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[Tempest]

https://ayoti.in/blog/anxiety-in-women-causes-symptoms-diagnosis-and-treatment/

(The grammar in the article isn't great, but the accompanying illustrations are what make it priceless)!😊

I'm leaving this here and hoping that some of you will be curious enough to pop over via the link and take a look. The symptoms are scarily similar to what a lot of women report in menopause, no?

Menopause is stressful, and so is life in general these days. We are generally bombarded with pressures from family, work, modern life and  influences via the internet and that can all add up.

I have found it useful to draw up a list to see exactly how much stress I am under, and I can tell you that it is a lot! So no wonder i'm getting the hot/cold flushes, jelly legs, racing heart and much more as listed in the link.....that I assumed were 'just menopause'. We, as a generation, are also more stressed about menopause itself - moreso than any other generation - as we are led to fear via media pressure getting older. We will all, of course, age - and as my former Consultant Professor Lumsden said to me - it is difficult to blame signs of normal ageing on estrogen depletion in what, after all,  is a normal part of the ageing process.

I personally have a problem with the phrase 'estrogen deficiency' in relation to a natural menopause  - i.e. not surgically induced prior to age of natural menopause or due to premature ovarian failure. One is not 'estrogen deficient' if this event - menopause - happens at the time biologically programmed according to your body's own ageing.

I know this might seem unpopular as the menopause transition is so tough and yes, I believe there is a role for HRT for some women whose natural transition is particularly tough and of course for women who have had surgery, chemo (if HRT is allowed) or POF.

I DO worry though that women may be feeling pressured to view their menopause as something that is abnormal and that must be delayed indefinitely at all costs, even if their experiments with HRT are not too successful or are not adressing the symptoms that they would hope.

I'm not deliberately trying to court controversy with this post, but these are my own thoughts as I have moved through this difficult time of my own surgically induced menopause at the age of 46. For information, my last conversation with Professor Lumsden's team (who I highly respect) confirmed to me that as I am now 49, my only need for HRT would be purely for symptomatic relief. I.E. - if I didn't or couldn't take HRT at this age - despite having no ovaries - I was not going to drop down dead because my heart would suddenly pack up, nor would my bones crumble nor would I turn into a wizzened wreck (or a man, as has been suggested on one memorable thread here)!

If I use stress management techniques (very important), gentle strength building exercise (Prof. Lumsden recommends pilates and is a fan herself), eat nutritiously and generally TAKE CARE OF MYSELF, all will work out in the fullness of TIME. And interestingly, Prof. Lumsden did say that if a woman is struggling particularly with more than just occasional mood swings, that either talking therapies or medication is appropriate to help prevent women into slipping into a major depression or a state of generalised anxiety that HRT may not be able to address.

So, thank you ladies for indulging me with this long post. It comes from the heart - and as always, i'm sending much love to all of you as I know how tough it can be, truly. xxxx

[Shadyglade]

Really interesting post. Will check out the link Tempest.

Thank you.

[Shadyglade]

If I am totally honest I have always had a degree of anxiety and although the meno definitely made it worse, I survived. Now I am much better and am probably the best I have ever been. Six years post meno and enjoying life, dispite the ups and downs. 

[Tempest]

That is so very positive to hear, Shadyglade! I have had to adopt the mantra 'Tempest - Know Thyself'. I now acknowledge that I had a good degree of anxiety and carried stress badly at times before all this menopause stuff came along - and having my own estrogen certainly didn't solve it then, so it's unlikely to be a total magical cure now if it comes via patch or a bottle.

It can help women TRANSITION, so that the road is less bumpy for those that need it. But it isn't the curer of all physiological and psychological ills.

I really am so very glad that you're feeling so much more settled now. xxxx

[Shadyglade]

Thanks Tempest. I certainly don't want the hormones back, natural or HRT.

Shush, don't tell anyone. 

[Kathleen]

Hello Tempest.

Thank you for a very interesting post.

As you say there is a definite similarity between the symptoms mentioned and the jolly old ride that is the menopause! My trusty meno book notes that more serious mental/ emotional disorders can  develop at this time in our lives and it's easy to see why. I think chronic sleep deprivation  also plays a part as disturbed sleep can be nerve shredding and when it persists for years it's a wonder anyone holds onto their sanity!

Thanks again for adding the link. The more we learn the better we'll be ( ooh, that could be a bumper sticker).

Take care.

K.

[Tempest]

{{{whispers}}}} after dealing with 3 weeks of HRT induced tremors/migraine/worsened MS muscle spasms.....me neither, Shadyglade! xxxx

[Tempest]

Thank you, Kathleen! It is certainly the up's and down's during the transitional phase that cause the problems, or an unstable form of HRT dosing or frequently changing HRT regimes. That's enough to shred anyone's nerves! 

Once everything settles - even at low levels - things do become calmer for most women, and Vagifem is then a woman's friend to keep everything down below comfortable if a woman is able to use it (some estrogen positive cancer survivors cannot, of course). xxxx

[CLKD]

   love the drawings 

Everything that the body suffers is surely, natural?  So if treatment is required, why not consider the options?  Hunger is natural.  Sweating is natural.  Periods are natural etc. etc. etc.; we have access to solutions from the day we are born. 

It can be Trial and Error to find solutions that suit us.  It took me a while to accept that I need to take anti-depressant medication for Life.  Once I accepted it DH and I had a Life together again.  Anxiety still strikes so I have the chemical measures to hand.  Without those I wouldn't be here.

Same with HRT - again can be T&E  .  But I think that this is probably true with other medications offered but we don't hear as much about those.  Some statins can cause intense muscle pain but there are several that GPs can try.

[Wilks]

Interesting reading and applicable to some but not all of us. Everyone's experiences are different, not everyone needs or wants HRT but it's a life-saver for some.
Your post is quite obviously at least partly directed towards things I've said elsewhere. Well, I stick by what I said, it's scientifically established that loss of oestrogen increases your risk of osteoporosis and heart disease, as well as vaginal atrophy. “Increased risk” does NOT MEAN that every post-menopausal woman's bones will “suddenly crumble” or they'll drop dead of a heart attack, or that they will definitely suffer from vaginal atrophy. And no one said that you “turn into a man”. You're exaggerating for effect.
I have low risk for osteoporosis and heart disease because of the amount of exercise I've always done, but some women may be at higher risk (family history, poor diet, sedentary lifestyle) so it is entirely appropriate for those women to discuss the pros and cons of HRT with their doctor.
Now let's look at mood problems- I have bipolar type II and I know that my mental health issues are not caused by menopause, but I've always struggled with severe PMS and PND, so hormones do contribute to it. There's pressure from some women, including Louise Newson unfortunately, that you should not take antidepressants for low mood during menopause. That pressure made me stop taking my medication and led to a mental health crisis. Similarly, your post could be construed as pressurising women not to take HRT because you personally don't like it and because menopause is “natural”.
In some respects menopause is a transition, some problems like hot flushes and mood swings relate to fluctuations in hormones, but some problems caused by low oestrogen aren't going to miraculously recover. Not all women have those long term problems which is great, but others do.
I hardly drink, never smoked, I have always been physically very fit, but menopause hit me like a train and I don't give a flying **** whether it's natural, it made me feel severely unwell. Who knows how long they have on this earth, maybe I have 1 more year, maybe 30. I'm sure as **** going to do whatever it takes to maintain a decent quality of life even if it means taking un-natural HRT.

Right, I've said my piece, ignore it, misquote me, do what you want. I have a feeling I'm not going to be staying on this forum much longer!

[Shadyglade]

Why are you so angry Wilks .  It is a perfectly calm discussion. 

Nobody is having a go at anyone.

[Conolly]

Hello ladies,

Tempest, thank you for the link, it's an interesting approach to anxiety. My own experience is that perimenopause and the hormonal fluctuations do worsen any other previous conditions and possibly act as a trigger to hidden ones.
Regarding treatment, it's a trial and error process highly dependent on individual genetic background and life history. AD's and HRT are options that should be prescribed only when lifestyle changes, psychological therapy and relaxation techniques have failed. Many times these latter are easily forgotten and the former are considered essential. Pharmaceutical marketing and a bit of laziness and conformity comes to mind.

Dotty and Wilks, I'm sure Tempest was referring to another thread. Each one of us has different experiences and health issues, no one is more knowledgeable  than the others and opinions are just opinions. Some facts are corroborated by scientific evidence but menopause research is at its infancy. Hormones are powerful molecules. These heated debates are solid evidence of that.

Conolly X

[Tempest]

Wilks, you obviously have a complex that everything is being directed at you which simply isn't the case. The lack of evidence for absolute protection against osteporosis and the fact that cardiac benefits are not absolutely proven were quoted to me by Professor's Lumsden's team. In case you don't know, she authored the latest NICE HRT prescribing guidelines.

The 'turn into a man' quote is from an old thread which may very well pre date your membership of this forum, so obviously isn't directed at you in that case.

I very much also understand how hormones impact bipolar as a very close friend of mine had to work closely with her psychiatrist to balance her medications during the perimenopausal period. Fluctuating hormones very much made her bipolar much more difficult to manage.

Dotty, I did not say that all of the symptoms are psychological and agreed that for women who are experiencing a difficult TRANSITION that HRT can help balance the up's and downs.  Without a doubt though, the risk benefit equation shifts after the age of 60 when a woman should be well post menopausal. This is why most GP's and specialists ask women to revisit their HRT needs periodically to see if they are still symptomatic.

On this note, there WILL be a return of symptoms when you drop HRT initially as it is like any other withdrawal syndrome. For some women this tapers off over time and they remain non symptomatic, for others symptoms may linger for some time. 

My real worry is for women who are using, for example, 4 pumps of estrogel into their 60's as when they are asked to come off or reduce their HRT by their GP or specialist (again, as the risk/benefit ratio shifts with age), they are probably going to have a pretty difficult time doing so as the WITHDRAWAL symptoms are going to be quite dramatic unless they taper carefully. In the cases of women who are asked to come off due to raised blood pressure or breast issues (in the cases of cysts of a suspicious nature), they may be asked to quit immediately - and then the fall will of course bring on symptoms that are much more severe potentially than those that they had originally when they started HRT if they are using quite a large dose. xxxx

[Tempest]

Thank you for your thoughtful reply, Conolly - I agree with so much that you've stated. Especially about hormones being powerful molecules! Indeed they are - and also about perimenopause exacerbating and unmasking any existing or hidden conditions.

Lifestyle is so important too - you are absolutely right that this avenue shouldn't be neglected.

 xxxx

[Kathleen]

Hello again ladies.

As we often say on this forum, everyone is different which obviously means that everyone's experience and treatment is also different.  Very frustrating all round!

 My consultant told me that eighty per cent of women over sixty no longer have symptoms but they continue in the remaining twenty percent and unfortunately there is no way of predicting which group you are likely to be in. I know someone who was still  flushing at sixty seven, just like her mother. This lady didn't use HRT as she was able to cope but if her symptoms had been severe she would have sought help. Incidentally a doctor told her that  she should welcome her flushes because he believed  a drawn out menopause conferred health benefits. He didn't say what he thought these health benefits were plus he may have revised his opinion if he was the one experiencing them for years and years!

This can be a rough ride and we are all trying to get through it the best way we can.

Wishing you all well ladies and take care.

K.