Panic attacks can be very common in Perimenopause and can be very scary when experienced for the first time, I often see with clients that Panic attacks can happen when they are feeling at their most calmest point and tis creates further confusion as to why they happen.
What is a Panic Attack ?
These are sudden attacks of very intense anxiety or fear during which you feel you are going to die, go crazy or lose control in some way. Panic attacks can happen without any warning, can last for a few minutes or as much as an hour. They are experienced on a very physical level and often start from physical sometimes you may not notice – a clenched jaw, tightness in shoulders, persistent shallow breathing which can lead quickly to a sense of breathlessness. The physical symptoms may have been triggered by anxious thoughts but now the sense of breathing difficulty is causing even more anxiety and panic – a natural response to feeling you can’t breathe.
Other physical triggers for panic attacks can be low blood sugar, extreme dehydration or lack of sleep, which combined or separately can lead to feeling dizzy, light headed, breathlessness and a sudden onset of panic or feeling of loss of control.
While people often describe panic attacks as ‘coming out of the blue’, there will often be an underlying trigger or combination of triggers, which have not been identified. Tracing back and knowing the triggers allows you to put steps in place to avoid them.
What can trigger a Panic Attacks ?
Common triggers would be facing a challenge and feeling overwhelmed by it, for example if fearful of being alone at night, driving on the road alone would seem daunting or if you have a fear of social encounters, making a trip to the supermarket might be an obvious trigger. In some cases, people feel a tightness in their chest or throat or churning stomach, which can lead them to believe they are in the grip of heart attack or a serious life threatening illness, thoughts that quickly escalate the sense of panic.
The panic stems from the confusion you feel and the feeling that you are losing control; the accompanying adrenaline surge affects any rational thinking during a panic attack. It is only when the adrenal gland becomes totally exhausted that the attack subsides as it cannot release any more. This is why, when you start managing panic, that light exercise (walking around the room) is such an effective treatment – it helps exhaust the adrenal gland and dissipates the panic.
Panic attacks are very common: it’s estimated that one in five people will have at least one in their lifetime. After experiencing one panic attack, it’s normal to worry about having another, You might start avoiding situations or activities that you think might trigger an attack, like shopping centres, public transport, airplanes, lifts or being alone. If you can observe that pattern, it’s a good time to have a panic management plan in place.
In some cases panic attacks can be a result of an underlying physical condition like thyroid issues, low iron, and heart and lung imbalances - and so for this reason we would always suggest a checkup with your doctor to rule out any physical causes.
Step by step guide for Panic Attacks
§ Breathe – use any of the techniques outlined for breathing that you like. The clenched fist and progressive muscle relaxation techniques are great ones for panic attacks. Breathing into a paper bag can also really help, you are breathing in the air you have just breathed out which stops you form losing so much carbon dioxide and reduces the symptoms of low oxygen.
§ Try not adding in negative internal dialogue in your head.
§ Remind yourself a panic attack is an excess of adrenaline in the body due to chronic underlying stress
§ Ice cube tip – if you have access to an ice cube try chewing one and also rubbing it on your inside wrist and the back of your neck (some people find relief from this).
§ Exercise: Pace the room, walk during a panic attack. Just try it – it works! You will burn off excess adrenaline which will shorten the attack; physical movement can help the body while it is in fight/flight mode.
§ Write down the thought and images going through your mind
§ Remember: It will pass
I often find some weeks a specific symptom comes up again and again in client consultations - this week I seem to have been attracting heart palpitations. A feeling of giddiness and heart palpitations can be very common in Perimenopause and very scary too.
What is a heart palpitation?
This is when you feel a fluttering or pounding heart beat - you will feel your heart is racing and beating much faster than normal. You heart can also skip a beat at intervals during palpitations. This intense feeling can extend from your chest up to your neck and throat.
This can be extremely frightening to experience even if just for a few minutes. In most cases palpitations are not usually a sign of an issue with your heart but very often due to other lifestyle factors.
Often to make things trickier they can happen at the same time as a hot flush.
What can cause palpitations?
From my experience with the women I have worked with lifestyle factors are the biggest cause and primarily ongoing chronic stress and anxiety. This is why I think we see it so much in menopause because we know this is a time when anxiety is heightened and the physical manifestation can be palpitations. The fall in oestrogen in these years also compounds the issue.
There are other factors too that can cause palpitations-
Smoking - this is one of the biggest enemies to menopause
Low blood sugar levels or low blood pressure
Irregular heart rhythms
Some cough and cold medicines which contain the ingredient Pseudoephedrine
What to do:
The very first step is to look at your lifestyle and really take stock - are you under stress ? Are you anxious ?
Smoking - If you spoke please talk to your doctor about ways to stop, it really is no friend to you. Research also suggests that women who smoke will have menopause earlier and with greater symptoms.
Alcohol & Caffeine - reduce, eliminate if you can, either in excess again will make the journey harder.
Exercise - incorporate activity into your daily life, this will help you in so many ways - stress, anxiety, weight all benefit from daily exercise. It doesn’t have to be a marathon gym session but a brisk walk or something you enjoy even for just 15 minutes per day will help you.
Sleep - ensure you get a good nights sleep.
Incorporate relaxation techniques into your life - breathing, yoga, meditation are all really good
Diet - more fruits, greens, whole grains. Try reduce salt & sugar.
When to see your Doctor:
If the palpitations don’t happen very often and only last a few seconds when they do then you can help this by making some of the lifestyle changes above. Especially look at anxiety & stress - bear in mind too the catch with palpitations is that they can happen when you're at your calmest but underneath, like the iceberg analogy, there is loads going on.
However if they start to happen more often and last longer with each episode then it is worth ruling out - overactive thyroid / anemia / or other heart issues.
Your Doctor will generally take full bloods and if warranted recommend an ECG.
Remember heart palpitations are very common in perimenopause and many women find once they make small tweaks to their lifestyle it can make a huge difference.
Remember too that just because you have finished menopause and enter the Post Menopause period this doesn’t mean you can stop thinking about your heart health - it is just as important and again lifestyle factors mentioned above are key.
Did you know today is World Sleep Day, as I said last week there is nearly a day for everything but I LOVE sleep. In my college days I most definitely did not adhere or understand the importance of a sleep routine but with years comes wisdom I guess!
A good nights sleep is imperative in Perimenopause, without it the next day can be so hard and your body will not be happy with you for not giving it the rest it needs to restore itself after a busy day. I'm not a late owl, I'm definitely a morning person and more so now than when I was younger - I also find those mornings at the weekend when I sleep in that bit longer I feel much groggier for awhile and it takes me longer to wake up. Conversely, those Sunday mornings when I'm up early and off for a run my body is buzzing and I'm flying for the day - our bodies love routine, they love the rhythm of routine and knowing the same amount of sleep comes at the end of every day. Yes this can be boring and yes we can't do it every night but if you can aim for it most nights your body will thank you. I love nothing more than an early night with a good book and knowing I have many hours ahead of luscious sleep.
Some Top Sleep Tips :
💖Use breathing techniques to help you drift off to sleep
💖If you are experiencing night sweats or feel sticky have a quick shower before bedtime, it will always make you feel better.
💖Research Valerian and passionflower, these two herbs can be very helpful
💖Practice good sleep hygiene:
o Electronics free zone
o Keep the room as dark and cold as possible
o Exercise during the day, not last thing at night
o A regular bedtime and wake time
o Declutter your bedroom. Take the time to do this a clutter-free room will immediately lead to a calmer mind.
o Do not look at your phone, or iPad the last thing at night
o If you worry during the night, use the Special Worry Time technique - see below.
o Avoid caffeine, alcohol in the late afternoon and evening.
The last few talks I have found similar questions come up from the audience or ladies in private - so today I'm answering those questions which I hope will reach and help others.
Please note any products mentioned are ones I have used and believe in - I have no affiliation to any products.
What do I take everyday ?
My go-to dailies are Camu Camu & Rhodiola. I have used Camu Camu for a few years now and I totally love it - it can benefit every one of every age. It contains Vitamin C from Camu Camu berries which contain bioflavonoids & amino acids so essential to our body’s everyday functioning. Vitamin C is an antioxidant and as such supports the immune system - Camu has a far greater reach containing beta carotene, calcium, b vitamins, minerals & amino acids. I also love how great it is for my skin - it’s a collagen booster and I find it really enhances my skin. Also to mention the Camu berry is often referred to as the Feel Good Fruit due to its mood elevating properties and it can be very helpful for mild to moderate depression.
For those who know me you will know I'm passionate about good ethically sourced products - Sara has had her own journey and the result which is helping so many people is these fantastic ethically sourced products from Peru.
Rhodiola increases tolerance to various stressors, i.e. mental, physical, and environmental. This herb acts predominantly on the hypothalamus in a way that normalises the manner in which the body responds to stress triggers. It is also said to reduce mental & physical fatigue.
Can soy isoflavones help with menopause symptoms?
Yes, they can - you do need to be mindful of how you are taking it, my preference is via food but you can use a supplement like Red Clover for a higher dosage. There are several arguments out there about the impact of soy and also when you have thyroid issues. In Asia and Japan, in particular, they suffer less symptoms than the western world - attitude I’m sure is one reason in Japan where women in midlife are revered, in the west the attitude is different, thankfully changes are happening on this front. Japanese women report fewer symptoms which may be due to the high level of soy in the daily diet.
I have no symptoms should I take any supplements now ?
Prepare and prepare some more!
If you have no symptoms now and your in your mid 40’s be mindful of the journey ahead and prepare yourself - get ready to embrace and enjoy this chapter. There may be rough patches but you will move through them - keep exercising, be social, eat good food and if you feel you need an immune support then Camu Camu is the very best support for anyone at any age.
Any suggestions for an intense fear of driving that came on very suddenly ? Last weekend I was driving and I got really anxious and wasn’t able to keep driving
Anxiety can, unfortunately, reach a peak in menopause and it can happen at any time. I see the fear of driving, fear of crowded places life supermarkets a lot. When this happens the first suggestion is to concentrate on your breathing - pull the car over, open the window if you can and breath very slowly and very deeply. I would do this for 5 minutes.
Distraction then is your next best friend - your brain has fooled you into thinking you're in a dangerous situation and you have gone into fight & flight mode. You need to distract your brain out of that mode - breathing will help.
What I have found great with clients is a podcast or an audio-book in the car. This really takes the brain away from focusing on anxiety. Longer term you need to look at more self-care, more downtime for yourself to re-energize your mind & your body.
How can I relieve itchy dry skin on my legs & arms?
Water, water and more water with electrolytes are essential for health at midlife. Good hydration will help towards dryness. Ensure you are absorbing the water you drink, rather than it just flushing out your system. To enhance hydration try add the following foods to your diet: Coconut water ,Watermelon,Celery, Kefir, Cucumber, Kiwi, Bell peppers, Citrus fruit, Carrots, Pineapple. I also find Extra Virgin Coconut Oil brilliant - Dr. Coy an Irish company do a lovely one that I use - I use it on my body and also in my cooking ( it's a lovely addition to a warm bowl of porridge). For your body you will find a small bit goes a very long way so it lasts ages and personally I love the smell of coconut.
Last week I was told I was in menopause - I am 41 what can I do?
Every week I am stunned by the increasing number of women going into early menopause - the symptoms of premature menopause ( under the age of 45) can be exactly as in natural menopause and the treatment would be the same. You do need to be mindful of other areas - long term bone & heart health. This is an area I am keen to work more in, as such I will be doing more on this over the coming months - going into early menopause comes with additional emotional and psychological challenges that we all need to be aware of - being kind and gentle on yourself is very important as you navigate early menopause.
I had my first ever panic attack a few weeks ago - is this common in perimenopause ?
Panic attacks can be very common in Perimenopause, they can happen out of the blue and sometimes even when your feeling your most relaxed. The first port of call is to rule out anemia - I have had several clients who have had panic attacks physically occurring like palpitations and when they have had their blood tested it has shown them to be anemic. This is not always the case but it is important to rule this out. The next step is to empower yourself to understand what a panic attack is and how your brain can fool your body into the physical symptoms - this will take the fear out of it and help you feel stronger and equipped to handle another one. There is much more to this form of anxiety and for that I would suggest you refer to the Best-friends Guide to Anxiety.
I suffer horrendous bloating what can I do ?
Bloating can be very common in perimenopause - it’s imperative you ensure your bowels are moving regularly. The average western diet doesn’t support regular bowel function so you need to be mindful of this, eat loads of fruit & vegetables and I would also recommend adding more fiber by way of Psyllium Husks. Psyllium husks make the stomach feel full and stimulate bowel movements in a very gentle way. You can buy these in most health stores - the taste is very bland and boring so a great alternative is Sylliflor by Rocahealthcare. They come in small sachets or larger tubs with lovely tastes and flavor - there is even one with added calcium which gives a double boost! Just make sure you drink plenty of water when you have it.
Have you found Maca helpful with night sweats and energy ? There are so many on the web how do I know what is good ?
I love Maca, it’s a fantastic and exciting herb - exciting as so much new research is coming out showing more great benefits it can give- just last month research was published to show the bone strengthening properties of Maca and case studies where osteoporosis was reverted to osteopenia.
Maca has been used for centuries and it’s use dates back to 8,000 BC! It is commonly known for its energy giving properties but it does so much more. In my experience it is the number one herb in perimenopause helping balance the hormones that change during this chapter, it is also a great source of iron & calcium.
What you really need to be careful with is the many forms of Maca on the market - I am saddened by the marketing campaigns of many companies that target vulnerable women by promising quick results from what more often than not are a substandard form of Maca. I only recommend products that I have personally worked with and that I am passionate about - for me the 3 Root Maca by Sara's Choice is the only one to consider in the market. What I really love is the accessibility to all of us with this product - Sara being so passionate about helping women provides capsules but once you know what your body needs you can move to the powder form - once your confident in dosage this is easy to use.
Please note the dosage with Maca is essential so please contact me with any questions.
I have hemochromatosis can I take Maca ?
Unfortunately not due to the iron content - you can look at other supports dependent on the symptoms.
I have just completed cancer treatment can I take Maca ?
Yes, you can but it needs careful monitoring, you will need to get your Estradiol levels taken and monitor these as you take Maca. Guidance and advise on dosage would have to be considered on an individual basis and also would need to take into account the type of cancer you had.
I sometimes feel there are now days for everything and we are taking the goodness out of events, but saying that there are many days on the calendar that do deserve recognition and today is one of those days. Last night I was talking to a group of ladies in Kilkenny about Perimenopause and it inevitably led to talking about evolution...did we draw the short straw we often wonder. Personally I don't think we did - yes we have a roller coaster ride through life....who doesn't...but it is our attitude to life, to ourselves that shines through. We are amazing beings, we are strong beyond our awareness and we are so adaptable. Think about the journey of perimenopause, all the changes that happen along the way and we adapt, we change, we bolster ourselves to move through all these chapters. The key is Embracing perimenopause, embracing the changes that happen and realising that out of this journey we emerge stronger women.
Butler House, where our event was held last night, was the Dower house of Lady Eleanor Butler, the first Eleanor Butler was the niece of King Henry II and joined the Butler family in the 14th Century - can you imagine the life she had compared to us today. Yes I am sure there was great privilege but I am also sure there was great constraint. Today we have so much freedom, we can make our own choices, we can direct our path in the way we want, we can accomplish so much when we put our minds to it. We are lucky, we are living in a great time, we have so much opportunity to make the very best of our lives and embrace the journey we are on.
Celebrate who you are, celebrate your shape, your size, your opinions, your everything - we are all unique and that's what makes this world so exhilarating. Embrace being a woman, embrace the challenges of perimenopause - they change us into wiser women - and most of all enjoy the journey.
Happy International Women's Day Goddesses !
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