Tuesday, February 1, 2011
Blaaaahhhh. Aging. Menopause. Warning: Probably TMI
I can't really share about my life without honestly sharing about a major frustration I've been dealing with. I apologize in advance for the long story, but I want to keep this to one post and return to subjects of a more upbeat nature!
I had 3 miscarriages at age 41 - 42, and that began my mostly-hate relationship with hormones. After each of the 3 times, I had periods of anxiety for about 6 months that coincided with menstrual cycles. It was really the first time in my life I'd had bothersome PMS or mood swings. In the worst of the anxiety, my body would feel edgy, nervous, anxious, even though my thoughts weren't. My medical doctors weren't much help, and dismissed the idea of hormone imbalance. They wanted to tell me I had too many kids and was stressed out because of it. I knew it was hormone-related...after all, I'd been pregnant or nursing for 14 years, then had a pregnancy suddenly end at 3 months in...All the hormones my body was comfortably used to had fallen to comparatively nil, and they couldn't accept this might affect my well-being? I was grateful to have a friend in our Bible study who'd been through post-partum depression and recognized the similar symptoms, and helped me know my assessment of my own body wasn't 'crazy.'
Those problems evened out and got better over time, even though I continued to have the lesser PMS issues. When I got pregnant with Prince CuddleBunny, had a normal pregnancy followed by breastfeeding, my body was much happier for a time.
Gradually the hormone swings with my monthly cycles became problematic again, mostly manifesting itself with heart palpitations (PVCs, which are benign, but not fun anyway), occasional migraines, poor sleep quality, and the anxiety. I wasn't fearful of anything but the feelings of anxiety, which were edginess, fatigue, and the highly dreaded nausea.
I started a lot of research and reading on my own, which helped me find that many, many women go through these types of symptoms during Perimenopause. So why weren't we hearing about it? I'd never heard of perimenopause throughout my life, only menopause, and the only symptoms I'd ever heard about were irritability and hot flashes, which I wasn't having. I also started seeing a naturopath, who understood why I'd be having hormone imbalance and helped me via diet, supplements, and some herbal support.
This approach was helpful, and I believe has made me a healthier person, but didn't stop all the hormone issues. My daughters took me to Urgent Care one night with an anxiety attack when my heart rate was 120 for nearly 2 hours, and I was unbearably nauseous. (I admit that it doesn't take much for me to consider it unbearable!) I came away from there with a prescription for alprazolam (Xanax). I chose to be very cautious of a drug that could become addictive, and took only 1/2 tablet, as needed for particularly bad anxiety attacks, so the 4-day supply lasted me over 14 months. When breathing, walking, distraction, or other skills I'd learned didn't help, the small dose of alprazolam seemed to quiet the worst of it.
As my cycles became less regular (some 26 days, others 90+ days apart), even though infrequent, the episodes of anxiety were harder to predict, explain, and deal with, and I didn't want to resort to more use of the Xanax. I spoke to my naturopath and we discussed bio-identical hormone therapy.
He didn't take any blood tests first, which made me a little uneasy, but prescribed a low dose, 'average' combination of hormones. 4 weeks later I started a period that lasted 3 weeks, and was having anxiety problems, so he took me off the HRT. He felt that his only other answer was to advise therapy combined with anti-depressants.
I started the therapy, but not the anti-depressants. The therapist and I both feel my symptoms and their timing support the idea that the anxiety is hormone prompted, and don't feel that daily brain-altering drugs are the best approach for an occasional problem. However, I knew that with my particular personality, and with the concerns I'd developed through this journey, I was likely contributing to the problems by panicking at the onset of any symptoms. I wanted to identify ways in which I could help, rather than make things worse. As a Christian, she's not only helped me with tips to help myself physically and deal with the brain and body things that happen in anxiety, but has reminded me to give my days and my fears to God in prayer, the biggest Help.
My next step was to search out a care provider more specifically knowledgeable about hormone balance and menopausal issues. This woman took one look at the oral HRT I'd taken and said she believed it was too high in progesterone for a woman nearing menopause, but wanted to take blood tests before guessing at what I might need instead.
She recommended a hormone patch, supposedly in hormone amounts more appropriate for my time of life...Then said it would help my hot flashes and headaches, which weren't my concerns, so it made me wonder about how well she'd heard me. (She also always seemed in a hurry, which bothered me, too.) She said the patches shouldn't alter my periods, and they should go back to becoming lighter and further apart. I gave them a try.
9 days after starting the patch, I had a week of a light period. After only a 1-week break, though, I started another period that lasted 3 weeks, heavy, then light, then heavy again. So I've been having a period for 4 of the last 5 weeks, and have had terrible sleep the whole time. Today (Monday) the period seems to have stopped, but I awoke exhausted (unfortunately not unusual for me), and the anxiety started up. Gaaaah! I have an appointment with a new doctor in the afternoon. She's supposed to be good listener and very thorough. We'll see what happens from here.
I can tell something is 'off.' Can't someone just figure out what it is?! And a good night's sleep...or 20... would be NICE.
After the appointment: The new doc says that with my symptoms, I actually need MORE progesterone than either of the doctors gave me before. Confusing. But she was really listening and trying to address my specific complaints, especially the sleep needs. I am to return in 2 weeks to report on how I'm doing, get a new blood test, and she'll adjust from there. She had a few ideas, so I have a little more confidence I may eventually get some relief.