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[Miss Lemon]

I am after some advice and some reassurance please ladies.

I'm a bit confused about things. My first and worst peri symptom was anxiety;it was crippling at first and I found life very difficult during that period and do not ever want to go there again. The anxiety coincided with the discovery that I had fibroids which, the gynaecologist advised, were caused by excess oestrogen. He recommended the Mirena coil but I declined and, after seeing a naturopath, opted for bio-identical progesterone instead which completely got rid of the anxiety and reduced the fibroids.

Fast forward a few years and I started getting hot flushes and VA in the mix,FSH levels say I am menopausal and my GP has prescribed sequi patches. I started the patches two weeks ago so have had two weeks of oestrogen and my anxiety is through the roof again - I haven't had it like this for years and the only time I did was when my oestrogen was high enough to cause fibroids.

I'm so confused as my GP says that hot flushes etc are caused by low oestrogen, not progesterone but I think it is high oestrogen that is causing my anxiety. Do I need to be replacing oestrogen? Is this a symptom that will ease as my hormones level out over time?

Any advice would be gratefully received. Thanks ladies! X

[clare663]

Hi Miss Lemon. One of my symptoms was anxiety along with the sweats, hot flushes and low mood (Im 5 yrs Meno) I had Evorel Conti patches 50mg. It took 3-4 days for the hot flushes and mood to rise and 6-7 days for the anxiety to go. On week six I had extreme nausea for a whole week and the anxiety came back and then I completely flipped and was suicidal. I ripped that patch off knowing that that was the issue. I think I get to the point very quickly, where the hormones build up and cause the extreme side effects.This all happemed on sunday. the anxiety left by tuesday eve and Im still not having the hot flushes so therefore, the oestrogen must still be in me but dropped off enough to stop the anxiety. Only time will tell if I get all the symptoms back again.

[Mojo61]

I really need to know if it is oestrogen that causes anxiety or progesterone? It is so confusing!

I was on Conti, but I'm due to start Sequi next week and no way do I want that awful anxiety I was getting back again!

[Dancinggirl]

I believe that it is usually progesterone that will cause low mood and PMT type symptoms.  I think it is very rare to have poor mood etc on oestrogen - most of us feel generally good on oestrogen when we get the correct level and this will vary from women to women.
I do think many women become very anxious about using HRT.  There have been all the scares in the past and GPs still fill women with dread over the possible risks (which are very small) - there is also the feeling that we are being weak in needing HRT in the first place as the lobby from those who advocate “riding the storm” is pretty strong.
Then there are naturally the side effects that are likely to happen as our bodies adjust and welcome the oestrogen.
The peri meno stage is very tricky as our own hormones will still be fluctuating for up to 2 years after our last period.

I think it is important to go into HRT treatment with a positive view point but expect some ups and downs.  Do look at lifestyle choices e.g. diet and exercise and do get enough rest and relaxation as well. Expecting HRT to control mood is the most tricky but you need to give HRT time - at least 3 months - to really see if it is working.  DG x

[GypsyRoseLee]

This question has had me pondering. When I spoke to the other consultant, who works alongside Prof Studd, a couple of days ago, I asked if my anxiety could be due to too much oestrogen. He replied 'Definitely not'. He went on to say that it is progesterone that can cause anxiety and low mood etc.

But I do know a few women on here who experience more anxiety if they up their dose. But I think it is very individual. I do know that progesterone is touted as being a sedative.

Anyway, consultant advised me to increase to 4 pumps of oestrogel, and 3 days later I can say, very, very tentatively, that my anxiety does seem better.

However I have also just finished my first 7 days of 100mg of Utrogestan too. So maybe my calmer mood is due to the Utro?

Time will tell.

[MIS71MUM]

I have to say that when I first used the gel, yes I did get increased anxiety. I think it was more because it gave my fluttery sensations in my body that then set me off panicking...and the cycle began.

However I didn't get quite the same sensation of a "hit" with the patches. For me they seem to deliver a steadier dose.

[dangermouse]

When oestrogen is low, particularly when it plummets, the brain panics and starts to pump out adrenaline to reset the system. This causes one type of physical adrenal rush.

However, if oestrogen levels go too high, either with peri upsurges or too much in HRT/pill, then it can be over stimulating, where you feel jittery and anxious.

In peri you often have a mixture of both types going on, but if you have the adrenal rushes mainly at night it points to low oestrogen/high prog as prog is higher naturally at night. In turn, day time rushes are more likely due to high oestrogen/low prog as oestrogen is higher in the day.

[Miss Lemon]

Thank you all for your replies. It is defo the oestrogen causing the anxiety/adrenaline rushes. I've been doing some research and have found conflicting info about whether it will settle down so am not really sure of best way forward but I can't go on like this.

Dangermouse, thanks so much for that; it makes sense. My rushes are during the day so I think I was right that I'm getting too much. So the question now is should I stop? Feeling this bad isn't conducive to working life!

Thanks again everyone!

[dangermouse]

Maybe reduce the patch dose if possible or get the Oestrogel instead.

It's not easy finding the right balance as you'll naturally feel different on different days of your cycle, so it's about finding the dose where you feel the most balanced throughout the month.

Or you could try the combined contraceptive pills.

[dogdoc]

Hey Miss Lemon. For me too estrogen causes SEVERE anxiety. In the early years of perimenopause I went insane with weeping, anxiety etc. I decided it was because my estrogen was too low and started estradot. For a couple weeks a month it was amazing. Felt so much better...and then I'd get into ovulation time where my own estrogen was still spiking. I would get cold hands/feet, chilled to the point I could not get warm ever, internal buzzing/vibrations, blinding headaches behind my eyes, visual changes and wobbles, panic attacks that went on for hours, weeping and weeping.   I can easily induce these symptoms within 24 hours just by putting on a higher ( like 37.5 or 50ug) patch even now. Once removed all symptoms are gone within 12 hours.

I can also induce a different but similar set of symptoms ( weeping, panic, nausea) by stopping progesterone ( it's bad when I come off not when I'm on). I am hoping that as I get farther along I will be able to tolerate a low dose of estrogen ( like 25ug) long term when both hormones reach a new steady low instead of upping and downing all the time.

[Hurdity]

The symptoms from stopping progesterone are progesterone withdrawal symptoms and classic symptoms of pmt just before a period - they are due to your body reversing the physiological changes that occur when you take progesterone, like in pregnancy. Once the progesterone has withdrawn from the system they should ease and you should feel good again on oestrogen only - presumably until it goes to high (I'm not familiar with adverse effects of this although presumably I must have had spikes in peri?). I imagine it must have to be very high indeed to cause problems??

Hurdity x

[dogdoc]

I am hoping Hurdity that once it's all simmered down I'll be able to tolerate both estrogen, and the progesterone. I was soooo convinced that my symptoms were low estrogen ( the ramped up, adrenaline feeling), but once I started to be able to induce the feeling with a patch ( not once but several times) I knew that for me it's estrogen itself, or maybe a ratio problem between the hormones that messes me up. . I think some of us are just unlucky enough to be super sensitive to absolute levels and to fluctuations as well. It's already settled down a lot. Too bad now it's a whole new set of symptoms...at least these are more 'classically' menopause symptoms and the doctors easily recognize them.

When you're 40 and go in complaining of anxiety, mood swings, hair loss, tingling face/hands, cold chills, headaches etc. etc. Hormones are not on any of their minds even when you mention irregular periods. "hot flashes" are the magic menopause words...they don't often recognize the earlier symptoms, particularly in younger women. And how sad is that.

[Miss Lemon]

Hi Dogdoc. Thank you so much for your reply. Yes, it was the oestrogen. I clearly don't need that at the moment. Every time oestrogen is introduced I go crazy, literally. I felt suicidal last weekend, again! I ripped the patch off and within 12 hrs I felt better, within 48 hrs was back to my old self. Why on earth would I continue to put myself through that! Do you use any progesterone at all?

Thank you Hurdity. I really appreciate your advice. For me the biggest issue is the mood swings and occasional hot flushes so I think, for now, I'll pass on the conventional HRT. Maybe at some point in the future I'll be able to tolerate it but obviously not now.

[dogdoc]

Miss Lemon...I am not on progesterone. After I trialled HRT early in perimenopause and figured out what chemicals were causing what symptoms it got easier to know what to expect and when. My symptoms have settled a LOT in the last year and a half. At ovulation I can still expect several days of weepiness, anxiety ( no longer crazy/suicidal anxiety though thank goodness), heart arrhythmia, difficulty swallowing ( weird but true)  freezing cold feet and generally feeling a little nuts and a little blue.   Then I"m OK for a week or so, then I get the progesterone symptoms ( comparatively these are better)...they are hungry hungry, slightly irritable. Sometimes really irritable.

I feel normal again 1-2 days before my period starts. This actually makes me very happy because at this point I should have almost no estrogen and almost no progesterone ( like what I'll feel like in menopause I assume) and although there are hot flashes overall I feel good. So hopeful the symptoms will be a lot more manageable when the fluctuations stop.

After my early mixed results ( and sometimes horrifying results) with HRT I decided to forgo HRT until I am routinely skipping periods ( when I know my estrogen levels really are low...not just up and down). I take vagifem twice weekly for dryness, and DHEA also intravaginally which has helped with sensation and ability to orgasm. I take Maca which improves my sleep and reduces my hot flashes.

I'm hoping I'm closer to the end of the trip than I am to the beginning. They say 60 days without a period means you are likely within 1-2 years of full menopause on average.  Means I'm likely more than 2 years away still. Bummer

[Belladonna]

My experience has been the opposite, low estrogen causes anxiety. Not like panic attacks but I start worrying about things in a really unhealthy way. Like having imaginary conversations with my boyfriend where I break up with him for some imagined hypothetical thing he has done. I really noticed it now because I came off a trial of BCP and went back to my patches, which I already knew have too little estrogen, only 50 mcg and I'm just 34 years old.

2-3 days after stopping the pills the anxiety started. I then realised that I had the exact same thing before going on the BCP, I just didn't know it was due to low estrogen. Thought I was just an anxious worrywart due to a lot of traumas in my life the past few years. But while on BCP I felt so calm, I had no weird repetitive thoughts or worries about future or imagined events.

When I understood the connection I put two patches on which has helped a bit however I am now getting too much progesterone... Still waiting for my doctor to call me back.