Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: JoannFran on February 08, 2022, 04:35:47 PM
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Hi ladies
I've been keeping a symptom diary and can now see that my peri symptoms (mainly anxiety, internal tremor, shaking) are worse from day 13/14 onwards. I seem to be at my 'best' (I use the term very lightly ;D) during days 1-12. I'm not sure I'm ovulating every month as can usually tell but periods are still regular. What would this mean in terms of hormones? Am I best when both estrogen and progesterone are lowest or is this not the case if I'm not ovulating? I'm trying to work out if I need estrogen or it it's causing the problems.
Anyone noticed the same thing?
Thank you x
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That was the same throughout my menstruating years. The few days prior to a bleed I would be angry, feel ill/nauseaou. The night B4 I would sob uncontrollably, even if a period wasn't due. 10 mins B4 a bleed began I would have to rush to the loo, even if a period wasn't due. AND PAIN :'(. Once the period had started I would feel much lighter of Spirit but dreaded each month due to the PAIN :'( :'(. I went on the Pill for that reason.
I never knew when I ovulated.
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I feel for you, my symptoms are worse lately , I’m trying some new HRT which seemed to be helping but today my moods are quite bad I feel like my head is about to blow off 😔 headaches, joint ache, low mood feeling incredibly overwhelmed 😔😔
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Assuming day 1 is the first day of your bleed you feel good on oestrogen only and bad when you add progesterone? So I think it's progesterone causing the problems. If you're on gel you could try increasing it during this phase, it didn't work for me but does for some. The other I found is that it got better the further I got towards meno so for me I think there was too much progesterone. Perhaps a different type of prog would be worth trying.
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Yes day 1 is first day of bleed. I'm not on any HRT as i tried estrogel but it made my anxiety a lot worse. This is just my natural cycle. So I'm thinking the anxiety is bad when estrogen spikes? I've read that progesterone is the first hormone to decline in peri. I wish I knew for sure which hormone is causing the anxiety because it's definitely one of them! Is there a way to find out? I know blood tests are unreliable but surely if I had one when anxiety is high I'll know which hormone is the culprit?? Arrghhhh!!
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How is your diet? Low blood sugar can cause anxiety surges and is affected by hormone alterations. Have you thought of eating little and often?
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It could be for a variety of reasons, I don't think there is a one size fits all. When my Peri journey started I was only ever symptomatic from day 14 to 28 every single month like clockwork. Raging insomnia and night sweats. But from day 1 to 14 I was absolutely fine. The reason for that (i discovered for me) was that your estrogen is supposed to climb during days 14 onwards (as well as your Prog) and my Estrogen was not climbing... hence bring highly symptomatic. During days 1-12 your own E would be naturally lower anyway and it seemed that that meant I was not symptomatic.
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Hi
thanks CLKD - my diet has been awful but I've seen a nutritionist recently and she said that low blood sugar (and spikes) plays a huge part in hormones. Something to do with insulin. So I am making a very big effort to eat little and often. Early days yet tho.
Thanks Gilla999 - how did you find out that your estrogen wasn't climbing when it was meant to? Blood test? I am seriously considering paying for a blood test every other day of days 14-28 to find out what the heck is causing this. I can't go on much longer like this - it's ruining my life :'(
Thank you all for your replies. Much appreciated xx
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My anxiety and insomnia were caused by oestrogen deficiency, completely gone with hrt though it did take 3 months.
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JoannFran the honest answer is it has taken me two years of self education, blood tests, research and trial and error to be able to understand what was going on with me. It is not a clear cut case (maybe Peri never is!) especially as I'm only 42. (I do love being able to write "only" 42 every now and then ;D )
Everyone is different but for me blood tests have been vital to understand what is happening, however without a benchmark to go on, it can be tricky to interpret ("is this lower than it was before?")
If it were me, I would be getting a blood test on day 21 of my cycle and seeing if that sheds any light. If your E is below 350 that's a good marker for needing HRT however as many others will point out, your E level is not always a diagnostic factor.
What actually happened with me was that in early Peri my Estrogen soared for about 2-3 years (late 30s) during the luteal phase day 14-28. I know this because I was having terrible painful boobs every month and it triggered me to get a blood test which showed my E was way above the top of the range. No one told me it could be Peri, I didn't have a clue, and I did nothing about it. Fast forward two years and my E then started to fall back down in the next stage of Peri and it was this fall from very high even down to middle that caused me to be highly symptomatic. It is known among decent meno specialists that your E doesn't even have to be clinically low for you to be symptomatic (which is why many doctors rightfully diagnose on symptoms alone) and it can be the fall from "very high" in early Peri down to "middle" which triggers symptoms. Once I started HRT my problems disappeared (except for a few hiccups along the way).
This is a long winded way of saying I don't think there is a one-size-fits-all, but it is absolutely possible from my story alone that your situation could well be estrogen deficiency despite only experiencing it for half of your cycle, however as you say it could also be low Progesterone as that falls first in Peri.
Another option other than a blood test is to do a Rhythm hormone profile test from Genova Diagnostics. I've done 3 over the years and found them very insightful. They are salvia tests but you do them every other day and they chart your hormone levels (both E and P) for you, so you can see what's going on over the course of the month - they aren't cheap but I have found them super helpful to correlate symptoms with a change in levels.
Hope any of this waffle helps xx
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Graze Girl Graze ;-).
My stand by foods: dried fruits and nuts; bananas; energy bars; ginger biscuits; Jacobs cream crackers, dry. Eat B4 the body is hungry. Even in the night!
Let us know how you get on. It took me 2-3 months to get into a grazing routine and another month to feel much better.
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Hi, absolutely I have the same thing. I find times of the month worse for symptoms (for me after ovulation seems better, which is opposite to you!). HOWEVER I would say to forget trying to work out what it means in terms of hormones …..I don’t think it’s possible to tell honestly. The only way to know is to try a few things if that’s what you want to do and see how you feel.
I’m finding as I get further through (now about 2.5 years since my periods started getting much closer together, they now seem to be getting further apart again)…the pattern is getting less defined and more confusing. I try to just take it day to day! I am nearly 46.
I do take HRT which has helped, I do still have bad weeks and good weeks but I think the bad weeks are less bad in severity so it’s at least increased the baseline if you see what I mean. I’ve done 3.5 months now and lots of symptoms have disappeared, hoping to increase dose soon but it is just trial and error as to whether that will help.
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I would add that the anxiety (sympathy, big symptoms here too) is “probably” caused by lack of oestrogen. How long did you try the oestrogen for? You need to give it three months definitely.
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Thank you all so much for these replies. They are so helpful. And make me determined to get to find something to help. I can’t live my life like this!
gilla999 - is the test you mention the same as a Dutch test? The nutritionist I’m seeing wants me to do one. How I would love to write that I’m only 42! ;) 46 feels like 86 at the moment!! Which HRT regime are you on?
VanillaLover - I tried Estrigen for 2 months last year and didn’t see any improvement so gave up (in hindsight I shouldv’e kept going and I could kick myself now). But my anxiety got so bad during that time and I thought the estrogen might be causing it. BUT since I stopped the anxiety hasn’t got any better so I can see now that perhaps it wasn’t causing it and I just hadn’t been on it long enough to make a difference. The problem is my brain now tells me that estrogen causes anxiety and the couple of times I’ve put the gel (or spray) on (tried 2 weeks ago), my anxiety goes through the roof! What a mess! Which HRT are you on?
CLKD - I’m trying very very hard with the grazing. Have stocked up on nuts, dates, protein bars etc. I’m cutting out sugar too. Definitely need to change the way I eat - was going 16 hours without food before 🤦🏼♀️
Thank you all for your support. Honestly this forum is a lifesaver to me xxxx
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Yes exactly, the same as the DUTCH test! You have to get it done through a provider but there are lots on the web - here's a link to who I've used in the past, all they do is send you the results, nothing else. https://smartnutrition.co.uk/health-tests/female-health-tests/complete-female-hormone-assessment-rhythm-and-rhythm-plus/
I'm on Lenzetto and of course Utrogestan. Tried Estradot for about two weeks originally but it didn't work for me - Lenzetto literally saved my life!
Really good luck in getting it sorted xx
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Hi there
It's important to understand what happens in a normal menstrual cycle to even be able to begin to guess at what might be the cause of any symptoms.
Oestrogen begins to rise around the time of the bleed and continues to rise until it reaches a peak around the time of ovulation at mid cycle. Thereafter it falls dramatically and then over the next few days begins to rise again to another, lower peak and then falls again in the last week. During the second half of the cycle after ovulation, progesterone also rises and reaches a peak sometime during/late in the second half of the cycle and when it too falls, this signals for the bleed to start and then we're round again.
During peri-menopause the fluctuations become more extreme though I was not aware that the second, lower peak is ever higher than the post-ovulatory peak. Also the absolute level varies from woman to woman.
These dramatic fluctuations just before ( ie during late reproductive stage when ovulation is still more or less regular) and during peri-menopause, in both oestrogen and progesterone are the csuse of most symptoms.
There is a lot of confusion about low progesterone and balance etc. I'm not sure whether the absolute amount of progesterone produced by the corpus luteum after ovulation falls during peri as the ovaries begin to fail, but certinly when there is no ovulation (anovulatory cycles) no extra progesterone is produced. Sometimes extra progesterone is used (and as part of HRT) to regulate the cycles and bleeding - but not to alleviate general symptoms per se.
I'm with CLKD on this one - shaking and tremors etc due to low blood sugar - hormones do have an effect on blood sugar regulation. The first thing I noticed before I was even peri-menopausal (regular periods) was that I would get hypoglycaemic ( low blood sugar) symptoms during the morning in the second half of my cycle and had to adjust breakfasts accordingly - which remains to this day in my late 60's! I attribute that to the metabolic changes caused by the rapid increase and then decrease in progesterone. Some women (me!) are affected more than others. For me as I said the blood sugar regulaton still remains a problem sometimes even when not taking progesterone as part of HRT.
So Joannefran - make sure you have a good breakfast of slow release carbs and/or protein and cut down on all sugars and refined carbs in your diet - and this will help regulate insulin.
Day 13-14 onwards after ovulation until the next cycle - as far as I understand it your oestrogen will never spike in the same way.
Notwithstanding Gilla999's experience and also being in early menopause (if I understand correctly) I would not get hung up on measuring oestrogen but concentrate on understanding the main principles of hormonal changes and especially continue to keep a diary. If your cycle is still regular then unlikely that you will yet need oestrogen though (and I might have mentioned on another thread) you can regulate your cycle using one of the birth control pills designed for late reporductive stage and esrly peri?
Just a few thoughts
Hurdity x
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I am taking Evorel 50 (and utrogestan). I would like to try 75 but need to wait for specialist appt first (yawn). I am also coming to the end of CBT (free, NHS) which has been really really helpful for the anxiety. I would say that the HRT has calmed things down massively too BUT only after the full three months (and I’m still seeing improvement now).
I should add that I also take antiDs (have done for years since PND) and have tried increased dose but it made little difference to the anxiety.
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Should also say that I suffer with the low blood sugar thing too. Be kind to your body and go with it! Give it some decent fuel etc.
I would love to try the newer oral contraceptive pills as I think it would be ideal for me in evening out the cyclical swings but I have migraines so it’s a non starter. Hopefully as I get older and my periods start getting far apart or stop (can’t come soon enough) it will be better in that regard.
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Just to chime in my two cents: you can absolutely still have a regular cycle and still need HRT :) Many meno specialists have told me this, and it was my own experience.
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Hi. My (long) story is similar, but also different.
I'm 45 now. Had horrific symptoms on and off for 4 years - I've tried all the pills available, some help a bit, but none made me feel good.
My symptoms are awful day 2-ovulation, then just not great after, but not as awful. I have now started having annovulatory cycles, which give longer cycles with bad symptoms - for me.
I echo what Gilla, says, we are very different in the way we respond to hormones.
I tried hrt for only 2 weeks - the estrogen made me feel horrifically poisoned. That was when I opened my eyes and realised im probably not low estrogen.
There's not much on this forum about the early stages of peri, where prog falls and estrogen can be erratic. I now believe that's where I am.
I've since had a 21 day blood test. This showed a good level of estrogen, for my age (obviously that's just one point in time, but it wasnt on the floor). My progesterone was on the floor however. I recall feeling particularly bad the morning of the test.
So, I'm now supplementing with progesterone. I've had a bad few months so I can't say yet if it'll work... More bloods to follow.
Unfortunately, my experience of the NHS is they dont take bloods, go off symptoms. I have bad symptoms, therefore I must need estrogen. I don't think I do.
That's not to say I won't need estrogen in future, just pointing out that I'm hugely symptomatic with early stage peri where my prog has bottomed out.
I think tests would be best for you. Give you an indication. I'm under a private clinic where they test and treat. It's expensive, but I had no other option. Good luck x
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Thank you all so much. This information is invaluable to me. I've ordered the dutch test on the recommendation of my nutritionist who is also helping me with food and supplements. I honestly didn't make the connection with the blood sugar thing but it makes total sense now because my eating habits were/are terrible (I'm addressing it now). I'd never have breakfast and go for hours without eating and then grab something sweet. Hopefully the dutch test will give me some clue as to whats going on with my cycle.
I'm thinking of ordering some ovulation tests to see if I am actually have anovulatory months. I'm not sure if this would this be helpful to know? I just desperately need to find whats causing this debilitating anxiety the second half of cycle so that I can try to balance it.
My Dr is really good but she thinks that low estrogen is the cause of everything and so tells me to up the dose ::)
I am considering just trying the utrogestan (without the estrogen) for the 2nd 2 weeks of cycle. 100mg vaginally. Anyone know if this is safe? Or anyone tried it?
Thanks again xx
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:thankyou: Huridty.
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Yes!!! Definitely a great big THANK YOU to everyone! So helpful hearing everyones journeys. I WILL get to the bottom of my inbalance!
:thankyou:
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It will be fine to try the utrogestan on its own. But, and it's a big but...oral progesterone is highly metabolised and can give side affects that other forms don't e.g makes you sleepy.
However, if you've been taking it with estrogen, I'm assuming you cope with it OK. So probably worth trying.
I have spent 4 years being told my estrogen was likely low. And the pill did not work enough for me - or gave me more daft side affects. My volatility just seems so high. Other countries seem much more up on the whole low prog - you'll find lots out there. Over here... It's an estrogen focus.
Now, only time will tell if that was wrong. My progesterone journey is on the 'alternatives' section under the compounded bhrt thread. Sorry, I don't know how to tag it. But it's very very early days, so I wouldn't want to sway you on that at present. X