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[Polly9]

Hi all,
This is my 1st post on the forum.
I've had a total abdominal hysterectomy with both ovaries removed a year ago. The past 6 months have been a rollercoaster of surgical menopause symptoms & extreme anxiety.
I started HRT (Estradot 50mcg Patch) which helped control some of my symptoms i.e. night sweats & hot flushes but the anxiety has got worse lately.
So much so that at times I have panic attacks & heart palpitations which is very frightening. I was prescribed Xanax (a once off) for a few days after a recent panic attack which had left me extremely anxious.
Following a review with my Consultant & GP visits, both have now suggested increase in HRT along with prescribing antidepressants.
Estradot 100mcg Patch & Sertraline 50mg.
I'm wondering if any of you are going through similar experience regarding the anxiety/panic attacks and if you are taking the same medications?
I would love to hear your personal experiences.
Kind Regards

[CLKD]

Welcome.  Anxiety can be caused by hormones.  However.  Personally I wouldn't be here without an emergency drug to take when anxiety strikes.

In the 1980s I had to take anti-depressant medication which keeps me more or less even. For years I had Valium as necessary, I used it the night B4 an Event that I was unable to avoid, i.e. visiting family  .  When that began making me feel ill, he gave me something else, as necessary but of course, meno-brain here, can't remember the name 

When anxiety takes over I know the medication will work within 25-40 mins., so rather than waiting to C if the feelings will ease, I take it immediately.  Some ladies find that HRT helps, some need both together.

If you take an anti-anxiety it will give you a chance to relax and make informed decisions.   

[GypsyRoseLee]

Hello 

I still have my uterus and ovaries. But I have struggled terribly with hormonal anxiety and depression since starting perimenopause. At times I have been in a very, very dark place. Years ago I had severe PND (again, hormone related) but what I have experienced these last few years has been much worse.

My symptoms only started to improve when I increased my oestrogen dose to 4 pumps (which is roughly 100mg patch, I think) + 50mg of sertraline. Within a day or two of this regime I felt myself calming down, and my head clearing. It felt quite Zen like. I also began to experience really epic, uplifting dreams which were rather lovely.

I have seen Prof John Studd and he told me that some women just need far higher levels of oestrogen, than others, to feel normal. This makes sense when you think about it.

Have you also been offered any testosterone? Low testosterone can cause depression, and I think you won't be producing any of your own now since your operation?

[CLKD]

   it really is Trial and Error 

[Hurdity]

Hi Rose9

 

Just to say also that is a very low dose of oestrogen (50 mcg) for someone who has gone through surgical menopause. That is the average post-menopausal dose often taken by women in their 50's and beyond who still have their ovaries.  You haven't said how old you are or whether you had started the menopause journey before your op - but it is such a shock to your system and from what I've read takes a long time to recover and get the right balance of hormones.

In your position I would trial the increased dose for some while and see how you get on, and also as GypsyRoseLee says you are most likely also to need testosterone.  I have never taken anti-depressants so I can't comment on there but see if you feel the same as GypsyRoseLee? Depending on how you are coping I might want to get the right dose of hormones if I could at least  at first, so that I knew what was what - ie increasing oestrogen and starting testosterone, before starting anti-depressants - but I know that for some women, if you are seriously depressed, these make the difference between coping and not. Only you know if you need to try this option now.

Your dreams sound amazing GypsyRoseLee!!

I know that some women in your position Rose9 have taken much higher doses - one woman was on 150 mcg for example - after all your body is not producing any at all.

Hurdity x

[CLKD]

My GP won't prescribe testosterone.

For survival I had to have medication as stated, however, my symptoms began B4 I was in peri..   Taking medication for my mental health enables me to make informed decisions more clearly.  Also, when very ill I wasn't aware that I was depressed, I knew I felt ill and desperate, had no logical thought patterns and never wanted to get out of bed.  ADs don't have to be taken for ever.   Maybe decide which symptom you need to ease first?

[GypsyRoseLee]

Hurdity - On reflection I wish I had waited for the 4 pumps to fully kick in before trying sertraline? But I was in such a dark place, feeling desperate, and had to think how that was impacting on my family. As it was, I started both within a few days of each other, so have no way of knowing which worked its magic?  Perhaps it was both?

I did read on here yesterday that a menopause clinic told a poster that ADs alone wouldn't work on hormonal depression/anxiety, and that you HAD to add oestrogen in.

I would be very interested in reading the success rates of hormonal depression being treated with just ADs Vs being treated with ADs + oestrogen.

My dreams aren't quite so exciting now, probably because the chemicals in my brain have balanced. But in the beginning I used to really look forward to going to sleep and all my dream adventures 

[Polly9]

Hi all & thank you so much for the replies.

It's good to read your experiences & advice. Hormonal anxiety is so real and frightening. Its terrible what we have all to go through. I'm 47 and hadn't started the menopause journey prior to my hysterectomy, so I've hit surgical menopause with a whooping bang!! A real shock to the system.

I began HRT within a few weeks of my surgery, in the form of oestrogen gel (Divigel) my symptoms were only mild at first. When the night sweats, hot flushes became more severe I was prescribed the Estradot Patch (50mcg) which seemed to take the edge of things and worked for a while, It's the hormonal anxiety that's affecting me badly at this stage.

I started the Sertraline…but got so sick I stopped after the 2nd day, OMG….it was horrendous!! I know I only gave it 2 days but it was frightening and I have been wiped out with the side-effects. I've read that many feel the same when they start and stick through it but I just couldn't, I had to stop as I was so nauseous, felt I was going completely mad & losing control.

I'm now trying to stick with the Estradot Patch increased from 50mcg to 100mcg in the hope that the increase in oestrogen will kick in soon and ease the symptoms.
Testosterone was never mentioned or recommended to me…I'm going back to my GP and have Gynae appointment upcoming so will definitely discuss all again. 

It's a long road in trying to get the right balance of hormones but fingers crossed things will settle.
Thank you all for the insight into your experiences & your advice. Here's to better times ahead for us menopausal ladies 

[CLKD]

I had to stop many anti-depressants due to sickness.  So don't beat yourself up.  Some of us find that Rescue Remedy products are useful, I don't even think whether they work, I use the mouth spray and get on. 

There are other anti-anxieties available, maybe an 'as necessary' tablet would suit you?  Do discuss with a Pharmacist they have private rooms, get an idea of what is on the market then go to your GP if you think you need something to ease your feelings.

GRL:  How does one know if anxiety etc. are hormonally led unless a person hasn't had similar ?  If they have suffered through the years then maybe oestrogen isn't necessary, I have atrophy treatment but don't require anything else.  I know that I have been lucky.  However, the pre-menstrual depression and anxiety were like nothing I had in later years ......... which I never related to hormones.  Interesting.