Recently I started to get a scary breathing disorder during strenuous biking. My throat would constrict, with my vocal cords tightening up to the point of loud wheezing on both the in and the out breath. The second time this happened, I paid close attention. I'd been thinking about something that upset me, felt like crying (which happens a lot these days -- this is my year for discovering all the classic peri symptoms!), and the sob in my throat turned into a severe vocal constriction lasting for about 30 seconds.

I promptly went and read up on asthma and learned that it can have its onset during perimenopause, but this just didn't seem like asthma, nor did it have the hallmarks of a panic attack. Not having a name for this problem, I went through a lot of web searching before I found one. I haven't consulted my doctor yet (my next checkup is in a couple of weeks and I'll bring it up then) but I believe I have a handle on what's going on.

The most common term for this condition seems to be vocal cord dysfunction (VCD) and it goes by dozens of other names including laryngospasm, paradoxical vocal cord motion, and irritable larynx syndrome. Wheezing in the vocal cords is called stridor, and I found lots of hits on "exercise-induced stridor" and "psychogenic stridor" (that is, triggered by emotional stress). The combination of exercise and emotional stress makes this a prevalent condition in competitive athletes, especially adolescent females, so a lot of the literature comes out of sports medicine and pediatrics. It's often misdiagnosed as asthma, leading to a lot of unnecessary medication when the correct remedy is speech therapy and/or psychotherapy. For an article on VCD in young athletes see http://www.usatoday.com/sports/2007-01-25-...sfunction_x.htm

Is there a connection between VCD and perimenopause, or is my onset of VCD a coincidence? Nothing I found on the web suggests a connection, so this is purely my own speculation. The above article gives the profile of the VCD sufferer as "a young woman striving for a high level of achievement." Boy, does that ring a bell: I may not be so young but I'm going through a hormonal upheaval as massive as a teenager's, and as a lifelong cyclist I'm striving desperately to retain some of my physical fitness, which has taken an upsetting nose-dive this year despite all of my efforts. I'm reminded vividly of the stress of being the slowest kid in gym class; that was not fun.

I can think of another possible connection. Any singing coach (or opera fan) knows, and probably a lot of you have found out, that the menopausal transition affects the vocal apparatus, causing dryness, muscle atrophy, and decreased flexibility of the vocal mechanism. Maybe these changes could make VCD more likely?

It's also commonly linked to GERD, which I see is a big issue for many of you and is occasionally an issue for me too.

Here are some more technical articles on VCD that I found useful:

http://cantbreathesuspectvcd.com/
http://www.chestnet.org/education/online/p..._27/print26.php
http://www.psychiatrist.com/pcc/pccpdf/v01n02/v01n0203.pdf (which mentions that in the nineteenth century VCD was recognized in women and called "hysterical croup" -- we've come a long way!)

Thanks to Sue LI whose post on laryngospasm filled in a missing link in my search (http://www.power-surge.com/php/forums/inde...showtopic=18547).

I've started to address the mood swings through nutrition, and I'm also learning to accept that I can't ride my bike as strenuously as I used to, and haven't had any attacks in a couple of weeks. The main thing is that I'm happy to have found a name for what I've been experiencing. I'm also thankful that I didn't pursue testing or treatment for asthma (which had been my first impulse and could easily have been my doctor's as well).

Has anyone else experienced VCD (or are now thinking you may have experienced it)?

Val

Hi vhm,

Thank-you very much indeed for this research. I truly think that it hits the nail on the head for some of the symptoms I suffered at the cusp of menopause. I suffered very badly from a weird hoarseness that present vaguely like asthma. A sort of wheezing tightness which seemed to come out of nowhere but was nontheless disconcerting. I believe that these episodes were interconnected with vaso motor iregularities and hot flashes. At one stage I thought it was allergy and then I started blaming my thyroid. Whatever the cause it certainly did exist and caused me to feel anxious.

To be fair, I think that you will find that the average doctor will be absolutely clueless on this one. Menopause is the real Cinderella of healthcare and issues like this are left for dead so no progress on their actual cause is made.
I am a realist and understand that most of the symptoms of menopause are pretty 'untreatable' safely but it would help to have reassurance when weird symptpms like this appear.

The good news is that I am approaching 3 years post and all those kind of symptoms are improving markedly. I think that you will need to go easy on yourself for as long as these symptoms exist and I do believe that you will be able to get back to your cycling afterwards.


XIII

Great research and very interesting. But, good luck getting a doc to acknowledge that this is peri related....

You mentioned singing and opera. Many sopranos retire around the average age of menopause due to not being able to hit the high notes. One article I read referred to meno as the "twilight of the sopranos." I don't sing but have found that my voice has deepened over the last 2 1/2 years of peri.

Good luck with the cycling. My own running took a bit of a dive when all this peri stuff slammed into me. Getting back on track, but with the help of hrt. Best Regards to you, JZZ