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?
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Interesting article. I was lucky. I had occasional night sweats for about a year but no other symptoms.
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I’m 48 and in the last year my perimenopause symptoms had become very unpleasant. From what I called “crime scene periods” to my libido falling off a cliff to night sweats to horrible insomnia to debilitating brain fog, I finally had enough. I found an OBGYN who specializes in menopause and got on HRT last month. I’m already sleeping better and my sex drive is slowly improving. I wish all women had appropriate medical support in this area.
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I was surprised to read that 30% of women have had a hysterectomy by age 60. I would have guessed a lower percentage.
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Apparently this generation will change how menopause is dealt with because we have no shame in discussing and the Internet. I did not have terrible hot flashes or weight gain but all sorts of other weirdness. Random joint pain, horrible fatigue, brain fog, murderous moods…was pretty terrible! I take a lot of vitamins and magnesium and a CBD caplet and two years later I feel pretty great. But I think when I turned 50 I had pretty much depleted every nutrient in my body. Now I’m back! I thought it was very hard to find info, eating plans. To be brief - lots of vitamins, berries & a banana every morning, and lots of green leafies helped me turn it around.
Also - this is hysterical: https://www.mcsweeneys.net/articles/thank-you-for-calling-the-perimenopause-hotline-where-our-hold-times-are-completely-unpredictable
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Totally not interested in any hormone replacement therapy after having had estrogen-sensitive breast cancer. Am happy for menopause to be on its way.
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Same here except 54. Waking every one-two hours all night long with night sweats and hot flashes, as well as the hot flashes sporadically throughout every day. Terrible anxiety, low energy, brain fog and feeling like I was losing my mind. Finally went on HRT patch 6 weeks ago and feel like I have my life back. All symptoms resolved, it feels like a miracle.
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Does anyone have experience with staying on Mirena through the menopause age to try to beat the symptoms, or do the symptoms just come when you finally remove it without replacement?
I have a (maybe inaccurate) memory that my mom went in HRT as everyone did those days, then the big study came out and since I was a med student I immediately told her to get off of it. But it was a while ago and I may have the details messed up.
Skimmed the NYT article this AM and generally agreed with the premise that the risk statistics were overblown (not taking prevalence into account when considering the increase in cancer risk).
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I’m not a candidate for HRT so my current doc prescribed a low dose of gabapentin. It was like a miracle for me for my hot flashes and sleep. I was literally waking up every hour dripped in sweat and was barely sleeping. The hot flashes went down to just a couple/night almost immediately and then stopped completed. Gabapentin for hot flashes: Effects, risks, and dosage
I took it for almost 2 years and then was able to stop and the hot flashes seems to be done (thank goodness).
Thankfully I don’t have any of the other problems that other women describe.
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I never had any issues with menopause. I did have an increasing number of headaches in the couple years leading up to it, as well as awful cramps. Then one day, I just didn’t have periods anymore. No hot flashes, no anything. The hormonal migraines I had suffered from since I was a teenager were gone, the debilitating cramps were gone, I didn’t have to worry about pregnancy anymore (birth control pills gave me horrendous headaches, so I couldn’t use them). I saw it as a wonderful time in my life.
My mom had been talked into HRT when she hit menopause at 49, which she was wary of from the start. She was diagnosed with breast cancer at 60, and she blamed the HRT. As a result, I wasn’t interested in HRT, so I never asked about it.
Perhaps a course of HRT for the first few years of menopause may have staved off my osteoporosis. What makes me angry is that women’s issues have not been, nor are they yet, taken seriously. We’ve had issues with menopause forever, but it’s not taken seriously as something that merits more research. Research has been pretty haphazard, and the medical community has accepted this as the way it is. Half the population could benefit from proper research. Representation of women in medicine will hopefully drive a movement to work to meet the unique health needs of women.
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I was lucky to have very little menopausal symptoms–no hot flashes, no mood swings, no brain fog. Which was good, because I had objections to HRT for other reasons (where Premarin got its name from) and would have been reluctant to use it. Not sure it’s still produced that way anymore.
I did have significant weight gain, but don’t think that would be a sole reason to use it.
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The weight gain at least in part comes form not needing to rebuild blood supply etc. when periods stop. Hysterectomy cured my chronic anemia but made me about 5 pounds heavier almost immediately even though I was not menopausal… that joy came later.
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On the subject of women’s health…
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I’ve been on an estrogen patch for most of the last three decades. I went off the patch for a few months about 20 years ago, then took much longer to make up for the problems that caused (multiple UTIs, severe atrophy, etc.) when I resumed using them.
When I turned 65, the PCP we’d begun seeing in our new location informed me that he would not continue my Rx for the patch. I scrambled to find a GYN would was taking new patients and would prescribe for me.
There were several stressful months while I searched for a doctor. I was able to time the refills of my old Rx to cover me and was lucky that a doctor who’s fairly new here had a cancellation so I got that appointment slot. I made it clear to her that this is a major quality of life issue for me. However many years I have left will not be spent in pain if there’s a way to prevent it.
I don’t have to see the PCP until summer, and am hoping to find a new one by then. For this 30-something man to completely dismiss the very real problems I experienced and simply say this is his blanket policy without any discussion was reason enough for me, and my husband, to find a new doctor.
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I also had breast cancer that was driven by estrogen.
After menopause, estrogen is still produced by the adrenals (and fat). For cancer, I had to take an anti-estrogen med (aromatase inhibitor) for 5 years, which induces a sort of super menopause on top of the regular one.
Menopause at 50 is “natural.” Total estrogen suppression at 60 or any age, is not.
Hot flashes still happen for me several times a day and let’s just say I am over 69. It’s been years, and the cancer meds didn’t help.
I think of them as power surges and try to enjoy them. I know that sounds strange, but I just kind of embrace them. And I save on heating bills.
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This thread is very timely for me. I have been on PremPro for about 5.5 years. Just turned 59. My PCP wants me off. Sigh. She’s referred me to an Ob-Gyn who does hormone pellets. My appointment is at the end of this month. I’m trying to read up on them. I have one friend who loves them and another who has mixed reviews.
I would be perfectly happy staying on the PremPro, but age 60 seems to be a magic number. I hate change. I did notice in the article that here have been NO studies done on women who started HRT in their 50s and then continued on into their 60s. My friend’s mom is 82 and still take PremPro!! She does take it every other day instead of daily. I guess I will have to take progesterone with the pellets?
Boo.
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This is the problem. There hasn’t been enough research to know anything for sure. It’s not like menopause is some rare disease!
I have always considered menopause to be another change in a life that is full of changes. For me, estrogen caused problems that disappeared when menopause hit , so I always considered it a welcome change. I have embraced it. I recognize that it’s not that way for a lot of women, though.
I was 47, so it’s been a number of years now. The one drawback for me has been osteoporosis. Even with that, I try to handle it naturally. I could be wrong, but I won’t take meds for it. My mom had bad things happen because of osteoporosis meds, so I focus on diet and exercise. Because osteoporosis is tied to changes in estrogen levels, it’s tied to menopause. The fact that we have a bunch of drugs to deal with the results of thinning bones does not, IMO, mean it’s okay to not look for ways to prevent it in the first place. I sound like a broken record, but darn it, women’s needs should be treated more seriously.
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This, so much this:
“Imagine that some significant portion of the male population started regularly waking in the middle of the night drenched in sweat, a problem that endured for several years. Imagine that those men stumbled to work, exhausted, their morale low, frequently tearing off their jackets or hoodies during meetings and excusing themselves to gulp for air by a window. Imagine that many of them suddenly found sex to be painful, that they were newly prone to urinary-tract infections, with their penises becoming dry and irritable, even showing signs of what their doctors called “atrophy.” Imagine that many of their doctors had received little to no training on how to manage these symptoms — and when the subject arose, sometimes reassured their patients that this process was natural, as if that should be consolation enough.”
Makes me so angry.
If men could get pregnant; if men had periods; if men went through menopause, the medical ecosphere would be SO different. There’d be abortion clinics on every street corner, for starters.
I am finally at 59 coming out the other end of at least 7 years of hell. The hot flashes are still there but thank god for the pandemic, because I work from home and can wear shorts and T-shirts and respond instantly without having to somehow gracefully extricate myself from some office situation to find a bathroom or get outside for relief.
I donated every sweater and sweatshirt I own. Layers of thin fabric are key. Cashmere, wool, forget it.
My mood remains grim, but nobody can see half my face when I am out (still) wearing a mask, so my RBF is probably set in stone by now but I don’t care anymore.
But one thing I wanted to mention, in case this happens to another woman and she is dismissed as I was - I started having intense heart palpitations at the same time as the other symptoms ramped up. I went to a cardiologist, wore a holtor monitor, and they were convinced I’d used it wrong because the results were off the charts - I want to say something like 20,000 per hour? That’s the number that I recall, but I don’t remember the context or the discussion, because I was dismissed so quickly (and probably having a hot flash during the appointment so in a hurry to leave) and the cardiology people and my (male) gyno both said they’d never heard of this in connection with menopause.
But it IS a frequent occurrence. So don’t let them tell you otherwise.
Mine went away after a year or so. It was extremely unnerving and so dispiriting to (once again) be dismissed.
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Are you me??! 
I also had an early menopause in my 40’s with basically no symptoms other than a short time of irrregular periods and then periods just disappearing.
And I now have osteoporosis and have refused drugs so far. But the pressure is on. NO ONE has ever mentioned/asked/commented that there might be a correlation with early menopause and osteoporosis to me! Hmmm. Makes me wonder since I do all the other things - eat well, take calcium/D, do lots and lots of weight bearing exercise - if the early menopause was a factory.
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This has been so eye opening for me! Especially the part about heavy periods being normal for perimenopause? Mine started getting heavier in my late 30s and also longer lasting with shorter cycles. I tried Mirena for 5 years and that was a disaster. I had to be prepared for something every day (once 4 months straight), and the constant bloating & constipation were terrible. And if I was lucky enough to get a week off, I felt so irritable (putting it mildly). It was a constant fight to not lash out at people. But, at least I didn’t have to double up on stuff all the time. It did fix that.
But once I was off, they came back as they were before. During covid, they rose to a whole new level. For a few months there was no way I could do power lifting moves in a gym. My doctor did a biopsy to make sure it wasn’t cancer. It wasn’t. I thought my body was just abnormal, but maybe it’s more common than I thought?
At 50, I’m now merging between the 2. They aren’t AS heavy, but there is no cycle. I have to be prepared pretty much every day. Fortunately, I haven’t had any of the other symptoms - yet. But I am wondering if HRT would not be good for me, considering how awful I felt on the Mirena. My doc said she suspects I’m sensitive to the Progesterone.
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