Re-living My Postpartum Anxiety
Progesterone Cream on Wrist
To be honest I should actually call this post: “What the hell was I thinking!?” I’m sure you’ve had one of those moments. Every single time I go against my intuition I have one of those moments. I had one recently.
If you recall, I went off my bioidentical hormones cold turkey and if you read that post I was afraid it would be a wild ride! In retrospect I should have weaned off them slowly – and whether my doctor should have known better or not is beside the point. I should have known better. And in fact, my inner voice knew better, why I didn’t listen to her I’ll never know. But I’m not going to beat myself up over it. Here’s what has happened since I went off my hormones:
The First Two Weeks:
The first couple of weeks into my living without bioidentical hormones seemed ok and it was slowly starting to leave my mind. It felt like I was forgetting something every night when I went to bed but I was starting to get accustomed to not reaching for my hormone cream.
Mid-Cycle: Time of Ovulation & Progesterone Increase
Exactly two weeks into my “withdrawal” as luck would have it I received a call from my doctor’s office. They called to say my doctor wants to book me for follow-up testing due to the results of my recent ultrasound. I was instantly worried as anyone would be.
The difference here is that worry doesn’t describe it. It began as worry and quickly became debilitating anxiety. No amount of reassuring me that the cysts on my ovaries are common and usually benign (non-cancerous) would settle my anxiety. There was also a spot on my liver which is characteristic of a liver hemangioma – it was described to me as basically a tangled mass of blood vessels – again usually benign, non-symptomatic and usually just discovered by accident during an ultrasound, CT or MRI scan. More common in women than men, age 30 – 50 (me age 44), who have been pregnant (me 5 times), and related to estrogen medications (that is something I have to research – could it just be more common in women who are estrogen dominant?)
Seriously, it’s hard to believe that I received this news exactly on the day that my progesterone level should have shot up. I should have been ovulating right around this day which for most women should mean an increased production of progesterone. I’ve never known why I don’t seem to produce enough progesterone and I can’t really say how much my body produced this month after going off progesterone.
Image courtesy of www.sciencedirect.com
Check out this chart to see what hormone production should look like in a normal menstruating woman. Mid-cycle is when women release an ovary – see that spike in progesterone that is supposed to happen as a result? When I finally learned about my infertility it became clear that I suffered from anovulatory cycles – meaning I didn’t ovulate and I wouldn’t have a period for 3 months, called Amenorrhea – likely caused by my estrogen dominance. Simply put when I’m on progesterone I ovulate – I have no idea what was happening with my progesterone during this cycle.
What I can say is that over the course of the week I was overcome with anxiety over this news. I couldn’t sleep – I had trouble falling asleep and staying asleep – so was fatigued beyond belief. My body hurt all over – anxiety hurts – every cell in my body vibrated with anxiety. I couldn’t focus on anything even when I tried. I struggled to get through each day and put a smile on my face.
My Eureka Moment
There is good news in all of this – the light bulb went off for me when I realized that I was feeling exactly like I did when I had postpartum anxiety. That’s when I realized that the level of worry I had did not correspond with what was actually happening in reality. The reality of anxiety is NOT the reality of life! When you’re the one in the throes of it – it’s hard – damn hard, to be self-aware. I’m knowledgeable about his stuff and try to be in tune with my body and yet geez it still happens to me!
Image courtesy of Pope Paul VI Institute, National Reproductive Hormone Laboratory
Check out the progesterone level of a pregnant woman and then imagine the drop in progesterone that occurs postpartum! Thinking back to my postpartum anxiety and seeing the chart makes me wonder how significant the drop in my progesterone level was after going off bio-identical hormones. That being said I think even a small fluctuation can create issues for women who are suseptible
The Good Great News!
Thank God for the realization that this anxiety was being caused my the significant drop in progesterone from going off bioidentical hormones. How do I know? I took a small dose of progesterone in the early evening – I slept through the entire night for the first time in a over a week and woke up without anxiety. And so I made it through to the end of this menstrual cycle using progesterone and living anxiety-free!
“anxiety hurts”
You know, I talk a lot about how physical my depression is & people just don’t relate. Then you come along. Oh girl, I’m so sorry that your anxiety hurts, but I’m thankful for your sharing. I’m so blessed to have met you! I’m super happy you got to the bottom of it so quickly – that’s the hardest when I’m in it – to be able to see. Xoxo
I understand completely but it took me going through it I suppose! I get how hard it must be for people not to be able to relate. Even during my anxiety I think every little ache and pain is cancer or some horrible thing. Then I remember my chest hurts from the anxiety – not from a heart problem or whatever. My head and jaw ache probably from clenching so much. But really every cell in my body hurts yet I feel like I can’t properly articulate it. But I know how your depression is physical the way my anxiety is.
I haven’t had anxiety like this since my son was born over 6 years ago. Went off my hormones and BAM! Makes you wonder how many women are suffering and haven’t related it to their hormones! You’re right – when you’re in it seeing is hard.
Thank you – you are the sum of all awe! š
Hi Sonya. Thank you for this blog. I also believe there is a connection between anxiety and progesteron defficiency as I definitely saw it with miscarriages and strong anxiety right before miscarriages happened. Were you able to find any studies that prove it?
Hi Diane,
Thanks for asking such a great question. It’s not hard to know why you’d have trouble finding studies on progesterone and anxiety. It seems that most of the research involving the sex hormones have focused on estrogen and generally the synthetic progestin. And fewer studies focused on women’s mood disorders. However there are a few studies showing that progesterone acts on the GABA receptors in the brain.
There are a lot of women like you and me who have experienced life changing effects of progesterone, however some women have experienced negative effects with progesterone treatment. Our endocrine system is such an amazingly delicate and complex system that I still think needs unravelling.
Here are a couple of references – you’ll notice they are a bit old which tells you how much we need more research in this area. I can dig out some more information for you if you’d like – let me know.
Smith SS, Waterhouse BD, Chapin JK, Woodward DJ. Progesterone alters GABA and glutamate responsiveness: a possible mechanism for its anxiolytic action
Le Melledo JM, Baker G. Role of progesterone and other neuroactive steroids in anxiety disorders. Expert Rev Neurother. 2004 Sep;4(5):851-60
Thank you Sonya. I will check those out. I found a doctor who actually listened to me when I mentioned a link between progesteron and anxiety. She actually asked me if I found some studies she can look at (which I have not) and said she would look for more info herself. So I immediately thought of you!
You’re welcome. Glad you found a doctor that would listen to you! Did you know that it can take 17 years for research to make it’s way into clinical practise!!!! Here’s another study about OCD but it discusses anxiety. I had OCD symptoms after my pregnancy as well. Progesterone made my intrusive visions go away almost immediately. All of my best to you!
http://europepmc.org/articles/pmc4620312