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[CrispyChick]

There is a post somewhere recently about somatic exercises. I think from my brief reading, this helps with trauma. May be something to look at.

[CLKD]

 

[bombsh3ll]

Does the combined birth control prevent the hormonal fluctuations of peri then? I have never been offered that, but then havent needed birth control per se for years as husband had the snip. My biggest issue with cyclical hrt was getting the dose right and not getting massive highs and lows. If your own hormones are fluctuating in peri underneath, does your approach still stop this? Really interested to understand how it could work for me.

Completely!

The combined pill shuts down your own ovarian function and adds back a stable low dose of estrogen and progestin that is the same every day, especially if you take it continuously like I do.

I've been on it since I was 29 and don't bleed at all or have any hormonal ups and downs. I am 45 now and have no clue whether I am perimenopausal or not, I could even be postmenopausal although that's unlikely - I have no way of knowing and no plans to find out!

I will simply switch to an appropriate HRT product in my early to mid 50's when menopause can be reasonably assumed.

Contraception isn't a consideration for me either - I lost my fertility to malpractice due to being left with appendicitis for 3 weeks before I was operated on, and complications delivering my IVF daughter left me with almost no vaginal opening, so that function of the pill couldn't be less relevant to why I take it.

I actually really wish the combined pill could be called something else or rebranded because I feel the contraceptive labelling means many women who would really benefit from treatment for health reasons miss out on it as they think it's not for them because they don't need birth control.

As with many treatments, nobody will offer it, you have to do the research yourself and go and ask for it, but as long as you have no medical contraindications it is very easy to get prescribed.

I take Zoely which has 17 beta estradiol however there are many different formulations so most people can find one that suits.

[Penguin]

Does the combined birth control prevent the hormonal fluctuations of peri then? I have never been offered that, but then havent needed birth control per se for years as husband had the snip. My biggest issue with cyclical hrt was getting the dose right and not getting massive highs and lows. If your own hormones are fluctuating in peri underneath, does your approach still stop this? Really interested to understand how it could work for me.

Completely!

The combined pill shuts down your own ovarian function and adds back a stable low dose of estrogen and progestin that is the same every day, especially if you take it continuously like I do.

I've been on it since I was 29 and don't bleed at all or have any hormonal ups and downs. I am 45 now and have no clue whether I am perimenopausal or not, I could even be postmenopausal although that's unlikely - I have no way of knowing and no plans to find out!

I will simply switch to an appropriate HRT product in my early to mid 50's when menopause can be reasonably assumed.

Contraception isn't a consideration for me either - I lost my fertility to malpractice due to being left with appendicitis for 3 weeks before I was operated on, and complications delivering my IVF daughter left me with almost no vaginal opening, so that function of the pill couldn't be less relevant to why I take it.

I actually really wish the combined pill could be called something else or rebranded because I feel the contraceptive labelling means many women who would really benefit from treatment for health reasons miss out on it as they think it's not for them because they don't need birth control.

As with many treatments, nobody will offer it, you have to do the research yourself and go and ask for it, but as long as you have no medical contraindications it is very easy to get prescribed.

I take Zoely which has 17 beta estradiol however there are many different formulations so most people can find one that suits.

Thanks! I'll have a look into this. I gave up on hrt due to extreme fluctuations in peri meaning it just didn't work for me. Would be great to be able to stop the highs. I've never taken the pill or any kind of oral contraceptive but from what I can see I don't have any of the risk factors that would mean I couldn't take it.
Thanks for the advice x

[ElkWarning]

Hey everyone. I hope you are well. I am trying to research into how people with pre-existing mental health challenges are finding the perimenopause. I seem to be in very early perimenopause. I'm nearly 51. My periods are still regular like clockwork, though with some minor changes. But I have complex PTSD and it feels like, emotionally, everything has ramped up several gears, and not in a good way: severe rage and distress attacks, especially when woken up, general nervous system activation and dysregulation - hence getting woken up more, sobbing fits, feeling like I'm regressing to the emotional states of my childhood and taking several steps back in terms of mental health progress. Irritable, feeling like I can't cope with things in the way I used to, distancing myself from any friendships where people have annoyed me or are generally very flakey etc. Some days are good, and I feel like nothing that bad is wrong with me. But other days are beyond awful. It's hard to know what may be psychological and what may be hormonal. Has anyone experienced similar? I've been prescribed HRT - I've yet to take it as I'm a bit anti-medicine and also have been unsure about the psychological component. But I feel myself edging ever closer😌

I hear that so hard.

I recently needed a brief letter from my GP listing my health conditions and it was pretty tough seeing it all there in black and white -CPTSD, autism, OCD, anxiety, depression ... When I was younger it would've said PMS (now PMDD).

I think I had two extended periods of crisis in my life, once in my early 30s and then later in peri. Both times I thought I was losing my mind. What I remember most was the rage and the fear, along with feeling like I was on the roller coaster from hell (or going to hell, I figured it was probably a circuit).

I don't think HRT was particularly helpful for me psychologically. However, it did help with some other stuff like muscle aches. I had to stop taking it due to unexplained high blood pressure. Also, like OCD contamination phobia type feelings.

For me, it's the therapy - weekly, 6 years in and counting, tbh, I don't think I'll ever be out of therapy. I'd had quite a bit in the past, NHS, mainly CBT type stuff, but also via community mental health teams in crisis scenarios (sometimes requiring hospitalisation). I'd sort of convinced myself that I'd 'failed therapy' until I (almost accidentally) ended up in front a highly qualified feminist therapist whose background is in women's services. She took me on at a massively reduced rate. I know I'm very lucky, but maybe that's the pay off for over 50 years of being extremely unlucky.

These days I'm ok. A bit blunt. Can come across as arrogant. Still have meltdowns, e.g. today, but these are entirely predictable and within the normal range of my reactions - I'm now a teacher and absolutely exhausted at the end of term, plus school holidays mean my routine changes suddenly and I find that challenging. Point being, I can manage my mental health at the moment with significant therapeutic support.

[CrispyChick]

Whilst I absolutely think 'the' pill has a place in peri, I must also pass on my experience.

Indeed my NHS meno clinic (during COVID - so phonecall) did indeed suggest I try the combined pill to flatten all fluctuations.

And try I did. Practically every single one of them. I lost 18 months of my life waiting out the 3 months on each pill, only to find they either triggered massive side affects, like daily migraines, or did not conceal my underlying symptoms. That's before you mention the awful start up mood swings that some gave me for the full 3 months. 

And - I was a pill user in my 20s and early 30s. No prob.

Yet, my own sister has merrily taken a coc pill for 20 years and sailed through meno.

I suspect, unfortunately, it's just more change at this stage. Whereas if you'd been on it previously and continued, perhaps works better.

Certainly folks should try. But again, it's not the magic bullet for everyone. And, as I say, it was the NHS meno clinic recommended it to me.

I had better success with the mini pill, which stops ovulation and keeps E levels relatively low. But my pms on it became unbearable.

I think if if was a great magic bullet, everyone would be doing it. X

[Dandelion]

Hey everyone. I hope you are well. I am trying to research into how people with pre-existing mental health challenges are finding the perimenopause. I seem to be in very early perimenopause. I'm nearly 51. My periods are still regular like clockwork, though with some minor changes. But I have complex PTSD and it feels like, emotionally, everything has ramped up several gears, and not in a good way: severe rage and distress attacks, especially when woken up, general nervous system activation and dysregulation - hence getting woken up more, sobbing fits, feeling like I'm regressing to the emotional states of my childhood and taking several steps back in terms of mental health progress. Irritable, feeling like I can't cope with things in the way I used to, distancing myself from any friendships where people have annoyed me or are generally very flakey etc. Some days are good, and I feel like nothing that bad is wrong with me. But other days are beyond awful. It's hard to know what may be psychological and what may be hormonal. Has anyone experienced similar? I've been prescribed HRT - I've yet to take it as I'm a bit anti-medicine and also have been unsure about the psychological component. But I feel myself edging ever closer😌

Hello
I am diagnosed CPTSD and autistic.
In 2009, things, physically, as well as mentally changed for me.
I was 42 so menopause did not enter my head and I had never heard of perimenopause. 
I blamed medication I had discontinued at the time.
At 47, an australian woman, not from a menopause site, suggested it, and HRT to me and directed me here.
Peri is when things fluctuate even still with periods.
That was when my mental health took an odd direction, but I always found something to be anxious about. I told myself some of my fears were real I was that "paranoid".
I hear you about regressing, I regressed at that stage.
I started being flaky as well and symptoms of my condition flared.
I even went down to 7st in weight, which isn't a good look when you stand 5ft 5inches tall.
Mental health services helped with that though, got me to see a dietician etc. I am now back to normal weight, well, post HRT weight as I was overweight before going on it.
Still I blamed medication, because I was now on HRT, since 2014, so it can't be menopause, right?
I thought I knew it all about menopause.
I am 58 and my plans were to come off HRT eventually and be one of those wise old women on YouTube who are fit as fiddles and really cool, but we need the hormones we lost, as not to have them is a future health risk as well as poor quality of life.
I thought I was "through" menopause.
Enter Dr Louise Newson's free educational content.
I have the attention span of a small insect, so I was well surprised that her lectures, podcasts live Q&A's etc held my attention.
Dr Newson is an absolute Dear 🙂❤️
She even uttered my symptoms, which was uncanny to be honest, a no one else really had.
She talked about testosterone.
I decided to pull my head out of the sand about menopause, I think I resented that I had needs, (Possibly some CPTSD symptom) and I got the testosterone.
It's too early to tell you the improvements.
If your HRT is the body identical type, it is not a medicine, like a drug, it's putting back what we lost so we are not at risk and our lives can be more stable.
In peri, like you are, it's a topping up of hormones, so that the lows don't feel like what you are experiencing.
All along, hormones were my problem, since 2009 when all this started, and I blamed my mental health conditions.
Oh dear, I have written an essay, I hope it's a good one.

[Dandelion]

Thanks so much for sharing your insights and experiences. I'm hesitant about medication as I've always tried to lead a more natural life - eating healthily, exercise, yoga, meditation etc. I don't really like the idea of things like HRT or anti-depressants, with side effects and risks and question marks over them. But I'm reluctantly getting to the point where I realise I may need to resort to them. I think I'm in early perimenopause so this could go on for years 😱. Counselling will also invariably be part of it. I'm also tracking monthly events. I think it all gets worse in the last week of my cycle, but not exclusively. I have seen other forums that talk about complex trauma and the menopause and I just wondered if anyone here could resonate. But your replies have been really helpful, thank you.

A lot of doctors try to fob patients off with antidepressants, and they don't take away some of the menopause symptoms, they numb them.
I actually asked for them in 2009 when I unknowingly started peri.
I spent thousands on a private counsellor too.
I wondered why the help with mental health was limited for me, and I now know it was hormones all along.
I wanted to go "au natural" as I "didn't need HRT" when really, we all do, not only to make life comfortable for us now, but to prevent future illnesses.
There is a small risk with synthetic HRT but we like to think all doctors are OK with prescribing body identical ones, like the ones we lost.
As for CPTSD Dr Peter Levine is great, as he knows all emotions are stored in the body.
There is also an online course with Irene Lyon, for healing trauma, but I have yet to look at that.
I've got an enormous amount of help from veilofreality.com podcasts, yet there was always one missing puzzle piece, and for me, that was testosterone and the free online educational content of Dr Louise Newson and her podcast guests, she has really good ones on.

[Aubrey]

Hi Eastside,

I hear you, trauma therapy is expensive, but think how much we spend in a month/year on clothes, makeup, creams and other self care things. Somehow that's OK because it enhances our physical appeal. Perhaps for those who really need it, and for a period of time, we could put that self care spending into therapy?

Just a thought.

[Eastside]

Thanks so much and sorry for the late response. I didn't expect more messages!
Great, I'll look for that post. I've now integrated deep breathing exercises into my morning and evening routine. Including vagus nerve breathing exercises. I've had two weeks off which has really helped to calm things down. I'm trying really hard to control my mind and not to spiral. I've definitely had some success with that. I'm trying to control the rage and keep calm, though I still feel very sensitive, irritable and hurt a lot of the time. But the rage just causes further mental decline. Somatic stuff is really valuable, I believe, so thank you.

[Eastside]

Thanks so much for sharing your experiences ElkWarning and sorry for the late response.
I'm so glad that therapy is helping. It seems that everyone has different things that either work or don't.
I identify with much of what you say. I've been in therapy most of my adult life, but only in patches for the last few years. As you say, finding a good therapist can be key. I was rather let down by a long term therapist. I still intend to go back into therapy, but it's not possible at the moment.
However, I've taken a cross-section of what I've learned from previous therapists and combined it all into some self-help efforts, including:
-Some yoga, meditation and gratitude exercises in the morning, along with deep breathing as per advice on vagus nerve exercises
-Journaling - amazing what I've achieved with this, but I only recommend it to address trauma if people have enough skills/capacities to manage what may arise as it can be quite powerful
-self compassion and self-soothing
-some CBT to try to combat brain spiralling, paranoia and catastrophising
-trying to self-parent myself, by adopting a nurturing/responsible parenting voice towards myself, which some may regard as woo woo, but I find it amazingly powerful
-trying to trick and divert the brain into calmer waters if I wake up in the night (which is basically every night). E.g by repeating soothing phrases over and over to stop my brain from spiralling

I've had anything ranging from huge success to minimal success depending on how much I've employed these techniques and how wound up I am. But I'm definitely continuing with it .

I am glad that things seem improved for you .

[Eastside]

Thanks Dandelion. It was a very good essay and sorry for the late reply. That's very interesting. I totally get that replacing what is lost can really help. I have pushed for the body identical ones which I've now been prescribed, so at least I have them here when I'm ready. Thank you again and I am very glad that it has helped you!

[Eastside]

Thanks Aubrey. You are totally right. It's a tough call, as my therapy is likely to go on for years, but I have to realise that there's nothing worth more investing in than in my wellbeing. Unfortunately I can't at the moment because I need a more settled housing situation first and to subsequently free up some funds, but I hope it will be this year. In the meantime I'm putting great efforts into using the tools from previous therapy and helping myself. But thank you for the wise words.

[Eastside]

Dandelion - you mention Peter Levine. I find those trauma experts great, and neuroscience ones. If you haven't heard of Janina Fisher, you may find it useful to check her out as well. I'm planning to buy her book. To me, she has totally nailed CPTSD and has made more sense to me than a lot of people and therapists in the past. But I need to check her out more.

[Eastside]

Hopefully I haven't left anyone out - I'm still trying to navigate how to post and reply - but thanks so much for all your contributions. They have been invaluable. I wish you all a healthy and happy (as possible!) 2025!