This is a continuation of a post on PeriMenopause and the failure of the medical establishment to handle women's health concerns effectively. You can find Part 1 here.
<this is a work in progress. Please excuse typos and errors...>
A few months ago I went to a new doctor at University Hospitals in Cleveland - an hour drive away from home, but the whole department came very well recommended. She was great, but i was fully expecting to have to fight for decent treatment. I was now bleeding constantly - the kind of bleeding and debilitating cramping I hadn't had in 20 years. She ordered tests, increased my progesterone. During my initial visit, i had a million questions - half truths and hints shared in social media posts - what is truth? what do the studies say? what do each of the hormones do? How does testosterone tie in? Once she understood that I was overducated and had a solid understanding of medical terminology (thank you classics education and a child with multiple chronic illnesses) she skipped explaining everything and started answering my questions directly.
And we stumbled across another condition. Turns out I've had something called HSDD, or Hypoactive Sexual Desire Disorder. She said it in passing while explaining the purpose of testosterone treatment, and i said "oh, i've had that for 20 years."
She stopped, looked at me, and said, "excuse me, what?" .
I said, "My libido decamped at least 15 years ago, and just never came back. I've given up on ever seeing it again."
She rapid fire asked me a series of very specific and direct questions, which i answered, and she sat and looked at me, dumbfounded. "Did you talk to your doctors?" she asked.
"Well, yes, of course. There was some super expensive supplement that might help, but it wasn't covered by insurance, stuides were inconclusive, and it cost like $800 a month. never gonna happen. <shrug>. It never came up again."
That same medicine is STILL the only approved treatment. Well, you can also microdose testosterone cream. It isn't indicated for HSDD, and up until recently it had a block box warning for use in women, and there are no dosing options for women so you have to purchase the male dose, and guess.... More than a decade later, and there is still just this same medicine...and it is still not covered by most insurances.
Because, why would women need to want to have sex? There's no real reason to study, or treat it. Amiright, ladies? <wink>
but i digress. Menopause.
My test came back with abnormal thickening of the endometrium. My doctor ordered an endometrial biopsy.
I said no.
Via the incredibly non-user-friendly patient portal (you all know exactly what i mean) the nurse replied that i needed it. I said, I will only do another EB if you knock me out, otherwise i'm not doing it. My one and only previous EB is the reason I understand the phrase "disassocating due to severe pain". I will never willingly go through that again, when there is absolutely no reason to. Knock me out.
....to be continued.
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