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Perimenopause anxiety (and a bit of a rant)


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I have been dealing with pretty crushing anxiety the last couple of months.  I was hoping that the cause was being overmedicated for hypothyroidism, but no. My labs came back perfectly normal.  So I'm guessing the issue is hormone-related.  I turn 49 in a few days.  I get pretty bad night-sweats these days, I have very occasional insomnia, and my last cycle was much shorter than normal. 

So, where do I go from here? Should I be looking into hormone replacement therapy? Xanax? CBD gummies? I feel like crap and I'm sure that I am not fun to live with when I feel like this.  Those of you that have gone through this, what actually helped to get the anxiety under control? 

Here's the ranting part:  I'm really angry that whatever is going on isn't from my thyroid, because that would be an easy fix. Now the doctor wants to do a whole anxiety workup, where I have to fill out a big survey about my "mental health history". I'm aggravated I have to do this, because I don't feel like I have a mental health issue. I feel like I have a medical issue that is presenting as a mental health issue, and no amount of talking about my feelings or taking a hot bath or "pampering" myself with fancy lotions or any of the other low-hanging-fruit type advice is fixing it, (seriously, if this was something a hot bath and some lotion could fix, I would have fixed it by now!). I've tried meditation, deep breathing, exercise, limiting caffeine, talking to friends, "mindfulness", eating healthy, new hobbies, old hobbies, walks in nature, reading inspiring and uplifting books, vitamins...name something self-care related, and I've tried it diligently for several months.  I know a lot of women struggle to prioritize themselves over family, but I have never really had that issue.  I am really good at making sure I have time in every day to meet my own needs; self-care isn't a problem here.  I still feel like I'm drowning in anxiety for at least one week of every month. 

End rant.

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3 minutes ago, MissLemon said:

I have been dealing with pretty crushing anxiety the last couple of months.  I was hoping that the cause was being overmedicated for hypothyroidism, but no. My labs came back perfectly normal.  So I'm guessing the issue is hormone-related.  I turn 49 in a few days.  I get pretty bad night-sweats these days, I have very occasional insomnia, and my last cycle was much shorter than normal. 

So, where do I go from here? Should I be looking into hormone replacement therapy? Xanax? CBD gummies? I feel like crap and I'm sure that I am not fun to live with when I feel like this.  Those of you that have gone through this, what actually helped to get the anxiety under control? 

Here's the ranting part:  I'm really angry that whatever is going on isn't from my thyroid, because that would be an easy fix. Now the doctor wants to do a whole anxiety workup, where I have to fill out a big survey about my "mental health history". I'm aggravated I have to do this, because I don't feel like I have a mental health issue. I feel like I have a medical issue that is presenting as a mental health issue, and no amount of talking about my feelings or taking a hot bath or "pampering" myself with fancy lotions or any of the other low-hanging-fruit type advice is fixing it, (seriously, if this was something a hot bath and some lotion could fix, I would have fixed it by now!). I've tried meditation, deep breathing, exercise, limiting caffeine, talking to friends, "mindfulness", eating healthy, new hobbies, old hobbies, walks in nature, reading inspiring and uplifting books, vitamins...name something self-care related, and I've tried it diligently for several months.  I know a lot of women struggle to prioritize themselves over family, but I have never really had that issue.  I am really good at making sure I have time in every day to meet my own needs; self-care isn't a problem here.  I still feel like I'm drowning in anxiety for at least one week of every month. 

End rant.

Hugs. I am right there with you.  Wish I had advice. Like you,  I have tried all the things but have come to truly dread that week each month.  It's brutal. 

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2 minutes ago, KeriJ said:

Hugs. I am right there with you.  Wish I had advice. Like you,  I have tried all the things but have come to truly dread that week each month.  It's brutal. 

It's so frustrating, and so much of the advice I find online is stupid or patronizing. "Try a hobby like gardening!" or "Acknowledge your feelings!". Wow, thanks for the tip. Guess I'll go yell at the tomato plants for awhile. 🙄

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Go to your OBGYN and ask to be put on a birth control pill with high enough hormone levels to stop these symptoms until you’re through with menopause. It’s what my mom did & she only had symptoms for about two weeks after she finally stopped the pill.

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Well, I was living overseas during that time, and didn't have available "all the things." Also, my periods had already stopped, but if I remember correctly, the anxiety hit sometime after my last one--maybe one-three months? (My last period was about 8-9 months after my next-to-last one.) I did not know until close to the end of that phase that anxiety was a menopausal symptom. Once I knew that, I kind of rolled my eyes at myself and didn't take the ramped up anxiety seriously; the same way that once you realize you have PMS, you just ignore your grumpiness because you know it really doesn't have roots in facts (or at least that's how I handled it). I was wondering if I was going insane until I googled something like anxiety and menopause. My high anxiety level lasted about six months, then dissipated to normal levels.

(I am not saying that someone who does deal with it differently shouldn't, by any means. It was just that for me, once I realized the cause, I felt like I could handle the symptoms.)

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4 minutes ago, Jaybee said:

Well, I was living overseas during that time, and didn't have available "all the things." Also, my periods had already stopped, but if I remember correctly, the anxiety hit sometime after my last one--maybe one-three months? (My last period was about 8-9 months after my next-to-last one.) I did not know until close to the end of that phase that anxiety was a menopausal symptom. Once I knew that, I kind of rolled my eyes at myself and didn't take the ramped up anxiety seriously; the same way that once you realize you have PMS, you just ignore your grumpiness because you know it really doesn't have roots in facts (or at least that's how I handled it). I was wondering if I was going insane until I googled something like anxiety and menopause. My high anxiety level lasted about six months, then dissipated to normal levels.

(I am not saying that someone who does deal with it differently shouldn't, by any means. It was just that for me, once I realized the cause, I felt like I could handle the symptoms.)

Unfortunately, that isn't working for me. The anxiety is far beyond just pushing past it. I know the anxiety is irrational, I know it's irrational while I am experiencing it, but I still can't get on top of it and ease it. It's beyond feeling a bit grumpy. 

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I had no idea anxiety is a part of perimenopause/menopause. Yay. 

I have no idea what to suggest, as I'm not to that phase of it yet (although, holy heck, it's been dragging on for years already and I'm just.so.over.it.). I'd think if your PCP isn't taking you seriously, and you think it's hormonal, maybe the GYN might be a better bet, as they probably deal with it more regularly as part of their practice, so might have better help to offer. Maybe. 

Hugs. I'm sorry it's like that. 

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3 minutes ago, Amy in NH said:

Commiserating.  We've found a rather unconventional solution, but I'm not going to discuss it here 😉

Feel free to pm me! I am open to all ideas and my in-box is a zero-judgement zone!

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Posted (edited)
9 minutes ago, Amy in NH said:

Commiserating.  We've found a rather unconventional solution, but I'm not going to discuss it here 😉

Well now I'm curious! Imagining a daily cup of tea but maybe it's something even more exciting...

OP, I'm working with a Naturopath on insomnia, anxiety and difficulty focusing. We're trying bioidentical hormones (very low dose), adrenal support vitamins, and DHEA. For me I think the combination of trying to get at root causes and regularly attending to self care (exercise, yoga, sleep) is helping. Not magical instant fix, but improving over time. On the nights I have insomnia I do guided meditations with Sleepphones on, and it's helpful to feel like I'm using that time to relax and change my brain waves even if I don't fall back to sleep. 

When the naturopath flagged some biochemical markers of chronic stress, I also took a hard look at stressors in my life including relationship dynamics, and we're working on that too. Unresolved issues are big anxiety triggers for me. 

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Posted (edited)
7 minutes ago, MissLemon said:

Unfortunately, that isn't working for me. The anxiety is far beyond just pushing past it. I know the anxiety is irrational, I know it's irrational while I am experiencing it, but I still can't get on top of it and ease it. It's beyond feeling a bit grumpy. 

I'm so sorry. I wasn't downplaying it, just sharing my own experience. But I'm truly sorry it is that severe.

(I wasn't grumpy, just comparing my attitude to it to that.)

ETA: I agree that I would talk to my obgyn about it rather than pcp. I'm sure they are more familiar with this symptom.

Edited by Jaybee
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No solutions, but right there with you. I have Premenstrual Dysphoric Disorder that sends me low and anxious before every cycle and some months now I have two cycles!  YAY (sarcasm).  I am so tired of being on my own version of a bad soap opera with night sweats, moodiness, and unpredictable cycles.  I exercise every day and that doesn't help.  I am on antidepressants and it doesn't really help. 

You are not alone!

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Mental health IS a medical issue. Out of whack or depleted brain chemicals can do a number on you. I don't view that any differently than hormones being out of whack. Why would it be? Anxiety is miserable. In your shoes I wouldn't hesitate one second to go on an anti-depressant for six months to a year (not Xanax--something that's meant to be taken daily). It takes at least six months to get the brain chemicals back to normal. Ask for one that's also known to help with hot flashes.

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Hugs. Perimenopause is not fun.

I am a bad candidate for hormones--migraine with aura plus significant family history of blood clots. Bioidentical hormones made me loony (even in doses that are a fraction of normal) and sent my blood sugar soaring. My estrogen and testosterone are high, but my progesterone is very low (sometimes in the post-menopausal range). My nurse practitioner tests with a Dutch panel. My cortisol is also high and doesn't follow a normal pattern.

What seems to be helping a bit:

  • DIM supplement to help metabolize the estrogen in a more beneficial pathway (this is Dutch testing information). It's a substance you get by eating lots of cruciferous veggies, but it's way more than you can put in your diet. I also eat a lot of cruciferous veggies because they taste really good to me at this stage of life, which I think validates that my body must want/need them. For starters, I eat three cabbages per week by myself, lol! That doesn't even touch brussels sprouts, cauliflower, etc. It does seem to help direct the estrogen breakdown in better ways.
  • Phosphatyldyserine at night to help with cortisol (new, not sure if it helps yet)
  • Other supplements for vitamin D, thyroid support, etc. My NP would prescribe thyroid meds if it were a bit more sketchy, but it's just not quite sketchy enough, so we support it (iodine, etc. with periodic testing).
  • Exercise helps some, but I think it would do very little if the other stuff weren't helping.

It does help me to realize that it's the hormones when something is suddenly just "too much," though that can happen to me at any time, not just one week per month. 

On a humorous note, my cycles vary seasonally. Longer in the winter and more frequent in the summer--you'd think I was a chicken or something. About the time our acquaintances with chickens have excess eggs, I have more frequent periods. 

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42 minutes ago, Katy said:

Go to your OBGYN and ask to be put on a birth control pill with high enough hormone levels to stop these symptoms until you’re through with menopause. It’s what my mom did & she only had symptoms for about two weeks after she finally stopped the pill.

I’m not sure how often they do that now, due to the stroke risk for women of peri-menopause age. I do think some kind of hormone therapy could be helpful (bio identical progesterone?), avoiding the ones that are risky for women in their forties or fifties.  I think it was low progesterone for me. I was having some of those symptoms and was in the middle of appointments to figure it all out when suddenly all the symptoms disappeared. A couple weeks later, I discovered I was unexpectedly pregnant. The symptoms did not return after pregnancy either. I expect they may be waiting for me again when my body goes back into peri-menopause mode. 

10 minutes ago, Pawz4me said:

Mental health IS a medical issue. Out of whack or depleted brain chemicals can do a number on you. I don't view that any differently than hormones being out of whack. Why would it be? Anxiety is miserable. In your shoes I wouldn't hesitate one second to go on an anti-depressant for six months to a year (not Xanax--something that's meant to be taken daily). It takes at least six months to get the brain chemicals back to normal. Ask for one that's also known to help with hot flashes.

It is a medical issue, but if it’s being caused by hormones, talk therapy and other typical mental health approaches aren’t likely to be as helpful as addressing the root cause. I had no anxieties specifically about anything at all, it was just a very chemical feeling. Like I had too much adrenaline for no apparent reason. Probably an anti anxiety medication would have helped with symptoms, but if it was caused by hormones, I would have rather targeted those instead.

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Posted (edited)

I was having horrible anxiety and perimenopausal stuff this spring.  My periods were SUPER wacky - short cycles, very heavy.  I ended up in urgent care for a 12 day period.  I went in and had blood work and my iron was just a TINY bit low.  Like I think had my blood draw happened when I was less hydrated, a different time of the month, etc it wouldn't have registered as off.  I switched to a good quality prenatal and I won't say it's been a miracle cure, but my anxiety is MUCH more in check, my insomia is a few days a month instead of most days, my energy levels are better so I'm getting better exercise, eating better, etc a few months out.  My last 2 periods have been 28 days and perimenopasal normal (icky heavy at the beginning, comes in spurts - the gyn I saw said that wasn't unusual for perimenopause) and 6-7 days which is in range for my normal.  I have been more mindful about eating meat.  We don't eat a ton of it and I was veg for a while which doesn't work for me at all.    

Anyway - I was just going to throw that out there in case it might ring a bell.  I'm sorry!  It sucks so hard.  I thought I was going to end up in a padded room this spring and covid stuff was not helping.  

 

Edited by FuzzyCatz
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I had terrible anxiety with perimenopause, and I was so young, no one really attributed it to that. But it was a really dark and sad time for me. I had never felt anything like it before. I wouldn’t leave my house, couldn’t go to work, I was a mess. And so irritable and mean. It was ugly. Normally, I’m as laid back as they come.

It’s a simplistic approach, but what ended up helping me was really hard exercise. For me, My medical dr explained to me that a lot of what I was feeling as anxiety was extra adrenaline in my system. The old fight or flight response I was doing nothing with was allowing the adrenaline to build on itself.  Physically, I was shaky, heart palps, on edge. Had a couple panic attacks. Anyway, he advised I try to get rid of my adrenaline and see how I felt. I wasn’t in great shape, so I just started walking and running as hard as I could for as long as I could until I was tired and had worked up a really good sweat. You have to exhaust yourself. Then I would walk for an hour or more. Eventually, I felt better. Not perfect, but a lot better. Once I was totally finished with menopause, which in my case was like 8 years, I felt like my old laid back self. The switch was so sudden it made me laugh to think it had been anything other than hormonal. 
I truly hope you find something that helps. 

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30 minutes ago, KSera said:

I’m not sure how often they do that now, due to the stroke risk for women of peri-menopause age. I do think some kind of hormone therapy could be helpful (bio identical progesterone?), avoiding the ones that are risky for women in their forties or fifties.  I think it was low progesterone for me. I was having some of those symptoms and was in the middle of appointments to figure it all out when suddenly all the symptoms disappeared. A couple weeks later, I discovered I was unexpectedly pregnant. The symptoms did not return after pregnancy either. I expect they may be waiting for me again when my body goes back into peri-menopause mode. 

It is a medical issue, but if it’s being caused by hormones, talk therapy and other typical mental health approaches aren’t likely to be as helpful as addressing the root cause. I had no anxieties specifically about anything at all, it was just a very chemical feeling. Like I had too much adrenaline for no apparent reason. Probably an anti anxiety medication would have helped with symptoms, but if it was caused by hormones, I would have rather targeted those instead.

They definitely still prescribe birth control for peri-menopause symptoms, but it might be only a mini-pill (progesterone only). The bio-identical stuff is a bit too woo for the doctors I worked with, but some might care.  It depends a bit on your age, weight, family history, and severity of symptoms. If you're diabetic and have multiple family members with blood clots, heart disease or strokes you're not likely to get anything with estrogen.

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I decided not to consider hormone treatment, because I heard that drags it out.  Once you stop the hormones one way or the other, you get the effects.  I just wanted it to be done as soon as realistically possible.

My chiropractor made some suggestions, which I was too lazy to follow.  Something about a certain kind of berry extract etc.  You might look into that if you have more patience than I do.

Mainly, my approach was to accept and understand what I was going through.  Yes, it made me a different person in some ways, but being conscious of it helped prevent me from responding irrationally, most of the time.  🙂  I do know some people have a harder time.  Like some people say they literally want to kill people.  I never really got past wanting to half-drown a few ....

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I had the rage, more so than anxiety.  Not sure whether they would both respond to the same things, but my OB recommended more exercise (and harder exercise), and cutting out caffeine as the first things to try.  I was like, NEXT?  Next was not hormones, as I had expected, but rather Prozac.  She said that for some reason Peri emotions respond to that, even if someone doesn’t feel depressed.  I was not super interested in trying it so I cast about for something natural.  I remembered that a friend of mine had used evening primrose oil to control PMS, so I asked her about it, and used borage oil (same active ingredient), and it worked for me, completely.  I liked the fact that it was a nutrient more so than a drug, and it seemed a lot more targetted than Prozac.

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1 hour ago, KSera said:

It is a medical issue, but if it’s being caused by hormones, talk therapy and other typical mental health approaches aren’t likely to be as helpful as addressing the root cause. I had no anxieties specifically about anything at all, it was just a very chemical feeling. Like I had too much adrenaline for no apparent reason. Probably an anti anxiety medication would have helped with symptoms, but if it was caused by hormones, I would have rather targeted those instead.

Yes, this is exactly how it feels.  I feel like I get stuck in a fight or flight response, like there is too much adrenaline and I can't find a way to "vent" it somewhere. All the standard advice like "accept your feelings, take a walk, start a new hobby, call a friend, try deep breathing, exercise, do yoga, quit caffeine, drink more water, try aromatherapy, keep a journal!"...like, those things take the anxiety down from 10 to an 8, (except for journaling. That just makes me ruminate, which makes it worse). Eight is better than ten, but not better enough to make me a pleasant person to live with or help me feel ok in my skin.    

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3 hours ago, Katy said:

Go to your OBGYN and ask to be put on a birth control pill with high enough hormone levels to stop these symptoms until you’re through with menopause. It’s what my mom did & she only had symptoms for about two weeks after she finally stopped the pill.

I have been on a low-estrogen pill (Lo-Loestrin) for several years now because of this. I don't get a period, and I plan to stay on this until I'm past it all. I struggled previously with more traditional bcp as I always felt like I had PMS, but this has been a lifesaver. 

I also have generalized anxiety. I am on an antidepressant but about 2 months ago I started buspirone for anxiety as well. It is not a benzo, you take it daily. A lot of reviews say it doesn't do anything to help and it seems like that at first. It doesn't have an immediate effect. But I noticed about a month ago I wasn't reaching for the benzos as often. I was previously taking Ativan 1-2 times per week (as needed) and I haven't needed any lately. So that might be worth trying. 

 

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My only peri symptoms are mental health related. 

Yoga, walking, therapy are helping me. 

In your shoes, I wouldn't hesitate to find a doctor with some understanding of peri/menopause. 

You may want to investigate HRT via patches (this is only from me listening to a BBC radio program on menopause at 2am so grain/salt).

You could also try a good naturopath. 

You could try an anti-anxiety medication in the meantime if it is overwhelming. The brain is part of the body and affected by changes in the body. 

 

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I’m also nearly 49 and have thyroid disease. I’ve had severe premenstrual anxiety for many years, usually about 5 days before my period starts. I also tried just about everything else. I take xanax for about 5 days each month. It helps a lot. I’ve never needed to increase my dose or become dependent on it because I don’t take it every day. I’ve been doing this for close to 15 years. A good friend is taking CBD gummies and having good results with those. 

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4 hours ago, Carol in Cal. said:

I had the rage, more so than anxiety.  Not sure whether they would both respond to the same things, but my OB recommended more exercise (and harder exercise), and cutting out caffeine as the first things to try.  I was like, NEXT?  Next was not hormones, as I had expected, but rather Prozac.  She said that for some reason Peri emotions respond to that, even if someone doesn’t feel depressed.  I was not super interested in trying it so I cast about for something natural.  I remembered that a friend of mine had used evening primrose oil to control PMS, so I asked her about it, and used borage oil (same active ingredient), and it worked for me, completely.  I liked the fact that it was a nutrient more so than a drug, and it seemed a lot more targetted than Prozac.

I've taken evening primrose oil for about 10 years now. I find it takes the edge off my ragey emotions. I haven't heard of it for anxiety, but it helps keep my emotions more upbeat in general, so it makes sense it would work. 

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1 hour ago, HSmomof2 said:

I’m also nearly 49 and have thyroid disease. I’ve had severe premenstrual anxiety for many years, usually about 5 days before my period starts. I also tried just about everything else. I take xanax for about 5 days each month. It helps a lot. I’ve never needed to increase my dose or become dependent on it because I don’t take it every day. I’ve been doing this for close to 15 years. A good friend is taking CBD gummies and having good results with those. 

I may try the CBD gummies. A friend said she would give me some to try, so maybe I will start there since it doesn't involve paperwork and a co-pay. 😅 

But it's good to know Xanax is an as-you-need-it option. That was something I wondered about.

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