Episode 127: Anxiety in Perimenopause: How Hormones, Blood Sugar Imbalances and Inflammation Are Impacting Your Mood

In this re-release of a 2021 episode, Dr. Lisa and Dr. Toni discuss the increased levels of anxiety moms in perimenopause are currently experiencing over the pandemic and what you might be doing to make it worse. There are many effective approaches to naturally deal with your anxiety so you don’t have to suffer. 

Did you know?

A research study that followed 3000 Canadian moms over 12 years showed that symptoms of anxiety and depression almost doubled between May and July of 2020 compared to levels between 2017 and 2019. 

Another study on the impacts of COVID-19 on Canadians reported that 24% of people rated their mental health as fair or poor compared to 8% in 2018. 88% of participants experienced at least 1 symptom of anxiety in the 2 weeks prior, with 71% feeling nervous, anxious or on edge, 69% becoming easily annoyed or irritable and 64% having trouble relaxing.

What is anxiety?

Anxiety refers to anticipation of a future concern and is more associated with muscle tension and avoidance behavior.

Anxiety disorders differ from normal feelings of nervousness or anxiousness, and involve excessive fear or anxiety. 

If you have 3 or more anxiety symptoms for a period of 6 consecutive months on an almost daily basis, you might be diagnosed with Generalized Anxiety Disorder. Consult with a licensed therapist for support and confirmation of diagnosis.

What are symptoms of anxiety?

Psychological or mental and emotional symptoms you might be experiencing can include:

    • Fear

    • Irritability

    • Restlessness, inability to relax

    • Difficulty concentrating

    • Decreased libido

    • Decreased emotionality

Somatic or physical symptoms you might be experiencing can include:

    • Arrhythmia or heart beat irregularities, increased heart rate or palpitations

    • Increased shallow or difficulty breathing

    • Nausea

    • Diarrhea, reflux or IBS

    • Sweating

    • Tremor

    • Increased urination

    • Increased appetite

    • Dizziness or vertigo

    • Increased sensitivity to pain 

    • Headaches 

    • Worsening of skin conditions like eczema, hives, psoriasis

Postpartum anxiety can happen to you even a year after you have given birth. 

Symptoms of postpartum anxiety can include the above symptoms, as well as:

  • Feelings of worry or dread
  • Racing thoughts
  • Problems sleeping
  • Hot flashes

What are possible causes of anxiety?

  • Hormonal change and fluctuations in perimenopause
    • Your brain’s response to hormonal changes can impact if you experience anxiety
    • Women with a history of mental illness, including postpartum depression and anxiety, are more at risk, as well as women whose moods are sensitive to hormone changes and have experienced PMS and PMDD
    • About 18% of women in early perimenopause and 38% of women in late perimenopause experience symptoms of anxiety and depression
  • Life or situational stressors
    • Changes in work, home, family
  • Individual genetics
    • Your genes can impact your neurotransmitter balance eg. COMT
  • Drug-induced anxiety
    • Alcohol, cocaine, caffeine, cannabis (see Episode 80 for more info on cannabis)
    • Amphetamines
    • Corticosteroids
    • Anticholinergics including some antidepressants
    • Hallucinogenics
  • Thyroid conditions (see Episode 42 for more info on thyroid)
    • Hyperthyroidism and Hashimoto’s thyroiditis 
  • Hypoglycemia
    • Low blood sugar can increase stress hormone cortisol
  • Lung conditions like COPD
  • Heart failure or arrhythmia
  • Brain inflammation or encephalitis, eg. traumatic brain injury, concussion
  • Nutrient deficiencies
    • Vitamin B12
    • Magnesium
    • Iron
  • Trauma, chronic stress and Post Traumatic Stress (PTS)

What are the conventional medical options for dealing with anxiety?

Prescription medications used to treat anxiety include:

  • Benzodiazepines like clonazepam, lorazepam, diazepam
    • High risk of developing side effects, dependence and tolerance
    • Nutrient depletions can include melatonin and glutathione
  • SSRI and SNRI antidepressants
    • High risk of side effects including impact on libido
    • Potential of worsening of symptoms in first 2-3 weeks
    • Nutrient depletions can include sodium, folic acid

What laboratory testing can be helpful for determining the root cause or factors of your anxiety?

Blood work – Iron panel, thyroid panel, vitamin B12 and D

Urine organic acids and hormone testing eg. DUTCH

Beck anxiety questionnaire

What are some natural approaches to address your anxiety?

  • Reduce alcohol, caffeine, sugar
  • Learn your situational triggers eg. running late
    • Avoid the avoidable
    • Prepare for the unavoidable
  • Practice RAIN – work of Tara Brach
    • Recognize – name the feeling
    • Allow – lean into the feeling, let it be, breathe
    • Investigate – physical feeling, self-talk/beliefs, what do you most need right now
    • Nurture – talk to yourself like friend, direct self-compassion
  • Interrupting anxiety or changing your state
    • Breathing exercises or humming to activate the vagus nerve
      • Diaphragmatic breathing with long inhalation and longer exhalation, research study showed lowers stress hormone cortisol practiced twice a day over 8 weeks
    • Splashing or drinking cold water
    • Ground yourself in the present by checking into your physical body, using your sense including smell and sound
    • Journalling
  • Prioritize sleep – see Episode 73 for more info
  • Exercise and moving your body
    • Bonus if you go outside for fresh air and sunshine!
  • Practice mindfulness and meditation eg. loving kindness practice
  • Avoid multi-tasking to prevent:
    • Increased heart rate
    • Feeling wired
    • Reduction in cognitive function and emotional control
    • IQ dropping by up to 15 points
  • Balance blood sugar and reduce pro-inflammatory foods – see Episode 45 for more info
  • Prevent anxiety-like hypoglycemic symptoms
  • Reduce inflammation fuelling anxiety

Supplements to consider:

  • Lavender, lemon balm, kava, tulsi, chamomile, passionflower
  • Adaptogenic herbs like ashwagandha, rhodiola, eleuthro, reishi
  • L-theanine, Lactium, taurine, 5-HTP, glycine, inositol, phosphatidylserine 
  • B complex
  • Omega 3 fatty acids
  • Magnesium 
  • Vitex for hormone regulation

Prescription medications to consider:

  • Bio-identical progesterone
  • CBD (also available without prescription in specific retail stores in Canada)

Other resources available:

  • Cognitive Behavioural Therapy (CBT)
  • Tapping or Emotional Freedom Technique (EFT)
  • Wellness Together Canada online portal

Today’s Mama Must Have: 

Dr. Lisa loves using her morning routine to set the tone for her day, including meditation, humming and chanting exercises

Dr. Toni highly recommends carving out some solo time for personal development and is currently enjoying the Living Passionately online seminar through Landmark Worldwide. It has made a huge impact on her mental health and helped to reduce the stress of the “should”s.

Dr. Toni’s next HypnoBirthing session for expecting parents looking to decrease fear and anxiety around labour and birth is happening this summer. Join her at https://www.hypnobirthingcalgary.com/register

Dr. Lisa’s Wild Collective in Fall 2022: get on the waitlist: wildcollectivetoronto.com

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Please tell your perimenopausal mama friends about us, too!

Stay safe and healthy everyone!

Disclaimer: The information provided is not meant to replace treatment with a licensed health care practitioner. It is for informational purposes only. Consult with a Naturopathic Doctor or other licensed health care professional to determine which treatments are safe for you.

Episode 89: Let’s Talk About Sex – In Conversation with Dr. Trina Read (previously released as Episode 23 on May 28, 2020)

Don’t feel like having sex? It’s time to listen to this re-release of Dr. Toni’s conversation with Dr. Trina Read, sexologist and CEO of the Business of Sex. They discuss the impact of perimenopause and stressful events (like a pandemic) on your sex life. This episode was originally released on May 28, 2020.

Dr. Trina has an unique perspective as a sex and relationship expert who has a corporate background in marketing and PR and who is also a perimenopausal mom.

In this episode, we cover:

  • How to use self care to bring libido back
  • Why you need to know your happy triggers for sex
  • The importance of knowing what you want out of sex and communicating it
  • Why you might want to take intercourse and orgasm off the table for better sex
  • How to have those awkward conversations around sex
  • Why personal lubricant makes all sex better
  • The importance of working your pelvic floor muscles

In perimenopause and in stressful times, you may find your libido is flatlined and don’t feel like sex.

Your body can only produce either cortisol (your stress hormone) or testosterone (your sex drive hormone). If you’re producing cortisol, you can’t produce testosterone.

In situations with great change, it’s important to connect with your partner and look for ways to be together, so that you don’t drift apart. Being proactive and finding pockets of time to be close with your partner helps your relationship, as well as feeling more powerful yourself.

Ask yourself – what can I do to help myself feel more sensual?

You can back into the groove and bring your body back to a place where you feel more centred and sensual by:

  • Taking a bath
  • Listening to your favourite music
  • Giving yourself some me time alone in your bedroom with a vibrator
  • Just making up your mind to connect with your partner (even if it feels forced at first)

The Centre for Menstrual Cycle and Ovulation Research (CeMCOR) was founded at the University of British Columbia (UBC) by endocrinologist Dr. Jerilynn Prior. There is lots of information about their research around menstruation and hormones at https://www.cemcor.ubc.ca/

UBC is also home to the Sexual Health Laboratory run by Dr. Lori Brotto that focuses on research around women’s sexual health. https://brottolab.med.ubc.ca/

Research shows that sexual desire is similar to happiness. For most women, in order to feel sexual desire, you needed to be triggered. You can learn positive triggers around sex and negative triggers around sex. You need to set up your positive triggers for sex.

Unfortunately, you may have been brainwashed to think that only 2 things available for sex is having intercourse and having an orgasm.

Sexual intercourse all the time can be a negative trigger for a lot of women, especially if you feel like it doesn’t quite do it for you.

When you can anticipate doing something that you want to experience, a happy trigger for sex can be created. Working on triggers for sexual desire and increasing your repertoire for sex are important for your sexuality to evolve.

Self care like meditation, yoga and tai chi lowers stress and cortisol and can increase your libido.

There are studies that prove that meditation improves your sex life!

Perimenopause is like reverse adolescence with wild ebbs and flows of estrogen and progesterone that can create mood swings, anxiety, hot flashes and insomnia. No wonder you don’t feel like having sex!

Once you hit 40 years of age, you produce less oxytocin. Oxytocin is a bonding hormone. With less oxytocin, you start being more “selfish” and focus on yourself. With more wisdom, self confidence and self care, you can feel more deserving and able to explain to your partner what you want.

This is your opportunity to create something different and better in your sex life! Your partner will be on board with you becoming a more engaged partner…it could result in you actively wanting sex more often.

If you’re experiencing vaginal dryness sometimes or all the time, sex can be painful. Trying out a few different brand of lubricants (silicone based, water based or a combo) can be a game changer for your sex life. Lubricant makes all sex better. You might even want to try a lubricating suppository.

If you don’t use it, you lose it! If you don’t use your vaginal canal, you could experience vaginal atrophy. Exercising your pubococcygeus muscle increases blood flow. Research shows that post-menopausal women who do Kegel exercises have bigger, better orgasms than women who don’t do Kegels. 

What’s the female equivalent to the towel test? 

Every woman’s uterus will prolapse to a certain extent. Greater levels of prolapse can create painful sex. 

There are options to address uterine prolapse other than surgery:

  • Herbal medicine like black cohosh
  • Pelvic floor physiotherapy
  • Bioidentical hormone replacement therapy
  • Laser rejuvenation

You can slide or decide: slide into painful sex or decide to do something different and exciting.

Too scared to talk to your partner about doing something different and new?

How can you start talking to your partner about sex when you feel awkward and uncomfortable. Dr. Trina’s website http://trinaread.com/ has many different articles you can share with your partner to stimulate conversation around sex and your own sex life.

Connect with Dr. Trina Read on Facebook at https://www.facebook.com/trina.read and Twitter at @DrTrinaRead

Watch for the release of Dr. Trina’s self help fiction book Amy Finds Her Sex soon!

Today’s Mama Must Have: 

Dr. Toni is a huge fan of her local neighbourhood buy and sell groups on Facebook. These can be a lifesaver for moms on a budget. 

Thank you for joining us today! 

Find the show notes at perimenopausalmamas.com or connect with us on Facebook and Instagram. We’d love you to subscribe, leave us a review and a 5-star rating if you enjoyed this episode.

Please tell your perimenopausal mama friends about us, too!

Stay safe and healthy everyone!