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[racjen]

It's lunchtime and I'm sitting here in bed crying because I feel so shit. As usual I've been awake half the night, acute anxiety kicked in at around 6am, got up and did some yoga stretches and had a cold shower at 8am, then drove elder daughter to school. Went to my yoga class and felt a lot better (it usually has a really beneficial effect), then came home and as soon as I walked through the door the anxiety and gloom hit again. I just don't know what to do with myself - I'm doing all the right things, loads of yoga, trying to think positive, eat well, find things to occupy my time, but since I lost my job I feel like a spare part and the anxiety prevents me from getting out and doing anything useful like voluntary work. This isn't me - I want the old me back, I want my life back.

Right now I'm SO confused about the right path to take HRT-wise, I feel like giving up altogether. I've had 3 months off utrogestan altogether on the advice of NHS consultant, to see if progesterone intolerance is causing the relentless anxiety. But after 3 months it's just as bad, and I'm bleeding all the time. And raising my estrogen level even more (I'm currently on Evorel 100 patches and my last blood level was 991) just results in a horrible sort of panicky depression which Google informs me can be a symptom of too much estrogen. Testosterone does the same. I'm getting to the point where I can only assume that chemotherapy has screwed up something in my brain, to the point where nothing that works for other people will work for me. If they'd told me this could be a possible result of chemotherapy ie your chances of survival are much better, but your quality of life will be pretty much zero I think I'd have taken my chances without. Right now I'd rather be dead than live life like this.

[Conolly]

Hello racjen,

So sorry to read this. I wish there was more awareness that chemical and surgical menopause are entirely different from natural menopause and need a multidisciplinary approach. You really need more support from your doctors.

Have you ever tried tibolone? It's completely different from other types of HRT. I have already told you my thoughts on tapering and letting your other hormones settle before trying HRT again, just to see where you really are hormone wise. I understand if you don't want to do it, though. It would take some time and maybe you don't want to wait in agony.

Conolly X

[racjen]

Hi Conolly, I already know that the results of the chemo were pretty much the same as having my ovaries removed altogether ie they were shut down completely. Tests when I first started HRT showed that both my estrogen and testosterone levels were pretty much non-existent, and at 52 I think it's highly unlikely they're going to start up again, so I can't see any point in coming off everything just to see what my own hormones are doing. My big fear is that if I come off estrogen completely I'll get really depressed to the point where I can't cope at all - at the moment I can function but life is pretty miserable, if it gets any worse I dread to think what might happen.

I have wondered about tibolone, but I'm not sure that the estrogen part would be a high enough dose - will ask consultant though.

[Robin]

I wonder if it's possible to use extra estrogen gel/patches alongside tiblone.

[Jenna]

I found this thread discussing it, Robin - hope it helps  :

https://www.menopausematters.co.uk/forum/index.php/topic,36469.msg584471.html#msg584471

[Conolly]

Hello racjen,

I was referring to other hormones... FSH, LH, AMH and cortisol. They also play a role in menopause symptoms, according to recent studies. I will post some links later on.

I had an insight this morning, maybe it's BS or it has already been discussed, but I thought it would be interesting to know your opinion (all ladies).

When women have surgical or chemical menopause and then starts HRT, the body is going to react the same way as women with intact ovaries that go through perimenopause, sudden drop and sudden increase in hormone levels, maybe that's why it's so hard to achieve a balance with standard doses of oestrogen.

Maybe a number of blood tests would be helpful in order to schedule the operation in synch with her hormonal cycle, as to avoid a sudden drop, and a proper oestrogen (and progesterone!) dose would be given to mimic her cycle and increased as needed, if symptoms are not being controlled.

The 'experts' say women who has gone through hysterectomy and oophorectomy don't need progesterone. Well, maybe they don't need it in the long run but they were certainly producing it before the op, so they should be given progesterone at least until they reach the average menopause age (51-52), a sequential regimen. After that they could taper off progesterone and eventually stop it, depending on symptoms.

Conolly X

[racjen]

Oh OK Conolly, didn't realise that was what you meant - I think you can get a bit fixated on the big 3 hormones and forget (or possibly as in my case never really be aware) that there are others involved too.

Birdy I suspect you're right - I don't think I'm progesterone intolerant, surely the fact that I've been off it for 3 months with no improvement kind of proves that? But I'll have to wait and see what the consultant says when I finally get a follow-up appointment. I don't seem to be able to take testosterone either - it has the same effect on me as too much estrogen, a horrible kind of panicky depression. There are times when I just think chemotherapy has buggered up my brain and that's that - there's no solution but to endure it and just hope over time it improves.

One really weird thing - a few nights ago I didn't sleep at all, literally not at all - accidentally drank a strong caffeinated coffee early afternoon and that was it, no chance. But it was the one and only morning I've had in well over a year when I didn't feel the acute anxiety at all. So whatever it is that's happening in my brain to create it happens during sleep. So there we are - the solution is just don't sleep....But seriously, does anyone have any idea what might be going on here?

[Conolly]

Maybe it wasn't the lack of sleep, but the caffeine? It's a strong drug for my migraines.


Conolly X

[CLKD]

Caffeine has no effect on me though coffee makes me nauseous 

Would stopping everything for a couple of months racjen allow your body to stabilise, clear itself?  Cortisol is the hormone that wakes us in the early hours, I would wake suddenly then go into deep, prehensile fear   

[CLKD]

I love the smell of coffee and had some last year a few times, but oh the nausea about 20 mins. later.  Same with milk shakes which I love, I get a lot of wind - I suppose it's the straw! I haven't been keen on alcohol for years and have never smoked.

I do like a drop of Tia Maria but avoid that also. I have found over the years that I have to stick to regular foods or I get quite queasy and when hormonal on a regular basis, would feel ILL at certain times of the month 

[Roseneath]

Hi racjen. I totally relate to everything in your post and I really really empathise with you. I have found mentally in Peri when I am at home (I work from home) my brain is wired on anxiety 24/7. I have night I go to bed tired then am wired by midnight and up until the birds start. Then the next day I am emotional and exhausted. I have started waking every 2 hours if I do sleep in a panic. All this has ramped up in the last half year. I am desperate to sell up, move away, get a job that keeps my with people/brain occupied etc.  I do now have a stash of sleeping pills and if I have three very bad nights I will take half one just to get some relief. I have a theory that some people are born worriers (Like me and my son) and some not (like my DH and daughter). Maybe Peri hits the worriers harder giving us so much more to worry about. Recently I just feel like I can't copy with the family etc but I know I must try and fight it.  I agree with hormone testing - if they got a group of us and tested up half a dozen times a day for 2 months there much be a pattern to this. I feel it is cortisol/adrenaline related and think my estrogen may be too high when I go super anxious. I am finally off to a Meno clinic Friday (3 hours away to nearest) so will see what they say. I am very reluctant to go on HRT again without  evidence  of what is high/low etc. Massive hugs to you.

[Roseneath]

P.S. I just wanted to add something positive to my post! I find that sometimes just putting the Radio on helps. Or there is a free App called Pacific which has 3 or 8 minute free visualisations.  One called ' The Tree' is very good . I felt bad today, just wanted to stare into space but made myself put it on. Anything to shift the mood. This time of year I am sure the lack of sunlight and outdoor living isn't good for mood.

[NaturalMystic]

That's the frustrating thing about anxiety.  One minute you can feel absolutely fine, it then hits you from nowhere, like being hit with a brick.

[CLKD]

Yep.  I have been known when in situations likely to cause anxiety, to look over my left shoulder and wait: but it doesn't happen.  When I'm bowling along OK, it hits.  Hard 

[racjen]

Interesting theory, that it was the caffeine not the lack of sleep itself. I had given up caffeine completely (I'm a real coffee lover and used to drink a lot of it, but then just couldn't tolerate it once the anxiety hit). Now I've noticed that one, not too strong, real coffee a day can really lift my mood and doesn't keep me awake as long as it's before lunchtime. So there may be something in that. As for some people being born worriers - I can't subscribe to that one, I was never a worrier before perimenopause and I wouldn't actually call myself one now, I'm not triggered by thoughts and I can control them - it's a physical process that causes my anxiety.