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[Greenfields]

I'm into my second cycle of HRT - taking 100mg Utrogestan and Evorel 50 patches.

The first cycle (month) I took this combination, things seemed to get better and better - I felt a lot better and so much more relaxed.

I'm now into Day 5 of the second cycle (month) and the last 5 days have been quite challenging - just really awful anxiety in the mornings with some nausea.

I recall the Dr saying that it takes around 3 months for the HRT to settle and work.

I'm wondering whether the fluctuations I'm experiencing are normal? 

Has anyone else had experiences like this where anxiety increases on HRT?

Does it settle down again?

I do have a lot of things to worry about - which I try not to focus on too much because it does me no good - but I am really thrown by these physical symptoms on waking - am hoping that by next month, things might have changed?

Any thoughts appreciated.

[jedigirl]

Hi Greenfields
I find mornings very difficult on waking. Awful nausea, anxiety at highest, every little worry magnified, brain fog, fizzy tummy, you name it. It always eases by mid afternoon at latest but is hard to handle at times.
 I find mine worst during and just after bleed, and I'm on HRT. I know our cortisol levels are highest in the morning and coupled with the fact that you have alot going on, it's hard to know whether it's fluctuating hormones or general anxiety.
My guess would be if you've changed to a different cycle it's a hormone fluctuation and will settle again.
JG XXX

[Greenfields]

Thank you so much for posting that jedigirl - I was beginning to think I was heading for another breakdown this morning because I felt so rotten. I still have the nausea and anxiety now - which is the longest time it's gone on from getting up in the morning since I started this program of HRT. It's so odd because prior to this latest experience, I was so positive about my future - moving back to Canada etc.  Now all I feel is sick, shaky and worried I'm going get sicker and also homeless.  It's not nice to experience this physically and I'm having a hard time dealing with it.  Yesterday I dragged myself to the gym and felt a bit better afterwards (until I damaged my car - hitting a bollard!).  Today I don't even feel up to going to the gym so I'm going to try and do some relaxation and yoga - but I've yet to eat lunch because I feel so nauseas.

Just wondering when things ever settle down?

[honeybun]

Unfortunately HRT does not always help anxiety. My anxiety started after I had been on HRT for two years.
Mornings are notoriously difficult and have to be eased into slowly.

What treatment did you receive when you had your breakdown. Was it AD's. Perhaps that might be a consideration for you.

I really do wish HRT was a cure for anxiety but for me anyway it's not.

I just keep plugging away in the hope of improvements.


Honeyb
x

[Greenfields]

Unfortunately HRT does not always help anxiety. My anxiety started after I had been on HRT for two years.
Mornings are notoriously difficult and have to be eased into slowly.

What treatment did you receive when you had your breakdown. Was it AD's. Perhaps that might be a consideration for you.

I really do wish HRT was a cure for anxiety but for me anyway it's not.

I just keep plugging away in the hope of improvements.


Honeyb
x

Didn't have any treatment for my breakdown - it was horrid.  Spent a week in bed trying to coax myself out of bed and trying to eat (which I somehow managed - lord knows how - but I did lose 13lb body weight as well).  I didn't fully understand what was happening to me at the time - I just knew I was very very unwell and not functioning properly.  Experienced extreme sense of depersonalisation and numbness and just mentally all over the shop - in extreme state of shock.  Acupuncturist I managed to get to see at the time suggested I go to the Dr for HRT as my body had also completely lost ability to regulate temperature day and night.  The first Dr I saw gave me an HRT med which was horrid and then she prescribed Sertraline 50mg (which I took for 2 days - absolutely horrendous side effects - all the most severe - so I stopped it).

My current Dr has changed the HRT so was a lot lot better.  And has prescribed exercise which I am doing as much as I can - but how I'm going to fit it in when I return to 'normal life'(!) is anyone's guess.

Have thought about AD's but my experience with Sertraline was so scary that I am frightened of taking something else - altho' I will need something at some point to deal with the stress of moving back to Canada (if I can manage to move).

Its very difficult getting Dr's appointments where I am - you have to wait 2 weeks.  Having said that, my current Dr is lovely and always reminds me that she's just a phone call away - whereas the first practice I belonged to were so unhelpful.  I recall standing in front of the receptionist at that practice begging to see someone because I was so ill and being told that all appointments were full and if I wanted an emergency appointment I should turn up at 8am the next day - which I did on 2 occasions - but it was the most awful experience of my life.  Never want to go through it again.

[jedigirl]

Greenfields
I feel for you, i struggle with nausea too. Try and eat a little or the nausea won't subside. I keep protein shakes in the fridge for my bad days, it helps to sip them and have something on my stomach. Breadsticks, rich tea biscuits, porridge all easy on wobbly tummy.
Do you have anyone to chat to at home about what's happening in your life?
Can you make plans to help ease your mind about the future? Is there anyone you could stay with if you lose your home or any alternative arrangements you can make? If you know you have a back up plan maybe it would ease your anxiety?
I take Citalopram 10mg for anxiety, Sertraline i tried and didn't like, and have some diazepam i can use for emergencies, which i rarely need but glad they're there.
Maybe you need a chat with your GP re some extra help for your anxiety, at least until things settle a little.
Big Hugs xxx

[dogdoc]

Greenfields. I went up too fast on the estrogen component. When I'm too high I get nausea, palpitations, anxiety/panic attacks, internal vibrations, hair loss, cold hands and feet ( sometimes cold everything), weeping, aching pain up the back of my legs and agitation. Like I've drunk 8 cups of coffee. I'd had these sensations before I even started on estrogen and had assumed they were symptoms of LOW estrogen...but nope. So in peri, on average, women have MORE estrogen than they did when they were younger, as well as more dips in estrogen ( faster and more precipitous drops). There's a lovely graph showing women's estrogen levels in early perimenopause....it looks like a bomb went off.

Our estrogen apparently starts dropping lower within a year or two of actual menopause.

So sometimes you may have too much estrogen causing one set of symptoms, and sometimes not enough causing another set. Add to that a whole different set for when estrogen is fluctuating. Good times right?

I wonder if slower and steadier is the way to go with estrogen. I'm on 12.5ug right now ( micro dose)...doing OK and got rid of all the symptoms of too high estrogen. Might need a touch more though as the low symptoms (vaginal dryness and hot flashes).

[Chi chi]

Greenfields I can really relate to your "breakdown" and how you describe it, the same happened to me 3 years ago completely out of the blue! Well I remember feeling like I was running on empty just beforehand, it was Christmas and a busy time anyway. Then come January, it was a Friday and me and hubby had been arguing most of the day (via texts) that evening I broke down and started crying and then didn't stop for what felt like weeks! It was the most terrifying experience I have ever been through! All the feelings you describe I had too, I truly didn't know what was happening to me, I felt so scared and was convinced I was going insane, I kept thinking and saying they were gonna come and take me away to some sort of institution  it really was horrifying. In the following weeks I was put on quite a few different AD's (one at a time) but none really made me feel "normal" again so I went back to the one I was on previous to the breakdown (escitalopram) It still really scares me to this day and I don't think I've ever gotten over it, I think about it every single day and am convinced that something in me changed  I just can't forget how I felt and how scared I was, it's difficult to fathom if I still feel that way or if it's just memories?? Like a permanent flashback (if that makes sense)?? I had PND with my first daughter but this was/is on another level!
I'm currently on estrogen and testosterone implants with prog each month, not really working as well (see other posts)  I was on gels before and found they really did help! Sorry I can't really offer you any advice but just wanted to say I totally sympathise and hope you find something that works for you 

[Greenfields]

Greenfields
I feel for you, i struggle with nausea too. Try and eat a little or the nausea won't subside. I keep protein shakes in the fridge for my bad days, it helps to sip them and have something on my stomach. Breadsticks, rich tea biscuits, porridge all easy on wobbly tummy.
Do you have anyone to chat to at home about what's happening in your life?
Can you make plans to help ease your mind about the future? Is there anyone you could stay with if you lose your home or any alternative arrangements you can make? If you know you have a back up plan maybe it would ease your anxiety?
I take Citalopram 10mg for anxiety, Sertraline i tried and didn't like, and have some diazepam i can use for emergencies, which i rarely need but glad they're there.
Maybe you need a chat with your GP re some extra help for your anxiety, at least until things settle a little.
Big Hugs xxx

Thanks for the hugs - I need them!  I made myself eat a late lunch of peanut butter and banana sandwiches as I felt so nauseous I couldn't eat till 2.30pm.  Oh and I did make myself eat porridge this morning - it was just a struggle to eat it with the nausea but I did it.

I live by myself which is hard so no, I don't have anyone I can really chat to altho' I do go to local mental health support groups as well as going to the sports centre for regular exercise.  I spent this morning at a Quakers meeting as well - so I do get out and about and connect with people but I don't have people in my life who would step in and put me up in a room - so it's really hard not to worry at times about the future. 

I self referred to a mental health agency in case my landlord tries to evict me in September if I'm not well enough to move but my support worker has told me that with the level of savings I have, the council will not view me as homeless - however I know I will struggle to get a room (never mind another flat) in the area I'm in if I'm not working and I'm ill - even if I do have enough savings to pay rent for another year.  There is a huge shortage of accommodation where I live.  The support worker is going to help me register for council/housing association housing but given the wait lists and the way it operates now (you have to bid regularly on property and the highest bidder gets the place) I don't think I stand much chance of getting anything for years unless my health worsens significantly. 

People say to me why don't you move North? - conveniently forgetting that I don't have the emotional resources or health at the moment to move North and moving is stressful at the best of times so moving when one is ill - especially as I've found a nice Dr to help me in the area I live in - is the last thing I'm up to at the moment.  Plus there's the question mark of getting a place without having a job.  As well as getting a job long term.  My tenancy is up for renewal mid-September so I'm really hoping that by mid-August I will be well enough to figure things out as that is when the current landlord will want to sort things out with the tenancy agreement. 

I haven't got any other support to fall back on in terms of a home - so it will be the local homeless shelter for me if I lose my flat and I'm not well enough to move to Canada - I'm hoping it doesn't come to that though.

I am scheduled to see a therapist on June 8th which I'm looking forward to the support of - she comes recommended and I hope she helps because I went to see another therapist and paid 150 pounds for 3 sessions only for her to tell me she couldn't help me!
The new therapist I see is also a psychiatrist which is reassuring but it will cost me 50 pounds a time.

It would be lovely to have a secure Plan B as it would relieve a lot of anxiety for me - but unfortunately the only Plan B I can come up with at the moment is to get as well as I possibly can and then get myself on to a plane to Canada where I can at least rent affordable accommodation for a while while I'm sick which won't cost as much as it costs here and where renting is easier.  But I do worry that the stress of the move will trigger another nervous breakdown and I really don't want to end up in the psych system in Canada - particularly as the benefits and housing support offered are a lot less there than they are here in the UK.  As well, I really need to get work out there too - and the 0 hours contract culture is rampant there - so I will have to be well enough to do at least 2 p/t jobs as it's really hard getting work.

(Not that I qualify for any UK benefits at the moment anyway - even PIP you have to have been in the UK 2 out of the last 3 years - which I haven't been -  And my savings take me over being eligible for any other benefits).

I think I'm basically stuck between a rock and a hard place at the moment although I constantly remind myself that I have savings and I haven't exhausted them yet - so that's a blessing.

I have thought about getting some p/t work locally to see whether I can manage it but, given that I want to try and take a trip back to Canada in July, I know if I start work in say the next couple of weeks, it will be difficult to then ask for time off in July!  As well, because I have days where I'm fine and then days where I'm not so good, it's difficult to judge at which point I'm safe (for want of a better expression) to pick up work and to know that I would stay healthy while doing it.  And as moving back to Canada will be stressful, at the moment, I'm just focusing on trying to get as well as I can - it's about 9 weeks now since I had my breakdown so I think I'm doing pretty well with recovery but it's hard to tell.  I still get very overwhelmed at times and I cannot listen to the radio much or read the news much. 

I've been also wondering whether the nausea I've been experiencing today is related to the fact that I barely slept last night despite doing exercise yesterday. I don't know why - whether it was the epsom salts bath I took (altho' it only had 3 tbsp in it!) or writing an email to a professor in Canada requesting some help with my reapplication for my masters next year or damaging my car paintwork yesterday (running into a bollard).  Or it could be perimenopausal anxiety and nausea!

Can you tell me how you found the Citalopram?  That is an AD I have thought about taking but when I looked online, the side effects listed were very similar to Sertraline - and that scared me.  I do think I will need to take something for a while if and when I move back to Canada - although, again, in Canada I will have to pay more for the drugs as they don't have the same drug coverage as here unless you have a good job with benefits - and there aren't a lot of those around these days unfortunately.

[Greenfields]

Greenfields I can really relate to your "breakdown" and how you describe it, the same happened to me 3 years ago completely out of the blue! Well I remember feeling like I was running on empty just beforehand, it was Christmas and a busy time anyway. Then come January, it was a Friday and me and hubby had been arguing most of the day (via texts) that evening I broke down and started crying and then didn't stop for what felt like weeks! It was the most terrifying experience I have ever been through! All the feelings you describe I had too, I truly didn't know what was happening to me, I felt so scared and was convinced I was going insane, I kept thinking and saying they were gonna come and take me away to some sort of institution  it really was horrifying. In the following weeks I was put on quite a few different AD's (one at a time) but none really made me feel "normal" again so I went back to the one I was on previous to the breakdown (escitalopram) It still really scares me to this day and I don't think I've ever gotten over it, I think about it every single day and am convinced that something in me changed  I just can't forget how I felt and how scared I was, it's difficult to fathom if I still feel that way or if it's just memories?? Like a permanent flashback (if that makes sense)?? I had PND with my first daughter but this was/is on another level!
I'm currently on estrogen and testosterone implants with prog each month, not really working as well (see other posts)  I was on gels before and found they really did help! Sorry I can't really offer you any advice but just wanted to say I totally sympathise and hope you find something that works for you 

Thanks Estelle - it has been such a horrid experience and I do feel very traumatised by it.  I find it difficult sometimes not to replay what happened in my head - if I hadn't responded to the panic attack the way I did, I would not have cancelled the moving arrangements and I would be back in Canada by now with a masters place to look forward to in the Fall.  The job I did in the UK didn't help either - I worked for a very abusive boss and I think the stress levels from that abuse definitely impacted me - I sometimes find myself replaying incidents in my mind - altho' I try hard not to.  I'm hoping that seeing the therapist on June 8th will help me with this. More than anything, it's so hard getting mentally well when you're on your own - I'd give anything to be living with someone who could support me a bit more but I have to be my own main support at the moment altho' I do the best I can to get support in the community as well. I really want to get well again and feel the competent and up beat person I used to be. It would be lovely to be in a secure place with respect to my housing and work so that I don't have to worry about survival - it's at the back of my mind even though I try not to think about it.

[Greenfields]

Estelle you might also find it helpful to get some counselling as well - if you're able to access it.  I've found reading articles on nervous breakdowns has helped as well - I struggled to find some decent information but these links to articles on the Internet were helpful for me:

http://www.theguardian.com/theobserver/2000/sep/10/features.magazine37

http://www.independent.co.uk/life-style/health-and-families/features/nervous-breakdown-happy-survivors-1022919.html

http://www.huffingtonpost.co.uk/louise-gillett/recovering-from-a-nervous-breakdown_b_6742854.html

Jeanette Winterson also mentions her breakdown in an interview on menopause: http://www.theguardian.com/books/2014/apr/11/jeanette-winterson-can-you-stop-the-menopause

I've also read 2 books which gave me hope.  One is called The Centre Cannot Hold by Elyn Saks and the other is called The Last Asylum: A memoir of madness in our times by Barbara Taylor.  Both books I found very helpful - they are both academics who have had mental health issues.  Elyn Saks has done a TED talk as well which is really good to listen to.  Both authors had serious psychotic experiences but have lived very productive professional lives - altho' in both cases they were able to do so by being able to afford good psychoanalysis for years and years - which is, of course, expensive.  However, reading their stories helped me - it gives me hope that, at some point, I can become the competent professional person I was and aspire to live my life fully.  However, even if I don't fully recover, I am going to do the best I can to live my life well - although it would be nice to get a job to earn enough to take care of my basic needs for a while! (roof over my head and food and heat!).

[Chi chi]

I really feel for you, it was hard enough for me with my hubby and mum around to help I can only imagine how much harder if must be for you 
I've tried therapy, counselling, EMDR, you name it I've tried it  also read quite a bit which as you say does help, makes you realise your not the only one! Although Doesn't always work  when your in the thick of it.

Thanks for the links 

[Greenfields]

Greenfields. I went up too fast on the estrogen component. When I'm too high I get nausea, palpitations, anxiety/panic attacks, internal vibrations, hair loss, cold hands and feet ( sometimes cold everything), weeping, aching pain up the back of my legs and agitation. Like I've drunk 8 cups of coffee. I'd had these sensations before I even started on estrogen and had assumed they were symptoms of LOW estrogen...but nope. So in peri, on average, women have MORE estrogen than they did when they were younger, as well as more dips in estrogen ( faster and more precipitous drops). There's a lovely graph showing women's estrogen levels in early perimenopause....it looks like a bomb went off.

Our estrogen apparently starts dropping lower within a year or two of actual menopause.

So sometimes you may have too much estrogen causing one set of symptoms, and sometimes not enough causing another set. Add to that a whole different set for when estrogen is fluctuating. Good times right?

I wonder if slower and steadier is the way to go with estrogen. I'm on 12.5ug right now ( micro dose)...doing OK and got rid of all the symptoms of too high estrogen. Might need a touch more though as the low symptoms (vaginal dryness and hot flashes).

Dogdoc how do you know when the estrogen level should be changed?  Just curious - am going to ask my Dr next week.

I'm on Evorel 50 at the moment which the Dr described as a 'mid-level range' of estrogen.  According to the packet, these contain 3.2mg of estradiol and the absorption rate is approximately 50 micrograms of estradiol in 24 hours.

I was fine on it until I hit this second cycle - I've had awful nausea and anxiety in the mornings since starting my second cycle and the last couple of days I've felt a bit shaky too for a good chunk of the day - altho' I don't know how much of that is just emotionally dealing with a sense of a set back in my health - as I feel under pressure to get better due to my precarious living situation.  I was really enjoying a sense that I was getting better and better until recently.

The patches have stopped the night sweats and hot flashes which is really nice - and most nights I do get some sleep - my quality varies though but as my nervous system is still recovering from the breakdown it's hard to tell what's menopausal fluctuations and what's due to my nervous system.

[Penelope]

Hi Greenfields are you still with us on here?Or has your HRT kicked in and you are feeling really good.I read you're post this morning trying to find the answer to my anxiety 5 weeks in on HRT.
Did yours go away as you progressed on it?💖 It's the only thing I'm left to struggle with.