35 Symptoms of Perimenopause – Depression

by Magnolia on March 1, 2010

Perimenopause depression.  I don’t know if  it’s the worst complaint from women in perimenopause, but it’s up there.  Usually right behind the rages.

During the worst of my own perimenopause symptoms, when those mood swings hit, it almost always began with depression.  A depression so heavy and oppressive that I literally could not get out of the bed for days.

A depression so dark and so sad that I would sob and cry until my eyes swelled shut.  It would not be a stretch to say that it was completely debilitating.

From what I’ve read, it has been suggested that if a woman is predisposed to depression prior to perimenopause, she will likely have a tougher time with the mood swings, and particularly depression, when she is perimenopausal.  This may or may not be true.

I cannot help but think though, that this attitude is a bit dismissive from male physicians who really have no clue what a woman’s perimenopausal experience is like. And to my many male readers, please know that I’m saying this as gently as I possibly can. I have no desire to alienate anyone.  I just find these types of attitudes frustrating because I know from experience how difficult perimenopause is for so many women.

The last thing we need to be told is that if we’re already predisposed to something, then perhaps we’re exaggerating our present condition.  Or worse, that we’re hysterical.  Whether one is predisposed or not is really irrelevant, in my opinion.  The facts are, perimenopausal mood swings and depression are real and what women really need are solutions, not suggestions that they are over-reacting.

The Chemical Roller Coaster

In one of my previous posts on depression, I discussed the effects fluctuating estrogen levels during perimenopause have on serotonin and norepinephrine levels in the brain.  Which, as you may know, play a very direct role in our moods.  Particularly, depression.

Serotonin and norepinephrine along with another chemical, dopamine, work in synergy in our brain.  When all things are equal and chemically balanced between these mood power players, we experience a general state of calm and well being. Serotonin, norepinephrine and dopamine can also reduce anxiety, improve sleep,  and generally take us to a happy place.

Serotonin and norepinephrine are also neurotransmitters .  Neurotransmitters act as messengers, if you will, transmitting information via neural pathways throughout our brain.  If there is some type of disruption in those neural pathways or in the ability of serotonin and norepinephrine to act effectively as neurotransmitters, then the result will usually be a difficult time with moods, depression, anxiety and insomnia.  Sound familiar?

Keepers of the Biological Gate

We also have these things called receptors in the brain.  There are many different types of receptors throughout our body, but all of them act as biological traffic cops, if you will, receiving, directing and modulating the many types of chemical transmissions that are carried out by the neurotransmitters, which include  the aforementioned serotonin, norepinephrine and dopamine.

One type of receptor for women, the  estrogen receptor, is heavily concentrated in the cortex and the limbic system part of our brain. The limbic system is the major regulating center for your mood, memory, sleep, sex drive, appetite and pain.  As you might expect, if the receptors are having a bad day (like, say, your estrogen is rising & your progesterone is falling) you’re going to have all kinds of biological road rage and chemical smash-ups. (Mood swings anyone?)

In the book Screaming to be Heard: Hormonal Connections Women Suspect, and Doctors Still Ignore by Dr. ElizabethVliet,  which I referenced in a previous post here, it is explained like this: (emphasis mine)

There are multiple connections between the limbic system and all the other parts of the brain….which carries messages to all parts of the body.  The rise and fall of estrogen alters serotonin, which affects pathways in the limbic system, which then produces changes in mood, sleep, memory, pain appetite and many other mind-body functions.  Changes in hormone levels, in turn, affect the amountof neurotransmitters produced as well as the sensitivity of the neurotransmitter receptors to the chemical messengers. No wonder changing hormone levels at puberty, in pregnancy, after delivery and at menopause can produce such a wide variety of physical and emotional changes!

What to Do?

Okay, so, if you’re anything like me, the first thing that went through my head was, “Well, if the key to keeping ourselves out of the “crappy place” and in the “happy place” is dependent (to some degree) upon managing the levels of serotonin, norepinephrine and dopamine in our brain, then, sign me up and tell me how do we do that!”

Antidepressants

One possible solution would be antidepressants. Also called SSRI’s (serotonin reuptake inhibitors).  Briefly, antidepressants work this way:

Neurotransmitters, such as, serotonin, norepinephrine & dopamine, that are  released from nerve cells into the brain only have a short time to relay their message to another cell before enzymes destroy them or they are taken back up by the cell.  This process is called reuptake. Once reuptake occurs, the neurotransmitters cease to have any affect on the brain.

In people suffering from depression (such as women with perimenopause) fewer of these neurotransmitters (due to our estrogen receptors being wacky, remember?) are being produced. Therefore antidepressants delay the reuptake of  these neurotransmitters, particularly, serotonin, thus raising levels in the brain. With more natural levels of serotonin in the brain, mood is elevated from the depressed state to a more normal state of mind.

As I’ve shared here before, I took Prozac, which at the time, was marketed as Sarafem, to help with my mood swings.  I will say that it certainly took the edge off and gave me the ability to relax a little bit so that I could at least “talk myself down” when they occurred.  It did not cure all of my perimenopausal ills and they came with a set of side-effects that I was not too thrilled about, particularly teeth and jaw-grinding (which is common) and insomnia (which is also common).

Eventually, the teeth & jaw grinding, coupled with the insomnia – that I sure didn’t need –  became too much for me to deal with, so I stopped taking them. However, some women  find they do actually work for them, so, please, by all means, if you think it is a viable option for you, take them!  But, as always, under the care of your physician.

Food Choices

Incorporating better food choices into our diet is always a good idea whether you are dealing with perimenopausal mood swings or not.  If you choose to go the antidepressant route, certainly eating well in tandem will increase your chances of getting the mood swings and depression under control.

Carbohydrates –  Yeah, I know.  Carb is one of those nasty 4-letter words that many women, particularly those of us in mid-life, try to avoid because they tend to cause us to gain weight.  But we still need a certain amount of carbohydrates  in a balanced diet and they also help to raise the levels of serotonin in the body.

Whole grains and high fiber cereals such as quinoa (pronounced keen-wah), steel cut oats and muesli are all excellent choices, however, and perhaps preferred over potatoes, white rice or pasta.  Beans, brown rice and a multi-grain bread can also be added to the list of  healthy, complex carbohydrates.

The benefits will include not only a natural mood elevation, but increased concentration, relaxation and calm and a healthier colon as well.  You can’t beat that!

Protein – Protein not only gives you more energy and but it also increases alertness.  The amino acid, tyrosine, found in proteins, increases dopamine, norepinephrine and epinephrine in our brain which then increases our alertness and excitement and decreases anxiety. Good protein choices could come from animal or plant sources.

Animal sources are considered high quality because they contain all of the essential amino acids our bodies need. Some animal sources are eggs, fish, poultry and red meat.  Plant sources are good and often chosen by those who do not eat meat.  Plant sources are considered lower quality sources, however, because they contain only some of the amino acids our bodies need.  But, they do still provide protein nonetheless.  Some plant sources of protein are beans, grains, nuts, and seeds. A good balance of complex carbohydrates and protein can help us achieve a simultaneous increase in energy level and a steady calm.

B-Vitamins

Vitamin B-12 and other B vitamins such as B1 (thiamine), B3 (niacin), B5 (pantothenic acid), B6 ( pyridoxine), B12 and folic acid, are essential to mental and emotional well-being.  The challenge with B-vitamins is that they cannot be stored in our bodies and we depend on our daily diet to supply them.   To make matters worse, B-vitamins are destroyed by alcohol, refined sugars, nicotine, and caffeine, so it is no surprise that many people may be deficient in these.

A deficiency of B-vitamins can contribute to memory problems, insomnia, depression, irritability and anxiety.  In addition, shortness of breath, heart palpitations and dizziness can also be caused by a deficiency in B-vitamins.  Of course, these same symptoms can be caused by many other issues, but for perimenopausal women, it is evident that B-vitamins play a crucial role in our physical and emotional well-being.

Food sources that can provide B-vitamins would include diary products like milk, cheese and yogurt, leafy green vegetables such as spinach and kale, beans, nuts, (which will also provide protein), eggs, liver and one of my personal favorites, brewer’s yeast. Brewer’s yeast can be taken in a pill supplement form or as I often do, sprinkled across a piece of multi-grain toasted bread with a little bit of butter.  I personally love the flavor.  Other’s don’t, so you may want to consider a pill supplement if you choose to take it.

Exercise & Attitude

If you’re anything like me, exercise is not exactly high on your list of things to do.  With my joint and back issues, this proves particularly challenging.  Not to mention, I’m inherently lazy and will quickly drop any exercise routine that requires more effort to accomplish it than the actual exercise itself – such as going to a gym.

Finding a good physical outlet, however, is a great way to lift mood and combat perimenopausal depression.  I prefer a quieter, gentler approach and so the stretching in Yoga and Pilates is a perfect fit for me.  Plus, it’s something you can do at home and never have to get out of those jammies!

The choices for physical exercise are limitless, really, so pick something that works for you and go for it.  Remember – the light from the sun is helpful in lifting mood, so perhaps just stepping outside to feel the warmth on your face can provide a little pick-me-up.

Attitude

Examining one’s thought life is an important part of dealing with depression, in my view.  If you find that your thoughts tend to lead you to a more negative outlook on your life, perhaps a little readjusting of perceptions would be in order.

Without question, menopause is a time of reflection as much as it is a time of physical changes. How we choose to frame and define our day to day life can and does have a direct impact on our mood and how we feel.

Sometimes choosing to overlook, dismiss or simply to accept what we cannot change, can keep us out of the mental dumps.  We may not be able to mentally talk ourselves out of menopause, but we can choose to have a less adversarial attitude towards our life’s circumstances.

For me, having some time where I can reflect, think, pray and quietly sort through my emotions and thoughts can help me grab the reins of my mind and make better choices in how I perceive my circumstances.

Change Brings Growth

These are just a few things we can do to combat and cope with perimenopause depression.  And as I always say, ladies, menopause is a transition.  It is not a permanent condition – though it certainly feels that way at times, I know.

Transitioning into a new phase of life will always come with challenges, but at the risk of sounding cliche’, challenges and changes can also be a time of personal growth and a new, fresher outlook on our life.

 

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{ 30 comments… read them below or add one }

Elizabeth March 11, 2010 at 9:27 am

Those perimenopausal bouts of depression can be so debilitating, and you are right that it pays off to take a holistic approach. One of my menopause ‘gurus’, Christiane Northrup, says ‘The best cure for depression is to be completely honest about your feelings especially the difficult ones like guilt, anger…then act…’. In midlife we can often be prey to unresolved feelings that come home to roost when we feel vulnerable and out of control. But Northrup is correct in saying that action, even if it’s only small, can make all the difference, and the minute we find the strength to seize the reins, the depression can begin to ease.

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Magnolia March 11, 2010 at 11:02 am

Elizabeth,

I find your comments insightful. I can certainly relate to the unresolved issues coming home to roost. I find this entire time of life completely fascinating in that regard. I’m currently researching for material to put in a book I’m writing on the changes that menopause brings into our lives regarding our relationships. Particularly marriage. I am fascinated with the connection between psychological and emotional health and that menopause seems to force the issue for so many of us. As a result, we tend to question every stinkin’ relationship we are in. hence, mucho divorce duriing menopause.

Thank you so much for commenting and contributing. I appreciate your thoughts.

Magnolia

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michelle james June 5, 2010 at 8:05 am

My pre menopause experience has been with Migraines, not depression. But I have found that by keeping my stress levels down, getting good quality sleep and doing regular low impact exercise has helped keep my energy levels high and the migraines under control.

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Magnolia June 5, 2010 at 3:41 pm

Hello Michelle,

I’ve had my share of migraines with perimenopause too. In fact, I think I had it all. :) Thankfully, it’s almost over for me and I can count myself among the menopause mavens. Till then, I soldier on. :)

Thanks for commenting!
Magnolia

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Kelly September 15, 2010 at 6:39 pm

Elizabeth have you ever considered Amberen to treat depression?. I started taking Amberen about 4 months ago and my depression is almost gone. Life is good again.

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Lily April 19, 2012 at 5:24 pm

Depression is my chief complaint. I would rather put up with hot flashes and anything else than this debilitating depression. Nothing, and I mean nothing, takes it away. Because most doctors don’t know how to treat hormonal imbalances, I’ve given up hope of ever being cured. I have spent over $10,000 on various treatments, and nothing works. Even with BHRT, I still suffer from it. It’s an unending darkness that no supplement, cream, or pill can take away or will ever take away. I believe that menopause is something that women just have to ride out. If there was a cure out there, I would have found it.

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Magnolia April 19, 2012 at 5:44 pm

Oh Lily, I hear you sister, and I do feel your pain. I’ve struggled with depression on and off my entire life. I was raised in a very depressive environment. Both my mother and father suffered from it horribly. I think for me, it was a learned behavior that is very easy for me to fall into.

When perimenopause came a long, I would just fall into the deepest, darkest, heaviest funks. Some days, I would cry uncontrollably ALL DAY LONG. :(

For me, eating as cleanly as possible, getting enough sleep, paying attention to my thought patterns and RIGOROUS physical exercise helps. Back in the days when I used to run 5 miles every day, seven days a week, on top of working out with weights, I never had depression. I could literally “run it off”

I agree there is definitely a certain element of menopause that we *do* have to ride out. For you (and frankly, me too), depression may be one of those things. But, I hope you won’t give up. I do know how you feel. Holy cow, I really do.

Magnolia

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mik March 12, 2014 at 7:50 pm

My perimenopause time was the best of my life. For the first time in my life my head was normal and I felt great. Now that Im in menopause Im feeling all the crappy symptoms you can possibly get, hot flushes , headaches, being vague, loss of memory weeping all the time with depression etc and having to pay a fortune for herbs and pessaries to combat the symptoms. It’s quite a debilitating issue for me and I’m finding it difficult to cope.

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mik March 13, 2014 at 9:52 am

My flatmate got me out of bed and we went surfing..I would have to say this is totally my best medicine :)

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Jana March 15, 2014 at 7:53 pm

Wow! I have been having horrible depression, crying, being snappy and sad at work, got so mad I ran into trees on the property where I live, ugh! I really don’t have much of a healthy lifestyle and am reading that this is important – not sure where to start.

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Magnolia March 17, 2014 at 9:47 am

Well, don’t hit the trees, Jana, that could hurt. :) I would recommend that you seek out the care of a physician who specializes in hormone health issues for women. Yes, diet and exercise are definitely important, but balancing hormones is part of the equation as well.

Those trees might be a place you can go to in order to relax and decompress, however. So, be sure and find time to just get outside and feel the sun on your face. That helps too.

Magnolia

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wendy March 16, 2014 at 11:33 pm

I have read so much that help me during perimenopause blog that helped me understand that I am not alone in this stage of my life , it helps to know what might help me through this and what I can try to ease through stage but have say I am willing to try almost anything to help with my depression and sore breast and really bad periods that last almost 10 days or longer and brain fog to say the lease , crying all the time and sadness , snappy at things that I would just blow of as nothing before this started please let this end soon

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Magnolia March 17, 2014 at 9:38 am

I’m glad you have found some help here, Wendy. Have you sought the care of a physician? It might be that some type of hormone therapy, dietary changes, and maybe supplements can provide some help and relief.

Magnolia

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Liz Doyle April 7, 2014 at 1:42 am

Thank you so much for this blog. Everything that you describe is exactly what Im experiencing but at the same time am being teated for major depression. However Im no expert but all of the symptoms you describe Im having and Im certain that Im in some stage of menopause. My periods are different to when I was younger. Im 51. Your blog has convinced me that it is time to find another doctor. Thank you so much.

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Lori May 28, 2014 at 7:07 pm

Thank you, thank you, thank you. I am 43 and have been experiencing some days of perimenopausal symtoms over the past 6 months or so. Most recently, I am absolutely unmotivated. I want to eat and sleep and do no more. I cannot seem to remember anything and I am resentful of everyone who relies on me. 6 months ago, I was in training for a half marathon, the happy, passionate mother of 4+2, finishing my masters in education and onfire with life. Now, I want to eat chips and watch tv. I told my husband yesterday that I think that I am going crazy. I can’t put words together. I can’t collect my thoughts or stay on track. I want to quit the job that I have loved. Could this be a temporary hormonal depression?

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Magnolia June 1, 2014 at 9:54 am

Lori,

Perimenopause is definitely temporary, and depression is a big part of perimenopause for a lot of women. Feeling as if you are losing control of your life and going crazy, is also a symptom. Perhaps you might see a physician who might be able to help you address your symptoms.

And please note, you are not too young to be going through perimenopause.

Magnolia

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Tammy June 3, 2014 at 4:45 pm

Relief to see I’m not going crazy, but feel like PMS all the time. I have a hubby along with two teenage boys. A lot of stressful events going on at the same time I’ve been diagnosed perimenopausal. I’m headed to my gyn this week to ask for other solutions other than a pill that will flat-line me. I’ve never experienced anything remotely close to this and I just want to be myself again and have fun. My marriage of 24yrs is suffering because of it. Just call me “Debbie Downer”, as my 18 yr old did.

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Magnolia June 5, 2014 at 6:54 am

Tammy,

I understand wanting to feel your old self again. And you will eventually feel “normal” again in that your hormones aren’t rocketing all over the map. However, you won’t come out of perimenopause feeling like the same woman. It’s a very drastic change. That does not necessarily mean it’s bad. But, the days of thy youth are over. :)

Magnolia

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Cana June 10, 2014 at 9:43 am

Thank you so much for this!! I have felt like I was loosing my mind. I am 42 years old and have a husband that is so compassionate but his patience is wearing thin. It’s only because he doesn’t fully understand how I feel nor can I describe to him what is “wrong.” My depression is worse in the evening. It crushes down on me around 4:00 and doesn’t go away until morning. I can sleep but I usually end up crying myself to sleep or crying in the middle of the night. When I wake up, I feel refreshed and foolish for feeling so down the previous night. I’ve been searching to see why it affects me so at night. It is so frightening to feel this out of control. It is affecting my entire life. After reading this and the replies, I don’t feel so alone or “crazy.” Thank you again and thank God this is temporary!

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Marie Moore July 4, 2014 at 10:51 am

Cana I know how you are feeling… Day in and day out I feel this way and just want some help… I have suffered for a long time with depression and my meds always worked well.. Bit since I’ve been going through perimenapause meds don’t want to work…. It’s very frustrated and I don’t know where to turn

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Cristin July 16, 2014 at 8:12 pm

I hate that middle of the night thing. When I get these episodes it always seems to happen at exactly the same time every night. It’s good not to be alone.

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Cristin Clarke July 16, 2014 at 8:08 pm

Gosh how good it is to know I am not alone . That crazy bitter taste had me really perplexed . It would come and go and I was not sure of the cause. My symptoms are basically cyclical and anxiety trumps the list. Such a horrible feeling. I am 51 and these and other symptoms just hit hardest this year. My male gyno sort of warned me by saying yea you’ll feel more symptoms as time draws close to menopause. I was taken out by the severity of the depression and anxiety. Thank you so much for this blog . I will be seeing my doctor to discuss all this ASAP. Also the memory thing is quite scary.

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Kirst August 1, 2014 at 8:48 pm

I’m so pleased I’ve found you. I’ve been having terrible bouts of depression for a few months. I lost a friend in October to cancer, this seemed to be the trigger. I was also at the time, selling my business, which let’s say didn’t go too smoothly. I am 44 and have a 4 year old son. I then , just before Christmas experienced my first anxiety attack! I went to hospital, thought I was having a heart attack. Breakdown in March and haven’t worked since. Along the way I’ve had incredibly sore boobs, very irregular periods, night sweets and fatigue. I have looked on the internet for more info but found nothing like this. It IS good to hear other people suffer too. I feel so very lonely, insecure, ugly, generally a waste of space! I went to the GP this morning, he has prescribed Fluoxetine. I am really hoping they make a difference. After 4 months off work, I have to get back to it, tiny steps though. I have something lined up and am so excited about it, I just don’t want those mood swings etc to affect me at work. Anyway, here goes.

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mary ann August 10, 2014 at 7:47 pm

I am 39 and for th last 3yrs i have been dealing with severe mood swings, fatigue and i absolutely want nothing to do with sex. My fiancee and i argue all the time. He seems to think i should just get over it and that perimenopause shoukd have run its course. Im not sure if im just depressed or if it is perimenopause. I am currently searching for a new physician. Im afraid if something isnt done soon my relationship will be over. He just doesnt understand. Thank you for all of the info, definately need to see a doc.

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Celine August 22, 2014 at 11:05 pm

Thnx for all these blogs. It was my husband who has recently suggested my feelings might be related to menapause & after reading Lori’s story, it could of been my story. I too am 43 & have just lost a parent, experiencing work related pressures & am unsettled with my long term job for the first time and have my oldest child leaving home. I just cannot seem to find ‘that everything will be alright’ feeling again. Close to tears often & quick to react & just not a happy person to be around. I hate taking it out on those that I love too. Is St. John’s Wort worth trying? I also need to exercise but for the first time in my life, don’t want to. Can see for the first time in my life, just how horrible this is for those that suffer from depression throughout their lives.

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Nicole September 1, 2014 at 7:47 pm

I am glad I found your website. It is horrible what some of us women go through with perimenopause. I have had issues with depression and horrible pmdd ever since I started my cycle at 13 which is related to childhood sexual abuse they have found which I did go through, I am in recovery from thc addiction and alchohol abuse, I lived through a 10 year abusive marriage, I am the mother of three, two are grown. My point in mentioning this is that my tolerance for pain, emotional & psychological is pretty high. And I have never in my life seen the strength and fortitude it takes to get through perimenopause with dignity. I am always stressed, irritable, angry, depressed, etc. I have tried some hormone therapy and I lost half of my hair last year. I am going to try another doctor and when I can afford it try the homopathic route. Just don’t give up ladies. Another thing I have recently started exploring is meditation. Warrior spirit is what it takes to ride this out. Oh my god, it is heartbreaking in a way isnt it? Just do you best to be kind to yourself and remember your worth is not dependant on how you feel. It will pass. God Bless us all for being willing to go through it. There are woman out there that give up during this time in there life through alcohol, drugs, and the worst I won’t even mention. Now that thc is legal in alot of states they are going to start saying that it helps hormone problems, please don’t believe them. It is a lie. Hormone therapy, etc( all the other things mentioned) are the only way. And i do believe meditation, healing sound, aromatherapy, and things along these lines help. I really believe during this time in our lives we are learning how to save ourselves. Does that make sense? It takes alot of hard work to go through this and we are worth it!

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Louise September 28, 2014 at 3:04 am

Thank you so much for sharing, Nicole. My story is the same as yours. I know I am not alone and your strength and perseverance gives me hope!

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LilyN September 29, 2014 at 1:43 am

I am SO GLAD I stumbled onto this blog. I stopped having my period since 1Q 2013 but the gynae told me mid-last year that I am not in menopause yet because I “still had eggs in my ovary”. I left my job of 17 yrs in Apr this year (likely due to me being emotionally unstable), joined a new co & left only after 4 months coz of stress-related eczema, anxiety attacks …. I am a single mother of 2 adult children and had been through much more stressful situations before but menopause really robbed me of my mental capacity! I really thought I was becoming a mental case until I read that a foggy-brain is 1 of the symptoms! One positive outcome of this is I have turned to God and this had helped me whenever I’m feeling so ALONE & in despair. I pray for all women who are going through this trying period that you will be blessed with strength to cope and that the symptoms will go away quickly. Please take care!

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Magnolia October 1, 2014 at 7:15 am

Hi Lily,

If you haven’t had a period since the first quarter of 2013, you have DEFINITELY reached menopause. I do hope you can find another job and stay busy. The last thing you need is too much time on your hands and trying to cope with hormone imbalance symptoms.

Have you considered estrogen therapy to help with the brain fog?

Magnolia

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Charmaine October 12, 2014 at 9:06 am

Went to see my (male) doctor because my breasts were so sore I couldn’t sleep on my stomach at night, or go without a bra. His advise was to take an anti-inflammatory! Surely I can’t live on these?! Reading all these blogs, I am sure I am going through peri-menopause! The depression and breast pain being my biggest symptoms. Exercise liftsy spirits somewhat (when not hurting the breasts too much)! Maybe time I consulted a female gynae with more understanding??

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