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Had two C sections and underwent gall bladder removal. Is anxiety and depression common during early menopause?

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General & Family Physician
Practicing since : 2009
Answered : 8985 Questions
Last year at age 40, I started having severe stabbing pains during my menstrual cycle as well as heavy bleeding for about five months. Sometimes I even suspected that the pain was intestinal cramps and not menstrual cramps. Sometimes I would be able to use the bathroom and the cramps would go away. But the cramps were severe stabbing pains. I could not breathe and often times be doubled over. They would only last for a few seconds; they were not constant. I had an ultrasound in October 2012 and the doctor said that I had a thick uterine lining - 12. I scheduled a D&C for a couple weeks later. However, I never had the D&C. While at the doctor's office for the procedure, I had a panic attack (first one ever). In addition, another patient had an emergency so the doctor had to leave to go to the hospital with the other patient. I left and never went back for the procedure. Also, during this time I was under a tremendous about of stress at work and at home. One of my sons was diagnosed with HSP, my uncle died at age 54, and my husband had to have emergency surgery (all within 6 months) plus I was working lots of hours at work. I started having severe anxiety and then depression. My menstrual cycle continued to fluctuate for the next year. Sometimes I would have one, sometimes I would not. Sometimes I would have spotting in the middle of my cycle and then nothing when I was supposed to. I basically had a nervous breakdown in XXXXXXX 2013. I was taken out of work and even hospitalized for 13 days. I am doing much better mentally now. I am taking medication and seeing my psychiatrist and therapist regularly. In addition, I also have psoriasis (had since I was a child). My psoriasis flared up the worst it ever has in August of this year. I have also started having joint pain in my knees and feet. My dermatologist thinks that the psoriasis has intensified to psoriatic arthriitis. I went back to my OB/GYN in September for my annual check up. She wanted to do another ultrasound and compare to last year. I had that ultrasound on 10/15/2013. The uterine lining is now normal but she indicated that there was fluid in my uterus. I cannot help but think that everything is related. Up until this time in my life, I have been pretty healthly. I have two children by c-section and then had gallstones three months after my second son was born and had that removed. Otherwise, I have never had any issues. I feel like I am falling apart. I think that I am in the early stages of perimenopause and all the hormone flunctations are causing a lot of the other problems. My doctor says that I am too young for perimenopause. But my mother started around 45 and one of her grandmothers had early menopause. Am I going crazy or can all of this be related and treated? My questions to you are: 1) Why was I fine for 4 years after my surgeries? I no longer have the stabbing pains but I am experiencing the menstrual cycle issues as well as anxiety and depression. I just told you that so you would have to whole picture. 2) What is the fluid in the uterus and what that could be. 3) could all of this be related? I know hormone changes can affect various aspects of your body. 4) Can I be going through early menopause and that is causing the anxiety, depression, aggravated psoriasis and psoriatic arthritis? 5) Is fluid in the uterus part of menopause?
Posted Thu, 28 Nov 2013 in Menstruation and Miscarriage
Answered by Dr. Shoaib Khan 1 hour later
Brief Answer: Looks like early menopause to me Detailed Answer: Hello ma'am and welcome. Thank you for the detailed explanation ma'am, it does really help a doctor to accurately advise. Starting with the psoriasis and symptoms of pain in and around specific joints, it does sound like your psoriasis has progressed into psoriatic arthritis ma'am. Do not worry about this, it is quite common, and even my father has it. It is treatable, and you should in fact seek treatment, as it can further progress and make mobility a problem once you are older. So it would be best to initiate appropriate treatment for the same. Next, coming to your first question; yes ma'am, your symptoms do seem to be related to perimenopause, and quite honestly we can never be too sure about when a women can start presenting with symptoms of menopause. So, do not worry about it, as long as you have completed your family and have and wish to continue an active sex life, it can all be managed well enough. 1) You were fine after your surgeries because the problem may have not been related to the surgeries. All menstrual irregularities, anxiety and depression are brought about by hormonal imbalances, which are the most common finding in woman approaching menopause. 2) The presence of fluid in the uterine cavity could be due to the following reasons: -Endometritis -Incomplete miscarriage -During menstruation -Hyper-ovulation -Cervical or endometrial cancer (rare) 3) Yes ma'am, all of this could be related. As you see from my second answer, conditions 1,2 and 4 are all possible in your case, due to a hormonal imbalance 4) Yes ma'am, you could be approaching menopause which can cause the anxiety, depression, and menstrual irregularities. But psoriasis could have been aggravated due to stress, which you have in abundance right now. Also, psoriasis in most individuals progresses with time into psoriatic arthritis. So this may or may not be directly linked to early menopause 5) It is not part of menopause per say, but it is seen in woman approaching menopause due to the hormonal imbalances. It is also considered normal when seen during menstruation I hope I have succeeded in answering all your queries in a manner best understood by you ma'am. Please feel free to write back to me for any further clarifications or if anything I have explained is still unclear, I would be more than happy to help. God bless.
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