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    dusty2927 posted:
    I also suffer from postmenopausal anxiety and have been a lifelong migraine sufferer. I had the migraines under control using an herbal combination of B vitamins, minerals, St. John's Wort, SAMe, and 5-HTP. I went to my nurse practitioner a year ago because of the anxiety and she prescribed 37.5 mg of Effexor, but that necessitated going off the herbal combination. The Effexor was effective for the anxiety, but the migraines have returned with a vengence. Now the NP wants to taper me off the Effexor and replace it with Inderal for the migraines. I was on Inderal several years ago and it was not effective. Should I try the Inderal again or go back to the herbal combination, and how do I deal with the anxiety now?
    Mary Jane Minkin, MD responded:
    Dear Dusty2927,
    Have you tried any estrogens? You may well be a good candidate for low dose transdermal estrogen, in the form of a patch or gel (such as Divigel or Elestrin)-all of these are bioidentical and plant derived. And you can balance these out with micronized natural progesterone (presuming you have not had a hysterectomy.) Many women with headaches and anxiety will benefit from using estrogens-so don't discount it as an option.
    Good luck,
    Mary Jane

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