HRT

Menopause and the Anxiety Loop

By Jennifer Upton

[This article is reprinted with permission from mySysters.]

Last month I was supposed to meet up with a friend for coffee.

She texted me at the last minute, “I can’t come out. I’m too anxious today. There’s just no way I can get on a crowded train.”

“No problem,” I said, “We’ll meet up when you’re feeling more social.”

We all have days like this. But they get more frequent as we journey through perimenopause and into menopause.

Menopause isn’t just physical!

IT’S IN YOUR HEAD

Changes in hormone levels can wreak havoc on mental health causing feelings of

* worry

* anxiety

* depression

* irritability

A study shows 58% of women aged 45–55 who were experiencing perimenopause had anxiety symptoms.

There are plenty of things to feel anxious about on a daily basis, but fluctuating hormones makes it worse.

“Did I lock the door when I left for work this morning?” becomes “I hope no one breaks in.”

“Why is the traffic so slow?” becomes “If I’m late, my boss will notice, and I won’t get that raise I wanted. If I don’t get the raise, I won’t be able to afford childcare anymore.”

“Will I be late for my doctor appointment?” becomes “I’ll have to re-schedule and ask for more time off work or arrange for child care again.”

“Did I send that email to my boss?” becomes, “If my co-worker beats me to it, then the boss will think I’m slow or forgetful. I’ll be replaced by someone younger.”

To make matters worse, going through perimenopause and menopause comes with new social stress.

Women who are going through menopause may encounter several physical changes that might have an impact on how they feel about themselves, their confidence, and their self-esteem.

Growing older in a culture that emphasizes youth can be quite discouraging.

Women in their mid-life frequently go through changes in self-worth and body image and might begin to reflect on their own mortality and ponder the significance or point of their existence.

Menopause can create an anxiety loop.

An anxiety loop is when we start to feel anxious about feeling anxious.

Our imagination is a wonderful tool that, when used wisely, can solve issues and inspire ingenuity to improve the world.

But when used incorrectly, it is so potent that it can conjure up situations in our minds that make us worry excessively.

This triggers our fight-or-flight reaction on a physical level, alerting the mind that a threat must be there right now.

Because of this, our mind becomes hypervigilant for danger and searches for a reason to justify the discomfort that our bodies are experiencing.

This in turn makes otherwise normal events seem threatening, which further arouses our overall fear and threat response.

And so, the anxiety loop escalates – feeding on itself like a faulty feedback mechanism.

Ways to manage menopause anxiety on your own

Breathe and count to 10!

Give yourself the time and space you need to work through what is a very stressful life change is crucial. It is a significant physical and psychological transition.

Give yourself time to wind down before bed to improve sleep

Exercise regularly even if it’s just a walk around the block

Be patient with yourself. If you don’t feel like meeting up for coffee, communicate how you’re feeling clearly to your friends and family. They can be a great source of support

Yoga

Meditation

If you’re having night sweats, keep the room cool

Listen to calming music (I like Dan Gibson’s Solitudes series)

Pamper yourself! Take a hot bath with scented candles or go to the salon or spa

Indulge in a bit of nostalgia

My favorite thing to do when I’m stressed is to watch an old movie I’ve seen before.

Rewatching movies can have a relaxing effect and can help with emotional management, according to researchers Cristel Russell and Sidney Levy.

Simply expressed, this means that since you already know the outcome, you already know how it will affect you emotionally.

Re-watching something might help you feel safe and in control of your emotions, which can be helpful if you're going through a stressful situation.

If some movies are associated with certain memories, movies can also make you feel nostalgic.

Perhaps you saw them as a child, and seeing them again as an adult allows you to reflect on earlier times.

Holiday films are particularly good for mental health, even in summer!

A recent study found that warmth and comfort are two physical manifestations of nostalgia.

What if I Need More Help?

If you’ve tried everything, but are still struggling, there are many options available for people experiencing anxiety.

Choose one of the many forms of talk therapy

CBT (Cognitive Behavior Therapy)

Talk to your GP about medication - you may have another form of anxiety exacerbated by perimenopause or menopause such as Generalized Anxiety Disorder.

Talk to your GP about HRT

Remember, the brain and body are continually communicating with one another through signals.

It's a feedback mechanism made to control our energy systems and adjust to any situation we may face.

So, take that day off and go to the spa.

Watch a movie when you get home and call your best friend.

Most of all, remember, there is no shame in asking for help!

[mySysters](https://apps.apple.com/app/id1196032521) is an app for women in **perimenopause** and **menopause**. Good Housekeeping and Woman’s Day named [mySysters](https://apps.apple.com/app/id1196032521) the **Best App for Women in Perimenopause** and a **Must Have App for Women**.

The information and other content provided in this blog, website or in any linked materials are not intended and should not be considered, or used as a substitute for, medical advice, diagnosis or treatment.

Jennifer Upton is an American (non-werewolf) writer/editor in London.

She currently works as a freelance ghostwriter of personal memoirs and writes for several blogs

on topics as diverse as film history, punk rock, women’s issues, and international politics.

For links to her work, please visit https://www.jennuptonwriter.com or send her a Tweet

@Jennxldn

For more information on menopause or perimenopause, visit mySysters.

Sources:

https://www.nhsinform.scot/healthy-living/womens-health/later-years-around-50-years-and-over/menopause-and-post-menopause-health/menopause-and-your-mental-wellbeing

https://www.menopause.org/for-women/menopauseflashes/menopause-symptoms-and-treatments/going-mad-in-perimenopause-signs-and-solutions

https://patient.info/mental-health/anxiety

https://patient.info/news-and-features/why-do-we-find-it-comforting-to-rewatch-our-favourite-movies

https://www.sciencedaily.com/releases/2012/12/121203082050.htm

https://rollercoaster.ie/occasions/christmas/so-it-turns-out-watching-christmas-films-is-good-for-your-health/

https://www.medicalnewstoday.com/articles/317552

https://www.nimh.nih.gov/health/topics/depression

https://welldoing.org/article/anxiety-loop-how-to-escape-it

https://www.mind.org.uk/information-support/drugs-and-treatments/talking-therapy-and-counselling/cognitive-behavioural-therapy-cbt/

https://www.nhs.uk/mental-health/talking-therapies-medicine-treatments/talking-therapies-and-counselling/types-of-talking-therapies/

https://www.nimh.nih.gov/health/topics/anxiety-disorders

WE WANT OUR HRT

By Jennifer Upton

[This article is reprinted with permission from mySysters.]

I started taking HRT almost a year ago. 

A combination of estrogen delivered via a transdermal patch and, for two weeks a month, a dose of progesterone

For the first 7 months, I had no problems filling my prescription. 

The 2022 shortage where British women were forced to ration and share prescriptions in the UK happened before I began treatment. 

Recently, things changed. 

My pharmacist called me with the dreaded news, “We don’t have those items and we aren’t sure when they will be back in stock.” 

When I asked why, there was silence. 

My life suddenly became a sequence of phone calls and googling every pharmacy within the greater London area to find the patches and tablets I so desperately needed. 

My fear of the return of night sweats and insomnia drove me. 

After the tenth phone call, I wondered if this was “drug-seeking” behavior.

 I went to the medicine cabinet and counted my remaining doses. 

The prospect of quitting cold turkey grew with every “out of stock” alert. 

Why take both estrogen and progesterone? 

Doctors commonly prescribe the combination of estrogen and progesterone to women experiencing symptoms of menopause and perimenopause who still have a womb. 

Taking estrogen on its own can cause a thickening of the lining or sometimes cancer. 

Progesterone helps prevent this. 

Progesterone is typically stopped within 5 years of starting HRT. 

Quitting HRT Cold Turkey

Many who suddenly quit HRT experience withdrawal. 

The symptoms are similar to perimenopause and menopause and can include: 

  • Temperature sensitivity

  • Hot flashes

  • Night sweats

  • Insomnia

  • Anxiety

  • Depression 

  • Irritability 

  • Fatigue

  • Difficulty concentrating

  • Headaches

I finally made the decision that many cannot afford.

 I found a private online pharmacy where I could fill both of my scripts for a grand total of £105 plus shipping.

 On the National Health Service, each medication normally costs £9.35 per item. I count myself among the lucky. 

As an American living in the UK, I’m in the unique position to have experienced two very different health care systems. 

One nationalized with many private options and one that operates entirely for profit. 

Neither system is perfect. 

Both currently have a problem serving those in perimenopause and menopause

The U.S. has no shortage of HRT, but the fact remains most women in the US will never have access to HRT for several reasons: 

Innovation can help fill the health care gap

Apps and blogs like mySysters give women a place to learn about what their bodies are going through and offer alternatives when they can’t get the treatments they need. 

If you are currently on HRT and can no longer afford it or find it in your area, consult your doctor about the best way to taper your doses to minimize your symptoms. 

What are the alternatives to HRT?

If you're unable to continue taking HRT or can’t start, there are alternative ways of controlling your menopausal symptoms.

Alternatives to HRT that may control symptoms include:

  • Regular exercise

  • A healthy diet 

  • Cut down on caffeine

  • Drink little or no alcohol

  • Cutting down on spicy foods,

  • Quit smoking

  • Tibolone – a drug that is comparable to combined hormone replacement therapy (oestrogen and progestogen), but may not be as successful and is only appropriate for women who last had a period more than a year ago.

  • Antidepressants – Although they can have unpleasant side effects including agitation and dizziness, some antidepressants can assist with hot flushes and nocturnal sweats.

  • Clonidine – a non-hormonal medicine that may help reduce hot flushes and night sweats in some women, although any benefits are likely to be small

Yet another issue to contend with is the tendency for the media to criticize “the commercialization” of menopause.

 Some argue this is the leading cause for the UK shortages, but research shows it’s a combination of demographics and ongoing supply chain challenges brought on by the Covid-19 pandemic.

 

If we want companies to come up with solutions for menopause symptoms, we need to stop complaining when companies create solutions for menopause symptoms that become popular to the point of shortage. 

America needs to make them available at a reasonable price as part of a national health care strategy.

 

The UK is making strides where the U.S. is failing on that point. 

Beginning in April, 2023, “women prescribed HRT - the primary treatment for menopause symptoms - will have access to a new scheme enabling access to a year’s worth of menopause prescription items for the cost of 2 single prescription charges (currently £18.70.)” 

Will this boost demand? Most likely. 

But, we’re still better off than in the States where we have not even discussed the possibility of such a program.

In the future, both countries will continue to struggle to keep up with the needs of increasing menopausal populations. 

It’s time to stop blaming the victims for falling for “commercialization” and step up our games. 

The information and other content provided in this blog, website or in any linked materials are not intended and should not be considered, or used as a substitute for, medical advice, diagnosis or treatment.

For more information on menopause or perimenopause, visit mySysters.


Jennifer Upton is an American (non-werewolf) writer/editor in London.

She currently works as a freelance ghostwriter of personal memoirs and writes for several blogs

on topics as diverse as film history, punk rock, women’s issues, and international politics.

For links to her work, please visit https://www.jennuptonwriter.com or send her a Tweet

@Jennxldn


Sources: 

https://medicalxpress.com/news/2012-05-counties-ob-gyn.html

https://menopausesupport.co.uk/?p=14434

https://www.nhs.uk/conditions/hormone-replacement-therapy-hrt/alternatives/

https://www.nhs.uk/mental-health/talking-therapies-medicine-treatments/medicines-and-psychiatry/antidepressants/overview/

https://www.menopause.org.au/hp/information-sheets/tibolone-as-menopausal-hormone-therapy

https://pubmed.ncbi.nlm.nih.gov/7145250/

https://www.gov.uk/government/news/hundreds-of-thousands-of-women-experiencing-menopause-symptoms-to-get-cheaper-hormone-replacement-therapy