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[lilbebel]

Hello friends,

I am three months into full menopause and have been on bio identical HRT since February. It has been wonderful for all my physical symptoms, but my anxiety and tearfulness are ruining my life. I am absolutely exhausted trying to keep going. Putting on a face and not letting people see me fall apart on the inside or tremble when the anxiety gets too intense to hide. Somebody please tell me this will pass? I need hope more than anything right now. I’m tough and I’m determined and I can get through anything if I know there is hope. I want to feel like myself again. I was never this frightened creature. I don’t recognise myself. I’m scared of everything and have a constant feeling of dread and being unsafe and I’m so sick and tired of this. It was brutal during perimenopause and it hasn’t eases yet. I’m hoping that because I’m still very early post menopause that my hormones are still something my body is getting used to at lower levels. Thank you for any encouragement or positivity. 

[Flossieteacake]

I can really hear the despair you are feeling. To feel so anxious is unbearable. Have you considered anxiety medication? It can really help to take the edge of the feeling.

I am sorry you have to put on a brave face all the time. Not being able to be yourself is really difficult. Is there anybody in your life who you think may understand how you are feeling? I know often people are unable to understand such things and will suggest silly things like going for a walk, but some people do understand.

Anxiety can be treated. Feeling anxious does not mean it will always be like this for you. Perhaps you need a little help. Maybe your HRT needs a tweak? You are very brave to make this post and reach out.

[lilbebel]

Thank you so much for your supportive kind words. I am on anti-anxiety medication but it’s not helping at all. Unfortunately, I’ve tried just about everything including therapy but because his feel so hormonal, normal strategies aren’t working. My husband is very supportive and thank God I have him. Nobody else knows what’s going on as they would not be supportive.

[Flossieteacake]

Hormones have a lot to answer for dont they? It can be so difficult. As it is hormonal is it possible your HRT needs tweaking a bit?

I am so glad you have a supportive husband. I know how unsupportive people can be with anxiety. Talking to the wrong people can make you feel even worse.

You will find lots of support from members on here so please post away.

[CLKD]

Hi!  what type of anti-anxiety medication have. you been prescribed?   If it's an AD it probably insn't the correct way to ease your symptoms.

In the 1990s I was prescribed a high dose of Valium for 5 days, then it was dropped until I was able to use  5mg 'as necessary'.  Because I know it works I never had to reach for any extra.  I would take 5mg the night B4 an event that I was unable to get out of knowing that I had 5mg to hand for the next day which I never needed.

In 2002 my GP prescribed Propranolol to stop the early morning anxiety surges which caused me to wake in the early hours, terrified.  That was successful 4 me, I stopped in 2020.  I have an emergency medication to swallow when anxiety floors me.

Is there a worse time that anxiety affects you?  Do U improve during the day?

Perhaps let us know what you have been prescribed. 

[lilbebel]

Hello, I’m on two pumps of Estrogel and 100 mg of Prometrium vaginally per day. I’m on .5 mg of clonazepam as needed for sleep and 10 mg of Celexa, which is absolutely useless. During perimenopause, my anxiety was very physical and mental. I had propanolol for the physical anxiety, but no longer need it. Since I entered menopause, the physical aspect has calmed down, but I’m still left with the emotional aspect. It’s like having really bad PMDD. The sobbing and the anxiety and then depression because I’m so exhausted feeling so bad. My confidence is shot and it’s been going on now for about three years so I’m feeling like I’ll never get out of this. I used to be worse in the morning and got better as the day went on. Lately, it’s bad from the moment I wake up till when I go to sleep. If I wake up during the night, I feel peaceful and okay. I actually like the night time. The days are brutal. I just went for a walk that’s good for anxiety and sobbed for the whole time. I’m doing everything ‘right’ according to the experts and am worn out. My gynaecologist is unsupportive and told me that she can’t tweak my hormones. She says there’s nothing left to try. I can’t take synthetic ones so she’s probably right.

[Gnatty]

Good morning. I don't agree that there is nothing more for you to try, what an unhelpful thing for your gynaecologist to say! There are lots of us that take more than two pumps of oestrogel, you will see that it's licensed for up to 4 pumps a day. So that is one option, to try and add in maybe an extra half pump for a while and then to gradually increase. Another thought once you have tried increasing your oestrogel is to try having a couple of weeks without the prometrium to see if that is the culprit? You said you felt like your symptoms were similar to PMDD which is I think usually fuelled by progesterone problems. There are women in this group that just take it for part of the month rather than continuously or take it alternate days instead as long as they have regular scans.

Do you have the option to look for another menopause specialist who could help you with all this?

Finally regarding the Celexa. I think 10mg is a low dose so you could investigate whether a slightly higher dose might be better. Alternatively there are plenty of other types out there, often it can take a bit of trial and error to see what suits you best.

It may be that once your hormones are optimised as you say you might not need an antidepressant. But there is certainly no shame in needing both and again there are plenty of women on here who do just that.

Please keep talking to us on here, we understand how you are feeling right now. Things will get better, please don't give up. xx

[sheila99]

Anxiety and insomnia can both be meno symptoms, they were my worst ones. I agree with Gnatty, try increasing the oestrogen and stopping the progestin, you could have a trial 2-3 weeks without or you could use a sequi regime for a couple of months. If your anxiety and insomnia arrived with peri there's a good chance it's hormonal and can be cured by oestrogen. If you had it before peri then possibly ads are a more appropriate route (some women need both). My anxiety was also worse on waking.

[lilbebel]

Thank you for your valuable input. I’m interested in stopping the prometrium to see if I feel better. I know I felt horrid on Provera. Unfortunately, I can’t take higher AD dose or another kind as they prolong my heart QT and can be fatal. So, my options regarding that are fairly non existant. I really am curious to know if it is the progesterone. I have suffered from anxiety and depression in my life, normally a reaction to circumstances/events, but this feels different. I just read this on the drug side effects for Prometrium, and it describes me perfectly:

“Psychiatric side effects

Very common (10% or more): Emotional lability (23%), depression (19%), sleep disorder (18%), nervousness (16%), libido decreased (10%), suicidal udeation.”

I had PMDD during my menstruating life. It got progressively worse every day after ovulation. This would seem to suggest that I’m highly intolerant of progesterone, including my own.

“The luteal phase is characterized by a gradual rise in progesterone. This hormone level increase begins shortly after ovulation and lasts until the beginning of the following menstrual cycle.”

I really hope I can find another doc who will support me having to tweak my hormone replacement and not have a strict one size fits all approach as it’s not working and I’m really suffering.

[CLKD]

Who over sees your QT and how regularly?  Would it be worth while discussing where you are at the moment with mental and physical health in relation to hormones?

[lilbebel]

My Cardiologist and family doctor. I was in hospital a year ago with tachycardia from perimenopause and my QT was near 500 which is dangerous. They found it directly related to the use of antidepressants. They are aware of my mental health struggles and have been really unsupportive. My family doctor said that I’m just treatment resistant. They basically given up on me because I’m not straightforward and have drug intolerances. They gave me a psychiatry consultation after making me wait eight months, and the guy said he doesn’t know anything about menopause. He also said he doesn’t have any colleagues who know anything about it. The system here is broken and does not know anything about midlife women going through difficult menopause.

[Ermin2trude]

Hi lilbebel,

The NICE guidelines state that perimenopausal and menopausal women can be on a 3 month regime if they can’t tolerate progesterone.

https://cks.nice.org.uk/topics/menopause/prescribing-information/hormone-replacement-therapy-hrt/

If you decide to stop taking the progesterone for a couple of weeks to see how you feel without it then you won’t be doing any harm and then you will know if it’s the progesterone making you feel so utterly desperate or something else ie. Not enough oestrogen.

Be kind to yourself.

Ermin x

[lilbebel]

Thank you so much for this great advice and information. I have decided to stop the Prometrium as of today FOR 2 weeks to see if that helps. My husband says that he has observed that I’m way worse mentally since I started HRT than before. It’s made me physically better and mentally worse. I tried to read the NICE guidelines for unfortunately it’s not available to people outside of the UK. I’ll see if I can find any other sources online. Thank you so

[Ermin2trude]

Hi lilbebel,

I’ve copied and pasted the relevant section from the NICE guidelines in case you can’t find it from another source.

Menopause:
Hormone replacement therapy (HRT)
Last revised in September 2022

For perimenopausal women, monthly or 3-monthly cyclical regimens may be used.
A 3-monthly regimen may be more suitable for women with infrequent periods or who are intolerant to progestogens. See the section on adverse effects for more information.
A monthly regimen produces monthly bleeding whilst a 3-monthly regimen produces a bleed every 3 months.
A continuous combined regimen is not suitable for use in the perimenopause or within 12 months of the last menstrual period.
Note: the absence of bleeding whilst taking a cyclical regimen reflects an atrophic endometrium.
Exclude pregnancy in perimenopausal women or women with premature ovarian insufficiency.
Check compliance with therapy if the progestogen component is taken separately.
If HRT was initiated in the perimenopause, consideration should be given to switching from monthly or 3-monthly cyclical regimens to continuous combined regimens after the woman becomes postmenopausal.
For postmenopausal women, monthly or 3-monthly cyclical regimens, or a continuous combined regimen may be used.
A continuous combined regimen may be preferred as it does not produce withdrawal bleeding.

[lilbebel]

Thank you for this. Very helpful indeed.