Panic attacks in menopause

Panic attacks during menopause are a very common symptom, which can also be a manifest sign of the onset of menopause. Changes in a woman's body during menopause are not only changes at the level of the internal genital organs, but also changes in the entire body. Panic attacks can be of varying degrees of manifestation, but in any case they require correction. The combination of panic attacks with organic changes in the internal organs is an indication for hormone replacement therapy.

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Causes panic attacks in menopause

Menopause is a period in a woman's life when various changes occur not only with the internal genital organs, but also with other body systems. This is a physiological process of changes in the female reproductive system, during which involutionary processes occur in the body. The hormonal background of the female body is very diverse and ensures not only the functioning of the female genital organs, but also affects metabolism, the tone of the vascular muscles, blood pressure, and the regulation of nervous activity. Due to this phenomenon, the female nervous system is very labile, and any hormonal disorders contribute to changes in nervous regulation. Therefore, along with menstrual dysfunction during menopause, there is a violation of the mental perception of what is happening. The violation of nerve conduction is also accompanied by an emotional factor of awareness that the female body is aging, which is why panic attacks often occur.

The climacteric period is conventionally divided into:

1. premenopause – the period from 45 years to the onset of menopause;
2. menopause – the period of the last menstruation, average age is about fifty years;
3. postmenopause – the period from the last menstruation until the end of a woman’s life.

All these periods are characterized by consistent changes in the body and if there are no disorders, then the nervous system works normally and gradually adapts to changes in hormonal levels. If there is a rapid transition from stage to stage, then various disorders occur, including panic attacks. Therefore, the immediate cause of panic attacks during menopause can be considered a sharp hormonal imbalance in the female body, which entails a violation of the normal work of the central and peripheral nervous system.

If we talk about the pathogenesis of panic attacks during menopause, then we should know about hormonal changes that disrupt metabolic processes in the cerebral cortex.

Premenopause is characterized by hormonal disorders, which are primarily of a central nature. There is an involution of the highest regulatory center - the hypothalamus, which is characterized by a gradual decrease in the sensitivity of the hypothalamus to the influence of estrogens, which disrupts its regulatory function according to the principle of feedback regulation. As a consequence of all these processes, there is not enough concentration of hormones and their alternation for normal regulation of the nervous system. Thus, the principle of the main dominant, that is, the menstrual function, is disrupted in the cerebral cortex, and it is with mental lability that such a violation can cause panic attacks. If all these changes also occur against the background of disturbances in the conduction of nerve impulses, then panic attacks are maintained and intensified. As is known, progesterone and estrogens ensure normal conduction of nerve impulses through the cell, and in a broader sense they regulate the tone of the autonomic nervous system. The autonomic nervous system is divided into the sympathetic and parasympathetic nervous systems according to the principle of action. The sympathetic nervous system ensures active processes in the body, which are accompanied by energy expenditure, and the parasympathetic division of the autonomic nervous system ensures energy accumulation. Such regulation occurs at the level of all internal organs and ensures their normal functioning. In case of hormonal imbalances, the parasympathetic nervous system cannot inhibit the activity of the sympathetic system, so panic attacks are accompanied by other autonomic symptoms.

Also, an additional pathogenetic mechanism for the occurrence of panic attacks is the central principle, which consists in the disruption of the processes of inhibition and excitation in the main brain, and this also disrupts the conductivity along the nerve fibers and further deepens the changes. At the same time, extraovarian foci of hormone synthesis are activated as a protective mechanism, and this contributes to the release of a large number of catecholamines, which significantly aggravate and stimulate the development of symptoms of panic attacks during menopause.

These are the main causes and mechanisms of development of disorders during menopause in the form of panic attacks, which requires correction to prevent the development of complications.

Symptoms panic attacks in menopause

Panic attacks are attacks of varying severity, which are accompanied by mental and vegetative manifestations, and there may also be symptoms of other disorders corresponding to the climacteric period.

Symptoms of panic attacks during menopause can develop gradually, or they can be sudden and can hide other pathologies. Also, the danger of panic attacks is that the development of the clinical picture is sometimes so pronounced that one can think of a serious illness from the mental sphere of a woman, but these are just functional changes provoked by hormonal imbalance. This also indicates that it is necessary to urgently treat such a pathology, since it disrupts the normal life of a woman.

The severity of symptoms may vary. As a rule, women are bothered by this condition in the morning and not every day. The most vivid clinical picture may be accompanied by a sharp awakening in the morning, a feeling of a rush of heat to the face, severe tachycardia, a feeling of shaking of the whole body, anxiety, a feeling of fear of death, headache, dyspeptic phenomena in the form of nausea, vomiting, diarrhea. All these symptoms can be at the same time, then we are talking about severe panic attacks up to neurosis. When not all symptoms are expressed, in this case we are talking about a more favorable option.

The first signs of a panic attack during menopause are a sudden onset of an attack of fear, deep anxiety or emotional instability with anxiety. This makes a woman panic and leads to an even more difficult situation. If menopause begins with panic attacks, then we are talking about a moderate menopause and a not very favorable prognosis, so we should immediately talk about hormone replacement therapy.

Symptoms of panic attacks are often not limited to the emotional and volitional sphere and are accompanied by vegetative manifestations. A woman is concerned about irritability, mood swings, depression, decreased sexual desire, fatigue. Also, vegetative manifestations can often be attacks of sweating, fever, headache and palpitations, increased fatigue, sleep disorders such as insomnia or drowsiness, impaired performance and daily activity. Often, a panic attack ends with a woman sleeping, after which all the symptoms pass and she feels better, there may be only residual effects in the form of a headache. A decrease in sexual desire and vasomotor manifestations are expressed. All these clinical signs accompany and aggravate attacks of panic attacks.

Depression, as a manifestation of menopause, along with panic attacks, is quite common and these two symptoms can replace each other. Panic attacks do not occur every day, and in their absence, a woman can wake up in a depressive mood. This is explained by the violation of excitation and inhibition processes in the cerebral cortex.

Other symptoms that accompany panic attacks are also associated with hormonal imbalance and associated pathologies. Often, during a panic attack, pain in the heart area occurs, which is not associated with stress, but occurs on its own during the attack. Such heart pains can occur suddenly and be accompanied by hot flashes to the face, a feeling of palpitations or interruptions in the heart's work. Panic attacks are also often accompanied by lability of blood pressure. In this case, symptoms of low blood pressure occur in the form of headaches, dizziness, nausea, as well as symptoms of arterial hypertension in the form of bursting headaches, nausea, palpitations, dizziness, flickering flies before the eyes. This occurs due to the fact that the processes of vascular tone regulation are disrupted, which contributes to periods of spasm of peripheral vessels, an increase in peripheral resistance and an increase in blood pressure. Arterial hypertension is also facilitated by sodium and water retention and an increase in the volume of circulating blood. All this during a panic attack is a very serious symptom and requires parallel antihypertensive therapy to prevent complications.

It often happens that panic attacks are accompanied by symptoms from the gastrointestinal tract. In this case, diarrhea, flatulence, bloating, and intestinal motility disorders are observed. All this also occurs against the background of a disorder of nervous activity and regulation of the gastrointestinal tract.

Headaches are often characteristic of a panic attack and are debilitating, do not respond well to painkillers, and sometimes require serious medication. They can occur during the attack or appear after it is over.

Speaking about the symptoms of panic attacks during menopause, it should be noted that they can be quite diverse. Often, everything begins with simple emotional disturbances, which over time develop into serious symptoms. Therefore, it is necessary to notice the clinical manifestations of menopause in time, because panic attacks are a very serious manifestation.

Complications and consequences

The consequence of panic attacks during menopause is a disruption of a woman's normal life. This is a very serious problem, since the symptoms of this pathology are very pronounced and are observed throughout the entire period. Very often, a woman's ability to work decreases, her general mental state worsens, and a vicious circle arises. Complications of panic attacks during menopause are possible complications from other organs and systems due to concomitant hypertension, tachycardia. Therefore, an attack of panic attack can be accompanied by an increase in blood pressure to such a level that damage to target organs occurs during a hypertensive crisis.

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Diagnostics panic attacks in menopause

It is very important to establish a correct diagnosis of a panic attack in time with timely treatment of the pathology. It is necessary to clearly differentiate between functional mental changes against the background of menopause and serious mental disorders.

Often women do not know what to associate their condition with, so it is necessary to be attentive to this issue and not to exclude any symptoms as a manifestation of the climacteric period. First of all, it is necessary to begin diagnostics with a thorough collection of anamnesis. It is necessary to find out when such symptoms first appeared and whether this is associated with a delay in menstruation. It is necessary to find out what the nature of the attacks is now, how the symptoms changed depending on the situation, and also to detail the patient's complaints.

If it is a routine examination by a gynecologist, then the woman needs to be examined on the chair, after which the level of the main female hormones in the blood should be determined. If a connection between panic attacks and menopause is established, then even in this case a consultation with a psychiatrist is needed, since a comprehensive approach is needed in treatment.

The tests that are necessary to clarify the diagnosis are general clinical and special. General tests are blood tests, biochemical blood tests with lipidogram and kidney function indicators, and urine tests. This is necessary to exclude somatic pathology and monitor the patient's condition. Special tests are determination of the level of female sex hormones.

Instrumental diagnostics of VSD during menopause is widely used not only for diagnostics, but also for differential diagnostics. Mandatory research methods are carried out - this is electrocardiography, which allows to exclude cardiac pathology in case of concomitant symptoms from the heart.

It is also necessary to conduct echoencephalography to study the features of cerebral circulation and exclude cerebral ischemia. This method involves recording echo signals that allow you to establish the blood supply to the cerebral hemispheres, and also allows you to judge the difference in intracranial pressure. This examination allows you to determine possible organic pathology and conduct differential diagnostics with involutional changes in the brain.

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Differential diagnosis

Differential diagnostics of panic attacks during menopause should be carried out with pathologies that are accompanied by similar symptoms - these are vegetative-vascular dystonia, acute neurosis, hypertensive crisis, as well as a number of cardiac pathologies in the form of myocardial infarction, angina pectoris.

Vegetative-vascular dystonia is a functional disease characterized by the same vasomotor and emotional-psychological manifestations. It is very important to differentiate these two conditions. With VSD, the symptoms are less pronounced and they are constant due to stress, while panic attacks have the character of attacks and the psychological side of the clinical course is very pronounced.

Hypertension with exacerbation in the form of a crisis can also be accompanied by cardiac symptoms with headache and an attack of fear. The main diagnostic feature in this case is high blood pressure in hypertension.

It is very important to carry out differential diagnostics of panic attacks during menopause with psychiatric pathology, since the severity of manifestations can be so great that it is difficult to differentiate these two conditions. Therefore, in this case, a consultation with a psychiatrist is necessary. But there are some diagnostic features. Acute neurosis, as a rule, develops under the influence of certain mental traumas or prolonged mental stress. In this case, a woman experiences a situationally unconditioned feeling of anxiety, which is accompanied by palpitations, chest pain, tremors, dry mouth, dizziness and lasts for several minutes. These symptoms are also accompanied by affective instability outside the attack and an increase in anxiety. Panic attacks during menopause occur without a stimulus, usually in the morning and in the period between attacks, the general condition does not change.

Clear diagnostic tactics and careful differential diagnostics allow timely detection of panic attacks during menopause and differentiation of this pathology from organic diseases and mental disorders for the purpose of timely treatment and improvement of the patient’s quality of life.

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Treatment panic attacks in menopause

Considering the fact that panic attacks during menopause are very pronounced and significantly affect a woman's life, treatment must be carried out immediately. There are drug and non-drug treatments. Drug treatments should be aimed not only at correcting hormonal imbalances, but also given the severity of clinical symptoms, in some cases psychotropic drugs are necessary for treatment. Non-drug treatment also uses herbal preparations, folk remedies and homeopathic remedies, which are also aimed at normalizing the emotional state.

Regardless of the chosen method of treatment, a very important component of successful resolution of the disease is the correct daily routine and nutrition of a woman during menopause.

1. Correction of the daily routine with normalization of the rest and work periods. It is necessary to precisely establish a rest regime after each work. This will help the body to distribute forces correctly and relieve stress while maintaining emotional stability.
2. Normalization of sleep by means of a regimen of rest – it is necessary to go to bed at about the same time, to sleep at least 8-9 hours a day. It is necessary to carry out hygienic measures in the room where the woman sleeps – wet cleaning, airing, fresh linen – all this helps to normalize the work of the brain and reduces episodes of panic attacks in the morning after waking up.
3. It is necessary to eliminate stress, tension, and bad habits, which only contribute to changes in the normal regulation of the nervous system.
4. It is necessary to properly organize leisure time with dosed physical activity in the form of light jogging, swimming or simple walking. This has a tonic effect on nervous activity and distracts from daily stress.
5. It is important to organize proper nutrition with dietary elements:
   • it is necessary to exclude fatty foods, which put a strain on internal organs;
   • it is necessary to organize frequent fractional meals in small portions with the exclusion of simple carbohydrates and with a predominance of vegetable protein;
   • the daily volume of fruits and vegetables should be at least 300 grams;
   • You should follow a drinking regime and drink at least 1.5 liters of clean water.

Drug therapy should be carried out in combination with other methods, and panic attacks during menopause are an indication for hormone replacement therapy. Drugs are prescribed after hormonal screening, but in most cases, combined treatment with both estrogens and progesterone is necessary.

1. Triziston is a complex hormone replacement drug. The principle of action is to regulate hormone levels, which in turn increases the tone of the nervous system with normalization of the function of cortical structures and a decrease in episodes of sudden changes in hormonal changes and panic attacks. This drug is produced in the pharmacological form of dragees of three colors, which are used according to a special scheme for three weeks, then a break for a week. The course of treatment is at least three to six months. Contraindications for prescribing the drug are malignant tumors of any localization, vascular pathology in the form of thrombosis in the anamnesis, hepatitis. It should be used with caution in diabetes mellitus, since the drug can change glucose tolerance, as well as in arterial hypertension. Side effects may appear in the form of cholestasis, liver dysfunction, embolism, as well as allergic and dyspeptic reactions.
2. Logest is a drug containing estradiol and gestagen, is a highly dosed drug, due to which its preventive role is manifested not only in the correction of hormonal levels, but also in the prevention of oncological diseases of the female reproductive system. The drug helps to level out hormonal imbalances and due to this, the symptoms of excitation and inhibition regulation disorders are reduced. Logest is available in the pharmacological form of capsules, containing 21 pieces per package. The intake should be started on the first day of the cycle. You can start taking it on the fifth day of the menstrual cycle in case of menopause in a woman. The course of taking the drug is one capsule per day for three weeks, then a break for seven days, then you need to resume taking it. Side effects are possible from the gastrointestinal tract in the form of stool disorders, nausea, a feeling of bitterness in the mouth, vomiting. There may also be asthenovegetative reactions, manifestations of hormonal treatment from the chest in the form of engorgement of the mammary gland, pain, discharge, and an increase in the release of vaginal secretions. Contraindications to the use of the drug for treatment are problems with blood clotting and a history of heart attack or stroke, malignant neoplasms, liver dysfunction, pancreatic damage and diabetes.
3. Velaxin is an antidepressant that is often used to treat panic attacks during menopause. This therapy is explained by the fact that often, to relieve anxiety and fear, it is necessary to take these drugs in combination with hormonal drugs. This drug increases the number of molecules that are responsible for transmitting a nerve signal, and the number of mediators that relieve depression and fear increases. The drug is available in the form of capsules and tablets, and the recommended initial dose is 75 milligrams during meals. Side effects of the drug can be expressed in the form of changes in the nervous system - dizziness, drowsiness, increased excitability, as well as loss of appetite, nausea, vomiting, diarrhea, increased sweating or dry mouth, palpitations and tremors of the limbs. The drug is contraindicated in liver and kidney pathology, hypersensitivity to the components of the drug, with simultaneous treatment with monoamine oxidase inhibitors.

Surgical treatment of panic attacks during menopause is not used, since there are no special indications for such intervention.

Folk remedies for panic attacks during menopause

The use of folk methods of treating panic attacks during menopause is very widespread, but such treatment should not be carried out in the acute period, since its effect is delayed. Such methods can be used together with medications. The drugs that are used are aimed mainly at correcting hormonal homeostasis and a calming and anxiolytic effect. For this, folk remedies and herbal treatment are used. The main folk methods are:

1. To normalize nervous excitement, it is necessary to take an infusion of motherwort and hawthorn herbs, for taste you can also add honey. To do this, take motherwort and hawthorn leaves, one tablespoon of each herb, pour boiling water over it and boil for several minutes. The infusion of these herbs is consumed warm, half a glass on an empty stomach for three weeks.
2. An effective way to normalize hormonal levels is to use walnut shells. Walnut tincture is prepared as follows: the membranes or shells are boiled for about five minutes in hot water, then the water is drained and half a glass of alcohol is poured in. This solution needs to be infused for about five to seven days, after which it can be taken one teaspoon twice a day, pre-diluted with boiled water in equal proportions. The course of treatment is three weeks.
3. Taking an infusion of sedative herbs is very good at calming the nervous system and reducing panic attacks during menopause. To prepare such an infusion, you need to take chamomile, mint, lemon balm leaves, then pour two glasses of hot boiled water over it and leave it in a dark place for three hours. You need to add a tablespoon of honey to such a decoction and drink it instead of tea at least twice a day. Such a decoction regulates the activity of the nervous system well.

Homeopathic remedies are able not only to correct hormonal imbalance, but they also restore the normal tone of the cortical structures of the brain and reduce the severity of symptoms during panic attacks during menopause.

1. Remens is a homeopathic drug that improves microcirculation in the vessels of the brain, regulates hormonal imbalance during menopause due to the effect on the hypothalamic-pituitary zone, and also has protective properties on myocardial cells and vessels. The drug is available in the form of a solution and tablets. The medicine is used on the first and second day in an increased dose - one tablet or ten drops eight times a day, and then for three months in the same dose, but only three times a day. No side effects have been identified. Contraindications to taking Remens are hypersensitivity to individual contents of the drug.
2. Klimakt-Hel is a homeopathic preparation that is an analogue of phytoestrogen preparations and helps to normalize hormonal levels during menopause. The preparation also reduces neurohormonal disorders with improved regulation of nervous activity. Klimaktoplan is used in tablets, one tablet before meals or an hour after three times a day. The course of treatment with the preparation is long - about two months. No side effects have been identified. Contraindications to taking Klimaktoplan are hypersensitivity to the components of the preparation.
3. Sigetin is a drug that is a synthetic analogue of the natural hormone estrogen, and allows you to replenish its supply during menopause. It has properties of both a tonic and a sedative. It has a good effect on the psychosomatic manifestations of menopause, as well as on the vegetative and psychological symptoms of menopause.

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Prevention

Measures to prevent panic attacks during menopause and progression of symptoms are non-specific. It is necessary to properly organize your daily routine with alternating periods of rest and work. You need to eat right, excluding all harmful foods and eating fruits and vegetables. Sleep is a necessary measure for health, its duration should be at least 8-9 hours. It is necessary to wake up with a positive attitude, this will help set the rhythm of the day and prevent attacks of attacks in the morning. It is necessary to eliminate stress in life and play sports, at least in the mode of walking. It is also necessary to exclude bad habits and treat concomitant pathologies in the form of hypertension, because blood pressure control is very important for the prevention of complications during an attack of panic attack.

Panic attacks during menopause can appear at the beginning of menopause, but can also develop in the midst of this period. In any case, they are accompanied by unpleasant symptoms and require correction of the condition, both hormonal and medicinal. It is necessary to promptly diagnose this condition and correctly conduct differential diagnostics, therefore, with any such symptoms, it is necessary to consult a doctor. Do not panic in case of such manifestations, because everything can be corrected and life can be returned to normal.

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Forecast

The prognosis for recovery in the case of manifestation of menopause in the form of panic attacks is favorable, but timely detection of symptoms and treatment aimed at correcting the homeostasis of hormones in the body and calming anxiolytic therapy are mandatory.

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