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[Greenfields]

I posted recently about the anxiety and nausea I've been experiencing with my second month of HRT.

As well as these symptoms, I noticed in the mornings that I was starting to wake up being aware of my heart beating.

I pulled out the HRT leaflets and discovered that amongst the side effects of the meds I'm on are: nausea, anxiety and palpitations!

This set me wondering - how do you know when the anxiety you are experiencing is due to genuinely feeling anxious about something versus anxiety arising from a menopausal hormonal imbalance versus anxiety arising from the side effect of taking HRT?!

I don't want to come off HRT yet because it has stopped my night sweats and hot flashes but it's hard to know, when I experience anxiety and nausea whether it's what I'm genuinely feeling about something or whether it's arising as a result of the physiological effects from the HRT or it's my own hormones that are up and down.

I'm just wondering how one deals with this and also how one makes judgements about things (making decisions on life choices for e.g.) if you can't trust your feelings around anxiety because you don't know completely why they are arising?

Or have I just lost the plot completely?!

[Briony]

Despite having had these symptoms pre HRT, when they arrived again in about the second or third week of starting, I was convinced it was a side effect - ie I was having too much estogen. To cut a long and boring story short, I have since learnt that it was actually still low estrogen levels causing it; the HRT hadn't kicked in then, and didn't for several months (my estrogen was v low for my age). Now I am on the pill, a dose 2-3 times higher than the HRT, and finally the nausea, headaches, anxiety etc has massively reduced (won't tempt fate by saying it has gone totally!).
It is so hit and miss, and we're all different, but I would give it at least three months if you can stand it.

Good luck x

[CLKD]

I think we all lose the plot at least once a day 

Do you think you can give it a 3/4 months trial?  Keep a mood/food diary as well?

The nausea is always the most difficult for me ……..   

[Greenfields]

Thanks guys.  I am going to give it 3 months - that will take me up till July I think.  The difficulty is that I want to make a trip to Canada that month too to figure out whether I can manage to move back.  Hence I really need to trust my feelings! Seeing the Dr next week so I'll ask her then.  What's weird is how icky I can feel in the morning and then how well I can feel by the evening/end of day - I feel like I have 2 individuals inside me at the moment - one ill, unsure and worried and the other confident and upbeat.

Today, so far, I didn't have as much nausea but waking up anxious and having worried thoughts flitting through my mind I find very overwhelming first thing in the morning - it took me 2 hours to get up and out of bed properly this morning because of it

[oldsheep]

very sympathetic as I'm going through a similar thing, don't know if it's the HRT not working or working too much (oestrogen). The mornings are the worst, with running to the loo. When all is going well, I have to take 2 tblsps of ground linseed to go at all 

The received wisdom is that it's low oestrogen that provokes anxiety, but I know when I had my oestradiol pills (I used to be on pill form) doubled in dose, I had anxiety attacks. However it was quite easy to trace that to the increased dose.

I think you'll find no doctor will want to change anything until you've been on HRT for 3 months. Maybe keep a diary?
If you have underlying anxiety eg Canada, the hormones might be making you feel worse?

[Kathleen]

Hello Greenfields.

So much of what you say rings bells with me. When I'm feeling good ( well just normal really but it feels good by comparison ) I tell myself that this is the real me and I'm finally through this menopause business but when I'm feeling jittery and nervous I forget the good times and become morose and panic stricken.

Your point about HRT side effects is a good one. I often have digestive issues and I noticed that one of the side effects of my patches is " wind ". I suppose this just goes to confirm that hormones from whatever source have a similar effect on our bodies and of course our emotional state.

I think giving things three months to settle is a good one and hopefully you will be in a more settled state by then.

Take care.

K.

[dogdoc]

Greenfields...you only have two people living inside you? I swear I have about 10.

I too noticed increase in anxiety, palpitations, weeping etc. For me I know it was too much estrogen as removal of the patch resolved all symptoms immediately ( like within 12 hours) and they didn't return. However after 'ovulation' time, different symptoms cropped up...including anxiety and weeping and palpitations.

I think so much of perimenopausal symptoms are hormone fluctuations vs total lack of estrogen. I know at some times my estrogen is very low, sometimes it's in the normal range ( or near enough) that I feel OK on no estrogen, and sometimes I think it might fluctuate upwards a bit ( get feeling similar to when I'm on too high of a patch).

One big experiment.
Tara

[GypsyRoseLee]

Briony can I ask why you are taking the Pill rather than HRT. My GP and consultant both mentioned the Pill as an option to control my extreme mood dips and anxiety. I think I'm still producing quite a bit of my own oestrogen but it is also fluctuating a lot.

My GP said that the Pill completely zaps your own natural cycle so should quell any mood dips.

But back when I used to be on the Pill I remember I still used to get PMS in the week before my period.

[Greenfields]

very sympathetic as I'm going through a similar thing, don't know if it's the HRT not working or working too much (oestrogen). The mornings are the worst, with running to the loo. When all is going well, I have to take 2 tblsps of ground linseed to go at all 

The received wisdom is that it's low oestrogen that provokes anxiety, but I know when I had my oestradiol pills (I used to be on pill form) doubled in dose, I had anxiety attacks. However it was quite easy to trace that to the increased dose.

I think you'll find no doctor will want to change anything until you've been on HRT for 3 months. Maybe keep a diary?
If you have underlying anxiety eg Canada, the hormones might be making you feel worse?

Yes, I'm keeping a diary and typing up notes for the GP (altho' I have a backlog of them to type up before i see her next week!).

Funny you mention the loo - I sometimes wake up and have explosive bowel movements - sloppy type diarrhoea or a mixture. Sometimes my bowel movements get really bitty as well - so lots of bits and they stick to the pan.  Sometimes they smell of vomit.  I never had this before HRT and I'm convinced that it's a side effect - although it might also be the fallout from the nervous breakdown as well. But diarrhoea is listed as a side effect on my Evorel 50 leaflet! 

Fortunately, once I've gone to the loo - sometimes 2 or 3 times in the morning on waking - it doesn't bother me too much the rest of the day.  The nausea did recently - there was one day where it didn't go till evening and I found it really hard making myself eat (which I did).

I feel lucky in someways that I have a lot of relaxation skills that I've learnt from yoga, meditation and life generally.  I've also had psychoanalysis and that really helps too in terms of helping me reframe my thoughts - the last time I spoke to an Italk counsellor she said she could tell that I had been through therapy because of the way I was able to reframe things.

However, it's only the last few days that I started to twig that the anxiety might not necessarily be generated by me but by the HRT side effect - I'm glad I'm aware of it now as i can tell myself on waking that this isn't necessarily me and how I am - but it's not pleasant.

I've worked out that 3 months on this HRT will take me up to around 22nd July - so I really hope things are settled down by then as I really want to get on with my life but don't feel able to at the moment until I'm sure that my nervous system can handle the strain of getting on and sorting out things.

I've just contacted a nutritionist and have decided to have a session with her to see whether there is anything else I can do diet wise to support my health and diminish my anxiety.  She recommended on the phone Epsom Salt Baths!  So I'm going to have another one in a minute!

[Greenfields]

Hello Greenfields.

So much of what you say rings bells with me. When I'm feeling good ( well just normal really but it feels good by comparison ) I tell myself that this is the real me and I'm finally through this menopause business but when I'm feeling jittery and nervous I forget the good times and become morose and panic stricken.

Your point about HRT side effects is a good one. I often have digestive issues and I noticed that one of the side effects of my patches is " wind ". I suppose this just goes to confirm that hormones from whatever source have a similar effect on our bodies and of course our emotional state.

I think giving things three months to settle is a good one and hopefully you will be in a more settled state by then.

Take care.

K.

Oh I get wind too - in fact, I've taken to underlining in pen all the side effects I experience which are listed on the manufacturer's leaflet!

[Greenfields]

Greenfields...you only have two people living inside you? I swear I have about 10.

I too noticed increase in anxiety, palpitations, weeping etc. For me I know it was too much estrogen as removal of the patch resolved all symptoms immediately ( like within 12 hours) and they didn't return. However after 'ovulation' time, different symptoms cropped up...including anxiety and weeping and palpitations.

I think so much of perimenopausal symptoms are hormone fluctuations vs total lack of estrogen. I know at some times my estrogen is very low, sometimes it's in the normal range ( or near enough) that I feel OK on no estrogen, and sometimes I think it might fluctuate upwards a bit ( get feeling similar to when I'm on too high of a patch).

One big experiment.
Tara

LOL love the 10 peeps! As for one big experiment ... hmm seems like one big crapshoot to me!

The other thing is if I move back to Canada, I will have to go through another regime over there - although they do do blood tests from the word go and tailor it to individuals results - which I hope would mean less side effects - but who knows?

[Briony]

Briony can I ask why you are taking the Pill rather than HRT. My GP and consultant both mentioned the Pill as an option to control my extreme mood dips and anxiety. I think I'm still producing quite a bit of my own oestrogen but it is also fluctuating a lot.

My GP said that the Pill completely zaps your own natural cycle so should quell any mood dips.

But back when I used to be on the Pill I remember I still used to get PMS in the week before my period.

Absolutely. I tried HRT first, having been diagnosed with very low estrogen aged 40 . However, despite giving it four months, I found that my symptoms improved only slightly. My GP (a new one who had been recommended after a nightmare with the previous one) said it was because HRT only 'tops you up' - it doesn't actually control your hormones. Therefore, at times I was having too much - or at least, it was fluctuating. On top of this, she said that your body needs something more substantial than HRT if you're still relatively young. She descibed it as a deficiency which needs treating like any other. Since I am a high risk for the pill, it was suggested I tried a very new form of pill which has bio identical estrogen (same as HRT) and is a much lower dose than the more popular ones. It's also a four phase pill with only two blank days (hence less risk of fluctuation effects). I was very nervous at first, but looking back, wish I had done it ages ago.   The final push I needed was from this lady on the forum:
http://www.menopausematters.co.uk/forum/index.php/topic,24521.0.html  (see reply 11).

Hope this helps. B

[GypsyRoseLee]

Thank you for replying Briony.

When my GP first mentioned the Pill I had a bit of a knee jerk reaction to it, and just dismissed it out of hand. But he said it could be an option as I am not overweight, don't smoke and rarely drink.

Eventhough my HRT might well be working, I am still definitely getting breakthroughs where my symptoms suddenly swoop back for a few days, with no rhyme nor reason.

I have never suffered with any physical manifestations such as hot flushes, or aches and pains, or vaginal dryness etc.

18 months ago I just noticed that my PMS was lasting much longer (starting just after ovulation and not going until about day 4 of my cycle), and that I was now experiencing very low mood and anxiety, as opposed to just feeling fed up and irritable prior to my period.

Before taking Qlaira were you experiencing low moods and anxiety? And has it helped?

[Briony]

Funnily enough, only a colleague said today I am more like old me than I have been in 3 years, and asked me what the secret was (ironically she thought I was pregnant!).
Basically, pre Qlaira, I had gone from being a confident, busy professional to a tired, anxious, moody  mess (amazed partner has stuck by me!). I was hiding it from others so my social life disappeared around me. GP was convinced it was all in my head (despite crippling back pain and weird sensitisations, nausea and crippling fatigue) and prescribed ADs which did nothing. Wasn't until a neurologist suggested a hormonal cause (despite no flushes, no hot flushes etc) that I got any relief.  Still not perfect, but the biggest difference with Qlaira, four months in (took a while to work) is psychological improvement. I even went for a promotion this month - would never have done that three months ago!Do still got the odd symptom, especially weird pains in calves and back, but nothing like it was before. Gone from an A cup to a C which is very strange - after living with a flat chest all my life - but I think I can live with it!!    x

[GypsyRoseLee]

Seems like we were pretty similar Briony. I have always been very outgoing and upbeat. But 18 months ago all that changed and within a week or so I became a shadow of my former self.

I was crippled with anxiety that verged on full blown panic at times. I started getting random insomnia. And I just couldn't face meeting up with friends or doing anything 'new'. All my self confidence had just drained away. I barely recognised myself.

Then I would suddenly feel fine again and it would be like the previous anxiety/depression was just a bad dream. I would be on top of the world for a week or two then it would all come crashing down again. And this just kept happening on and on and on. I really thought I was slowly going insane because it was all psychological, and my mood could dramatically dip in the time it took to drink a cup of tea.

I'm going to give my HRT another couple of months to see if they stabilise my moods/anxiety some more. I think my most recent horrible mood dip was due to my patch not being properly absorbed because I was going on holiday and I'd had a spray tan. Can't believe I didn't twig what was going on 

But if I'm still very up and down on HRT then I will go back and see my GP and ask about Qlaira. Does it have to be that brand, or would any brand of the Pill work, do you know?