Let's Talk About Menopause
February 1, 2023 10:22 AM   Subscribe

Women have been misled about menopause Hot flashes, sleeplessness, pain during sex: For some of menopause’s worst symptoms, there’s an established treatment. Why aren’t more women offered it? or maybe we should talk about extending reproductive longevity. After all, we don't fully understand the purpose of menopause as most mammals don't experience it. There are theories.

Or perhaps we should Cancel Menopause altogether?
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posted by [insert clever name here] at 10:23 AM on February 1, 2023 [2 favorites]


So, I'm pretty much in menopause. My doctor and I are on the same page about me not really wanting medication unless I absolute need it for something; I don't like tinkering with my body chemistry too much, and I also know I'd resent it for "oh, crap, it's yet another thing I have to try to remember, sigh". I was (and am) single while I was in perimenopause, and the biggest symptoms I was having were the hot flashes, and on the one or two rare occasions when I had a hookup with a gent, it was uncomfortable.

Today, the biggest aftereffect is that my libido - which was once fairly high - has just TANKED, like someone flipped a master switch to "off". And - honestly, that's actually had some positive effects; it was like some weird fog cleared and the entire rest of my life rushed in like "FINALLY, you can start paying attention to us again" and that's been a good thing. But...I am also open to the possibility that who knows, maybe I'll meet someone and sparks will fly and...I'll want to do something about that. I did discuss that with my doctor, and she said that there were some on-the-fly treatments I could try if that day ever came.

However - I've also started seeing my blood pressure and heart rate creep up. It started doing that when I was 50....right about the time that perimenopause ended for me. So when that article said that menopause also had an impact on heart health...I did a serious double-take.

I think I'm going to print this out and bring it with me on my next doctor's visit.
posted by EmpressCallipygos at 10:43 AM on February 1, 2023 [15 favorites]


A bit of anecdata that may help others: my partner, without uterus but with ovaries, had bad hot flashes and shitty sleep until they got on the estrogen patch, actually half of the 37.5 patch, a really tiny dose, because the full patch was rife with unfortunate side effects, and every four days instead of 2x week. The more interesting story is that none of the earlier SSRI-based attempts to control menopausal symptoms worked at all, and were actively harmful. Cue the recent diagnosis of ADHD which they've always had but really started affecting their work since menopause ...
posted by seanmpuckett at 10:50 AM on February 1, 2023 [3 favorites]


What is as interesting in that first link is (did some Googling to verify) the revelation that when your ovaries stop producing estrogen your belly fat becomes a secondary source. I had no idea fat created estrogen.
posted by emjaybee at 11:12 AM on February 1, 2023 [7 favorites]


Well, I just had a hysterectomy three and half weeks ago (fibroid related). They left my ovaries so I'm technically not in menopause yet, but I'm almost 47 years old and aware that I just sped up the process.

Both my mother and grandmother had hysterectomies in the early 40s for the same reason. Both were off and on HRT and both reported significant improvements to their quality of life while they were on (I can back this up from personal observation in Mom's case. Both stayed(Nana died at 94 due to COPD from being a lifelong smoker/have stayed (Mom is in her mid-70s, still works full time and doesn't have any chronic health issues save a bum knee) pretty healthy. I will likely fight for estrogen pills. I am no longer interested in needless suffering just because I was born with a bunch of machinery (now blessedly gone!) I never wanted to use
posted by thivaia at 11:12 AM on February 1, 2023 [4 favorites]


Can we stop fertility AND menopause? Just, like. No periods, no getting pregnant, no menopause. I don't want any of it, lol. I guess the minipill takes care of the first two, but taking that thing on time's a bitch, IUDs suck... can someone just CRISPR me with the parts of being a woman that I like and take out the parts I don't? Plz and thank you.
posted by pelvicsorcery at 11:14 AM on February 1, 2023 [50 favorites]


Also, thank you for linking this. Enlightening and infuriating.
posted by pelvicsorcery at 11:26 AM on February 1, 2023 [3 favorites]


No periods, no getting pregnant, no menopause. I don't want any of it, lol. I guess the minipill takes care of the first two,

And even then the minipill isn't great at that first one. Unless by no periods we mean one long never ending breakthrough bleeding experience (I'm not the only one, right?). Which I guess is technically not a period, but that's not really what we're asking for when we say we don't want periods.

I know why the phrase "extending reproductive longevity" is used. But I'm with pelvicsorcery, I don't want to have my fertility extended. Avoiding the other side effects would be great, though, and really appreciate the links!
posted by ghost phoneme at 11:29 AM on February 1, 2023 [7 favorites]


At 46, I am not sure whether I am officially in perimenopause--I have a Mirena IUD that was implanted in 2018 so no more periods and that alone changed my life for the better--but my sex drive has definitely dwindled (boo), sleep can be a little harder in the coming (despite a rigorous adherence to sleep hygiene), but nothing else really. Wait, thinning hair! Boo to that!

I too have a female doctor and let me tell you: it doesn't make a whit of difference that we share a gender, I really have to advocate for myself on anything. (The IUD was the only thing where we saw eye to eye.) I do not look forward having to find relief when perimenopause or even menopause hits.*

*I'm in Canada and I can't just get another doctor; to say there's a shortage is an understatement
posted by Kitteh at 11:31 AM on February 1, 2023 [4 favorites]


Can we stop fertility AND menopause? Just, like. No periods, no getting pregnant, no menopause. I don't want any of it, lol. I guess the minipill takes care of the first two, but taking that thing on time's a bitch, IUDs suck... can someone just CRISPR me with the parts of being a woman that I like and take out the parts I don't? Plz and thank you.
posted by pelvicsorcery


eponysterical.
posted by We put our faith in Blast Hardcheese at 11:34 AM on February 1, 2023 [36 favorites]


Wow, beautifully eponysterical comment from pelvicsorcery, nicely done!

I'm scared about menopause because being on hormonal birth control made me very, very depressed. It sounds like estrogen supplementation is a game changer for a lot of people, but in my experience turning up my estrogen dial yields awful results. This stuff can be so individual and it's so hard to find info on what's helpful for people who are "like me" in how we respond to hormone changes.
posted by potrzebie at 11:34 AM on February 1, 2023 [5 favorites]


like some weird fog cleared

It's exactly like that. I can see so much more clearly now after menopause.
posted by caryatid at 11:40 AM on February 1, 2023 [3 favorites]


No periods, no getting pregnant, no menopause. I don't want any of it, lol. I guess the minipill takes care of the first two,

And even then the minipill isn't great at that first one. Unless by no periods we mean one long never ending breakthrough bleeding experience (I'm not the only one, right?). Which I guess is technically not a period, but that's not really what we're asking for when we say we don't want periods.

There seem to be about three different responses to the minipill. Perfection (no periods, no breakthrough bleeding), manageable (lighter periods and/or occasional breakthrough bleeding), or horrendous (continuous or heavy breakthrough bleeding). And it doesn't seem to be possible to work out which group you'll fall into without trying it.

I'm in the perfection group, which is the luckiest thing to have ever happened to me. Particularly as I can keep taking it until I'm 55, and I'm a poor candidate for HRT having previously had an oestrogen-related DVT.

HRT has become a lot more popular in the UK and there have been difficulties with shortages.
posted by plonkee at 11:49 AM on February 1, 2023 [2 favorites]


The knowledge imbalance when it comes to the awareness of menopause and its impact is striking. As a middle-aged man I learned a lot in those first two links, my sympathy for those going through perimenopause has gone from zero to 100.
posted by furtive at 11:52 AM on February 1, 2023 [7 favorites]


like some weird fog cleared

I went through early menopause (just a genetic thing, my Mum and grandmum also did) and am fully post-menopausal now, at 49. I still have a fairly high libido, but I have so. much. less. patience. with any kind of patriarchal bullshit whatsoever. I am just done. I am focused on other stuff.

My initial response to "extending reproductive longevity" was honestly a kind of horrified knee-jerk jesus no that's how they keep us down even though I don't actually believe there's some nebulous "they" who are advocating for this stuff to keep women docile.

Anyway being post-menopausal is amazing. I don't have periods or mood swings or hot flashes or sleeplessness. Too bad we don't get here until our knees are shot.
posted by joannemerriam at 12:05 PM on February 1, 2023 [26 favorites]


I learned a couple years ago that my mom never went through menopause, since she had to have her ovaries removed before that would've set in. That must've been amazing.

Unless by no periods we mean one long never ending breakthrough bleeding experience (I'm not the only one, right?).

I'm in perimenopause right now and my previous period lasted about two weeks. It was very weird. What you're describing sounds pretty bad, though; I hope things got better!
posted by May Kasahara at 12:16 PM on February 1, 2023 [1 favorite]


I'm 54 and I started taking estrogen (and progesterone) in early 2022. HRT has improved my sleep, almost eradicated my night sweats (which were honestly terrible) and my hot flashes (annoying), and boosted my mood some. I'm very happy I'm able to take estrogen, that it helps me, and that my doctor suggested it and talked me through the possible side effects.

I have some friends my age who have been reluctant to start HRT because of possible side effects, but I have been medicated all my life (for allergies, asthma, migraines, depression, anxiety) so side effects have to be really terrible to scare me off.

I hadn't had a period since I was in my 40s because I was on a 3-month birth control pill (to control migraines) and I usually skipped the week of inactive pills (because I don't like migraines) and I have to say - not having periods is awesome and yeah, if I could've skipped that hassle for even more of my life, I would've.
posted by See you tomorrow, saguaro at 12:26 PM on February 1, 2023 [4 favorites]


Any report on a study that mentions a percentage increase in risk without noting the baseline risk level in a population is extremely suspect to me. Not surprising that that was used to derail women's health.
posted by Ferreous at 12:40 PM on February 1, 2023 [6 favorites]


potrezbie, I hear you! I am 59, have been in menopause for hmm 6 years and HRT did not work for me, so you are right to be concerned. It is doable without it though.

I have a history of hormone related migraines and HRT, just like regular birth control pills, did trigger them. It kind of made everything worse as well as increasing my anxiety to unbearable levels. So I stopped and, well, just sort of toughed my way through the symptoms, including but not limited to brain fog, insomnia, and periods so heavy I went through a super tampon and 2 super pads on top of each other every 45 minutes on the first two days. I ruined a lot of clothing and a lot of sheets; the mattress is still and forever stained. Not as bad as a friend who had to get her driver's side seat replaced, though. Perimenopause was fairly brutal. I don't have much good to say about it.

The other side has been far, far better. Unfortunately I am not really the bearer of undiluted good news because my hot flashes, which started well over a decade ago, have never stopped. HRT didn't do a thing to stop them and neither has anything else, although they are, thank the gods, way less frequent than they used to be. Apparently I am a super flasher, lucky me, that sounds like so much more fun than it is: I should be running naked through stadiums regularly instead of waking up in a pool of sweat just last night. My new doctor has put me on Gabapentin to try to help the newly rekindled insomnia and the ongoing flashes; we'll see.

Reading this article and hearing about the links to childhood abuse and poverty and stress as well as the concerns about cardiac symptoms is eye opening. No doctor has ever asked about all that, so I hope it gets widely read and distributed.
posted by mygothlaundry at 12:43 PM on February 1, 2023 [1 favorite]


I'm kind of horrified at the idea of canceling menopause. I did get hot flashes. It was not really a problem, though sometimes embarrassing. My libido is definitely in the off position, which kind of sucks. And that middle age lady fat around the middle makes me sad. But overall, I like being post-menopausal. I agree that there is a clarifying effect--and I aspire to being the duck lady on Three Pines. Taking hormones or whatever doesn't appeal to me. If I need to have sex, coconut oil is my friend. You can't make me go back!!
posted by RedEmma at 12:45 PM on February 1, 2023 [5 favorites]


I hit the jackpot with the Nuvaring. I swap them out with no breaks and very rarely have any breakthrough issues to speak of. I was very excited to try Annovera for exactly this reason, but there were unacceptable side effects there.

Just mentioning that in case it's useful to folks open to experimenting with ways to get rid of their periods for ever - a dream!
posted by prefpara at 1:14 PM on February 1, 2023 [1 favorite]


I know that a lot of aspects of being a person who can bear children are unpleasant, and totally respect that lots of people who have no interest in making use of that capability find it burdensome, but, having spent some time in infertility and pregnancy loss circles, being able to slow the "ticking clock" would make a huge difference to a lot of people. There's so much assuming and "letting nature take its course" that is just torturous when you're in the thick of things, even moreso when statistical deadlines start looming.

Different people have different needs. I wish the medical field was better at recognizing and acting intelligently about that.
posted by DebetEsse at 1:25 PM on February 1, 2023 [19 favorites]


i'm 42 and have been feeling perimenopausal for like 8 months. gyn and pcp say no way i am too young and also i take oral birth control so there is simply no way. meanwhile, i can't sleep, i have night sweats, i feel like i'm losing my mind because i can't remember shit or think quickly, and my whole vaginal/labial area is a mess. i don't have sisters or "older women" i can talk to. i've tried talking to my mom about her experience, but all i know is she "got menopause" at 51 and the HRT she was on likely contributed to her breast cancer at that same age.

i have read 8-10 books on peri/meno and some have been interesting. but i simply do not care about the "loss of my femininity" or "inability to bear a child" or "becoming invisible" because i have never cared about those things and have always been invisible due to my appearance. i just want someone to take me seriously and give me some vaginal estrogen or something to see if that helps with those localized issues. but nope i am too young.
posted by misanthropicsarah at 1:26 PM on February 1, 2023 [9 favorites]


You are NOT too young. You are the same age I was when that started for me.

Go back to your doctor and RAISE HELL. This is affecting your quality of life in a major way.
posted by EmpressCallipygos at 1:55 PM on February 1, 2023 [19 favorites]


And if they say that it can't be menopause, then say "well, FIGURE OUT WHAT IT IS SO WE CAN STOP IT."
posted by EmpressCallipygos at 1:56 PM on February 1, 2023 [13 favorites]


I miss my estrogen. My skin is drier, and I feel older in unspecified ways. Estrogen is ripe. I still misplace words, but if I'm patient, they arrive. I am delighted not to have had a period in years. Nice to lose the expense and inconvenience. I can't remember when my last period even was, but I was in my 40s.

Despite that, I like being a crone; I feel wiser, I have a longer view, there's a long list of things about which IDGAF, while I care passionately about other things that matter. Much of the world dismisses us while we are busy enriching our lives and the lives of others.

I suspect a lot of men should read the articles and these comments; most men are resolute in declining to learn about menopause. And health care systems are equally bad at researching women's health.

There was a flurry of memes about crones talking about knitting, or book group, until men stopped listening, then planning revolution. Let's make that happen.
posted by theora55 at 2:08 PM on February 1, 2023 [20 favorites]


From one misanthropic Sara to another Sarah, seconding EmpressCallipygos. You aren’t too young. I turn 40 this year and my night sweats and even more-irregular-than-irregularly cycles started around 37. I asked my healthcare team last year, and they were like well what other symptoms do you have, and I told them my skin’s like I’m in puberty again and my libido is all over the place (previously quite “healthy”) and just more rage and sentimentality than what I’m used to. They were all like “congratulations. You’re most likely in perimenopause and this can take up to 10 years!” I am on the strugglebus in that none of my friends are here yet, are already way past this, or have had their uteri yeeted. My mom never really talked about it, but I believe she was late 40s-early 50s and if I remember the timing correctly, she seemed to be over it in fewer than 10 years. One aunt told me mid-40s. I do know I cannot do hormonal birth control, so HRT is probably out of the question. I have to wash so. many. sheets. But the crazy thing is that I went from miserable, heavy 7 day bullshit to dainty 4 day situations. Except now it’s every 21 days instead of 28ish.

What’s the ETA of this boat to Crone Island again?
posted by sara is disenchanted at 2:09 PM on February 1, 2023 [7 favorites]


NYTimes has an article today about routinely removing women's fallopian tubes to prevent ovarian cancer. Compare that to the way men feel about having their prostate removed, when prostate cancer is inevitable if you live long enough.
posted by theora55 at 2:31 PM on February 1, 2023 [1 favorite]


Thought I'd share because I always forget to post interesting topics I find to metafilter. I've been hit by the stark realization I've been in perimenopause probably for two years. It took a lot of symptoms and spaciness piling up to figure out. And I'm aghast at how little I know and knew and yet when I brought up to my doctor "oh maybe all these thing I've been dealing with are perimenopause, she was like "yup that sounds about right" Like why would I be the one to have to suggest it to my doctor?

I personally have been struggling with just not feeling like me anymore, and I'm not even in menopause, just perimenopause. I'm sure its the estrogen because I was given a local estrogen ring that has a brief period of systemic estrogen increase, and suddenly, I found me again. It was shocking. I've been trying to understand and discussing options with my doctor have left me feeling like there is a lot missing in how we look at menopause. I've also been chatting with the good folks at /r/menopause and there are a lot of frustrated women. It's got self-selection bias all over it, still it's also a lot of gen-x women pissed off about this and trying to figure out what to do. That is providing me some comfort.
posted by [insert clever name here] at 3:11 PM on February 1, 2023 [6 favorites]


I did the menopause thing. I'm 53 and mostly done with that now. Hot flashes have subsided, I get ... reasonable sleep without sweating through the sheets. Belly fat is *sigh* here to stay and muscle loss is infuriating. I miss sex. I miss BEING INTERESTED IN SEX. Like, that's just... a huge hole, like a missing tooth. It is horrible to WANT to be interested and ... not. be. interested. I mean, OK, time for other hobbies and such, but still. Wow, super hormonally mediated, at least for me, and like, it totally evaporated. I feel pretty eunuch these days. On the plus side, I'm getting a lot of other very interesting things done in lieu of getting laid. So there's that, I guess.
posted by which_chick at 3:51 PM on February 1, 2023 [3 favorites]


I am glad to see menopause get a whole lot more attention and respect these days. Dr. Jen Gunter wrote a great book about it.

I went through menopause a few years back at 48. It's great to have graduated and to not have to worry about fertility or pregnancy any more. I also was surprised that I didn't have symptoms to speak of, maybe a couple of hot flashes. I say this not to humblebrag, but to point out that it is not true that each and every person with uterus and ovaries is destined to years of misery. The main article linked said that about 15% of people don't have symptoms. By all means, the 85% should get as much help as medical science can provide. I just literally did not know that it was possible not to be awful until I went through it and it was nonawful.
posted by Sublimity at 4:37 PM on February 1, 2023 [6 favorites]


I spent several years working on HRT breast cancer issues in the mid-aughts. There was plenty of publicity on the subject, for years, and I am not surprised that both doctors and patients are still hesitant to mess with it.

I am also not at all surprised that consensus has shifted. My conclusion at the time, when I had read all the relevant medical literature and arguments and statistics, was that HRT wasn't the miracle drug that Wyeth claimed, but also probably would not give me cancer. Time will tell, probably within the next few years... But at least in theory I'm willing to accept a slight risk of major complications in return for quality of life.
posted by mersen at 4:37 PM on February 1, 2023 [1 favorite]


I turn 56 next month. No signs of menopause except that for two weeks before Thanksgiving, I had hot flashes. And then they stopped. It would be delightful if that was the whole shebang, but I'm keeping my expectations low. Reading with interest.
posted by The Wrong Kind of Cheese at 4:40 PM on February 1, 2023


Who else here wants a shirt that says:

B I G
MENOPAUSE
E N E R G Y
posted by fiercekitten at 4:49 PM on February 1, 2023 [17 favorites]


I am glad to see menopause get a whole lot more attention and respect these days. Dr. Jen Gunter wrote a great book about it.

The Menopause Manifesto has been sitting in my TBR pile, and I plan to post about it on FanFare at some point. I'm glad I'm not the only one thinking about this subject!
posted by MonkeyToes at 4:49 PM on February 1, 2023 [1 favorite]


this and the intro article published with it seem such like scaremongering with an undercurrent of "oh no, the poor pharmaceutical companies" that i'm having a hard time taking it seriously, even as i start to experience some of these symptoms myself and acknowledge the information might be perfectly valid.
posted by Clowder of bats at 4:56 PM on February 1, 2023 [1 favorite]


I also was surprised that I didn't have symptoms to speak of, maybe a couple of hot flashes. I say this not to humblebrag

Yeah, that is one thing that has been discussed a lot on the menopause subreddit, because of the likelihood people that aren't experiencing any issues aren't going to come looking for help. But also, WHY? There doesn't seem to be a good explanation yet, or even much look into it. Is it a function of some ovaries staying more active than others even after fertility and menstruation has stopped? Is it a function of body fat, either more or more efficient at producing estrogen? Is it that those without/with minimal symptoms have higher testosterone natural? Something else? And even why some women only have these symptoms during perimenopause, some only for a few years into menopause, and some for the rest of their lives.

All seems like they would be good to know if we care about the quality of life for women.
posted by [insert clever name here] at 4:58 PM on February 1, 2023 [8 favorites]


I have so many questions about perimenopause, and it seems like I really don't know a good source for any of the answers that might be useful to me. I've got two books floating around about it, but the grand absurd frustration is that SO LITTLE RESEARCH HAS BEEN DONE, since people with female reproductive systems have been held as aberrant (and abhorrent) from the beginning of Western medical history. I try to figure something out and hit so many ARGH, PATRIARCHY walls, and I'm already hormone-rageful, and mostly I just wanna say UGH UGH UGH UGH
posted by lauranesson at 5:27 PM on February 1, 2023 [8 favorites]


Like, I am the friend in the friend group that introduced the idea of perimenopause at brunch about five years ago, to aghast reactions. I am the friend people come to to talk about their symptoms and to compare notes and recommend ideas, and I DON'T KNOW ANYTHING, because WE DON'T KNOW ANYTHING
posted by lauranesson at 5:30 PM on February 1, 2023 [7 favorites]


I think a lot of the problem is just that people respond so individually to changes in their sex hormones. Like, I know that hormonal birth control is routinely prescribed to women to make their acne less severe - but I had beautiful post-Accutane skin for one amazing year and then started hormonal birth control and within two weeks was getting acne again, plus I was suicidally depressed. That stuff is Bad For Me.

It really makes you think - gender aside, maybe there really are just a bunch of different types of body and some of them really need certain hormones and make those hormones, and some of them need other hormones and make THOSE hormones, and then a bunch of bodies don't actually make the hormones they need and we should let people supplement their bodies' natural processes to improve their quality of life? This perspective informed by 13 years supplementing my thyroid hormones. I know it's less politically fraught than supplementing testosterone or estrogen, but it probably shouldn't be?
posted by potrzebie at 5:44 PM on February 1, 2023 [13 favorites]


Huh, no one has mentioned testosterone.
posted by sibboleth at 7:27 PM on February 1, 2023 [3 favorites]


When my periods stopped at 46, I almost overnight developed a daily severe headache that took 10 months to resolve. I tried everything...and a great acupuncturist, plus a year on tramadol and muscle relaxers to stop additional triggers is the only thing that kept me functional.

After the agony subsided, just as mysteriously as it started, I might add. I was able to actually think clearly, and best I can piece together is that I probably went through estrogen withdrawal that caused terrible head pain, but very little traditional menopause symptoms.

If I could have taken an estrogen pill to stop them, I would have in a second, but instead I was poked, prodded, MRI'd and medicated trying to figure the root of the pain. Sadly, I have training in reproductive medicine, and know that hormones aren't all big and scary as it was made out to be, but I was TOO SICK at the time to successfully apply that knowledge to myself. My whole mind was consumed with coping with this constant pain. All that time and suffering and not one doc suggested that the end of my fertility and my crushing headaches could be related.

I'm a little salty about it still and I should probably start some HRT soon, as I am now 49, but I just keep putting it off now that I feel good.
posted by doktorj at 8:44 PM on February 1, 2023 [11 favorites]


I'm non binary and dealing with peri menopause and a partial hysterectomy has been really odd.

A therapist (no longer MY therapist thank god) gave me a copy of some enormously popular book about menopause, I think it might have been "the wisdom of menopause" and I bounced off it so hard.

My cis women friends who were going through hysterectomy needed to talk about grieving for their womanhood and fertility and I'm like "oh?"

My next therapist and my GP never thought to mention perimenopause as my anxiety & depression gradually climbed and climbed for no apparent reason.

The online support groups are also extremely cis Woman centered which is understandable but such a peculiar experience when you're trying to make sense of things as a non binary person. It's not just that my experience is not included, my experience apparently does not exist at all for most of these people.

Thankfully I now have a trans man as a therapist who totally gets it.

Also, by the way, watch the blue as I'm about to post a thing about how being neurodivergent affects people's physical and mental health, including the fact that neurodivergent AFAB are enormously more likely to experience PMDD and problems with peri menopause and menopause.
posted by Zumbador at 9:06 PM on February 1, 2023 [24 favorites]


One day in 2002, I was on my bike going home after work, and suddenly I started bleeding buckets, literally. There was a huge pool of blood under me and as I moved on, there was a trail of blood like I had been stabbed. For some reason I called my stepmother first, she was a nurse, but I don't know why I didn't call the hospital right away. She made me call the hospital, she had never heard of anything like it, and the doctor told me to relax: I was definitely in perimenopause and it was completely normal. Normal??? This was something I had never heard of in my life, and anyway I was 38. But they insisted. And suggested I take some iron supplements.

At the time I was very skinny, and worried about HRT because my stepmother had cancer, and I felt sure it was because of HRT (today I realise I can't know that), so my self-medication was to deliberately eat a lot to gain weight. It worked a bit too well. I eventually put on 25 kg. And the symptoms disappeared for at least ten years. When they returned, I was in the middle of one of the most difficult times of my life, and I can't really say what was what when it comes to lack of sleep, hot flashes, brain fog etc.

Anyways, one of the things that happened was that I got tested for the BRCA mutation, and discovered I was at very high risk for cancer. (And that I have a whole unknown family because my great-grandfather slept with the maid). So I had my ovaries removed, and my menopause shock-started. That was rough. And I am supposed to have a mastectomy, but that over-weight is delaying the procedure.

But now, I am so happy with that aspect of my life. One of the great feminist writers, I don't remember who, wrote about how she felt menopause was like returning to childhood, and I agree. There is a lovely lightness in my mind that had disappeared when I went into puberty but is back again now. I'm still struggling with some mental health issues, but there is a significant difference that I can't exactly describe other than this comparison with the child-mind.

I've grown up with a positive attitude towards older women, and I've never feared old age, but the weird thing is that the older women in my family and their friends were very worried about age and appearances and sexual attraction, and while I loved them and admired them, I was always determined I didn't want to take that route. That has served me well. I mean, I truly love and admire all those ladies who do all the make-up and the jewels and the pretty nails, but to me personally it is a huge waste of time. And the other day one of my students said she had noticed I was often wearing the same dress and that she loved it. It's like a fancy lab-coat with huge pockets that is easy to launder and I have several identical ones in black and blue. It made me feel happy to be a different type of role model. Someone who is not about being pretty but about being practical and focused.
posted by mumimor at 9:46 PM on February 1, 2023 [15 favorites]


I didn't share this initially and I didn't know if I wanted to publicly disclose something so personal. But the more I have reflected on what you all have shared and what this community is to me, the more I think it's important to talk about openly. It's not that I didn't have some guess or inkling that hormones and perimenopause might be contributing to some issues I was having. I did suspect, especially as weight piled in my middle, or that I was constantly tired, or that I had depression that while better on an antidepressant, my optimism and enthusiasm faded. Feeling weepy all the time didn't help. And sometimes it WAS better. I've been through a lot the last few years, so all of that could be a result of ongoing, grinding, difficult circumstances that for a long time just DID NOT LET UP.

The part that clued me into this being perimenopause, the leadup to menopause, was sexual/genital issues. My clitoris had shrunk, although I wasn't entirely sure at first because it wasn't as if it was something I was thinking too hard about. But I also had trouble masturbating, just having less feeling. I attributed it to stress. When I could, orgasms were weak. Again, seemed like it could be chalked up to stress.

But the thing that confirmed something was happening was being intimate with someone, and having very little feeling down there. It just didn't feel like *anything* I was the multi-orgasmic girl and I felt genuinely lucky that sex felt so good. And happened with a guy I had been with before, although not recently, so I knew damn well what things should have felt like.

I had heard of vaginal atrophy as this vague issue that struck some women down, with little context. I didn't know how prevalent it was, or that it could strike before actual menopause, or it didn't just involve less lubrication and thinning vaginal tissue. It's ALL your genitalia atrophying with the withdrawal of sex hormones, along with changes to your urethra, which leads to both incontinence and increased UTIs. Vaginal dryness can be so painful that walking itself is painful.

Genitourinary Symptoms of Menopause. Even the name is misleading because yes it can start before menopause, it can happen while a woman is breast feeding, and it can happen to trans men on HRT.

For me, no health professional has EVER hinted this was a part of menopause and the lead up to menopause. No media. No friends. Healthcare professionals tell women that incontinence is a result of childbirth or weak pelvic floors. Do more exercises. (Sound familiar? Its you, you just gotta exercise more to fix [health condition]). I had so many UTIs the last couple years, and no medical professional hinted at anything other than a shrug at the frequency.

I feel a little weird posting it here because there are people I know IRL on metafilter. The flip side is I want to shout this on top of mountains to share a warning I never got. I'm completely dumbfounded this is not discussed and I had to find out first hand, google a bunch, connect some dots, then talk to my doctor to confirm.

The extent and the timeframe an individual deals with it is not clear. Literature suggests its about 50% of postmenopausal women, but its not clear if that's actual number affected or if thats because women are embarrassed to seek care or are even aware what is causing problems and that they don't have to just "live with it". Some women have talked about themselves turning into a "Ken Doll" down there.

One of the great feminist writers, I don't remember who, wrote about how she felt menopause was like returning to childhood, and I agree.

"In the absence of sufficient levels of sex steroid hormones, the genitourinary organs essentially return to the structure and function more representative of prepuberty. Vulvar tissue can appear diminished, obliterated, or even fused, and irritation or erythema can be evident. The introitus becomes narrow with a loss of hymenal remnants, the cervix can become flush with the vaginal vault, and pelvic organ prolapse is not uncommon. The vagina can become shortened and narrowed; its surface can appear thinner, less elastic, and smoother (fewer rugae) with visible petechiae from intradermal or submucosal bleeding or inflammation. Urethral changes can include development of a urethral caruncle with urethral prolapse when the mucosa is circumferentially everted at the meatus. The loss of acidity in the vagina is associated with decreased resistance to non-native bacterial or fungal infection and there could be subsequent development of ascending bladder infections, overactive bladder, or recurrent urinary tract infections." (From this paper.)

Indeed.
posted by [insert clever name here] at 11:49 PM on February 1, 2023 [44 favorites]


I'm in my 40s and really, really not looking forward to menopause, even though it comes with the promise of never having to deal with menstruation again. I know it's empowering for some people, but I have a hard time keeping up with life even without hot flashes and night sweats and mood changes and unpredictable bleeding. I'm afraid that I'm going to lose both my job and my mind, and given the current state of medical care in this country, I have a feeling I won't get much help from doctors, no matter how much I'm struggling.

A friend of mine had intense hot flashes that would wake her up repeatedly during the night such that she could only get an hour of sleep. She suffered the effects of extreme sleep deprivation for a year as she tried to find a doctor who would prescribe HRT. Most refused because of the cancer risk associated with estrogen therapy.

She finally found a doctor who would work with her and hormone therapy got her life back on track. Years later she developed stage 1 breast cancer, which was detected early and surgically removed. Even so, I'm pretty sure that if she had to go back and choose whether or not to do HRT, she'd do it anyway.
posted by evidenceofabsence at 1:54 AM on February 2, 2023


Insert Clever Name: what you describe is almost 100% my own experience as well, re: sexual response impact. Someone else above said that they wanted to want sex again, and I know what this is like too.

....So you may be pleased to hear that every once in a blue moon something can come back again; I have no idea where it came from, but yesterday at work, about an hour before I was getting ready to head home, some kind of....mood came on me; and I spent the next hour or so twitching and waiting for the earliest possible opportunity to go home and let's just say that it's a really good thing my roommate didn't get home for another hour and heard any of the noises coming from my room.

(I'm going to chalk it up to the fact that I tried a 10-minute simple cardio workout during my lunch break - something I've recently started doing to take care of the blood pressure thing - because at the very least it'll motivate me to keep THAT up.)
posted by EmpressCallipygos at 3:39 AM on February 2, 2023 [5 favorites]


Ugh I'm in a similar boat of arguing with my PCP who says I can't be in perimenopause because I still take BCP (in my mid-40s) but she also can't explain why I'm suffering from night sweats, insomnia, and other notable changes to some bodily functions and it is extremely frustrating to be told that it's all in my head and/or not worth fixing.
posted by TwoStride at 5:09 AM on February 2, 2023 [1 favorite]


potrzebie, sara is disenchanted, I (cis female, went into perimenopause in my late 30s, now postmenopausal at 44 but still have symptoms) talked to my GP about the whole situation and expressed my fear that HRT would affect me in the same way as the combined oral contraceptive had - I too became very depressed on the pill. She reassured me that the doses are much lower in HRT, and suggested we try it. I'm now on the oestrogen spray and progesterone capsules, and it's improved matters enormously, without any mental health side effects.

You may still not want to try HRT but I thought I'd provide a reassuring data point. My symptoms were troublesome enough that I wanted to try treatment, YMMV.
posted by altolinguistic at 5:14 AM on February 2, 2023 [4 favorites]


I'm now on the oestrogen spray

Hold up - you can get it in spray form?
posted by EmpressCallipygos at 6:37 AM on February 2, 2023 [1 favorite]


Mona Eltahawy: The Power and Glory of Menopause
posted by MonkeyToes at 7:01 AM on February 2, 2023 [3 favorites]


I'm so jealous of people with mild hot flashes. I had a complete hysterectomy ten years ago and mine are still absolutely unbearable. Estrogen patches are ruinously expensive but if I don't wear them I have to entirely stop what I'm doing every 20-30 minutes to endure heat that feels like I'm going to burst into flame and a full-body prickling sensation that makes me want to tear my skin off. I can't sleep. When does it end?

These conversations are hard offline because people always want to harp on the side effects of HRT as if I don't know them. I've already had cancer once, and yes, I'm terrified. But I can't function without it, and no one else is going to pay my bills.
posted by the liquid oxygen at 9:46 AM on February 2, 2023 [1 favorite]


I've got significant autoimmune problems and the one thing I know for sure about menopause is that it's pretty much closed out one significant set of involvements (in my eyes). According to my late mother, it was going to solve everything, but that has not proven to be true. I think between the eye stuff and getting rid of menstrual migraines it's been an overall plus for me.

My doctors have been very negative toward HRT for me so I haven't tried it.
posted by gentlyepigrams at 9:53 AM on February 2, 2023


my comment here has links to a few meno books and my thoughts on them, if anyone finds it helpful.
posted by misanthropicsarah at 10:28 AM on February 2, 2023 [3 favorites]


I'm struggling. As much as I want to see better research and therapies for dealing with peri and menopause (and I'm definitely at that stage), my initial reaction was that all that research would be primarily directed into extending fertility and better therapies to provide relief would be secondary concern.

In other words, I'm in pelvicsorcery's camp. I don't want to be fertile. I just want to stop feeling shitty.
posted by theBigRedKittyPurrs at 11:16 AM on February 2, 2023 [8 favorites]


Hold up - you can get it in spray form?

EmpressCallipygos, yes in Europe there's a spray (I'm in the UK, the spray seems to be manufactured in Hungary), it's called Lenzetto. I don't know if it's available in the US.

My GP is great and very clued-up, and told me that transdermal preparations have a better side-effect profile than tablets, and that many women find the gel quite sticky. So I apply two sprays to my forearm every night and boom, no more hot flushes.
posted by altolinguistic at 11:20 AM on February 2, 2023


Well, I guess I know what conversation I ought to be having with my GP…
posted by Bottlecap at 11:56 AM on February 2, 2023


Okay, this seems like the right place to share that my first hot flash was sometime in late February or early March of 2020. I had no idea what was happening. I was at a friend's house, hanging out with another adult and one kid, and I felt suddenly hot and feverish. I was terrified I had Covid and this was the first sign and I was going to give it to them, and I got out of there so fast. Riding my bike home in the cool winter air felt fantastic, and I was so confused when I got home and didn't have a temperature.

I continued to get these flash fevers yet never had a fever. My face was flushed. I was so confused. I was sure it was some sort of weird Covid symptom that no one had talked about. I would have multiples of these flash fevers every day! They were triggered by stress in a meeting online (where I could see the red creeping over my face on Zoom!) or even cooking dinner and getting too close to the heat of the pan. It was incredibly frightening, especially in the context of the pandemic, when everything was stressful and scary.

I finally googled "facial flushing causes" and when number three or four was "menopausal hot flashes," well, friends, I could not have rolled my eyes harder at myself because of course that's what it was. Of course!

I finally had a telehealth appointment in mid-June and was prescribed an estrogen patch as soon as my doctor confirmed high levels of FSH and signs of menopause. And wow, the effect was almost immediate. I went from multiple hot flashes weekly to rarely one, maybe sometimes at night. In retrospect, I'm incredibly glad I had a doctor who took me seriously and prescribed HRT.

It's been so frustrating to me to be going through this with and realizing how little we all know about it and have talked about it, and how it's treated as a joke in popular culture. But I'm very glad to be part of generation of people where we are finally learning how to talk about it openly and share more and good information and work to interrupt much of the misinformation and lack of information that's been the menopause landscape.
posted by bluedaisy at 12:58 PM on February 2, 2023 [7 favorites]


theBigRedKitty, estrogen is NOT about extending fertility, not at all! It's about treating symptoms!
posted by bluedaisy at 12:58 PM on February 2, 2023 [1 favorite]


Ugh I'm in a similar boat of arguing with my PCP who says I can't be in perimenopause because I still take BCP (in my mid-40s) but she also can't explain why I'm suffering from night sweats, insomnia, and other notable changes to some bodily functions

These doctors - grrr. I was in perimenopause and then apparently full menopause with all these side effects while being on Ashlyna (birth control pill.) I'm not sure where these doctors are getting their info that the BCP prevents menopause.

My doctor did say the BCP could mask menopause in blood tests, so I went off Ashlyna for two months last year so we could do testing to confirm that I was in menopause. Then we agreed on trying the HRT - a small dose to start and building up if I tolerated it and thought it was helping. The BCP did not help in the slightest with my menopause symptoms but 1 MG of estradiol per day has.
posted by See you tomorrow, saguaro at 1:01 PM on February 2, 2023 [3 favorites]


Thanks for posting about this extremely important topic. I have commented here several times previously about my experiences with menopause symptoms and HRT (which hugely improved my quality of life). It's criminal that there is so little research into menopause, and awful that we are left to deal with things on our own, with our chances of a good outcome greatly affected by both privilege and chance (e.g. availability of a well-informed doctor).

The NYT article is great, but one thing I wish it had stressed even more is that menopause is not just an issue for those of us who have hot flashes and other symptoms. Previously I had NO IDEA that, for example, my risk of cardiovascular disease would dramatically increase when I started losing estrogen, and the only reason I became aware of this point was that I was forced to start reading about menopause because I developed awful symptoms. How many women who "suffer no symptoms whatsoever as they sail into menopause" are aware that they need to start proactively managing aspects of their health that they may have always taken for granted? The lack of public health messaging on the full implications of menopause is a reflection of just how little society values women's health and their quality of life, particularly as we get older.
posted by mydonkeybenjamin at 2:48 PM on February 2, 2023 [14 favorites]


Testes haver here, and I am learning a ton from this thread. I’ll echo that I feel like this stuff just really isn’t talked about publicly. I know all about women in my office who’ve had breast or ovarian cancer, a a decent amount about folks pregnancies and fertility treatments. also the poor accountant who had prostate cancer and worked up to 2 weeks before he died because he needed to keep insurance. But have never hear any discussion about menopause.

I know my mom talked to her older sister and was one HRT for a time, but have little exposure otherwise.

The fertility extension angle would have been very beneficial to my sister in law, who started showing peri menopause symptoms in her late 20s, froze some eggs, and had quite the journey to grow her family.
posted by CostcoCultist at 9:10 PM on February 2, 2023 [1 favorite]


Previously I had NO IDEA that, for example, my risk of cardiovascular disease would dramatically increase when I started losing estrogen, and the only reason I became aware of this point was that I was forced to start reading about menopause because I developed awful symptoms.

Dementia too. And I, like you was forced to find this info out after the quest for "why is my body doing these strange things" search.

My browser tabs right now are insane. I was doing this a couple weeks ago, finally put that aside but posting this had me down the rabbit hole again. Over and over I am shocked how little of the information we have on menopause and estrogen has not been communicated to women or their doctors.

The one piece that gives me hope? In hitting pubmed tonight, I found a lot of papers on estrogen and it's impact on multiple systems, diseases, inflammation states and cognitive function, many with an eye on menopause or across the lifespan, with dates ranging 2019, 2020, 2021, and 2022. How useful it is yet, I don't know. How long will it take to get in the hands and heads of doctors, I really don't know.
posted by [insert clever name here] at 12:42 AM on February 3, 2023 [4 favorites]


I'll also recommend the book by Dr Jen Gunter. She's collected all the medical info you might need, and tied it together with rage at the medical establishment and support for you taking control of any part of it you can. You don't have to read it cover to cover. Just the start, end and the chapter/s relevant to you in the middle.

I've had an easy, early menopause. I only had my blood tested for it as a ruling-it-out thing when I suspected I was having problems with my Cymbalta. And I'm thrilled to be done with fertility, even though the other effects are low-grade crappy. I've started MHT as a protective measure against heart disease and osteoporosis, since I'm high risk for both. It helps a bit with GUS and brain fog, for me.

But my friends are in the last stages of trying to get pregnant, or dealing with irregular bleeding so bad they end up in the ER, and all the other uterine problems they've managed over the years. I feel guilty for having such an easy time of it. I wish there were better resources for them, I wish GPs had the slightest fucking clue about menopause, I wish I could make it better somehow.
posted by harriet vane at 4:28 AM on February 3, 2023 [3 favorites]


Obligatory Baroness Von Sketch.
posted by Go Banana at 8:04 AM on February 3, 2023 [1 favorite]


If you get some HRT up in there, do you have to keep taking it for all time, or just until actual menopause? Asking for me. I am so confused.
posted by lauranesson at 11:12 AM on February 3, 2023 [2 favorites]


Seconding acupuncture and chinese herbs.
Though dated, Susun Weed's "Menopausal Years The Wise Woman Way" also offers all kinds of support.
posted by Mesaverdian at 11:53 AM on February 3, 2023


My least-favorite menopause symptom started right before I turned 40. Basically, the skin down there began to tear open when I had sex. Not EVERY time, mind you -- only randomly. Sometimes the day after sex, even!

I went to the ER several times, was tested for everything under the sun, prescribed drugs to treat herpes and tested for cancer (apparently I have neither of those things). I spent weeks in bed crying, off and on, over the course of about 6 years. Lying in bed every time, unable to dress myself, walk or go to work, applying topical lidocaine and praying it never happened again.

I saw a urologist; he was no help. I saw a nephrologist; also no help. I went to a different Ob/Gyn who specialized in reproductive cancers; also no help.

I'm posting this on the off chance that even one woman, somewhere, will see this and realize she's not alone. Because I googled so hard trying to find the answer, and no amount of scientific studies or books or talks with older women or changing doctors 6 times helped me find clarity. I certainly don't love that someone who knows me could read this and be horrified by it.

But guess what? Eventually, the issue stopped on its own. I still hate menopause. I'm 50 now, and struggling through the final dregs of it. Headaches, yes. Pelvic floor weakening? Yep. (I've taken up kickboxing to improve the belly fat/stave off incontinence issues.)

My own grandmother took HRT until her death at 86 without incidence.

I pray I am lucky enough to find a doctor willing to listen to my preferences regarding estrogen therapy. I'm on low-dose birth control now, but my Ob/Gyn said this is the last year she would willingly prescribe it to me.

All that said, I seriously miss having a sex drive. It pops up every so often, but it's closer now to a Groundhog Day type of annual occurrence than not. Though I do try to "fake it til I make it" far more often than I used to, in hopes of jump-starting that part of my brain (and body) again... hell, I'd settle for simply finding consistent doctors that believed and listened to me instead of insisting I just need to lose 5 lbs, or try lipitor, or whatever. I think I might have sex-related PTSD, honestly.

Ladies, whatever awful shit is happening to you in your 40s and 50s, I believe you. I pray it passes. You are not crazy, or alone.
posted by Unicorn on the cob at 3:48 PM on February 3, 2023 [11 favorites]


I have someone close to me who is an endocrinologist (who is also in menopause) and I told her about this article and she said that there is good data, not just from the study the article talked about, that the hormone therapy the article calls safe is not and absolutely raises one's risk of breast cancer. So if that's true, and no endos looked over this piece before it went to print, then that feels really irresponsible.
posted by pelvicsorcery at 8:11 PM on February 3, 2023


the hormone therapy the article calls safe is not and absolutely raises one's risk of breast cancer
Really encourage you and your friend to read the book Estrogen Matters: Why Taking Hormones in Menopause Can Improve Women's Well-Being and Lengthen Their Lives -- Without Raising the Risk of Breast Cancer by Avrum Bluming and Carol Travis, which discusses the failings of the nurse study extensively.

Remember that your friend is in generation that was taught wrong in med school. That's part of the point in the article -- that there was a lot of misinformation that circulated for years and is only now being untangled.
posted by bluedaisy at 8:28 PM on February 3, 2023 [2 favorites]


Also, please give your friend the article and let her review the facts and check the sources. Sometimes we are defensive when presented with new information from people outside our communities of expertise.
posted by bluedaisy at 8:31 PM on February 3, 2023


Our brain chemistry changes, that's why my post-menopausal life has been all DGAF

the best articulation of this change is in the book The Wisdom of Menopause - some parts are woo woo, and she did write it while going through her own, but the information on the mental boost and the impact of menopause on intellect was life changing for me

sample

the perimenopausal lifting of the hormonal veil—the monthly cycle of reproductive hormones that tends to keep us focused on the needs and feelings of others—can be both liberating and unsettling.
posted by infini at 5:20 AM on February 4, 2023


I've thought a lot about the hormonal stew EVERYONE dives into when they hit puberty.

John Cusack quoted something a friend of his told him in an interview once, when John was working with a couple of kids in a film - an eight-year-old and a twelve-year-old. The twelve-year-old seemed uncannily wise and savvy, and Cusack wasn't expecting that from "a kid". But his friend wasn't surprised; "every twelve-year-old is a Buddha", they said. You see things with a clarity and wisdom at about that time that you then spend the rest of your life trying to get back.

And if you think about it - puberty is just getting going when you're about eleven or twelve, so that's a time when you're old enough to start thinking in a bit of a complex way, and at the same time, you don't have all those hormonal urges influencing your thinking yet.

That's the "fog" I believe lifted for me, I think - those hormones influencing my desires and thinking lifted, and I'm back to that Buddha state I was in at age twelve; but even better, I also have another 40 years' worth of lived experience to draw from as well.
posted by EmpressCallipygos at 5:58 AM on February 4, 2023 [3 favorites]


the perimenopausal lifting of the hormonal veil—the monthly cycle of reproductive hormones that tends to keep us focused on the needs and feelings of others—can be both liberating and unsettling.

It was exactly this kind of thing that bounced me off The Wisdom of Menopause.

I have never experienced my hormonal cycle as keeping me focused on the needs of others.

I think that book might be extremely helpful for many, especially women who struggle with looking after themselves and valuing themselves.

But it wasn't for me.
posted by Zumbador at 7:19 AM on February 4, 2023 [6 favorites]


If you get some HRT up in there, do you have to keep taking it for all time, or just until actual menopause? Asking for me. I am so confused.
If you're taking it as a protective against the increased risk of heart disease or osteoporosis (which is what I'm doing) you're supposed to keep taking it until the average age of menopause, which is 51. Otherwise I think it depends on your symptoms and risk profile. Like any medicine which has an actual effect, it has its own side effects and increased risks. And it's not free. I'm definitely more flatulent on it, but that's a worthwhile trade-off at this point in my life. I don't anticipate taking it into old age. But never say never, y'know.

But seriously, do give The Menopause Manifesto a read if you're anywhere near this stage of life. Gunter is really good at explaining how to tell the difference between symptoms which are statistically common, normal-for-you, weird-but-ok and/or needs-professional-input. And she explains all the treatment options (not just HRT) with their trade-offs, and encourages you to do what works best for you. There's no one-size-fits-all solution for menopause, just a bunch of options.
posted by harriet vane at 8:28 AM on February 4, 2023 [3 favorites]


I found it useful more from the framing of 'you're not being driven by urges to procreate' and thus 'please men'....
posted by infini at 12:12 PM on February 4, 2023 [2 favorites]


I’ve likely been in perimenopause for 10 years now and only recently found the menopause clinic in my area and got HRT. (Fuck the female gyno who implied that HRT is for post-menopause and asked me which ONE symptom I’d like addressed.) I wish I’d started on it sooner. I’ve been absolutely mad, at times. I’ve felt like I’m flying apart, I’ve raged, I’ve burned bridges, I’ve gained weight, sex drive disappeared, broke out in miserable chronic hives, my bits have been falling apart (lichen planus), lost muscle and strength, developed vertigo, incontinence (thanks to the pandemic, I mostly work from home, yay!), brain fog, hot flashes, hair thinning, my husband has had to adjust to absolutely freezing temps I keep the house at overnight, ready for bed at 7:30pm/exhausted, resurgence of ADHD.

It’s my understanding that there are estrogen receptors all over your body, including your brain. When I miss a turn or forget something obvious, I just tell my husband “my cells are starving for estrogen; I don’t know what else to tell you.”

Here’s what I know so far, for me (in no particular order): taking estrogen immediately (same day) stopped my joints aching. One brand of generic estrogen makes me feel more like myself and increases my sex drive more than another brand. Carbs and sugar bring on hot flashes (but eating keto doesn’t help me lose weight anymore). It’s not just the heat of the hot flashes - it’s the brain fog and weird disorientation that comes with it.HRT doesn’t give me migraines - I’m pretty much migraine free for the first time since 3rd grade. I’m considering testosterone, but probably can’t afford it. I’m trying the Galveston diet (which is essentially a lower carb version of a Mediterranean diet, but not as radically low carb as keto and was developed by an OBGYN for menopausal women.)

FYI - I tried meds for the ADHD and they didn’t really help (Strattera, and then Adderall) - but then I started HRT and the ADHD meds immediately kicked in so hard and I hated them and quit taking them. I just continue to struggle with the ADHD. It’s possible that, for women, the meds need estrogen to work well. This is another area that needs research.

The menopause subreddit is definitely worth checking out.
posted by vitabellosi at 7:15 PM on February 4, 2023 [4 favorites]


Vitabellosi, one of my frustrations has been that my adhd meds have stopped working. It was suggested I built a tolerance to it- which fair enough, seems to happen to some people. But I was on a stable dose for several years and then it just stopped working? Like I still had some stimulating effects without focus. It just made my mind go fast with no direction, like amping up adhd symptoms as opposed to controlling them.

I knew full well that estrogen played a role in dopamine regulation already. And I talked to a few women online that had similar experiences. Tried lowering dose, increasing dose, taking bupropion, taking tolerance break, all under supervision but never suggested it could be hormones. I even brought up this possibility, the answer I got was “see your gyno” but what would she do in this context? Answer is nothing. Now with a low dose localized estrogen ring, I’m getting some relief from adhd meds again. Not the way it was, but I want to push for systemic hrt with my doc (she is reluctant). And the idea the local estrogen isn’t system wide seems to be not quite true; the estrogen ring I use apparently improves bone health in post menopausal women even though the rise in circulating estrogen is “negligible”.

Also this post started out where I had planned to infodump interesting research I was reading on estrogen, including estrogen in the brain. But as I was reading to understand perimenopause and menopause, I figured I’d start there. I did save the other links for a later post though.
posted by [insert clever name here] at 9:06 AM on February 6, 2023 [5 favorites]


My mother-in-law started with HRT when she was in her 50s and was taking it until she died in her 80s about ten years ago, to the point where she was still having periods.

I decided early on that if the choices were HRT and periods or menopause and its symptoms - I was totally happy with menopause. I figured that having to deal with perimeno/menopause symptoms in my 40s-50s was going to be a helluva lot easier than dealing with those in my 60s or later.

And I am totally happy that I have menopaused because I love not dealing with periods.
posted by Barbara Spitzer at 8:09 PM on February 20, 2023


My mother-in-law started with HRT when she was in her 50s and was taking it until she died in her 80s about ten years ago, to the point where she was still having periods.

So this doesn't happen for everyone (it's not for me), and trying another medicine or hormone combo can change that.

For folks reading this: there's a LOT of misinformation in this thread. Please refer back to the article quoted, and then read the books linked from that article, and talk to a good gynecologist.
posted by bluedaisy at 12:13 AM on February 21, 2023 [2 favorites]


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