Menopause Matters Forum
General Discussion => New Members => Topic started by: Meema on December 20, 2024, 10:54:33 AM
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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
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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
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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 :-\.
:bighug: Is your Mum's partner in a care situation or at home?
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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 :)
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Following this as I have setraline in the cupboard ready as back up
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Would U consider Setraline if U didn't have peri-menopause symptoms?
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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.
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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.
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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.
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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
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My 1st panic attack was aged 3 and I've suffered intermittently since :'( worse during my late 30s early 40s. Group :hug:
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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
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The best of luck Meema, please let us know how you get on x
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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.
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That’s very interesting… I don’t know anything about DHEA tests… how do you get this tested?
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Meema ......... what's to lose? I would have taken heroin if I believed I would never have another panic attack :-\ :'(. My GP however prescribed Propranolol to ease the surges which worked for several years. There is help out there and not every1 gets awful side effects.
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Hello Meema - and everyone else.
I'm new here too and quite nervous about posting if I'm honest, but when I read your posts it was almost as if I could written them myself!
So, I just wanted to say hi, and to say that I feel your pain. And whilst it's awful that any of us should have to go through this kind of thing, it's also good to see I'm not alone.
The anxiety I am feeling at the moment is horrendous and completely debilitating. Like you, I'm finding even basic tasks very challenging - I even struggle to get up most days.
I'm 52 and started HRT last January only to have it stopped by another GP in April, then re-started again in July by a more sympathetic GP. I was initially using 2 pumps a day but increased that to 3 in early December. I also take Sertraline and have done on and off for years. That was increased from 50mg to 100mg in early November, then up again to 150mg a few weeks ago.
I'm sorry to report that the anxiety I'm experiencing is not improving but I guess this could be because I've taken the sertraline for such a long time already. As the person above has said, what's to lose?
I was interested to read what another member said about spacing out the Oestrogel dose. I think I will try that because I use the gel before bed, and then always feel so much worse first thing in the morning.
I do hope things improve for you soon.
I'm pleased to say I feel a little better myself just by posting this.
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:welcomemm: Flossy McFlossy - Is Sertraline a dedicated anti-anxiety medication? Would your GP be willing to discuss adding another drug with it, i.e. something to take 'when necessary' or a betablocka with or instead of?
I've taken anti-depressants since 1988/9 : most did me well for many years B4 my brain pooped out so others were prescribed : as well as 'valium' [1990s] and Propranolol [2002-2020] which helped when needed . I now have an emergency pill to take when anxiety floors me. I have a phobia which is the base causation. It stops me travelling, booking hotels, holidays .... even visiting friends :-\ although I am able to go out and about on the spur of the moment.
Gardening is my solace or sitting by water.
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Hi CLKD :-) Thanks for the warm welcome.
I was prescribed the Sertraline for years (on and off) for depression/anxiety, and was once prescribed Propranolol also. I tried to get off the Sertraline many times over the years but always struggled with side-effects coming off it, and then side-effects again going back on it! In the end I gave up trying to get off it and was just bobbing along on 50mg.
This psychological stuff I'm going through these days is different though - I'm not sure I can fully explain how but on the whole it doesn't feel like the increased dose of Sertraline is helping, whereas in the past it usually did.
My GP has suggested trying a different Anti-D but so far I've said no because of those previously experienced side-effects. I might review it with my GP in the new year.
Thanks again for responding. You've certainly got a lot of experience to draw on :-) I hope you're managing OK yourself at the moment. Christmas can be a funny old time. xx
(Sorry to Meena - didn't mean to rail-road your thread.)
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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.
Hi AKatieD
I dont mean to hijack this post but I am interested in how you treat low DHEA levels if they are low.
thanks x
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What's DHEA please?
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hi clkd
its a hormone produced in our adrenal glands. Its peaks in our mid 30s I think, then it tails off xxx
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I take DHEA, also known as "poor man's testosterone" for androgen replacement and am very happy with it.
Been on life extension brand sublingual for the past 2 years.
It has restored my free testosterone from almost zero to the top quintile for young healthy women.
Medichecks have a blood test for DHEA levels, which I have used and can recommend if anyone is interested in testing.
Some people advocate for saliva testing but in my experience saliva is not very accurate - I got two saliva tests from 2 labs on the exact same dose, time of day etc and one was undetectable, the other off the charts high.
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:thankyou:
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Sorry did not spot the questions. Yes, DHEA is a precursor hormone to sex hormones. It has a balancing effect with cortisol, so increasing DHEA (when low) can reduce high cortisol levels.
DHEA is not available in the Uk but can be got from iHerb. The micronised version was recommended to me.
Pregnenolone is available in the Uk over the counter and is further back in the precursor chain than DHEA in producing sex hormones. Some, like Dr Myhill, recommend using pregnenolone instead of DHEA.
Both can help control high cortisol levels and can increase sex hormones. Both are relatively cheap compared to HRT.
I started on DHEA and added in some pregnenolone later. My cortisol levels have gone from over the top of the range to now being low, within a few months.
I also have thyroid issues and the Paul Robinson books recommend doing both blood and saliva tests. An 8am blood test (i do fingerprick tests with Medichecks etc) which tells you total cortisol levels so shows if you are producing cortisol. Also the saliva cortisol tests give you the free unbound cortisol levels over the course of a day ( Genova, Regenerus etc do this) and can include DHEA. By comparing the two free/ total levels and including DHEA you can start to work out where any problems lie.
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Morning all - this is really interesting and something I'm going to look into.
I had read that testosterone could help with low mood and motivation but my GP didn't agree - she said it's only for low sex drive and that's what NICE says, and it's not licensed for women in the UK so I do understand her position. Not sure if you've found the same Meema?
I looked into getting it privately but it's a cost I just can't swallow so DHEA might be a good alternative. It's definitely something I'm going to look into.
I hope you're doing OK Meema - your thread has certainly helped me. Let's hope the New Year bring us both some solice and relief xxx
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Sorry did not spot the questions. Yes, DHEA is a precursor hormone to sex hormones. It has a balancing effect with cortisol, so increasing DHEA (when low) can reduce high cortisol levels.
DHEA is not available in the Uk but can be got from iHerb. The micronised version was recommended to me.
Pregnenolone is available in the Uk over the counter and is further back in the precursor chain than DHEA in producing sex hormones. Some, like Dr Myhill, recommend using pregnenolone instead of DHEA.
Both can help control high cortisol levels and can increase sex hormones. Both are relatively cheap compared to HRT.
I started on DHEA and added in some pregnenolone later. My cortisol levels have gone from over the top of the range to now being low, within a few months.
I also have thyroid issues and the Paul Robinson books recommend doing both blood and saliva tests. An 8am blood test (i do fingerprick tests with Medichecks etc) which tells you total cortisol levels so shows if you are producing cortisol. Also the saliva cortisol tests give you the free unbound cortisol levels over the course of a day ( Genova, Regenerus etc do this) and can include DHEA. By comparing the two free/ total levels and including DHEA you can start to work out where any problems lie.