causes for adrenalin surges for no reason?

I am 39 and went through premature menopause at 26.  Before HRT I would have 20 hot flashes a day that were just miserable.  Occasionally I would also have this feeling of an extreme adrenalin surge upon awakening.  It went away with HRT.  I stopped HRT for personal reasons.  When the hot flashes are bad I take it for a short while then go off.  My problem lately though, and I don't even know if this is related to menopause, but I feel like I am "stuck" in this major adrenalin surge.  It does not go away, it feels awful.  I feel like someone has just startled me terribly, but mentally I'm not concerned about anything.  It ALOT worse in the mornings, but never really goes away.  The Dr's really don't have an answer.  This is NOT a normal sensation.  What could cause this?  I'm on day 6 of the HRT and it is still just as strong.  It would normally be gone on day 2.  So what could cause a surge in adrenalin for no reason?  Please help!
Dawn P

[Machelle Seibel, MD]

It does sound like you are going through a very difficult time. What you are calling adrenalin surges could very well be sensations due to menopause because they went away with HRT. However, it is important to talk with your doctor to be sure that there isn't some other medical problem happening. Unfortunately, without an exam and more information, it is difficult to be more specific. But anxiety and  hot flashes are both associated with low estrogen. Other reasons can be panic attacks, adrenal tumors, heart arrhythmias as well as other causes.

You might discuss with your doctor alternatives to HRT. Also, some antidepression medications such as Cymbalta are used for both anxiety and depression. Other medications are also used for this purpose.
Machelle Seibel, MD