A while back, I listened to a program by Rachel Russ of Ideastream Public Media about Menopause, and specifically about the failure of the medical community to study, treat, and even discuss the condition. I ended up writing into the show to share my experience. This is a revision of that email.
I don’t think you can underestimate the failure of GPs and OB/Gyn's to take menopause symptoms seriously, and their inabiity to treat it in ways other than throwing drugs at it.
I started perimenopause at age 42. My primary symptom was severe insomnia - I'd fall asleep fine, but wake up 3 to 5 hours later, and just lay there all night. After 3 months of this, i had aged visably, I was exhausted all the time, I couldn't think straight. I begged my doctor for help, with no idea it was related to perimenopause, just that I couldn’t think, couldn’t concentrate, because I wasn’t sleeping. She put me on antidepressants, which did NOTHING, doubled the dose, which caused me to sleep all the time, decided to take me off of them, did it too fast, resulting in withdrawal symptoms: wild, violent mood swings, brain zaps, sudden rages. I was also given Ambien to help me sleep. That was the extent of their help for me. I went on suffering.
At no point did anyone talk to me about perimenopause. At no point did anyone discuss hormone replacement therapy. If they had, I would have told them, oh, my mom had hormone receptor positive breast cancer, so I can’t do HRT.
Because that’s what I had been told.
At no time did anyone say, actually, that’s not really true. You probably can, we will just need to do a medical evaluation and medial history to see what is best for you.
I suffered for a decade. Think about that for a minute. a DECADE. 20% of my life up to that point. Unpredictable periods. Disrupted sleep patterns that came and went. No hot flashes or night sweats, but my ability to regulate my body temp was completely haywire - if I got hot, it took hours to cool down, and i'd have to use cold compresses. If I got cold, it was impossible to warm up, and required hot drinks, heating pads, and multiple blankets. Eventually, my periods stopped, and I started losing body strength. I hurt. All. Over.
I went to my docs during all of this. I complained. The body pain was out of this world. Just standing up from a seated position was oh my god painful. I gained weight, because moving hurts. I had no energy to do anything. I had no libido at all. If I managed to get motivated to do something, tendons and muscles would sing with pain, get enflamed. I had IT band tendonitis, hand/wrist pain from repetitive motion (hammering motion while laying pavers by my pool, for a couple of hours 2 or 3 days a week), tennis elbow, and golfer elbow. All of this in a single summer: within one 3 month period, and I had all of those ailments.
I went from an extremely physically capable woman, used to doing heavy work by myself, a former landscape foreman, former loader operator, avid gardener, farmgirl....to a woman who struggled to carry a basket of wet laundry up from the basement to hang outside. Gardening was impossible - no energy, and I'd get so HOT. My property that used to be filled with flowers, was overgrown with weeds. People would ask me why had i let everything go?
It was demoralizing. My marriage suffered. I hated myself. I hated my body. I felt old and useless. I was actively working on accepting that I was ugly, and no one would ever find me attractive again. That this was what happens when you get old.
I was 54.
Then, it wasn’t a doctor who initially helped me, but an online community of Gen X women. They kept talking about HRT, and how life-changing it was. Then I happened across a video by some doctor I don’t remember, saying that the risk factors of HRT for women, are LOWER than for testosterone replacement therapy for men, and THAT gets prescribed constantly.
I thought, huh.
And I looked around for a menopause expert in my area.
I found one. After my first apointment, I sat in my car and cried like a baby. i SOBBED. Someone was LISTENING. Someone was explaining how menopause affects the body, how loss of hormones impact things like muscle strength and energy levels. Someone said there was a way to feel better.
I started HRT. Within 3 months, I fired that doctor. She never once even EXAMINED me. She never did blood work. Asked me a few questions. Prescribed meds. Told me to go away. When I returned and explained that HRT was causing an ongoing herpes outbreak, she told me I was wrong, that herpes had nothing to do with hormone levels…I politely said, uh..yes it did. I’ve lived with herpes for 26 years. Anytime I’ve had a significant hormone shift in my body (pregnancy, a miscarriage, birth, stopping breastfeeding, menopause) I suffered herpes outbreaks. I know my body and how it reacts to the virus. She refused to increase my dose despite no other changes to my problem symptoms, and told me to come back in 2 months. You had to be there, but she made it clear she was doing so to punish me for disagreeing with her. I hadn’t ASKED her to increase it. She said, well, since you’re having PROBLEMS I don’t think we should increase your dose yet. She stood up and walked to the door. She paused with her hand on the doorknob, door half open, and said, “you know, correlation is not causation,” and shut the door.
now, don't get me wrong. That phrase is 100% accurate. Correlation is not, in fact, causation, and believing it is results in many of the crackpot fake medical treatments and wellness trends that waste billions of dollars a year and harm millions of people.
This is not that. I had 26 years of first person observations to base my statement on. I had read medical articles studying the phenomenon. I had had to stop birth control pills in my 30's because of constant outbreaks that nothing helped. The only thing that stopped them was stopping BC. She disregarded me and my observations, and denigrated me for daring to think i could voice such an observation.
I looked around for another menopause doc. All the others in the area weren’t accepting new patients.
Went to my old OB/Gyn, the one who delivered my daughter. Hadn't seen her in a few years; I had been going to my GP for annuals. She agreed to take over the prescription, and increased my dose. Then she said she hoped that RFK Jr could straighten out the whole Autism thing with vaccines.
<mental version of running into a brick wall>. I had just gone from someone using "correlation is not causation" to dismiss my concerns, to someone actively treating correlation as causation. I swear you can't make this shit up.
I haven’t been back. I have no idea what to do now. I’m on a relatively low dose, and it is definitely helping. But I’ve started bleeding unpredictably, and cramping on and off all the time. It’s a trade off.
So. Yeah. My point is, doctors are given little to no training on how to treat menopause. Let’s be honest - there has been little to no RESEARCH on menopause and it’s affects on physical and mental health of women, or how to treat it. They throw drugs at it (NOT hormones….anti-depressants. Oh my god, does that make me angry. I am NOT depressed! My body is betraying me! Help me fix the problem, don’t medicate me into stupefaction!
I had already been robbed of a decade of my life. I was robbed of vitality and stamina. And I seriously resented it.
I eventually tried another doc. I will continue this sad story in a separate blog post. You can find it here.
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