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[RachelMicheleRoss]

Hi, I am 52 and am going through perimenopause following a hysterectomy (with retained ovaries) last summer. It’s difficult to tell when my cycle would be as I don’t have a womb/bleeding, but I was having irregular periods before the operation.

Since last autumn I have noticed (and regularly recorded in my diary) a definite pattern of tension/anxiety building through the day and easing in early afternoon - so 11-3pm is my worst time, unfortunately when I was at work. I have no physical symptoms - just the psychological ones which are very similar to the pmt I used to have monthly.  I have since found many research articles online which state that oestrogen has a 24 hr cycle (like many hormones) and specifically peaks during the night - in fact it is a causative factor in sleeping patterns and poor sleep during menopause has been linked to lack of oestrogen.  I also developed a noticeable tendency to catastrophise about problems and get them out of all proportion - and ‘feel’ them far too intensely.

In the past month I have had an extreme version of this daily pattern (not every day but most days) with awful chest-clenching panic attacks during the day, making me call the samaritans a few times. These were triggered /exacerbated by a pretty bad relationship issue which arose a month ago - so are not all caused by hormones. However there has been a very noticeable pattern (recorded in my daily diary in detail) of sudden relief and a feeling almost of being drugged up and happy some days from between 4 and 9pm.  At times the awful situation I am in has seemed almost negligible and easy whilst under the influence of this flood of oestrogen!

In the autumn I got oestrogen gel from my gp, and during the past month I upped my dose from 2 to 4 pumps a day - with 2 am and 2 pm - in a desperate attempt to try and even out the daily ‘troughs’. This was with the support of a private menopause consultant (which I would recommend using if you can afford). She also suggested I switch to patches if this didn’t work - it didn’t, so I put on my first patch yesterday and felt a lot more stable (though I am on an increased mirtazapine dose too, which has probably helped).

I was wondering if anyone else has noticed this daily cycle in oestrogen /moods - as it surely can’t just be me affected this way? I have been reading a lot around menopause and listening to podcasts, etc. and I haven’t found any references to it so far.

Thanks for reading.

[Dawn3129]

I definitely notice the daily hormone cycle and its virtually tue same as you! Do you feel mirtazipine helps? My anxiety is heightened before my period too x

[RachelMicheleRoss]

The mirtazapine definitely helps me - I took it for a year 10 years ago when I was leaving my husband and I had some panic attacks. It really dampened down the heart palpitations and had no side effects for me except increased appetite / weight gain (which I needed at the time having lost weight/appetite).  I would only take it having first tried hrt though. And be careful with antidepressants - I was prescribed citalopram first and it really made me feel mad - really awful.  So drugs can affect people very differently.

[Penguin]

I am on hrt and have a similar pattern to you, by late pm, my anxiety peaks during the day from mid morning onwards and by the evening I am so much calmer.
I am confused re the peak overnight bit though, as I've always felt this is when my estrogen drops the lowest. Including physical changes like my breasts getting bigger after my morning estrogel, peaking throughout the day and then softening overnight until first thing in the morning. Maybe just me though amd perhaps I am too sensitive/ hypervigilent to the slightest changes due to my anxiety!

[RachelMicheleRoss]

Oestrogen makes you calm - its a feel good hormone - so maybe it’s more of a drop during the day (=more anxiety) and return to normal levels (low anxiety) over the evening/nighttime.  The breast tenderness happens when you are having more oestrogen - it’s like a mini version of what happens when you’re pregnant.  The 24 hr cycle in oestrogen is set out in a number of  medical research papers I’ve read online - search for circadian rhythms female hormones or similar. Interestingly oestrogen is thought to be part of the chemical mix which brings in sleep for humans each night - a bit like melatonin.

[Penguin]

Oestrogen makes you calm - its a feel good hormone - so maybe it’s more of a drop during the day (=more anxiety) and return to normal levels (low anxiety) over the evening/nighttime.  The breast tenderness happens when you are having more oestrogen - it’s like a mini version of what happens when you’re pregnant.  The 24 hr cycle in oestrogen is set out in a number of  medical research papers I’ve read online - search for circadian rhythms female hormones or similar. Interestingly oestrogen is thought to be part of the chemical mix which brings in sleep for humans each night - a bit like melatonin.

Oh so the breast tenderness (or rather sensations) correlate to putting the gel on in the morning, that's interesting. Then settles when levels are lower but normal later in the day. And then the nighttime problems happen if estrogen dips too low overnight, eg insomia, flashes etc.