Research has shown there is a direct link between PTSD symptoms increasing along side perimenopause as it transitions into menopause. PTSD symptoms that increase alongside menopause include hyperarousal, avoidance, dissociation and rage. Scientists believe PTSD symptoms increase due to fluctuating levels of estrogen in the brain. Luckily, these symptoms resolve once a woman moves into post menopause, where hormones level out. The problem is that this process can take between seven and fourteen years.
Estrogen helps to regulate the HPA axis and suppress stress evoked ACTH release and CRH neuron activity; this means that estrogen lowers how much cortisol gets released in order to help the system return to a baseline state. So, as estrogen declines and fluctuates during menopause, cortisol production and regulation changes, and the HPA axis becomes less predictable and more reactive. Therefore, your emotions and feelings have more room to take over your mood in order to be dealt with.
Many women have trauma they’ve suppressed in order to cope with life. Estrogen normally keeps women’s stress responses to trauma stable before menopause; this is what makes it easier to ignore old memories or triggers from completely derailing your day. Over time, the long term stress of keeping trauma buried while living life causes more cortisol to be released at a faster rate when a trigger occurs. The ability to keep trauma buried changes during menopause, because the estrogen levels are no longer steady enough to keep up, so memories and feelings begin to peek out.
As menopause progresses, the swings in estrogen are much greater, which makes it harder to deal with the stress created by past trauma. Sometimes memories that you didn’t know were there begin to surface. There are some common behaviors women experience during these swings such as saying something harsh to a friend or family remember and then feeling terrible after.
Other ways these fluctuations may show up can be seen through misunderstandings. Feelings may also spill out over a television show, while the nightly news leaves you numb. You may read too much into a test or email and question whether the sender is mad at you, or whether they still even like you. You may wake up at 3am feeling panicky, or like something bad is going to happen. Sometimes you’ll even see women regress back to the age where the trauma occurred.
Luckily, in addition to HRT, therapy at Austin Concierge Therapy can help as well. We can help you find, unearth, and process your trauma, so it never bothers you again in the same way. EMDR (bilateral stimulations) is one tool we utilize. We also use a somatic method called SIBAM that helps you isolate where trauma resides in the body. Finally, for deeper level trauma that doesn’t respond to normal modalities and accompanies depression and anxiety, there is the option of ketamine assisted therapy. Texas Direct Medical has partnered with us to help provide ketamine as an option, when necessary.
