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.


  1. There's a thread going on right now on GW on the Home Dec forum over on the Conversations side about perimenopause. I've been having a terrible time with hot flashing lately. I've been in perimenopause for the last year(which is way early, but my mom went through it early, too,) and it's been a bear this last month. My cycle's been all over the place. Anywhere from 30 days to 49 days. My doc doesn't seem to be at all concerned. Maybe I need to go doc hunting.

  2. I might check out that thread. As I understand it, perimenopause can start in the early to mid 30s. Maybe your dr isn't concerned, because it's just a fact of life. If you are uncomfortable, though, or your life is disrupted, there are definitely things you can try for relief. I am happy I started with a naturopath for the milder stuff, but now need a little more expertise. I should be close to full menopause, so am glad that HRT won't have to be used for too long...I hope.

  3. It gets better gals! I have been post menopausal for 12 years. I still have hot flashes. Bill read that women who are plagued by hot flashes have a 50% lower incidence of breast cancer. A trade off I'll take.

    Rhome, I am so sorry about your miscarriages. I lost a twin at 35 weeks. Would have lost both but for ultrasound and emergency c-section. I would have enjoyed more children. I am so happy with the one we have.

  4. I'm sorry about your precious twin, Cotehele. But happy for you that they were able to save the other! I knew a woman who was being pushed into having a D&C for a 'obvious' miscarriage, but insisted on an ultrasound first, and saved a twin that way.

  5. I don't know if I'm perimenopausal (I'm at the right age), but the past couple of years, I've suddenly started having anxiety attacks. So yes, it stinks. I'll be following to see if your doctor has any suggestions. Laxsupermom, hot flashes sound miserable!

    Cotehele and RHome, so sorry for your losses. I can't imagine the pain of losing a child at 35 weeks. I've had three very early miscarriages (battled infertility for years). I don't think our culture knows how to acknowledge those kinds of losses.

  6. I have WAAY too much experience with anxiety attacks, so if I can help at all... It can be a combination of hormone shifts and life. But if they relate at all to certain times of the cycle (even if they're times you didn't know were a big deal in the monthly ups and downs), or like many of mine, seem to be related to nothing in my life, they're likely hormone triggered.

    I, too, can't imagine getting that far into a pregnancy and losing a baby. My miscarriages were at 12, 9, and 7 weeks. People don't understand that no matter how early, you already have big dreams and plans concerning this particular child...No other can replace him/her, no matter how many you have at home. I can only imagine that after you've gotten to know the baby through their movements, etc., that it is even tougher.

    It took me a year to get pregnant the first time, and several months to get pregnant with #3. So it took me awhile to get past feeling like it wasn't 'easy' for me to get pregnant! Made me appreciate the miracle each time even more, I guess. I never got to needing fertility treatments (except for an endometrial biopsy and subsequent progesterone prescription after the miscarriages), so can't imagine what that stress is like either, Gena.

  7. Ladies, it matters not how far along the pregnancy is. It is always an emotional catastrophe to loose an baby. My heart goes out to you.

    Gena, infertility is so hard to deal with. We were married 13 years before becoming pregnant. It's common to adopt, then get pregnant. Our variation was get a dog. I was pregnant the next month. :-)

  8. An emailed comment from JC:

    "Rhome, I think you're doing a service to talk about this kind of stuff.
    There's a lot of blather by "experts" out there, but very little about
    what real people go through. I had a terrible time before menarche, but
    so far the perimenopause has been pretty mild.

    Have you had your thyroid checked? Another hormone thing, but sleep
    disruption and insomnia can be symptoms of low thyroid.


  9. Thanks, JC. We did seem to go from no information about such things, to all sorts of information from people we don't know if we can trust.

    I had 'thyroiditis' several years ago, in which my thyroid got a virus or something in it...Went from dumping thyroid hormone into my system, so was 'hyper' for awhile, then it almost shut down...and finally evened out, leaving me 'hypo'. So I've been on thyroid medication since...and recent TSH and Free T4 levels seem to be good.

  10. I'm a former GW kitchen poster and have been following your blog since shortly after you started it.

    I had a hysterectomy at age 39 and thus no period to gauge my cycle. Not too long after that, I had just the very rare anxiety attack, most of them occurring at night when in bed. Rationally, I knew I was physically okay, but I could have sworn I was having a heart attack and was going to die. By the time I hit age 42, I was having more frequent full-fledged anxiety attacks. Again, with no period to gauge my cycle, I couldn't link the attacks to anything. I did have a few attacks at predictably stressful times (hubby in the hospital for surgery, etc.) I did finally have to go the Xanax route for a short time, and, like you, I chose to cut the tablets in half.

    About a year and a half ago, I started with the hot flashes.

    I'm now 45 (and a half!) and the anxiety attacks have really settled down. I will occasionally get a mild anxiety attack at night, but breathing and meditation seem to help enough for me to head off to sleep. The hot flashes have subsided as well. I'm feeling much, much better in general. RHome: I totally appreciate the sleep issue. When visiting both my MD and my acupuncturist, that was my primary compliant: Please help me get a good night's sleep! I'm now sleeping soundly the vast majority of nights :-)

    I've thought about seeing a naturopath, but cash flow is a bit tight. I did see an acupuncturist for both the anxiety and the hot flashes. Acupuncture helped for a short time with the anxiety, but I do believe it helped longer with the hot flashes.

    My heart goes out to those of you who have lost babies and those who have been thus far unable to have babies. I believe it is incredibly difficult regardless of when it happens.

    Thank you for opening up about this. When I was dealing with it, there was really no information out there, no frank discussions, and the information I could find was a bit on the questionable side.

  11. Sorry it took me awhile to see your comment, Mandie...I usually get email notices of new comments, but I didn't get one for yours.

    It's a wild time, right? And different for everyone, which I understand is a bit tough for docs, but harder for us! Thankfully, our insurance covers the naturopath like any other doctor. There were times, though, when I wanted to take him by the collar and shake him, yelling, "Get me some sleep!!!" I only sound crazy to these people (or they treat me like I am) when I want tests for everything, because something is out of whack and I want them to test til they find it and FIX it. Sometimes I feel like they give up after the most basic tests and tell me I should feel fine, and if not, time for anti-depressants.
    I'm glad to hear your experiences with these things are getting fewer and milder!

  12. Thank you for sharing your personal experience with such an intimate matter, RHome. I would guess that more women than not have issues of this type.

    I was never pregnant but went through some high doses of fertility drugs so I'm thinking I'm in for a wild ride; in fact, I think I am already there, but as you experienced, I also have doctors who tend to be dismissive. I can't help but wonder if they are insurance and drug-company driven in everything they see and do. I can thank the Lord I've never had a serious medical issue, but if I had, or ever do, I am not sure I will trust that large Duke-based group, as nice as they are.

    Just to clarify, not to argue but it's a common misconception -- only about 5% of women who adopt then become pregnant (when they continue to try); it's just that we hear about those stories much more commonly than those who only adopt, because they make great stories and are true miracles.

    Thank you for being so open and honest for the benefit of others.


Related Posts Plugin for WordPress, Blogger...