Speaking of dreams, last night I dreamed I accidentally went to work, and had worked for awhile before I remembered I wasn’t supposed to be there. So then I kept trying to leave before I got caught, but kept getting stopped: patron needing help, coworker wanting to talk to me, etc. It ended with my supervisor accusing me of doing it on purpose, and me getting very angry about the accusations—and then I woke up.
One of our cats has been hiding under our bed, which is not typical. Also, he is a boy who likes his chow, and he has not been showing up at meal times. After two days of this, this morning I took him to the vet, and she says his vitals are good and she suspects pancreatitis, which cats can get for a number of reasons, and doesn’t have to be a big deal, especially in a young and otherwise healthy cat. She gave him fluids and a couple of shots (anti-nauseant, anti-inflammatory, vitamin B-complex), and says that if he’s not better by Friday morning she wants to see him again, but that she suspects he’s going to be just fine.
But what I wanted to talk about was that when I called to make the appointment, I started crying on the phone. I was not particularly stressed or upset about the cat; I wanted to take him to the vet, yes, but he DID seem basically okay. The crying started as soon as the nice receptionist asked what was going on with him and I started trying to tell her—which of course initially made her think the situation was much worse than it was. It was embarrassing, and also frustrating.
I feel like perimenopause is really kicking my ass, emotional-regulation-wise. I have long had an issue with choking up when I am trying to talk about anything stressful or even just dramatic, but this is significantly worse than it was. Even with my phone issues, I used to be able to make appointments even for worryingly-sick CHILDREN without choking up. Now my voice starts shaking much earlier and much more easily and for much less reason, and turns to crying much sooner. I also get angry much more quickly and much more severely (e.g., going right to thinking “WE ARE GOING TO HAVE TO GET A DIVORCE!!”). Afterward I will be a little amazed, remembering how mad I got over something relatively minor, and feeling grateful I didn’t do anything rash (e.g., actually saying out loud “WE ARE GOING TO HAVE TO GET A DIVORCE!!”).
I am wondering if hormone replacement therapy would help. It feels like such a huge hurdle, though: I have to find a doctor who doesn’t still believe that debunked study from around 2000, and then I have to find out if they’re covered by my insurance, and then I have to make an appointment, and then I will very likely have to make half a dozen phone calls to straighten out the insurance, and UG.
Actually it doesn’t look all that terrible when I write it out (except for the insurance part, and that might not happen). I have a tab open for finding a menopause-certified doctor, and there are a few within reasonable distance. Probably they take my insurance, which is one of the most common ones. I don’t have a work schedule to work around, so figuring out an appointment time won’t be too difficult. And maybe it will go just fine! Maybe I will like the doctor and they will know just what to do, and the hormones will work, and there will not be too many negative side effects, and I will feel so much better!
Have you dabbled in hormones for perimenopause? WAS it a hurdle? DO you feel so much better? WERE there side effects?
I have always been a crier and an overemoter and the last several years have indeed been worse. One thing that helps me when I am choking up is to smile and to take a deep breath. It helps re-set me a little bit. Best of luck with the hormone replacement therapy jeez I – well I was going to say I don’t know why it has to be so difficult, but I really do know why. #patricarchy
I have ALSO always been a crier, but with peri I’m also NEWLY an OVERLAUGHER. Like something strikes me as funny and I’m laughing louder and longer.
Bodies are strange.
If you are still having cycles a very good option for Peri going on continuous homornal birth control. I just started this three months ago and it has been an absolute dream for my emotions. I did have a lot of annoying spotting and breakthrough bleeding the first two months. Dr. Gunter of vajenda.substack.com recommends this too, she says often HRT isn’t a low enough dose to calm the hormonal chaos of perimenopause. Good luck, finding a doctor and figuring out a right for you treatment is hard!
I just went through this process in January and had many of the same fears. In fact, the process was very easy and I got zero pushback from the doctor. I would say, however, that the doc is unlikely to *tell* you it’s the right choice. I think it’s better if you describe your symptoms and tell them you would like to try HRT if that’s your preference. I think it was hard for me to understand that there isn’t a test that will say definitively it’s time. You have to make that determination for yourself. I had no insurance issues and I did have to titrate up once from the lowest dose but at that point I noticed a big improvement in the night sweats and disproportionate irritation. Plus I just kinda feel more like myself. Just go in with the confidence and entitlement of a white man and it’ll go great. 😆
This is a good comment.
Be skeptical about people peddling ‘hormone tests’ and special diets/supplements/yada-yada. Lots of unregulated people trying to make money out of perimenopause these days.
If the symptoms are bugging you sufficiently, then I agree with Jaida that you need to just describe the symptoms and ask to start. A good doctor will take a thorough enough history so that they can help you ascertain the risks/benefits of different regimens and advise accordingly. Good luck!!
The purpose of hormone therapy is to treat the symptoms of menopause/peri-menopause! There is no ‘test’ to determine that you need a hormone therapy, but rather its to help you feel better. Beth is right that there are a lot of snake oil sellers for various tests and supplements. I’ve been there with ya, Swistle, on the wild emotional swings. It gets better after a bit on the other side of menopause.
I would start with your regular OBGYN doctor before searching for someone new.
Yes was going to say this. I was having some very odd symptoms, told my OBGYN (who is a midwife). She was worried enough to run the labs. That’s the starting point. My estrogen is way off. Now we’re titrating some medications trying to get it right.
Totally hear you on the extra crying, and peri is also giving me extra-heavy periods, which I loathe. I’m on the progesterone-only mini-pill for now, and I got it through my regular OBGYN.
That plus acupuncture are helping me tremendously with both issues… I think. Or else just FEELING like I am DOING SOMETHING is what’s helping? But either way, it’s better!
Yes, HRT can definitely help you with that. I’ve been on it over a year and it’s been such a relief. I remember thinking in certain moments, “What I should be feeling right now is mild annoyance, but what I am instead feeling is BLIND RAGE.” That plus horrible painful acne, insomnia, and a bunch of other symptoms I can no longer recall off the top of my head, thank god. No side effects, just a months-long ramp up to get to your optimal levels and you’re feeling good. I highly recommend Midi Health. 100% virtual, they take your insurance, and this is what they do, so there’s no worry about trying to find a doctor who believes you or will prescribe you HRT. I’m so happy a friend told me about them or I would probably still be suffering without really understanding why. Not an ad! Lol. Although reading it back it kind of sounds like one. I’m just so happy not to be feeling that way anymore (and probably my husband is too.)
My mom had similar mood swings with peri-menopause but this was years ago and I don’t think there was treatment. The anger over things that she would have been calm about before was surprising to us, the kids! I have not quite reached that stage but I think it’s not too far off. I think my PCP would handle it (I hope) since I don’t have an OBGYN.
I did the same crying thing as a hormonal teen so this is a reminder to myself not to be surprised if that happens again.
HRT helped me TREMENDOUSLY with the mood swings I was having. Something very minor would happen, that even in the moment I knew was minor, and yet the absolute RAGE that would go through me, phew. I am on the progesterone pills and estrogen patches. There are some supply chain issues getting the estrogen, since apparently demand is up from that study being debunked (though that should mean you’re likely to be able to get it prescribed, right?), but so far I have been able to get it and it’s worth it to me. I hope you’ll be able to find something that helps.
HRT has made my life so very much better. I just feel like my normal self again, I will never stop taking it. Really just so so good. I even read that not only is it not dangerous, it can help us avoid problems like osteoporosis and other things. I wish I had done it in my late 40s (apparently it helps with those things more if you start sooner) than waiting until 52. Highly highly recommend. I have heard that Midi Health is a great way to get it. I live outside the US so it doesn’t apply but I have met the founder of that company plus sent friends there and they all say it’s great. Online consult and covered by most insurance.
As always, these comments are so helpful and interesting! I’m 49 and started experiencing a lot of what you’re describing last year, especially the crying and also horrible, crippling anxiety. My only child was graduating high school and heading to college out-of-state, so I spent a long time convincing myself it was just normal “big transition” blues. But then I’d find myself tearfully wailing to my poor husband, “Nothing is actually wrong! She’s graduating with honors and going to a great school, but I feel like this is the worst thing in the world.” But then I realized – I felt exactly like I did right after giving birth, when I had a wicked case of postpartum anxiety. Looking back, it was definitely hormonal changes tied to perimenopause. But since Zoloft had worked well for me postpartum, I decided to try it again. It’s been an absolute miracle. I haven’t felt this emotionally stable in years, maybe even ever! It’s been about a year now, and it’s still working perfectly at the same dose I started with.
The comments are making me wonder if HRT might be effective too, but for now I’m sticking with the “if it ain’t broke, don’t fix it” mentality. Regardless of what you choose to try, I gently encourage you to choose something. I let it go on way to long because the anxiety was making it hard to take the necessary steps and I wish I had taken action sooner.
I have been very pleased with an estrogen patch & progesterone pills; I’m 53 and started last year. I haven’t found doctors to be against it any more? I’ve dealt with a nurse midwife (gives annual exams etc), an internal med doctor and an OBGYN who is a menopause specialist. All 3 were perfectly in favor when I described my symptoms (some difficult sleeping, some night sweats, some irritability, some weight gain). The OBGYN is the prescribing doctor.
I had hormone positive breast cancer, so obviously I can not take any hormones whatsoever. I’m also on a medication to reduce the risk of recurrence to almost nothing (yay!) with the side effect of launching me in to estrogen zero menopause (worth it, but not so yay). My amazing gynecologist told me to try Amberen. It’s a non-prescription supplement available on Amazon, but unlike so many of those it has been studied and is safe for patients for whom hormones are contraindicated and effective. I used them during the tough transition time, when I wasn’t sleeping and was basically PMSing at all times. I was lucky and my system settled out and I stopped using them. But, I recommended them to a friend who was also a breast cancer patient but with awful menopause symptoms. (Her doctors, even her gynecologist, offered nothing.) She regularly tells me how life changing it was, and she still takes them. So, if for whatever reason, HRT doesn’t work out, maybe try that. It’s literally an Amazon order
Thank you for the Amberen req. Since google reports they’ve done clinical trials I looked them up on clinical trials dot gov. The only investigator listed for the 2 Amberen studies I found is in Moscow. Also, peri-menopause is medically termed Climacteric Syndrome. I don’t know what that means clinically but thought it was interesting :)
I also had estrogen positive breast cancer. I had been on HRT for 15+ years at that point but now I’m on an estrogen suppressing medication. My main problem after stopping the HRT was hot flashes. I was having intense episodes 5-15 times a day! My oncologist suggested taking 400iU of vitamin E daily, and let me tell you that has been life changing. She did say it doesn’t work for everyone and it does take a month or two to really kick in. I do still have a couple of hot flashes a week, but they’re mild. I hope this helps someone
I’ve been on estrogel/estradiol gel for about 2 months. I still have a Mirena IUD which is probably doing something as well. Have noticed a gradual improvement in temper – my god my teenagers could drive me into a titanic rage. I still lose my temper when they’re being particularly obnoxious, but I feel like it takes longer to get to that point and it’s less frequent and it’s less overwhelming. I still have anxiety so I am working on trying to notice and talk about when I’m being unreasonably anxious. Sleep has gotten more reliable too. Hoping that improvements continue and glad to be on it!
Ohhh thank you thank you thank you for ringing in! I have a Mirena too, and an appt. Monday afternoon, and have been worried I can’t do much else! This gives me hope.
I was offered a compounded testosterone cream, which I’ve for a good while now, when I complained of non-existent libido. Side effects: terrible chin/jawline acne and OMG the chin hairs. And I seem to be *miserable* if I skip it. I don’t know that it has upped my libido exactly; I can say I’m more inclined toward participation, possibly because the payoff has become spectacular. But that’s not the same as being interested of my own accord, which was what I was hoping to jump-start.
My major complaint has been that I can get through the week reasonably ok, possibly due to some structure and routine, but when Saturday hits I’m basically kaput. I have stuff I need and want to do on weekends and I have no oomph to do anything much other than the bare minimum.
I am 52 and my youngest child is 18. I always had a mirena and no periods, so peri/menopause was never on my radar until it has recently become such a hot topic. I have since found out that I am well and truly post-menopausal, which makes me realise that I definitely went through menopause from about age 35-45 because that was the era of the blinding rage, terrible sleep, easy tears etc etc.
NOW, as a happily well and truly post-menopausal women with no HRT, I am generally calm, don’t cry, sleep ok etc. (I do still overheat but I think that’s just my normal). So I would like to assure anyone who thinks they might be near the end of Peri, that the life Post can be truly delightful
It took some trial and error, but HRT has helped tremendously. My worst symptom was awful anxiety that manifested physically in my stomach (a tight “swoopy” sensation).
My doctor unfortunately still believed that outdated study. I told her I wanted to try HRT and she said, “I don’t like to prescribe that.” So I immediately went to Midi. They saw me the very next day. I cried because my new provider said, “You’re literally a prime candidate for HRT.”
I had to continually increase my dosage (I started on the patch) because it would work for a bit and then not, but after a shortage at my pharmacy meant I kept getting the one brand I had an adhesive allergy to, I switched to the daily gel and I kid you not, my anxiety COMPLETELY DISAPPEARED the very first day. It’s been 3 weeks and I haven’t had anxiety once. Truly a game-changer.
All this to say, it’s worth exploring and if your doctor dismisses you, try an online provider. (I fired my in-person doctor and requested a new one.)
HRT is a game changer and I think it will help you with mood regulation—it definitely helped me and I had very similar issues as you described. I’ve been on it for about 2 years (I’m 51) and I love it. My OB wouldn’t prescribe it (old school) so I found an NP who specializes in menopause and she prescribed it right away. You likely will not need any base level type testing. Basically if you are a certain age and having symptoms it’s assumed that your hormones have plummeted. I highly recommend it. I feel MUCH less likely to divorce my husband. :)
You’ve gotten several comments that say what I would say: I had really life-affecting mood swings and emotional instability and HRT has been tremendously helpful. I have estrogen patch and progesterone pills.
My hot tip: if you end up on patches, get a box of Tegaderm and use it over the patches. They wouldn’t stay on me without it and it helps reduce itching.
Oh! I also forgot to say (perhaps I’ve blocked it out) that I had to find a new PCP to get HRT, among many other issues that were blithely shrugged and by my long-time doc. Calorie counting seemed to be his answer to all of my perimenopausal complaints so I moved on.
I’m in the UK, so the medical system here is different. I was 41 and had to fight my doctor a bit to get referred to the menopause doctor (if I’d been over 45 my normal GP would have prescribed HRT but I was 41 so she wouldn’t. Sigh). The menopause doctor was lovely, though, and I’ll have been on oestrogen gel and a mirena IUD for the progesterone for two years in June. It’s made SUCH a difference. My big problems were anxiety (felt like I couldn’t do anything, no confidence, terrified to do even normal things I’d done a thousand times before) and depression, and that went away almost completely within days. My hot flushes disappeared. And my mum has osteopenia so it helps with avoiding that as well. Would definitely recommend you try it out if you want to. Good luck xx
I had an adenoma on my liver caused by birth control pills (0.1% chance FTW!), so I’ve been advised not to take anything hormonal for the rest of my life! But I am at the age and the rage, yes! And the tears at literally nothing. I started taking a Centrum menopause supplement – Clear mind and calm mood. It may be a placebo effect, but I do feel like it makes a difference, and it is on auto-delivery now. Not to say there aren’t days, but they are much fewer and farther between, and less intense. I hope you find something that works for you, and you can always try some of these Amazon suggestions until your appointment is achieved. Good luck!
I’m not on HRT but after this shitty week of sleep I’ve had, I’m wondering. But my symptoms are never TOO bad and so I just don’t make the appointment. Every couple months before I get my period I get so fatigued and a little nauseous. I don’t get the rage though, but I do cry if I hear certain songs. I don’t know if that’s changed though, I’ve always been a crier with certain music.
I have no experience with HRT, but I am having emotionally transparent dreams. Found out yesterday that child the younger is taking a summer job halfway across the country and won’t be home this summer (not even for family beach week). So last night I dreamed my wife decided to go with them and leave me behind and in the dream I was crying so hard…
I have anxiety and depression as a baseline but they have 100% ramped up the last couple of years (I’m 51). I had to take time off to reset my crazy pills because no bueno mi amiga. I feel less like playing in traffic now so the next step is scheduling with a gyno who is old enough to have experience with this peri bs but young enough so that she’s not quoting the hrt bs from 2 decades ago.
My pms symptoms now include exhaustion, brain fog and general stupidity. When I wake up in a daze from a random 3 hour ninja nap I know Carrie will be at the prom shortly.
I’m here to cheerlead for vaginal estrogen. It fixed my sleep and other issues. My NP said there’s no downside to it. It’s cheap, $7 per tube which is supposed to last about 4 months. That was the starting point for my HRT and the NP said I could step up to patches if it wasn’t enough. After a year I’m pretty pleased.
I searched “menopause docs near me” and found a lovely one who takes my insurance. I started on progesterone pills and a combined estrogen/testosterone lotion in January. The progesterone makes a huge difference in mood and sleep (my level was at ZERO), and it’s inexpensive ($15-20 for 3 months). As others said, minor annoyances no longer induce rage. The estrogen supports mood but also reduces joint pain and other physical symptoms. I don’t know what the testosterone does, haha. Nothing has especially helped my periods (heavy and frequent) but it’s tolerable when I don’t feel desperately sad and angry.
My ob/gyn was VERY dismissive and gave me some samples of birth control (progesterone-only, which was sort of on the right track) but said “your insurance probably won’t cover it” and that was all she offered me. She was right, my insurance would NOT cover it, and it was over $200/month. I was very angry. She was a great OB, I’ve been seeing her for 20 years, but I think I have to move on to a provider who is more GYN than OB and treats older women.
You’ve gotten a lot of really great feedback on HRT. I commented on. @Sundry’s post a few weeks ago when she asked about re-starting. I’ve been in menopause about 4 years but was still having lots of symptoms, so I essentially just TOLD my primary care doc that I wanted to try HRT. She simply said, “Ok! Let’s do the combipatch.” I’ve been on it about 8 weeks, and I have noticed some improvements in hot flashes and night sweats. I was over the peri RAAAAAAGGGGGEEEEE already, so no change there.
I hope the kitty is improving and there is no need for a follow-up visit.
Check with regular OB (I’ve had luck with 2), while my GP was not on board. Also consider Midi Health. If they accept your insurance this is a very easy and thorough option.
It’s common to get a combo of an estrogen patch and a progesterone tablet, that’s what I have and several similarly aged friends.
The patches go on your abdomen or on your rear end. The clear ones are aesthetically more pleasing at first, but the adhesive tends to attract fuzz and gunk and you end up with a ring around the patch of sticky ick. The clear patches didn’t stick as well for me and I switched pharmacies. Now I have a large and slightly more firm texture of a patch which is white and more noticeable, but these tend to last close to the entire week of wear.
If you do end up with a patch and it comes off, I’ve found that aiming the blow dryer at it for about 10 seconds will reactivate the adhesive and it can be reapplied.
Initially the patch caused me to itch, not sure if it’s the estrogen or the adhesive, but it went away. Some users spray a little fluticasone on wherever the patch is going to go to reduce the itching. My patch doesn’t itch when it’s on anymore, but it does when I remove it. It’s very similar to the way my skin felt after I had a cast for a broken arm removed. Very itchy and the skin under the patch is sweaty. Resist the urge to scratch it, because the newly uncovered spot seems a little more fragile and easy to scratch open.
One of coworkers said a tiny thing that hurt my feelings and I just immediately started crying. So, so embarrassing. My best friend in the whole universe, who has made her love for me clear and unwavering, thumbs upped a text and I sobbed while wondering if she wanted to break up! Everything is on a knife’s edge right now.
Like Rose above, I did hormonal birth control 24/7 for YEARS and LOVED it! I had a ton of bad symptoms associated with my cycle and it was such a blessing not to have to suffer from them. BUT I’m now on the other side – at 53 my doctor had me go off them this past Christmas and then I had a light period for about a month, and then nothing. She tested my hormones a couple of weeks ago and declared me to be in menopause and asked me how I was doing and when I answered she said it didn’t sound like I needed HRT yet but to let her know if I started having issues that could be helped by them.
This brings me to a question and I hope people come back to this post to re-check the comments because I need input: Last night my husband – who makes dinner for the family maybe 6 times a year – decided that the big cupboard we put food in was too full of old stuff. I came home and he’d thrown out everything that was expired, including half my “just in case” cans AND a set of lovely little jams I’d received as a present but then admittedly did not eat. I have told him in the past that canned and preserved food does not become inedible until essentially the seal goes and there evidence of contamination (bulging cans, molding or drying-up jars). He did not care. And when I told him how upset he made me his reaction was “They’re gone. If you wanted that food you should have eaten it.”
So my question is: Should I be as absolutely furious as I am? Is this hormones? Hoarding tendencies? Am I mad because I KNOW HE KNEW I would not have wanted him to do this and it’s about not caring about or respecting about my feelings about him changing MY kitchen stuff? I can’t picture ever not being angry when I think about this, just like I’m still mad he moved all my plastic storage stuff from a low, non-bothersome and child-friendly level into an overhead cupboard in 2010 then got pissed off every time he opened it and something fell out for the 4 years we were in that house. I don’t want to talk to him. I want to reassert how enraged I am and how disrespected I feel every time he tries to engage with me in a breezy way about other things like HOW could I not have gotten over that already? I have never been an emotional person, like, not even when I was pregnant, and now I’m questioning my future with a man just because he threw out some 4 year old jam that I’d told him not to touch. Like how would he like it if I trashed his DVD collection he hasn’t looked at in years?
I would be INCANDESCENT. We DO NOT decide FOR OTHERS what THEY no longer want/need!! And when we tell someone we are unhappy they threw out our stuff, their response should not be THAT WE DIDN’T USE IT THE WAY THEY THINK WE SHOULD HAVE and that THE ITEMS ARE NOW GONE SO *SHRUG*. I think his DVD collection is a VERY GOOD COMPARISON. Paul has DVDs WHEN WE DO NOT HAVE A DVD PLAYER, and I do not get rid of them, because they are HIS.
THANK YOU! I feel so VALIDATED!