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[applejack]

Happy New Year all

I've just had the first half of my meno issues sorted - mirena working well since polyp removal and scrape, no more bleeding yay!  Turned off like a tap two weeks before christmas and not had any issues since. Vagifem doing what it's supposed to do.

But then there's the other half. From  June I developed chronic insomnia and an oestrogen reading showed around 60 so the next mission was to up that. We went as high as a 150 patch which got the reading up to just under 300 by September when it was last checked. But the sleep, whilst it improved (going from 3-4 hours a night to 5-6), still wasn't right. I can get up to 7 hours sometimes, but it's broken and not restful and to get up to 7 hours in the first place means still being in bed at 10am which is not conducive to my job! I always, ALWAYS, see 4am. Every bloody night.

My menopause specialist thinks I'm anxious and doubts it's the oestrogen anymore.  I am anxious, yes. Heart palpitations, missed beats - I took my blood pressure the other day and of course it was high. Usually I just take a few breaths and try again but I started shaking, teeth clacking, my son had to sit me down and hug me because I was trembling. I check my pulse rate every five minutes like a loon. I don't know if it's the insomnia feeding into the anxiety or vice versa.  ANYWAY...

We tried 4 pumps of oestrogel for 6 weeks, so a lower dose than my 150 patch - this is when the anxiety and ectopics ramped up. I prefer a patch so she's suggested going with 125 rather than back to 150 because she's pretty sure it isn't low oestrogen causing my problems now, hence the mirtazapine.  I've searched the forums and it gets good reviews for sleep which I need. The weight gain frightens me somewhat and is making me find excuses not to take it like - what if my oestrogen is still under 300 and I just need a higher dose to get over the line and get my sleep going? Would it not be better to check first before taking this thing? Then there's me, in the early hours, wide awake with my heart pounding in my ears desperate for sleep and thinking well perhaps I should just take it.

She's very experienced and has not been wrong so far. She said I was displaying very obvious signs of anxiety - even over our teleconsult she could see it. I'm just a bit scared of taking this thing, feels like jumping out of the frying pan and what if it really is just low oestrogen still? Then again if it wasn't for the notorious weight gain warnings I'd probably jump at it.

One other thing, over the past 15 months there's been a lot of emotional upheaval in my life, and a lot of change and a lot of adjustment. The thing is, I'm a bit of a worrier anyway, but I'm also pretty emotionally robust, or so I thought, so this is all a bit...unexpected.

I don't know what I'm expecting anyone to say, to be honest. "Take the bloody tablets, you'll be fine" probably.

[Gnatty]

Take the bloody tablets you'll be fine! I take 15mg mirtazapine. No weight gain to speak of and I now sleep really really well. Once you start sleeping better you will be in a much better position to evaluate oestrogen etc etc. The world is a scary place with no sleep.

[applejack]

Hahaha!

That's a very good point, actually. You're right, I shouldn't be making cack handed decisions whilst running on empty. 

[CLKD]

What's to lose?  I have taken antidepressants since 1988 ........ gave me my Life back.  As well as an emergency anti-anxiety med., previously I used 'valium' as necessary; usually prior to an event that I was unable to get out of, knowing that I could swallow 5mg during the day.  Never needed it ;-)

[applejack]

I've had valium (is that diazepam these days?) for flying but they never seemed to work!

[CLKD]

Same thing  .  It worked lovely for me.  I don't expect though it would if I considered flying anywhere!  I don't drink but would need something a lot stronger ;-).

[ElkWarning]

The thing that's waking you up is cortisol - which is what happens if you've been anxious for ages.  You can't actually think your way out of cortisol.  Interestingly, it also causes weight gain.  So if you need a way to rationalise this, would you rather gain weight on the tablets, or gain weight with the cortisol?

^^ Sorry, bit of a smart arse thing to say.  Personally, I went down the route of CBD oil (costs a fortune and takes quite a while to stabilise things).  Much less anxious now I can actually get a night's sleep.

Best

EK

[applejack]

Heh, smartarse maybe but it’s a fair point and it’s made me think.

I wanted oestrogen to pull me out of this - the fewer chemicals I’m fiddling with the better. But I guess there are also risks in going for such a high patch dose I end up wiping out the UK supply of estradot single handed.

Ok I’ll do it. Should get them Wednesday, so will take my first one in the evening and see what happens.

One question re anxiety - Sure I’m generally stressed at the moment but  I also get heart hiccups when I’m not actually aware of any particular stress, like when I’m watching the tv with the cat purring happily on my lap, or reading a book or something. Is this common or should I be worried?

[sheila99]

My worst symptoms were anxiety and insomnia. Both completely gone with the right dose of oestrogen. I'm not convinced your doc is right, it sounds more like oestrogen deficiency to me. Can you get a private blood test if gp won't do it? It could just be that you don't absorb well and need a higher dose. Anxiety meds can be helpful for short term use but if it's from oestrogen deficiency imo hrt is more appropriate (mine took 3 months to go).

[applejack]

She is private so I’ll ask.  We’ve gone up to a 150 patch for four months without much success. That seems pretty high already - we also tried a 4 pump oestrogel regime for a month with no success.

It did cross my mind that we should go higher but 175 or 200 seems a bit scary.  My GP certainly won’t prescribe more than 100.

[sheila99]

The important bit is not the strength of the patch but the amount you absorb from it. It might be that you need 2x100 patches to absorb the same as me on on a 25 patch. I also think one month wasn't a long enough trial. I had very little improvement after the first month, very much up and down after that but take 3 months. Did your anxiety and insomnia come with peri or were either pre existing conditions?

[applejack]

I've always been anxious to be honest - was on escitalopram for a few years in my late 30s, so it lurks.  I've never had insomnia and shaking and palpitations like this before though, even though my sleep has never been great.

I was on a 50 patch for 2 years and felt fine. In February I started bleeding and there followed several months of failed attempts to solve it - this is the point at which my sleep went haywire and my oestrogen level was tested and found to be below 100. No idea how long it had been that low.

After 4-5 weeks on the 150 regime in summer, my level had gone up to 250, then went up again to 280 or so a month later - that was 6 months ago. So it was heading in the right direction but not had it checked since then.

Just to clarify - I've been on a higher oestrogen dose since august.  The month on the oestrogel was included in that, in December. I just didn't get on with the inconvenience of it compared to the patch.

I really don't know what to do now although have just requested another blood test so hopefully she'll be able to organise that for me. I'm not sure what a good level is - 300? Although I see some posts on here with levels of 400 post menopause so have no idea. Googling has not proved conclusive.

[applejack]

Well as an update we're going to check it again in 8 weeks. This gives enough time to get a more realistic reading.

But because I'm struggling so much with insomnia the tablets, which will be kept low dose and hopefully short term, will get me through the horrible phase I'm going through right now.  I honestly can't cope another day, let alone 8 weeks. Hopefully that oestrogen goes up and if it doesn't, then we'll have to increase it but as you say, Sheila, it takes time and it does look like I need a higher dose and haven't got there yet. I don't think my mental health can take the wait at the moment though. It feels like I'm being given a prop but frankly I need it as I'm at my limit.

[Gnatty]

Good luck, I think you will really feel the benefit of the tablets quickly x

[applejack]

Thanks Gnatty, I really hope so.

Do you know what I also think isn't helping - and I don't know if it's just me but...bloody gadgets.  i've got a pulse tracker, a heart rate monitor, a sedentary bpm monitor, a sleep tracker which tells me my hrv in the morning is terrible and needs seeing to - I've become obssessive about checking them every five minutes.  All on my wrist.

I used to only use the watch for picking up messages and exercise tracking which is great - set targets to walk more, burn more calories, steps etc. I don't think any of that is bad. But the other health apps - talk about getting addicted to sleeping pills.  My worst addiction right now is checking charts and graphs and worrying if 58 bpm will kill me because yesterday it was 55bpm whilst at the same time listening to that voice in my head saying "this is nuts, woman, stop looking".  Those things are like crack cocaine to me.

Going to have to delete them. It seems like knowing everything about my health is making me feel worse.