Will HRT end my feeling of dread?

SINCE I stopped taking hormone replacement therapy (HRT) eight years ago, I’ve been waking up with this peculiar feeling of dread. Should I go back on HRT? I am 66 years old.

ALTHOUGH we talk about menopausal symptoms in terms of hot flushes, I see many women in this stage of life suffering with anxiety and insomnia.

Your description of a ‘feeling of dread’ describes very well how people feel with anxiety or panic – literally a feeling of dread that comes over like a wave, which cannot be rationalised.

Other mental health symptoms such as depression can also be associated with menopause due to the fluctuations in hormones that occur.

Treatment for panic attacks involves therapy sessions, either face-to-face or online, where patients learn mental tricks to help control the problem.

The question of restarting HRT involves weighing up the benefits versus the risks. It may be more appropriate for you to consider treatment specifically targeted to panic, such as cognitive behavioural therapy or a low dose of an antidepressant.

AFTER suffering head and neck pain for a year, I was diagnosed with cervicogenic headaches in April and treated with a ‘nerve block’ – but it didn’t work. Will medication help?

CERVICOGENIC headaches are a type of ache that start in the neck, usually because of problems with the spine.

The pain in the head comes alongside pain at the top of the neck and the base of the skull, with symptoms worsening when you move your neck.

Patients often describe feeling pain much more on one side of the neck, in the shoulder and the arms.

The discomfort may last for days and during this time they will suffer from a steady rather than throbbing type of headache.

These types of headaches are common in people in certain occupations who may hold their neck and head in a set position for long periods of time. They can also be the result of an injury caused by an accident, such as whiplash.

A nerve block – an injection that numbs the neck nerves – is not only a treatment for cervicogenic headache, it is also a diagnostic test.

If the pain does not go with a nerve block, it may not be cervicogenic headaches causing the pain. In which case other medications are often used to solve the problem.

Treatments include antiinflammatory or musclerelaxant medications. But physiotherapy can also be used – stretches and exercises may help a patient regain full movement of their neck and manage the symptoms.

Cervicogenic headaches can be misdiagnosed – the problem may, in fact, be other types of headache such as migraine. If treatments are not working, other types of headache should be considered.