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[jess]

Hi  Finding the radio 4 Women's Hour menopause slot v interesting this week.

Can someone tell me - being 5 yrs or so post menopause - re symptoms like anxiety or depression - are these symptoms that can relate to lack of hormones at my time of life? How do I know if these symptoms are 'life' related or hormone related? At what point do you say I'm so past the Menopause this symptom must be something else (like aching joints being due to old age and not menopause) ?
I'm nearly 60. 

[Dancinggirl]

This is a really good question.  How much of anxiety and/or depression is down to a lack of oestrogen?

There is no doubt that the menopause ‘messes with our heads'.  Highly capable women find they fall apart when meno hits. However, the notion that once we are through peri meno and well into post meno, that things settle and life gets back to normal, I believe this is unrealistic. Coping with life stresses gets far harder generally as we age. Our health, energy, mental agility will naturally become more fragile.

Post menopause is permanent but if flushes and night sweats subside this will make things better - but we can never go back to what we were in our 40s.  Men often go through what is laughingly called “a mid life crisis” - which is basically a big loss of confidence and desperately trying to rekindle their youth.

I am nearly 62 and, over the last couple of years, I have come to realise that I have to adjust my life to accommodate the ‘fragility' I now feel - I have to pace myself.  The lack of hormones is not the only issue - I know a lot is simply age related and since I came off HRT 18 months ago, while part of me feels sad not to have the oestrogen, I know it wasn't actually making that much difference any more. I'm not giving in to old age, I want to embrace all my life experience can bring to my future and, most importantly, keep learning but now simply in a slower, less stressful, way. I have become more selfish, probably more cranky in many ways (I don't suffer fools so well these days) and, very importantly, I have learned to relax more. 
Am I more anxious than I used to be?  YES!  Do I still get depressed? YES!  BUT - I do rationalise these aspects better these days and employ the strategies I know will help and accept help from others.
If anxiety and depressions does become overwhelming, then I know I must seek help and probably try an AD/SSRI - life is short and HRT is not the only option.  DG x

[jess]

Thanks for your reply dancingirl.

I've just come off hrt after 5 years. Only been a month but the flushes haven't returned so...
Gone back on anti deps though as feeling down like never before  (felt like this BEFORE I came off hrt) for a few months now. I early retired just over a year ago. Husband retired also last Easter. Had 2 operations last summer/Autumn.  Trying to work out why I'm feeling like this . Think about death/dying alot. Parents died nearly 2 and 5 years ago...  just wondering whether to blame it on post meno or life! Hopefully the anti deps will kick in soon....

[Dancinggirl]

jess - have you considered having some counselling?  I had counselling for a year in my mid 30s ( early meno hit plus so many life problems) and I found it really helpful. It was very CBT based and I learned strategies to help with so many things.
It seems very common for anyone, particularly at our age, to become focused on negative things. Retirement in itself is a big adjustment - low self esteem, health issues etc can play havoc - everything seems to come at once - I think it can be a combination of life, getting older, being post meno and just feeling low!!! DG x

[CLKD]

I had depression in the 1980s, with appropriate treatment.

Does it really matter what is causing your symptoms?   Appropriate treatment of anti-depressant treatment can be tried for 6-8 months, along with HRT if necessary.   Some ladies find that keeping a diary of mood/food/symptoms useful to chart a pattern.

I had talking therapy intermittently in the 1990s. Helped: discuss, decide, ditch 

[racjen]

Personally I think it does matter: both politically, because we need women's problems to be taken seriously in so many different spheres and this is one of them - women suffer from depression and anxiety far more than men do and i think we all know why that is. And secondly, because anti-depressants and anti-anxiety meds come with their own set of side-effects,  long term health implications and the very real possibility that they just won't work for some individuals. I don't think it's enough to say let's treat the symptoms, what does it matter where they originate from - it does matter, everything you put into your body will have a knock on effect elsewhere. And CLKD, you're coming from a very different place from most of the women on this forum - your depression and anxiety have been a lifelong problem so clearly for you ADs and anti-anxiety meds are appropriate, that's not the case for everyone and it's not helpful to make out it is.

[Hurdity]

Hi jess

Just wondering why you have come off HRT if you were benefitting from it - or maybe you weren't any more?

It is now generally accepted that low mood and anxiety can be caused both by the extreme hormonal fluctuations of peri-menopause, and low oestrogen.  This was featured particuarly on Woman's Hour this week - that menopausal symptoms are more than just flushes and sweats - joint pain, anxiety and depression are also important but often overlooked symptoms ( by doctors) which HRT can help to alleviate. Even when you have "gone through the menopause" your oestrogen levels remain low for the rest of your life and can be a major factor in affecting your mood, especially for those who are more sensitive to this or who have lower oestrogen levels in post-menopause.

Also the other thing is - the hormonal fluctuations (of peri-menopause), as well as low oestrogen (of post-menopause) make you less able to cope with life's stresses - due to volatile (in peri) or low mood (when post).

You mention that your flushes haven't returned but that's not to say they won't.  When I stopped HRT  it took 3 months for my symptoms to return fully - (and worse!) although flushes and sweats came back within a few weeks (I then went back on it). You obviously have your own reasons for coming off and for starting anti-depressants but just to assure you that taking HRT  (rather than anti-depressants) into your 60's is perfectly acceptable and accepted by specialist gynaecologists.

I am sorry to hear about your parents and that will of course make you feel sad and be aware of your own mortaility - but grief is a normal emotion and doesn't not mean that there is anything wrong with you. Your operations may also play a part. It sounds like you need to look after yourself and pace yourself emotionally and physically too?

Some of your feelings may be to do with retirement - are you making sure you are making the most of your extra time? new horizons to stimulate you? Diet and exercise are crucial at this stage in life and getting out in the fresh air vital for well-being and gaining a positive outlook on life.

You are only 59 and could have another 30 years - don't consign yourself to old age yet!

This is about you not me - but just to say I am in mid 60's and have been taking HRT for almost 11 years and can honestly say I have never looked back. I eat a very healthy diet, go to 3 exercise classes a week when I can, go on holidays, festivals, lots of gardening - and it's the best thing I did.

I would blame most of it on post-meno but also think about what you want to do over the next x years and where you want to be and perhaps re-think your meds maybe - taking into account what racjen said?

Whatever you decide - here's hoping you resolve your problems and turn yourself around so that you can have a positive outlook and make the most of your life to come

Please do ask if there is anything else we can help with.

Oh and there was a blog published today on this website on CBT which might be of interest (the author was also on Woman's Hour!). https://www.menopausematters.co.uk/daisy/Dr-Daisy-jan2018.pdf

Hurdity x
 

[jess]

Dancingirl - I am actually a qualified Counsellor  (non practising) - physician heal thyself!

Hurdity - I came off the hrt because originally I was advised only to be on it for 5 yrs though I know this advice has changed. The other reason was because I lost a bit of faith in it as I had some bleeding when I went on a different type last year which resulted in the discovery of cysts on ovaries and i ended up having ovs and tubes removed but all because of knock on from bleeding which was caused by the hrt. I will go back on it if mg symptoms return but it's not due to coming off the hrt that has lowered my mood as I was going down before this. X