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[Meema]

Hello, I’m new to this forum but really in need of some solidarity or support.
I’m perimenopausal (age 47) and been on HRT around 2 years. This really helped with brain fog, anxiety, night sweats overall well-being and I was pretty stable for a long time. Difficult family events sent me into a bad place with anxiety in spring this year and I have had a lot of therapy since then (EMDR) to deal with some difficult past events. I was doing really well and feeling relatively ‘normal’, managing work, teenage kids, elderly parents etc until about 3 weeks ago when I have had a huge crash. Struggling every day now with anxiety/ panic attacks and low mood. I’ve had to stop working and am finding it difficult to even do basic household tasks. Gutting, particularly over Xmas!! I had some blood tests at the doctors and my oestrogen levels were actually very high. I’m on four pumps of oestrogel. I’m feeling really desperate and wondering whether to go down the route of antidepressants although I’m really scared to do so. My question is…. Could this big wobble be hormone related and should I ride it out a while longer before going down the meds route? It’s only been 3 weeks but feels like forever! I’m scared of getting worse and I need to be strong to support my mum at the moment as her partner is nearing the end of his life.
Sorry for the big offload - difficult time and needing some sisterly solidarity x

[DottyD68]

Hi Meema,

Sorry to hear you are struggling with anxiety. I found that when I was on 4 pumps of gel my anxiety, jitters, palpitations went through the roof. Strangely enough it was at this time of year too so probably exacerbated by the chaos of Christmas and also family health issues. I found when I gradually reduced my gel those symptoms eased off. It is worth discussing with your GP. You may find other symptoms re-occur/occur when you reduce to gel and it can be a balancing act of deciding which symptoms are the most bearable, in my experience. Hope you get it sorted X

[CLKD]

Why not drop the amount of replacement to 3 then 2?  It mayB that your body has adjusted so it no longer requires such a high amount?

Those symptoms are dreadful  and I found them worse at this time of year, from late November to Mid-January I would want to hibernate  .

   Is your Mum's partner in a care situation or at home? 

[Meema]

Thank you for replies,
I have just had an appointment with a really lovely GP. She thinks that my extreme anxiety response has almost certainly been triggered by oestrogen levels rising and falling rapidly, then spiralling as I’ve not been able to get it under control with the usual things… then feeling low as I can’t get a grip on it. She says that HRT alone can’t always manage these symptoms and has prescribed sertraline to get me back on my feet.
I’m quite wary of taking SSRIs but also desperate to feel better. Has anyone used this combination successfully? I would appreciate some encouragement. Thanks 

[Booroo]

Following this as I have setraline in the cupboard ready as back up

[CLKD]

Would U consider Setraline if U didn't have peri-menopause symptoms? 

[bombsh3ll]

Why not aim to stabilise the estradiol levels in the first instance rather than adding psychiatric medication? Surely that would be the logical solution if both you and your GP believe hormonal fluctuations are implicated.

As gel is rapidly absorbed, resulting in a sharp spike then a drop, splitting your dose into two or even three applications per day rather than the whole lot at once can be helpful.

Alternatively you could consider patches or oral estradiol.

It also sounds as if you are dealing with some really challenging things at the moment, and experiencing a perfectly normal and reasonable human response to traumatic circumstances.

Sadness and fear in this situation are not pathological and nor can they be medicated away with a pill, which is unfortunately often the only resource available to a GP with 8 minute appointments and patients queuing round the block.

I would at least explore the possibility of non drug therapy with a psychologist or appropriate counselling before antidepressants.

[CLKD]

However many do use HRT as well as anti-depressant and anti-anxiety medications.

It is well documented that pre-menstrual syndrome can cause awful mental health issues so regardless of whether this is hormonally linked, mental health medication should help 1 C the wood for the trees.  1 can always wean off ADs etc. once balanced.

[GalwayGirl]

Hi Meema
So sorry to hear this and you have my sympathy, I have been in a mess for 6 months unable to work. Also had a number of difficult life events then hit peri very badly- ended up in a total state of collapse. I have really struggled with hrt - can’t tolerate progesterone and wasn’t absorbing gel, still not sure if it’s actually helping me as still very unstable mentally. I started citalopram and coped for 11 weeks it was frankly awful and then came off them too quickly and have since bombed and even more unstable mentally. Now torn as to what to do next re: meds
My thoughts for you would be:
Can you tolerate the anxiety to see if hrt will level out?
Are you fully aware of all side effects of ADs especially the agitation and anxiety experienced when starting them?
You may well be able to tolerate them but just be aware if you are particularly sensitive (I am) and how it may affect you.
You may be totally fine - I have friends who have started them without a bother and swear by them, I can’t say the same unfortunately. Best of luck to you and let us know how you get on.

[discogirl]

Hi meema

I also just wanted to reach out. Ive also struggled with my mental health. Im trying to get it under control using cbt and mindfulness. When you feel better I'd be interested in you using EMDR as therapy.

I think maybe bombsh3ll could have a point in that you could try spliting your gel or try patches which would give you a more even dose.

I hope you manage to get sorted whatever you decide to do as one who has struggled with severe anxiety over the years its really horrific and I wanted you to know your not on your own.

Lots of love x

[CLKD]

My 1st panic attack was aged 3 and I've suffered intermittently since  worse during my late 30s early 40s.  Group 

[Meema]

Thank you so much for taking the time to reply and for offering support. These have been exactly my concerns as I really don’t want to go down the SSRI route unless I absolutely have to. Unfortunately I have reached a point where I’m just not functioning. I could barely move yesterday and just consumed by fear the whole time. I’m either stuck in freeze state or panic.  It’s the worst! I’m no good to anyone at the moment and something has to change. I wish I could stick it out longer but feel like I’m living in a bit of a nightmare. I don’t recognise myself at all. I’m sorry to hear that others of you are also suffering. I never in a million years thought I’d be in this state.
I’ve started with 25mg sertraline this morning which makes me feel sad but I can’t carry on as I am. Will let you know how it goes x

[discogirl]

The best of luck Meema, please let us know how you get on x

[AKatieD]

I have had simething similar. Been on stable hormones for a few years but had a crash in the spring after a series of stressful events,, losing all energy and having panic attacks.

I know it is not my 4 pumps of iestrogel as taken that for ever.

Did find that my cortisol was off the scale and DHEA levels non- existant, so I sm treating that and it has helped with energy and anxiety.

Test by saliva cortisol 4 times over the day ( preferably with DHEA) as one test and 8am blood test of cortusol at same time for full picture.

[Meema]

That’s very interesting… I don’t know anything about DHEA tests… how do you get this tested?