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[honeybun]

We went to see her.

I have noticed (and I have been one ) that there have been more and more requests for help with anxiety.
If you look at the new topics the majority are from women suffering debilitating anxiety symptoms.

When we go to our GPS we are either dismissed or offered ADs which some can't tolerate.

What would Dr Currie advise us to ask for as some GPs are sadly lacking in menopause knowledge.

It seems to me that guidance in this is lacking.

It would be very helpful if we could have her advice as it seems to me that apart from flushes this is up there as one of the worse ( and most misunderstood ) symptoms.

Honeyb
X

[Clovie]

I'd be very interested in this too, Honeybun, as I have hit some awful awful lows while on the progesterone element of the HRTs I have tried so far.

Also, before I tried HRT, anxiety, irritability etc was one of the main reasons I went to see my GP to get HRT along with the other biggie, hot flushes.

I am on oestrogen phase at the moment - so feel much much better than when on perog phase - but it feels I have still not recovered from my last prog phase (2 weeks ago now )
I don't want to tell my GP how I'm feeling as I know she will try to push ADs and they have never worked for me in the past (PND and PMT)
I tried to tell my gynae specialist I would like to try upping my oestrogen to see if that helped but she was adamant I couldn't try that. I wanted to supplement 2mg tablets with some gel or something but she said NO!
So I am putting up with it for now but I am aware it it affecting my whole life
I am still waking up occasionally at about 4 am and the world is a bleak bleak place 
So I would welcome some advice too before I get pushed down the AD route.

[CLKD]

I think GPs should be encouraged to read this Forum, to attend any Conferences or talks that Dr Currie puts on .......... and to net-work with those who know more about menopause.  Years ago drug companies would host evenings ........ so the medical profession had the opportunity to get together and discuss.  I know, I oragnised some  - food was good 

[Emma]

There's a whole bunch of stuff under the 'symptoms' tab
http://www.menopausematters.co.uk/symptoms.php

including a downloadable vaginal atrophy checklist at
http://www.menopausematters.co.uk/pdf/VAchecklist.pdf

do we need more?

[bobjool]

I absolutely agree.............I have suffered just about every symptom going but anxiety has by far been the worst.I am not on HRT as have fibrocystic breast condition and it was advised against it.Have been to the Doctors so many times with different symptoms its become a joke and I almost feel embarrassed to go now.There really should be much more done for women going through the menopause in the way of proper support and helpful advise and in fact every Doctors surgery should have a dedicated menopause team of a councillor for any pschological  issues and either a nurse or a doctor trained in all menopausal problems.And long term it would be a much more efficient and no doubty cost effective service and gods know I think we all deserve it.

[honeybun]

The whole bunch of stuff does not really address anxiety and how it can be dealt with.

The information on HRT preparations is excellent and many of us have been able to approach our GPs fully prepared and clued up.

As anxiety seems to be one of the most asked about symptom on the forum it would be good to have the same level of information so when we visit our GPs we would have some ideas of what to discuss with them.

Honeyb
X

[Taz2]

I would think the main way of dealing with it is to offer anti-d's which also have an anxiety relieving element and/or counselling or CBT. I'm not sure what else there is to be honest 

I found that the expert meno specialist didn't have anything to offer apart from the things mentioned above. There is not always a "cure" for everything unfortunately. HRT definitely made my anxiety worse.

Taz x

[Rowan]

I agree with what has been said but there is only so much that can be prescribed for anxiety and menopause and I think most GPs do the best they can. There are no miracle cures and Pharmaceutical Companies do there best to churn out more and more drugs, we are disappointed when we are prescribed them and disappointed when we are not.

Anxiety comes in many forms you only have to google it to get pages and pages. Read up all you can and approach your GP as you would with HRT knowledge, you can only try.

Healing is different to surgery or drugs, support and a sympathetic manner is what most women need, but GPs are pushed for time, the NHS is at breaking point with our demands. I am sure GPs would love to have a menopause team on their books but where will the money come from?

There are places you can go such as Women's Centre, Menopause Clinics ( though they really often don't offer much more then a GP would) prescribe.

I think the MM site has covered just everything there is on offer for menopause problems, it could be that we have to help ourselves there is enough information out there.

On a personal note I suffer badly from PTS and panic attack syndrome, it took five years to overcome it all, I never took drugs except zopiclone for sleep though I was offered drug treatment, I did it myself and one of the best things that helped me was diversion therapy. My menopause symptoms were under control with hormone therapy, I am now through it all and out the other side. I researched and research all that I could and that itself was healing for me.

[lesley998]

I agree Honeyb that there seems to be a lack of understanding about WHY we get this awful anxiety.  I too had it as you might remember, and it went beyond any 'normal' anxiety that I had before...accompanied by a feeling of doom, terror, nervousness, butterflies in the stomach that lasted all day.   It realy was one of the worst times in my life, I thought I was going loopy.  Because of my symptoms - jerking awake in the early hours, jittery etc, I figured it was being caused by too much cortisol or adrenaline being released into my system.   Somehow, the normal balance of chemicals in my body had gone awry.    As soon as I STOPPED the high dose HRT I was on, the anxiety stopped too - literally stopped like that, within a day or two never to return.  It is so strange, as most women report that HRT helps their anxiety.  I would love to know more about it. 

[charliegirl]

Am waiting for a call from Dr Currie as she advised me have low dose HRT last July, have felt great for a few months and now come crashing down with severe pmt pain and depression, it has just ruined a holiday to spain and feel so disappointed, just need to feel better, will let you know what she advised.
charliegirlx

[honeybun]

Silver lady.....What is diversion therapy.


I know there is no quick fix or standard treatment just as with HRT. But it has been so surprising to see so many topics appearing on the forum regarding anxiety.
As its such a problem I thought maybe there could be some more advice available.


Honeyb
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[Hurdity]

This is a complex issue .....

This is what it says on the menopause symptoms page Emma linked to:

Psychological menopause symptoms such as mood swings, irritability, anxiety, difficulty concentrating, difficulty coping and forgetfulness may be related to hormonal changes, either directly or indirectly e.g. due to sleep disturbance.

This is what it says on the Menopause Matters FB page:

Antidepressants are not recommended for first-line treatment of menopausal symptoms such as flushes and low moods, yet are often offered by some GPs. Some antidepressants can be used if HRT is unable to be taken for medical reasons, but only after full discussion and after ruling out the use of HRT.

I think the first thing to ask would be - have you suffered from these symptoms at other times in your life? If so have they been related to your cycle, or post-natally etc? If so then the cause is likely to be hormonal and a partial "cure" I imagine, possible through finding the right replacement hormones.

If you have had such (anxiety) symptoms and they haven't related to anything that could possibly be hormonal, then presumably you might have had treatment for them in the past and perhaps will need to do so again - whether through holistic methods (such as learning to cope through psychological means) or taking prescription drugs.

If the symptoms have only arisen as you approach peri-menopause and there are no other reasons for you to feel this way ( re life events) then decreasing oestrogen and hormonal fluctuations are likely to be the reason - as well as possibly declining testosterone.

Any doctor that reaches for the prescription pad and tries to fob women off with ADs without looking at your history and considering a hormonal cause is guilty of lazy medicine.

Having said that as several have pointed out HRT is not necessarily a miracle cure.

Many of the synthetic progestogens used in most of the HRT preparations can cause anxiety in some women - which may be as bad or worse than the pms/pmt symptoms experienced during the natural cycle. Some women expect to feel better than on their natural cycle which is unlikely.

For women on continuous combined HRT ( continuous progesterone) especially if synthetic - they may have permanent anxiety - just due to the progestogen - and possibly without even realising it and then may get prescribed ADs instead of a change in HRT or even worse, instead of HRT at all.

As you found sweet pea - you had a high level of anxiety with your HRT, which I remember was the Prempak type I think - equine oestrogens? This type again can cause these feelings - I have read several instances including one woman last year ( or maybe earlier) who felt almost suicidal on this particular type.

These last two are due to not having the right preparation.

If after trying bio-identical estradiol through patches or gel at the right dose, and bio-identical progesterone (Utrogestan), the symptoms (of anxiety and depression) do not subside to a level able to cope with - then is the time to look elsewhere - but not to abandon HRT as it will be doing you good!

Ask for a testosterone test - low levels can cause these symptoms I understand, although this is still not mainstream.

We are complex organisms and even endocrinologists probably do not fully understand all the interplay and feedback of all the hormones and steroids, and the effect of mood, diet, environment on these. Trying to work out the reason why could keep you worrying for years.

One thing we are certain about is that oestrogen becomes deficient at menopause, testosterone gradually declines, and the thyroid sometime start to play up - amongst other things.

This is where I would start (hormone replacement), along with having a healthy diet, making sure you take regular exercise - including outside in the fresh air on most days, stopping smoking, limiting alchohol, having enough sleep, doing relaxing things.....

Then you will be in a better position to cope with the other things that happen at this time that can contribute to anxiety - empty nest, grandchildren, job changes, retirement, relationships etc

This has turned into a bit of a ramble - soz folks - hope someone manages to read and find it helpful!!!!

Hurdity x

[charliegirl]

Hurdity, you are amazing, have learned so much from your posts on here, makes me think I have always had hormonal linked problems ie pmt and post natals. You explain things really well. thank you!
charliegirlx

[lesley998]

...I agree charliegirl, and I also wanted to say to Hurdity to never ever apologise for 'rambling'...your ramblings have  set my mind at rest many a time,  you have such a great writing style, and I have had more help from your posts than from any GP about meno.

[CLKD]

Could you get your GP Surgery/Practice Nurse to arrange a meno-type Clinic in your area one evening?