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Dr. Tim, MD
Dr. Tim, MD, Board Cert. OB/GYN
Category: OB GYN
Satisfied Customers: 1011
Experience:  General OB/GYN, complicated obstetrics, complicated GYN
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Please could you advise me. I am suffering from anxiety which

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Please could you advise me. I am suffering from anxiety which started with the onset of the menopause. I feel like somebody has hijacked my personality. I used to be very laid back and able to cope with running my own business and my family ( i have 3 children) with ease. I now spend too much time walking around with a pit in my stomach feeling as if something awful is about to happen to me or my family. I wake in the early hours with adrenaline pumping through my body as if a plane is about to crash into the house and I am at the end of my tether. I am sure this is to do with my hormones, as I have friends who are going through the same thing to lesser or greater degree, and because there are a few days each month when I don't feel so bad. My GYN thinks that I should go on HRT but I am not sure ? what would your advice be ? If I do decide to take it what type should I take and given that I have huge anxiety about my health is it a good idea... ? I think that I respond well to Oestrogen but do not do well on Progesterone - I know that I have to have Progesterone but are there different ways of taking it - Or should I just wait for my hormones to balance themselves out naturally ?
I would be grateful for your advice.
Many thanks

Dr. Tim, MD :

Hello, I would be happy to help you today with your question.

Dr. Tim, MD :

Please give me a few minutes to review your question.

Dr. Tim, MD :

I have a couple of questions

Dr. Tim, MD :

1. Do you still have your uterus?

Customer:

Yes

Dr. Tim, MD :

2. Have you ever been treated for anxiety or depression in the past?

Customer:

no

Dr. Tim, MD :

Here is what I think (please give me a minute to type):

Dr. Tim, MD :

I agree with you, if there has never been an issue with anxiety or depression in the past, then these mood related changes are very likely related to the changes you are experiencing related to menopause. In the setting of menopausal symptoms, we often approach them by treating the symptoms individually if possible. In your case, the options would include:
1. Go ahead and go on HRT (combined E/P because you still have a uterus) - the doses are very low and well tolerated
2. Consider an antidepressant medication (such as Prozac) - it often works great for hot flashes and certainly might help with the anxiety and panic related symptoms as well.

Dr. Tim, MD :

It is safe to use HRT in the short run of about 5 years - so great for this transition.

Dr. Tim, MD :

It can be given as a pill or patch - it really does not matter how you take it.

Customer:

Ok, thank you I might try HRT - do you have any types that you would recommend ? I think there is one that combines E and p at the same time do you think that is a good idea ?

Dr. Tim, MD :

I think that if you can get it in a combined form, this is much easier to remember to take than if you have to take two pills, or a patch and a pill. I am certain that you will feel remarkably better. This is a common problem and sometimes very difficult to control. The good news is you will get better over time.

Here is a link to check out as well: www.nams.org (I think it is correct - North American Menopause Society)

Dr. Tim, MD :

Does this all help?

Customer:

Yes, thank you very much.

Dr. Tim, MD :

If you are satisfied, please provide a POSITIVE RATING. It has been a pleasure to help you with your question!!

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