early but then dozed heavily.

Don't feel as groggy this morning as yesterday, but I do feel quite jittery and anxious this morning, whereas I didn't byesterdsy morning. Bit worried that it's not going to stop the anxiety and dreads now.

But my period arrived last night. It's been 5 days since I stopped taking the BCP so I suppose this is a withdrawal bleed? So maybe that isn't helping matters? Though I have worn a 50mg patch every day since stopping the BCP, but it hasn't been string enough to stop me having a bleed obviously.

My GP advised me to not wear any patches or take anything hormonal for next 3 weeks until I see my consultant. That way I can tell how I feel in just an AD with no hormonal support.

But I am frankly scared to not have any added oestrogen. So haven't followed his advice. Naughty I know.

[Rebelyell]

Hi GRL, I hope you are starting to feel better and totally sympathise with the anxiety issue, it is really debilitating.

I took oestrogen only HRT [had a hysterectomy years ago but kept ovaries] for six months but anxiety got very bad, then had panic attacks out of the blue.  I stopped the HRT and felt better for a while but then panics came back before Xmas last year.  I tried HRT again but got so stressed I finally gave in and took citalopram 10mg.   I still took half an HRT daily. 

I really, really wish the citalopram had worked for me, it stopped all hot flushes and all panic attacks but I felt fairly numb, extremely tired and suffered with bad digestive problems.    Withdrawal was also a bit wobbly despite taking it very slowly. 

Nine months later, still on HRT, I am now back into major anxiety and panic attack symptoms and am thinking about trying another AD.  Or, giving up oestrogen as I have a suspicion that for me, it just adds to anxiety - or at least does nothing to deal with it.   My reason for posting is that really - I notice you felt the same and wonder how many other people find it either does nothing for anxiety, or actually causes it?

[dazned]

See how you go next couple of days ,maybe after the bleed stops you might be more settled. Maybe when the patch is due to be changed don't use a new one see how you go. You can always stick one on again if things are too bad but you might be surprised 
You would get a bleed wouldn't you as you withdraw from progesterone 
It would be an idea if you could see your specialist without hormones if you could manage as your gp said that way you would know what symptoms you are looking at dealing with.
I strongly believe that hrt is brilliant at combating hot flushes and aches and to some extent VA but anxiety,panic attacks,insomnia,which are my main symptoms not so much unfortunately.
Hope you get some results soon.

[Chocolatechaos]

GRL if you are young for menopause the added oestrogen will help against lose of bone density and protect against cardiac disease etc. May be worth considering?

[crazydaisy]

Dear Craizydaisy

So glad that the mirtazapine is working well for you.  I have a prescription for it but have hung back.  Are you on the 15mg dose?  I have been scared to start on antidepressants but the menopausal anxiety can be so debilitating.  I wish you a continuing calmness.

Meg

Yes I take 15mg a night I do not feel the need to increase it, I saw my GP yesterday and he is happy to keep me on this low dose for a while, and if I need it, he will increase it to 30mg.

Please give it a go, I was so scared to take meds for my anxiety too, things that mess with brain chemistry really made me think hard if I wanted to take them.

I am glad I tried them, and I have had not had any bad side effects at all. Anxiety is awful and spoils so much of our lives.

I believe mirtazapine  has a very low side effect profile, its gentler than SRRIs, I feel like myself, how I used to be before peri , I get up in the mornings without that dread and fear, I can sit and watch a film etc.

Try them and see how it goes x

[CLKD]

You are filling your body with lots of different types of medication and your GP is correct - so as Dazned suggests, don't take the next HRT 'dose' to see what is actually working.  Your brain is an organ that requires support, we forget it because it's up there  …….. out of sight, out of mind until we begin to feel anxious or depressed.

Some medications can make a patient agitated but I believe that ladies here have found good benefit from what you are taking.  Little steps!

[GypsyRoseLee]

Chocolate, I had a bone scan in the summer and my bones are 'very good' no sign of anything untoward, thankfully.

It's a very, very tricky decision for me to carry on with HRT.

The facts are that nearly 3 years ago my periods definitely suddenly got much lighter and at the same time my PMS got much worse. So, typical peri indicators.

But at the same time, I had also been under enormous stress and uncertainty for the previous few years. Really quite bad. Then exactly 2 years ago we got some bad news which ramped up the stress and uncertainty even further. I don't think it a coincidence that within a couple of weeks of getting this bad news, the anxiety attacks arrived, and thecearly waking with feelings of dread etc.

Since then I seem to have fallen into a cyclical pattern of having good/bad weeks. The longest I ever go is 2.5 good weeks. Then all the anxiety/depression comes back.

My logical head tells me it MUST be my hormones causing this. But I can't shake the belief that I'm just suffering with
anxiety/depression because of all the stress I have been under for roughly 4 years. And that it comes and goes depending on what is happening in my life.

Bizarrely 90% of the things causing the extreme stress have now been resolved, and my life is much easier and calmer. But it hasn't made me feel any better.

[babyjane]

do you think it could be a combination of factors, there is a lot going on with your poor body and also your emotions.  Probably not just one cause.  On the other hand it can take one stressful event to kick start an anxiety disorder that can have lain dormant for years and I believe this is what triggered mine.  Sort of the catalyst that cause my body to decide it can't deal with any more thrown at it.

[CLKD]

Post Traumatic Stress takes many forms ………. be kind to yourself GRL.  Let the medication do the work ;-) 

[GypsyRoseLee]

I guess I could be the victim of really shitty timing. Labouring under huge stress for a couple of years, only keeping my chin above water. Then BOOM my ovaries decide this is the ideal time to start shutting down too.

Can anyone confirm for me, for once and for all, that suddenly having much lighter and much shorter periods, and your boobs suddenly stopping swelling up and being painful every month = lower levels of oestrogen?

I asked my consultant but she never really answered me.

[Briony]

I think HRT works wonders for the physical elements of peri menopause, but maybe not so effective for the anxiety and mood swings?

I'm not convinced. I think that it depends more on what your 'dominant (peri) symptom/s' are - they seem to be the one/s hardest to beat. For me, after a few months, the HRT helped my mood a fair bit, as did the BCP (more than an AD had) but the physical symptoms remained more problematic (especially the headaches and fuzziness/fatigue).

In the case of younger women (pre average meno age), we firstly need to replace the estrogen we're missing, but may also need to treat our dominant symptom in addition to this - so for some, an AD helps; with migraines, triptans or pain killers are required; others require help sleeping. I guess that's what makes it all so complex and hard to diagnose!

If I've learnt anything from this hormonal chaos, it's that no two people are similar and no two people respond to the same treatment in an identical way (as our Marevlon experiment proved!). 

One thing I am beginning to think more about is the difference in efficiency between bio identical products and synthetic ones. I'm really shocked by how badly by body accepted synthetic progesterone, yet seemed to respond well to Utrogestan. I'm therefore wondering whether, in peri, the optimal treatment would be suppression of ovualtion (to avoid fluctuations) but achieved by a bio identical method?    http://www.studd.co.uk/depression.php

B

[dazned]

GRL you are like me,or how I used to be ,I wanted to know the how,why's,what etc now I just don't care,I just wanted it to stop ! 
I've always been a black and white type of person,it is or it isn't I've had to learn to adapt and accept that sometimes things are what they are,it was hard but much better off for changing my attitude.
As others have said it not really the question of whether it is hormonal at the minute you just need some respite from it all. It's not easy to keep being a human guinea pig 

[dazned]

I'm not convinced,but that's just me ,that Prof Stud is 5years old. Just my take tho.
I was much worse when my gyne trialled me on higher estrogen ,as you say we're all so different.

[Briony]

I'm not convinced,but that's just me ,that Prof Stud is 5years old. Just my take tho.
I was much worse when my gyne trialled me on higher estrogen ,as you say we're all so different.

I know what you mean, Dazned. I  seem to swing from one idea to another.        Some see Studd's views as out dated, though interestingly, the PMS society suggests something similar:

   http://www.pms.org.uk/assets/files/guidelinesfinal60210.pdf       (See chart at end).


What I struggle to understand is why women on a higher dose of hrt often find it harder to tolerate, yet so many women take the pill - some into their late 40s - which is so much more potent in estrogen? That baffles me.

I think , for me, the crucial thing is that I need to suppress ovulation and so avoid the hormonal swings - my problem is finding the best way to do this.   From what I can tell, taking under 100mcg patches, you're 'topping up' your own estrogen, so in peri, this can send your levels rocketing. Whereas once you go to 100mcg-200mcg, although it sounds more, it stops ovulation so your own levels are not in the equation?

[CLKD]

The Pill is designed for a different use i.e. to stop the risk of getting pregnant.  Once hormone levels begin to fluctuate I think that progesterone is the 'baddie' that ladies are suddenly aware of.  My periods got lighter, more intermittent, disappeared; came back, intermittent bleeds, then stopped