I started getting a lot of out of the blue anxiety in 2017. Late 2017 and early 2018, I started getting scary levels of depressed during my periods, though I'd be okay the rest of the month. Tried 5-HTP in 2018 to see if that would help. It didn't. Then not long after I had a very traumatic experience that left me panicked, afraid, depressed, and anxious for a whole month. But, I could sleep. (I think this mental breakdown was coming anyway, but the event pushed me over the edge and made everything too much to handle.)
Well, after that month, things got better. I still had some physical anxiety, and could get triggered now and then from the trauma just watching TV, but it wasn't so bad. I was able to have fun again. I could still SLEEP. Until one day, in September 2018, I couldn't. I had building insomnia, and anxious feelings. My thoughts weren't anxious yet, but they would be within a few days. My brain likes to analyze why I feel the way I do, which means digging up the worst thing it can think of and getting on a hamster wheel with it trying to resolve something that cannot possibly be resolved, in the hopes of making myself feel better. And, of course, that thing was the 2018 traumatic event. Great.
This last year has been hell. I really wish I hadn't been traumatized while my hormones were swinging around in 2018. It would have helped me cope better. I would have been thinking of something far less scary, you know what I mean?
In the beginning, I would wake up after only a few hours of sleep with panic attacks. Could not go back to sleep. Heart palpitations started up, too. By heart palipitations, I mean sitting in front of the TV and my heart rate suddenly jumping to the 80s, 90s, and even lower 100s for about 5 minutes, then going back down to the 60s or 70s. My heart never does this in front of the doctor, of course. Within two weeks of all this starting, my thyroid popped out of my neck. For the first time, I had hope that I would be given magic medicine to make all of this go away. But my blood work was really weird. Normal TSH, somewhat high free T4. Confused my GP. Biopsy and ultrasound showed a benign multinodular goiter. Within a month, my free T4 levels had dropped back down to be within normal range.
I was declared cured! But my symptoms were still with me. On top of it all, I had started having severe muscle weakness in my legs during my period and felt really feverish, but without actually running a fever. For a whole week, I was throwing my jacket off, then putting it back on, over and over again, within quick succession. I still couldn't sleep. My body was so stressed that my leg started involuntarily twitching, often waking me up even earlier. Or just doing it while I was watching TV. I suggested to my GP that if it isn't my thyroid, could it be my lady hormones? She said, "No way! You're too young!" (I was 35 at the time. I am now 36.)
I saw an endocrinologist in December, who confirmed that my thyroid was okay. My thyroid still hurt on and off, though. She said it's thyroiditis. Like, an autoimmune attack on my thyroid, but my thyroid and pituitary gland are functioning normal. She said the biopsy wouldn't cause that kind of nerve pain I was having. I was told to see a cardiologist for the heart palpitations.
It was my podiatrist who helped me figure out that, yes, I just might be entering perimenopause at my age. Especially a few months into all this, I was still feeling feverish and weak during my periods--and only during my periods. It took a while to see the pattern. Yes, they were hot flashes, and not some peek-a-boo hyperthyroidism. Fun!
Anyway, she referred me to an OBGYN (and to a specific cardiologist just in case the heart palpitations were something else). Finally, a referral that made sense! Heart turned out to be okay. I saw the OBGYN nurse practitioner. She believed me! She got some blood work done. My FSH and everything else was in normal range. She figures I'm not technically in perimenopause yet, especially since my periods are still regular, but she figures that my hormones are beginning to swing. (Personally, I figure it's perimenopause when you're getting hot flashes. I don't care what their stupid test categories are.) I got my first birth control pack.
Sadly, I've been on 4 birth control packs now. Each time, the nurse makes me suffer on it for 2 months (with the exception of the first one). It's eliminated my heart palpitations, the weakness in my legs, and the hot flashes. But, the insomnia, anxiety, and depression are still really bad. She started me on 10mcg estradiol with norethindrone acetate (progestin), and slowly raised it up to 30mcg estradiol.
Due to the two migraine auras I had while on the birth control, and the fact that this family of birth control isn't doing the job for me, she just switched me to a totally different family that is triphasic and has desogestrel instead of norethindrone acetate. She told me that this kind of progestin would help me feel like I had more estradiol that I did. Unfortunately, I'm doing worse on this one. She lowered me a bit to 25 mcg estradiol. I realized also when I looked up desogestrel on Google that it is a very, very potent progestin, and that there is nothing about it making anyone feel like they have more estradiol. This pack is so awful it brought back my heart palpitations, and on the first night I couldn't even sleep at all. Like, I couldn't even FALL ASLEEP. And that was after an already hellish period week of interrupted sleep and heightened anxiety. It was the last thing I needed.
Thankfully, I took up an offer my GP's nurse practitioner had made me a few months ago, and she put me on some Trazodone. Without that, I wouldn't be sleeping at all right now. (Yeah, I stopped seeing my GP. I've oddly found the GP's nurse practitioner as more likely to refer me and be helpful.)
The first week of Trazodone was awesome! I started sleeping more, but I also had the anxiety GO AWAY. My brain felt like it was a floating balloon, totally on Cloud 9. It felt different, but it was way better than how I had felt the past year. Then the balloon popped and I was back to feeling anxious again. I hate these hamster wheel thoughts and feeling down. It's a bit better today, but...ugh. I have to remind myself that at least I'm finally getting some sleep.
I did realize something though. The week where I felt best on Trazodone...was the second week of the triphasic pack. When I started feeling anxious and scared again, was about a day and a half after I started week three of the triphasic pack, which raised my desogestrel level. Figures.
I think this is proof that I need more estradiol, not less. Unfortunately, nobody in their right mind is going to put me on a 50mcg estradiol birth control pack. Especially not with the two migraine auras I've had. I still wish I could try and see, though. Just even for a month, and see if that's the answer. Oh well.
My OBGYN nurse practitioner already is thinking about switching me to patches to top me off because of the migraine auras. (Risk of stroke goes up when you're having migraine auras.) I'm rather scared, because something tells me I'm one of those oddball women who normally operates on a LOT of estradiol. I doubt topping me off with some weak patch is going to get me sane again.
I did go to the local sleep disorder center the other week. My endocrinologist actually bothered to refer me a couple of months ago, after I broke down crying in her office during my 6-month checkup visit asking her why I can't sleep. I shouldn't have had to cry to get help! And, I didn't even know there was such a thing as a sleep disorder center until then.
Anyway, the nurse practitioner at the sleep disorder center was really awesome. But she also said something to me that made me very anxious. That a lot of women entering perimenopause need to go on strong antidepressants. She specifically mentioned Effexor. I'm really scared of some of these drugs. They sound so hard to get off of! I felt brave enough starting Trazodone. I don't want to add another one that might give me brain zaps if I need to come off of it. Or worse, gives me brain zaps while still on it full dose because I suddenly developed a tolerance.
What should I do? Are estradiol patches better? Does that mean I'll end up with more estradiol in my system than I would with birth control because it's my natural ovaries' estradiol plus the patch estradiol? Or will I end up with less and still be suffering?
As it is, I'm starting my placebo pill tomorrow, and I refuse to do a second month with the current birth control pack. I've got some Maca capsules and some OTC estriol cream. I know it sounds desperate, but hopefully it's enough to reboot my ovaries and keep the hot flashes at bay. No point in being on a pill that gives me even worse insomnia than if I didn't take anything at all.
Anyway, thanks for listening to my introduction! I'm so glad there are support groups for this. I couldn't imagine living pre-Internet with nobody with similar experiences to talk to.
