I went to a psychiatrist today because I am just beyond tired of feeling cr*ppy. I have seen him before because I was having severe anxiety. It turned out, at that time, that I was experiencing horrible anxiety because of sleep deprivation due to severe sleep apnea. He put me on a small dosage of Klonopin at the time and I started on CPAP to treat the sleep apnea. I am now having severe mood swings and a low level of anxiety that is significantly more pronouced the week before my period and the week of. He had some interesting insight that I thought I would share with you ladies. He first said when he sees someone with severe anxiety that is not a result of stress in ones life he immediately considers sleep apnea and thyroid problems. If he rules both of those things out and his patient is a women in the peri years that is his third considertaion.

He said that he sees women EVERYDAY who are experiencing what we are. Women in their forties and early fifties who have no quality of life due to hormones being all wacky because of perimenopause. He said they all feel the same way. Anxiety to the point that they feel like they will snap at any second, nervousness, and internal shaking. He told me I had three options. I could stay on the course I am right now and just try to plow through this, I could go on HRT though there are risks, or I could go a on low dosage antidepressant that will take the edge of my anxiety. Those are the options. That's it.

He said women in this age group are experiencing the roughest times of their lives because hormones being all out of wack. Now, it appears many of you do not want to try an anti-anxiety drug or an anti-depressant, but I for one don't know why people who are so opposed to taking these drugs. If you had MS you would take the drug the doc recommended. If you had cancer you would follow your docs recommendation. Why should this be any different?? I for one am going to try the low dosage AD to see if it will improve my quality of life. He said I could just take it during the time of the month my symptoms were most pronounced and lay off of it the rest of the month.

I am not going to avoid a med if it will improve my quality of life. I will let you know how it works for me. I probaly hate taking meds more than all of you combined, but if it will improve my quality of life then I am going to step up and give it a try. We could all be in perimenopause for a long time and I for one want to feel good while I am doing it.

He doesn't see women who sail through peri without any bad symptoms, or those who find relief through herbs, diet, etc and don't see him because they've managed their symptoms without him. So there are three options from where he sits, but they aren't the only options.

It seems that what he left out is that there are risks with not taking hormones. There may be risks with taking natural hormones but I have seen my grandmother and mother and I know what is going to happen to me without hormones. I do not want to go there. The ADs may be great and help you feel better but your hormones will still be low. For me, low hormones mean loosing my teeth, having a hump on my back from osteoporosis, having a horribly dry vagina, loss of sensation and loss of pleasure with sex, saggy skin, poor muscle tone, fatigue, watching my body turn into my grandmother in a very short time. For you, loss of hormones may not lead to these same issues. Just watch for them though. It was horrible for me when my dentist told me that I had lost so much bone in my mouth that I was going to loose my teeth!

Kathy

Well, perhaps he doesn't, but I don't see to many women on this forum sailing through menopause in a "natural" way. If they were there would not be so much heartache on this forum. Eveyone would just be talking about the success they have had with herbs. Herbs, by the way, can be harmful as well. Now, the doctor did mention that there are women who try to go the natural route and end up in his office. Perhaps you are just stronger than the rest of us.

I was just sharing my experience. I knew someone would attack me because I was not going the natural route. Well, guess what, I have tried the natural route through a Wellness Center in Houston and the dumba** doctor almost killed me because he did not know I had sleep apnea. Did not even consider it.

So, I am glad that your herbs and exercise work for you, but they do not work for me and I suspect they don't work for most women because in reality if herbs worked we would not need drugs.

Hi ShakingInHouston,

I think your doc is basically correct. The women who sail through menopause or can get by with some herbs are not typically the ones experiencing the bad symptoms, so of course they would have no reason to see your doc. The question is really for those of us experiencing the bad symptoms. I have found herbs to have only subtle, if any, effects, not nearly what I have needed. Magnesium is the one thing that has really helped. Of course these are all trial and error and it can take a long time to find what helps.

Many of us have tried taking the "natural route" but have realized that some extra help is often needed. During my worst peri days, I used xanax for the horrible anxiety I experienced. That drug was a godsend. I am not one to want to be taking drugs either, but there comes a point where you have to decide if you want help. I knew that I had to get the anxiety under control in order to make progress with anything else. I no longer need any kind of drug, but I understand why any one of us would need an anti-anxiety or antidepressant for some time during this process. The other option of course is to try HRT, but no doubt about it, whether synthetic of bio-identical, the same risks exist. I simply asked myself that if I were to experience one of those potential side effects, would I still have been happy to have used the hormones? The answer was a clear no, so I decided that was not an option for me. I found xanax effective, allowing me to function, to work, etc., while also seeking out relief for some other symptoms. Some are afraid of the addictive nature of these types of drugs, but at low doses, which is really all you need, I experienced no issues.

Everybody will decide what is best for themselves. Some will choose meds, others HRT, others will fight it out with only herbs. I think sometimes on this forum people think that just because someone made a decision to go one way, that another way is wrong. None of it is wrong. Everyone makes the best decision for themselves and their situation and no one should be attacked for coming to their own conclusions.

Wishing you the best.

Houston - we have a problem Sorry, just needed to say that.

Anyway, "better living through chemistry" is my personal choice. The Prozac and the Levoxyl have made all the difference in the world. I tried the natural route. But like Pixie, I needed to get emotions, anxiety, depression under control.

We all do what we feel is right for us.

No wrong way - no right way.

That wasn't an attack, just an expanded perspective. It just looked strange that those were the only options he mentioned.



I'm just starting with peri and I have no idea if natural methods are going to work for me. If they don't, I'll be trying one of the three your doctor suggested.

I basically agree that everyone has to make this decision for themselves and I respect and honor that choice for each and every woman. But to answer the initial questions from the post for myself...

"but I for one don't know why people who are so opposed to taking these drugs. If you had MS you would take the drug the doc recommended. If you had cancer you would follow your docs recommendation. Why should this be any different?? I for one am going to try the low dosage AD to see if it will improve my quality of life. He said I could just take it during the time of the month my symptoms were most pronounced and lay off of it the rest of the month"

First of all, I agree with Kathy about the risks of NOT supplementing with hormones..I'm not opposed to taking AD's....but they're for SYMPTOMATIC relief..they will not address any underlying cause(s)..which may only worsen over time. Recent research has indicated that for AD's to work, there have to be a viable number of receptor sites (which are hormone receptor sites)..It may very well be that without..AD's will not work or eventually lose their ability to work. There is similar research regarding progesterone and GABA receptors. I also think that the risks of AD's and anti-anxiety meds need to be explained to any patient that receives them (and I don't just mean the pharmacy hand-outs).

I'm open to AD's/anti-anxiety meds ONLY after I've achieved measured optimal physiological levels of hormones (e.g., thyroid, estradiol, progesterone, cortisol which are all low for me; and testosterone, DHEAs which are all high).. Until then, I'll tough it out and/or add in some aminos/vitamins/herbs to get me through. These are things my body knows and recognizes. It doesn't make sense to me to take "Vitamin P" (Prozac), when my body needs estrogen or another hormone.

Just my thoughts on the matter for my OWN course and path.
Avi

Hi Avi,

Thanks for your post. I really enjoy reading your perspective. What concerns me is that so many doctors and the media seem to really push the risks for hormone treatment but they leave out what happens to women when they do not supplement their hormones. I am happy to treat my hormones and see my depression disappear so that I do not require ADs. Sometimes because I am in peri, I still struggle but I am learning what works and what does not.

Women and doctors say that they do not want women on estrogen. They fail to mention that even after menopause most women make a small amount of estrogen anyway. Also, many women gain weight so their fat can make even more estrogen (estrone which is supposed to be more dangerous than the estradiol that we supplement with). So these women who do not want any estrogen actually are making some of their own and are actually “on estrogen” whether they like it or not.

Their dose is wrong though. (IMHO)

The amount of estrogen that is supplemented by estradiol is just a small amount (if you are doing regular replacement and not something like Wiley). The amount that I am taking is only supposed to increase my estrogen by 40 points. So now my estrogen with supplementation is up to about 88 points. I think that number is really low when you consider that younger women’s estrogen spikes up in the 500-600s around ovulation and tends to run around 200 except during menstruation. I just do not understand why raising our estrogen just a small amount compared to what younger women run is so controversial. I know that adding estrogen can cause endometrial buildup so we need to take progesterone but that is the main down side that I have found. I have not been convinced by the media and the current studies that I am taking a bigger risk by supplementing than I am by letting nature run it’s course. I think I am lucky to have a picture of what will happen to me without supplementation. I cannot be in denial about what nature is going to do to me because I have seen it for my own eyes and it is extremely disturbing. I want to have quality of life for my remaining years; if I go the natural route my quality of life will shrink just like my height will.

Kathy

Kathy:
I couldn't agree more..I think we all need to make our choices, but they need to be well informed ones. I've learned the hard way that I have to take my health into my own hands. Doctors are advisers not supervisors and ultimately what is going to be is up to me.
I've learned so much about hormones from reading the Vliet books, also Klaiber and a new book (forget authors) called "Estrogen and Depression", which is primarily a compilation of study reviews.
Sometime this weekend, I'll PM you about Vliet..I wanted to talk to you more about progesterone.
Later,
Avi

Hi,

Kathy and Avi's posts are right on.

As a person with long-standing depression and anxiety issues, it has been my experience that most psychiatrists have no clue about hormones and do not really know how or why antidepressants work. In most health fields, one will have a test to indicate whether there is something awry and then, if warranted, will receive a medication or other remedy to address the problem.

In psychiatry there are no tests--only clinical symptoms which can be the result of any number of issues.

Last February, my psychiatrist advised me to stop hrt because of the progestin side effects. After doing this, I experienced the worst mental and physical effects--suicidal depression, palpitations, internal tremors, sexual dysfunction, vaginal dryness, hot flashes, crying jags, brain fog, etc. (pretty much almost all of the 34 symptoms listed on PS). I resumed hrt but am still trying to get back to where I was before this ignorant professional gave me his advice.

I have an older sister who takes antidepressants and has never used hrt--only vaginal estrace. She has osteoporosis, periodontal disease, high cholesterol, and other issues.

I would suggest that people do their homework before embarking on a course of action. Remember that you are your own best advocate. Don't rey on someone else to know what's best for you.

Colleen

Wouldn't it be great if it were possible to find and have doctors who could present us with all the pros and cons, totally objectively, and give each of us individual advice as to what would really be best for us and our bodies? Unfortunately, doctors are either on one side of the fence or the other, so they are biased by their own subjective opinions. I would like it if menopause clinics would pop up all over the country to serve women going through this time of life. They would understand all the symptoms that have been talked about on this site and they would understand and communicate the full range of options to deal with them. They would support us as we tried various options until we each found our own balance that allowed us to get through this without the trauma that so many of us are experiencing. We would have a support system that would be there for us, doctors to see regularly, phone support if needed, etc. We would feel understood and supported.

Sounds like a pipe dream, but it should be our reality in this day and age.

I agree with your dr and had the same response from my gyno back in 2005. She said: it is swinging hormones, and there are options to either suffer, or take HRT, which will add to existing swings( she qas right, tried BHRT and it made me a huge mess and anxiety central) or try tranquilizers or antidepressants, to survive through the transition. So, I did and now I have some of my life back. Anxiety is still there, premenstrually and midcycle, but at least, I can sleep thorugh the night, drive, work, exercise and looking forward to my. I am not saying it is an answer to all issues, but I being a pill-phobic myself, wonder, why women are so reluctant to try AD or tranquilizers. Many won't think twice to start calcium channel blockers and beta-blockers, that can do much more harm than tranquilizers. But they will be surprised to know that getting your autonomic system back in normal state will resolve heart palpitation, high BP, and other scary symptoms and help to avoid quite dangerous beta blockers and similar medications. Most of the problem are dye to lack of sleep and swinging hormones that cause over stimulation of our autonomic system, that in turn causes high BP, heart palps, etc/
Of course, none of the medications is without risks but somehow we have to get to the other side of the hill, so I have chosen tranquilizer (not AD). I also changed my mentality regarding medications, after all I am not getting younger, so might as well get used to the idea of needed medication one day.
JMO.