Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Milamam on May 21, 2016, 06:28:16 PM
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http://psycheducation.org/hormones-and-mood-introduction/basic-information-about-estrogen-in-psychiatry/
Came upon this article describing the role of estrogen in women's anxiety. It gives food for thought re higher levels of estrogen replacement and increase of depression/anxiety. My take of it was :"it's a question of the right balance".
Milamam
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That is fantastic Milamam, and pretty much taps I to what I'm thinking about what has been going on with me lately.
I can ABSOLUTELY vouch that too much estrogen does cause anxiety. The type of cyst I had for which I had my oopherectomy (and it was a whopper by the time I had my op.), was causing huge surges in estrogen and I was literally on the ceiling! Almost immediately after I had the surgery, my anxiety totally disappeared. Fast forward just over a year post op. and I start estrogen only HRT and bingo! Here I am again. I hope by dropping my dose that the anxiety will decrease. I'm wondering if in my case my body 'remembers' when it was totally estrogen logged and said 'oh no. Not THAT again'! And maybe this is why I am having such a tough time. I guess I can't know for sure. The whole hormone thing is still a bit of a mystery in some ways, especially as we are all unique!
Thank you so much for sharing!😊xxx
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The 'body' itself won't 'remember' but the brain can become conditioned to certain feelings, triggered by similar situations.
Even though I know the clinical reasons why I go into 'flight or fight' response, the physicality takes over :-[ ……. :'(. If a body becomes used to living at a certain adrenaline level, then the come-down can be awful - I remember when I stepped in after a sudden death close by, after the fuss and funeral were over, I was deeply depressed for 3 weeks. Even knowing the cause, didn't help the physicality :-\.
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On the two occasions I was given some HRT to try it sent me up to the ceiling. I probably didn't need it but the doctor wanted me out the consulting room.
In my youth I couldn't take the Pill for the same reason, it had me climbing the walls.
My current very clued up lady GP surmised that I am likely hypersensitive to oestrogen and am probably still producing enough of my own for my needs which could be why I have not had the awful menopause experience that some of you poor ladies are having. The symptoms I have had have been quite manageable especially with the information contained in these pages.
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I think that could be the danger when doctors either don't know enough or aren't interested enough, they don't realise that every woman is an individual case and what works for one probably will not help another and they lose patience, blaming the woman for not trying hard enough.
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Very interesting fact!! My GP put me on HRT in 2012. Sent me over the edge within a week! I managed well until this year when anxiety, night sweats etc returned with a vengeance and am now on Evorel conti patches. Anxiety only in short waves and getting further apart so I have always belived that I still had enough of my own hormones before and then overdosed on them.
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Hello clare, it certainly sounds like it. Pity really as my earlier experiences with HRT when I didn't need it put me off trying it when it might have helped in the early days of permeno. However I didn't have a really bad experience and am ok now. Hope you do well on your treatment.
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I was the same babyjane and it took me 4 years to give it another go but that was because all my symptoms suddenly worsened!! It is much better this time round on the patches, even though I did have a few unsettled days with crying and low mood.
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Interesting link - but I can see the devil is in the detail and a few more specifics would be interesting. eg some of these studies were talking about Premarin - which as we know is not bio-identical but a mix of horse oestrogens (including some estradiol) which are more potent than our own - and many women do indeed experience problems on this particular one.
So if you had a bad reaction in the past and to the birth control pill - well it might have been Premarin you were given, and the birth control pill again contains very strong synthetic oestrogens - so cannot be compared with estradiol. Similarly if you took HRT orally then you may well be reacting to the metabolites and whatever happens to the excess oestrogen after it's gone through the liver - so it's not as straightforward as it seems.
For me the starting point is the basic fact - we are designed to "like" oestrogen - this is our gender hormone. Most women feel at their best during the middle part of their cycle when oestrogen is at its highest and progesterone very low. By several years post-menopause oestrogen has decreased to a low level - and this is established to be responsible for low mood, anxiety etc (though not of course in everyone).
During peri-menopause ( and possibly the late reproductive phase too?) oestrogen levels fluctuate hugely so may be suddenly abnormally high ( though nowhere near as high as they are during pregnancy) - and maybe this sudden increase to higher-than-normal-for-you levels causes some anxiety also in some women? I don't think there is enough information on this.
Added to this there is the overall pattern of oestrogen falling as peri-menopause progresses ( even though there may still be spikes?) - and all sorts of reactions occur - hence the wilderness women find themselves in trying to work out what's what as periods and cycles start to become erratic.
As I said on another thread - replacing oestrogen from outside (exogenously) doesn't seem to always do exactly the same job as our own endogenous oestrogen - not least of which I presume because there are so many other hormones coming into play as well.
In addition those like babyjane who appear super-sensitvie - many women experience initial side effects from sudden increase in oestrogen - but many of these do subside after a few days or weeks leaving women feeling much better in the end - and the sensitivity is reduced by using transdemral estradiol ( ie patch or gel). If you don't need progesterone then all the better - that is out of the equation! Lucky for those women!!!
My view is that peri-menopause lasts for fewer years than post-menopause - if we are lucky to live a long time - so we are more likely to be without it for a long time. Therefore it is worth riding out the initial side effects if you can find a non-medical way of coping ( ie without drugs like ADs and BBs!) - so that you can benefit in the longer term.
Also - those who have tried it when not yet in peri (ie still having regualr periods) and given up because it doesn't work for them - I would say don't give up for ever - you may well find you benefit later on when your hormone surges have lessened and ceased.
Oops got carried away yet again - but hope you get what I mean?! ::)
Hurdity x
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Hurdity, you always have such balanced posts. Thank you!! In my own case, I think I'm not 'liking' how I feel right now with the feelings of being somewhat 'ramped up' and jittery because it reminds me of my peri days which were very, very rough without HRT. Right now as you know, I have been struggling with virtually no estrogen for a good while post oopherectomy and my body had to do a power of adjusting to that. Now it's having to adjust again! I actually spoke to the Consultant at my menopause clinic again and she said 'I was really hoping you wouldn't have a rough time but I thought you might do'. I think in my case I can expect much more of the start up jitters than your average bear! I see lots of 4,7,8 breathing in my future, with a tidy dose of 'om' to get me through (fingers crossed). In my case, it is essential that I stick with HRT!
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Hi Hurdity
Brilliant post - one which I am going to show to my Dad as the reason why I spend a lot of my time crying!
The best word in the whole of the piece is "wilderness" and best describes how I feel about the Peri!
Thank you.
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Mis71Mum, I definitely refer to this as my 'wilderness years'! :o
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http://psycheducation.org/hormones-and-mood-introduction/basic-information-about-estrogen-in-psychiatry/
Came upon this article describing the role of estrogen in women's anxiety. It gives food for thought re higher levels of estrogen replacement and increase of depression/anxiety. My take of it was :"it's a question of the right balance".
Milamam
Thank you, bookmarked, will read later. My hrt helps flushes etc, but no change in low mood.
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I was having the hormone discussion with some friends, one is post meno and feels much better than all her earlier years and the other had a hysterectomy (due to severe fibroids) but still has her ovaries. The latter had just 2 weeks of drenching hot sweats and feels great now, so isn't sure if she's post meno yet.
Both had heavy and painful periods all their lives and they have not tried HRT as they feel so good. I am the opposite - light painless periods but very rough perimenopause so far. As I was told my oestrogen was low in my 20s and they had very high levels and were very fertile, we were wondering if their levels are now optimum and mine are too low/volatile due to our different starting points. My friend said she had found this pattern with other friends where the easier your periods were when young, the worse the menopause.
So if our levels are so massively different to each other this could explain a lot. Perhaps some women have enough natural protection without HRT?
Hence, adding oestrogen would make some women feel terrible and others great. I guess they really need to do the all day (or all month?) blood testing you can apparently ask for to get a true picture of your needs. (Sorry saw the doc on This Morning mention it for perimenopause testing, but forgotten the name and if every few hours or every few days).
I believe you get the adrenaline rushes at both ends points, as oestrogen is stimulating the more you have and too low causes corrective stimulation.
Balance is key but it's not easy to achieve for some!
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Dear Dangermouse
I really think you are on to the truth of the matter in your post, so very well put. I am having a terrible time with the menopause. No end in sight after eleven years of flushing, very high levels of anxiety etc etc. I was lucky in that I never had long or heavy periods but I did have difficulty conceiving and only managed one child after one miscarriage. I am sure that there must be some connection in these things as you say. One size of treatment cannot fit all and a lot more reseach needs to be done!
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Dangermouse,
Your observation might have a lot if truth indeed!
I am 45 now, started peri I think in my early 40ties. I had always had very heavy snd painful periods as a girl, but they suddenly improved when my first child was born at 31 years. They became light/normal, no pain, no nothing! Such a relief! This continued all through my thirties until now these past few months (i am on HRT since 43) when the cramps and PMS returned. So sad about that!
I think I was quite firtile all my life but at 36 I had quite a hard time conceiving . I had to take additional Utrogestan for about a year before our second daughter was conceived. In retrospect I think I might have started hormonal fluctuations at that time although periods were regular.
In short, I find now while on HRT that I do better on lower dose of E although too low broght about anxiety and bad mood. Too high also made me bloated, jittery, unsettled, unhappy. I am struggling now to find the right balance!
Where I live in Bulgaria you can go to a private lab and request to be tested even if you are not referred by a doctor. So ideally, if you want, you can track hormone levels throughout the month! One test ( four hormones -LH,FSH, E, Prog) will cost about 20£. Not impossibly expensive but I don't see a point of doing it. Rather, what I have done is test these four hormones on day 3-4 of each cycle. This tells me how I feel versus where my hormones are.
When I do this, I go for the test and then take my morning HRT pill. I have found out that if I take it before the test, results come back very scewed. I do it because I have been cutting my pills in half for the past 3months to alleviate bloating and letargy that I experienced in Dec/Jan.
Sorry, got carried away. Balancing is soo complex, isn't it?
Milamam
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Interesting Dangermouse. Two of my lifelong friends had very light, scanty periods with no pain....they both breezed through the menopause. Whereas I had heavy painful period and my menopause has been, and still is, hell.....the hrt works wonders for the flushes and sweats, they have completely gone, but anxiety and low mood remains, it comes and goes for no reason. Some days I just feel weird like something is terribly wrong, other days I'm on top of the world......never have got to grips with it.
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I agree with your observations. My periods were not horrendous but they did dictate more than I would have liked. Had no trouble whatsoever conceiving and a try out of HRT in my late 40s sent me climbing the walls.
I have not had too bad a time of it and have not used HRT since.
I have a 3 yearly DEXA scan, the last one being November and my bones are fine so far. I am now 59 and any meno symptoms are much less bothersome than they were, flushes milder and less frequent and moods more stable. Just need a low dose beta blocker and AD daily for anxiety problems.
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Hi all! Very interesting but I had no problems with my periods in the slightest. Very regular and no pain whatsoever. Got PMT while I was on the pill. Had no problem conceiving but suffered from PND after first birth which only cleared when I had my second. Couldnt use the pill after that though as side effects were severe. I got sterilised when i was 36 and now know that the peri started (just hot flushes) soon after. Couldnt take HRT in my early 40's (sent me totally doolally within a week) but have just stated on conti patches (Im now 49 and 5 years since natural period stopped)and settling well (at the moment).
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I always had very heavy bad periods from a young age ended up having a hysterectomy due to them and had a terrible time with peri just starting to settle I hope three years post meno.I have the patch and some days feel fine others anxiety is dreadful I think we are all different and how heavy periods are have nothing to do with it .
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I know there is wide variation in women's natural levels of oestrogen - you only have to look at the data on the range of estradiol levels at different stages and the ovulatory peak - to see this. It would be interesting to know how this relates to experience of menopause, and periods - but I can't seem to find anything. I'm probably not googling in the right way. There is discussion about the causes of heavy bleeding in principle but not that the problems (in menopause) are more likely to occur in women with higher oestrogen levels overall - although this would be intuitively the case.
I know there is evidence of women who have suffered extreme pms and cyclical depression responding to oestrogen therapy before menopause - this is what Studd bases his work and practice on. I'm not sure that pms would be related to heavy periods though - especially if low oestrogen is a major component?
If you find any studies on this dangermouse I would be very interested :)
Hurdity x
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I had the most terrifying experience with too much oestrogen.
I was put on 4 pumps of Estrogel which gave me a level of anxiety and hypermania which I will never forget. Truly teryfying.
I will never touch Estrogel again.
I am now on 50mcg patches of EVOREL. I find the patches altogether gentler.
I'm clearly VERY sensitive to hormones but I can vouch that too many made me feel horrificly anxious and manic.
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Hi joesmum, I can appreciate what you say as I found the same effect many years ago when I was given HRT patches to try without my levels being checked and I don't believe I needed them. I was convinced our son was planning to murder us as we slept, so much so that I wouldn't go to bed. Fortunately I added 2 + 2 correctly, realised what was happening and ripped off the patch.