My Question To Be Answered By Dr XXXXXXX D Dear

Brief Answer:
Dear XXXXXXX Consider hormone replacement therapy. Counselling may help.

Detailed Answer:
Dear Mrs XXXXXXX

Thank you for consulting me for yourself this time.

I have read your query carefully and understand what you are going through, I really appreciate your effort to seek help for your problems.

1. Heaviness in the head when the blood pressure is normal is an indication that you are under a lot of stress. This can be particularly difficult as you are also perimenopausal and the hormonal imbalances that occur in this age do make things worse, quite intolerable to be honest.

First thing to do is to check your estrogen, progesterone and FSH and LH levels, that will confirm the perimenopausal hormonal imbalance, and if confirmed, initiating hormone replacement therapy (HRT) under the guidance of an endocrinologist and a gynecologist will certainly help greatly.

2. Please check with the ophthalmologist again to make sure you do not have recurrence of uveitis or increased pressure inside the eyes, it always better to be on the safer side.

That said, the stress itself can cause tiredness in the eyes as well, other causes of tired eyes are refractive errors, can happen even after cataract surgery, so getting your eyes checked will rule out any eye related issue.

3. It is indeed good that your blood pressure has been normal even while you are going through stressful situation.

Keep checking your blood pressure once in 3 months.

4. You can continue taking iron and calcium tablets, you can add a multivitamin along with that to make sure you have adequate vitamin levels as well.

There is no harm in taking iron, calcium and multivitamin like A-Z tablets daily in the prescribed doses.

5 to 9 - These could be a result of hormonal imbalance, or it could be due to some on going difficult situation at home or at work.

The best way to tackle this issue is by first trying to identify if there is any triggering factor in life.

It could be monetary issue, or it could be related to your children, their studies or it could be due to caring for someone who is dependent on you, or it could be an issue in your relationship.

I would want you to sit down and try and relax, and think carefully what is happening in your life, your spouse and children.

Was there any major stressful event in your family recently?

You need to provide breathing space for yourself in your family and make a habit of making time for yourself.

Take a leisurely walk on the beach or in a park once every 2 to 3 days.

Read some books, novels in your free time.

Keep yourself well hydrated and start doing mindful meditation. Learn this meditation technique, it is quite relieving and helpful in avoiding stress.

You say your mind is always occupied with thoughts, what kind of thoughts come to your mind?

Have you considered that something maybe bothering you, and you need to do something that you have always wanted to do?

Take a break from work for some days.

That said, these are also quite common symptoms of hormonal imbalance, so please do get that check first, then we can try to solve your problems one by one.

I hope you will find my answer to be useful.

Wishing you good health and happy life.

Best regards

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Brief Answer:
Please do FSH, LH, Estrogen and progesterone levels, consider HRT.

Detailed Answer:
Dear XXXXXXX

Thank you so much for your kind words, it is our responsibility to help our patients.

1. D&C showing simple hyperplasia is quite suggestive of hormone imbalance, the best way to conform is by directly measuring the hormone levels.

Please do follow the meditation techniques and other suggestions in my earlier answer.

Consult an endocrinologist and specifically ask for HRT, (in your case cyclical monthly regimen of HRT is suitable as it will regularise your periods also, this should contain both Estrogen and Progesterone in it, or if you wish you can also opt for 3 monthly cycles, where you take estrogen for 3 months and then progesterone for 14 days at the end of which you will get your menstrual period).

2. XXXXXXX please stop worrying about brain tumour, brain tumours do not cause heaviness in the head, brain tumours cause loss of function of the area of the brain affected.

Your symptoms are due to hormonal imbalance, this happens with most of the women who go through menopause.

For uveitis and eye irritation, please do visit your ophthalmologist without fail as it can get worse and can keep make already stressful situation worse.

3. Your mother is 72 years, she has lived her life successfully and she has raised a wonderful woman like you, you should try to be happy about her successful life. Coronary artery disease can be effectively managed with modern medicine and if needed angiographies. But you can not force anyone to go for it when they are adamant.

It is quite unfortunate that the present government has made it difficult by propagating pseudoscience and older people tend to believe such stupid things more easily.

If is completely unwilling to take modern evidence based medicine, then you can not force her to, you have to accept the fact that it was her choice. You did the best you could. You can not carry everyone's burden on your shoulders for ever.

You have to let go and move on. I am really sorry, I know this sounds harsh. But remember, it is her life.

4. Stop worrying about small issues my dear, I understand that it is not as easy as saying it.... You have to focus more on your personal well being and time for self. Do meditation, read books and novels, do something that you are very passionate about, do those things that you wanted to do as a teenager, take vacation.

You work so that you can have a life, do not let work become life, there are many beautiful things in life that make it worth living.

5. Finally, perimenopause refers to the period around complete stopping of menstrual periods. That is, 2 years before the complete stoppage of menstrual periods to 2 years after the complete stoppage of periods.

Since you have been having infrequent periods since 2 years, your periods might stop in one year, and you may experience these mood swings and hot flushes for another 2 to 3 years. Then they will usually settle down gradually.

No, it does not affect a woman's life significantly.... It is a physiological phenomenon, every woman goes through it, by the time a woman reaches the age of menopause, she would have completed her reproductive life ( she would have how many ever children she desires) and would not be having any intention of having any more children as you know, taking care of children and raising them in this ever complex world is not an easy job.

There is no need to worry about menopause, things will only get better from there.

Please let go of your fears and relax.

Go out and take a walk in the park, enjoy the little things in life.

I wish you splendid life ahead XXXXXXX do keep in touch if you need any further help or assistance, I will be more than happy to help.

Best regards.

Dr. Yogesh D, MD

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