Help with a coworker/friend

June 26, 2007 8:27 AM

Hormone filter...How do you tell a friend/coworker who has had a hysterectomy that she really, really needs to be on hormone therapy?

We've been friends & coworkers for many years, but she's driving everyone at work crazy. She used to be really cool, but since the hysterectomy, she's been crabby, moody, negative and really not nice to be around.

Here's the trick...she's rather sensitive and no one wants to hurt her feelings. What's the best way to handle this?

posted by Mrs. Smith to health & fitness (50 comments total)

There are lots of reasons unrelated to hormone therapy that she could be crabby, moody, negative and not nice to be around. Try depressed, sad and angry about having had a hysterectomy. You don't give circumstances of this - whether she is older or younger, has children or doesn't, whether it was medically called for or not. But its easy to see that having a hysterectomy, even if it was voluntary could leave her with mixed feelings, sadness anger and depression and potentially resentment towards women who have not gone through it.

You are calling for a solution before you know what the problem is. Ease off! Why don't you take her out for a hot chocolate at the nicest hot cocoa place you can find and just ask her how she is doing and if she is okay?
posted by zia at 8:34 AM on June 26, 2007 [3 favorites]

Hysterectomies are serious procedures that take an incredible toll on the body as well as on the emotions. My own mother took a good year to recover. Unless you're an exceptionally close friend, it's really none of your business to say anything about her mood at work. Support, instead, would be nice.
posted by meerkatty at 8:35 AM on June 26, 2007 [1 favorite]

Are you sure her problems are from the need for hormone therapy, and not from the emotional fallout or stress from the surgery? I think having a hysterectomy would make me moody and negative!

I think the only way you can do it is if you let her talk about the surgery and the stress in her life right now. If, when she's done venting, she says something like, "I just don't know what to do!" that's your opening to say, "Well, did your doctor suggest hormones?" You have to care about her well-being for this to work.

At all costs, avoid talking about the toll on you or how difficult she's been to work with. I think that no matter what you're going through it's probably worse for her.

Good luck to both of you.
posted by christinetheslp at 8:39 AM on June 26, 2007

I think the best thing to do is to talk to her boss. Approach it with "I'm worried about Mary, she has seemed really upset recently, and it's starting to affect the mood in the office." It's part of a manger's responsibility to control the culture/mood in the office.
posted by radioamy at 8:39 AM on June 26, 2007

Are you a medical doctor? Is she your patient? If the answers are no, then what are you doing trying to prescribe hormone therapy?

The best way to handle this would be to develop some compassion for your friend/coworker.
posted by jamaro at 8:40 AM on June 26, 2007 [1 favorite]

What's the best way to handle this?

Do nothing, since her surgery is none of your business.
posted by chunking express at 8:43 AM on June 26, 2007 [3 favorites]

You cannot tell someone they need hormone therapy. It's not your right, nor is it your business. You do not know that her mood changes have anything to do with the hormonal changes, or that hormone therapy would change anything.

If her moods & behaviors are bothering you, though, then as a friend you have the right to say "Gee, you really have seemed angry/tired/upset/down lately. Is anything going on?". If you are truly her friend, then it's your responsibility to be concerned about how she is feeling, but it's also your responsibility to listen to her and allow her to figure out what's going on and how to deal with it on her own.
posted by tastybrains at 8:47 AM on June 26, 2007 [1 favorite]

Oh, and to elaborate, telling someone they need to be on hormone therapy is worse than asking someone if they're "on the rag" if they act snippy.

Just please, whatever you do, don't do it.
posted by tastybrains at 8:57 AM on June 26, 2007 [1 favorite]

Whoa...guess I should have gone into more detail...

She's in her late 40s and the surgery was medically necessary...but it happened 1 1/2 - 2 years ago. Her kids are all grown, so it's not like she was hoping to have more babies or anything like that.

The issue is that she's been like this ever since the surgery. It's not like she has a down day once in a while--it's all.the.time. In my experience, hormones fluxuate according to a woman's cycle--but even during pregnancy, the hormonal "episodes" aren't a constant thing--even when the hormones are pretty consistant for 9-10 months. Thus, my thinking that this was a hormonal issue.

I really don't think it's depression...it just seems to be a mindset of negativity, which wasn't there before her surgery. It's affecting everything she does--even her job...to the point where I'm concerned about it being in jeopardy.

Maybe it isn't my business, but we are friends, as well as coworkers, and I want to see her get better. Oh, and by the way, I have asked her how she's doing (often) and she always says she's fine.

Any helpful comments on my question would be appreciated...if you want to flame me, you can save the keystrokes. Thanks.
posted by Mrs. Smith at 9:14 AM on June 26, 2007

tastybrains has got it; let her and her doctor handle the diagnosis. The most you can do is point out a symptom in the bestest-friendiest way possible and never in a million years imply that you have any clue what the cause is.
posted by monkeymadness at 9:18 AM on June 26, 2007

Offer to help, sure, but unless you're her medical professional, you don't know that she "really, really needs to be on hormone therapy." There may be many reasons why she is/isn't, and none of them are your business unless you're the aforementioned doctor, or unless she shares them with you. If she says she's "fine" she's obviously not interested in pursuing it in detail.

That being said, DO offer to help, tell your boss you're worried, continue to ask how she is, maybe take her out to lunch so she can have a longer conversation with you one-on-one, rather than the pat 'fine' answer. In short, focus on being her friend.
posted by nkknkk at 9:18 AM on June 26, 2007

Zia said what I would say, only Zia said it nicely.

"A coworker recently had a body part amputated. He used to be really cool, but since the surgery, he's been crabby, moody, negative and really not nice to be around...here's the trick...he's rather sensitive."

No kidding, whoda thunk.

If you have been friends for years as you say, support, for whatever it is that is bothering her (hysterectomy related or not), would seem the friend's choice of response.

If her work is suffering, her supervisor would be the person to address that subject with her. If it's just you and her other coworkers "suffering," because she's not the happy- bouncey office mate right now, pretty much it's just too bad for you and them; it is, as others have noted, none of your business.
posted by faineant at 9:28 AM on June 26, 2007 [2 favorites]

My hysterectomy was also medically necessary (as opposed to what, cosmetic?), but was done BEFORE having kids. I've never been on hormone therapy nor has any doctor (or coworker) ever suggested it. Hopefully I'm not such a drag to be around. If I was, I'd hope someone would approach it in the way that nkknkk et al suggested.

If people other than you have noticed this, yet she insists she's fine, she doesn't want to confide in you, so I doubt any suggestions will be well-received.
posted by desjardins at 9:30 AM on June 26, 2007

Yeah, that's more than a 'trick' - like tastybrains said, even if you get moody on your period, a lot of women will be upset if someone suggests that they're moody because they're on their period. At the same time, plenty of women will be comfortable using it as an excuse for moody behavior if they're the ones who bring it up (so if Jane acts bitchy and Jack says, oh, is it that time of the month, Jane probably says fuck off, but if Jane acts bitchy, and Jack says, what the hell, Jane might say, sorry honey, it's that time of the month.) Which is to say, if there's someone close enough to her who can talk to her about the problems she's dealing with as real personal problems, she might say, I dunno, I've just been feeling really crabby & moody recently, and then a suggestion about hormones could be brought up... do you know for sure she's not on hormones? is she against the idea or something?

If the problem is that she doesn't seem to realize that her personality issues are serious, but she has been against the idea of taking hormones, you could suggest she look into some sort of therapy to help with the mood swings. Hormones are not the only solution - every woman goes through menopause eventually. She may just need support, counseling, relaxation or some sort of caring environment to help her through something difficult. If everyone's been suggesting that she just take hormones as if that will solve everything, she may be more resistant to it precisely because she's going through more emotionally than just the chemical changes, so even if treating it chemically would help, she may, somewhat irrationally, feel like it's dismissive of the actual emotional pain.

Of course I don't know the circumstances of the surgery or the choice not to take hormone replacement, so I'm just throwing some ideas out there...
posted by mdn at 9:30 AM on June 26, 2007

You should tell her, but you should also know that she might hate you for it. I can think of a handful of people in my life -- whom I still seriously dislike to this day -- who improved my life drastically by telling me something that was hard to hear, none of their business, and that everyone around me was thinking but not saying.
posted by the jam at 9:32 AM on June 26, 2007

I really don't think it's depression...it just seems to be a mindset of negativity

In case anyone doesn't mention it, that could very well be depression.

Her "I'm fine" responses may be just a reaction to what she takes as a sort of business-chatty question. If you think her job is in danger or there's a problem with it, take it to a supervisor. If you're concerned for her emotional well-being and you're close enough to talk about real issues you can open with a question that's a little less "how are you" and a little more "you don't seem like yourself lately, how are things at home?" or whatever. Maybe find some time outside of work to have a friendly heart-to-heart so it's clear that you're trying to connect not in a "you're sort of screwing up at work" way.

You're talking about a woman with a family who has to grapple with whatever medical issue made this surgery necessary, who may have a husband or other partner who is also dealing with it, or may have to think about how to meet men with her new body. I have known women who have gotten hysterectomies and their responses to it have been all over the map. Personally I think I'd stay flipped out and irritable for a good long time over having my organs and part of my vagina removed and then going to work where everyone knows about it but can't really talk about it etc. It's also possible that the hysterectomy is part of a larger medical issue which is a big deal for anyone but especially someone in their 40s.

It's possible there is something that your friend needs to help her be happier and there may be good ways to help her figure that out, but you probably need to take a few steps back before you move forward in that direction.
posted by jessamyn at 9:34 AM on June 26, 2007 [2 favorites]

Well, I missed your more detailed response on preview, my apologies.

The thing is, regardless of whether *you* think she should continue to be affected, it has nothing to do with how she may really feel. Like any other grief (if, assuming you are correct and her moodiness stems from the surgery), there isn't a set time in how soon someone 'should be over it.' She may never be over it. You don't think it's depression, but you're not the person to determine that.

Then again, she may.

If you've asked, and she says she's fine, as nkknikk said, she obviously doesn't want to pursue it with you now. You could continue to be open to being supportive if you like (and that would be a lovely thing for a friend to do), but you can't 'fix' her to make her what you want her to be.
posted by faineant at 9:38 AM on June 26, 2007 [1 favorite]

Pretty much everything Jessamyn said.

"A mindset of negativity" pretty much is depression. Beck's definition for depression is negative thoughts, moods, and behaviors, often triggered by an outside negative event; even is she doesn't necessarily meet the DSM criteria, it certainly sounds like she's got all these in spades.

When my father had a stroke, he was pretty much an asshole for two years (and only broke out of it because my mother got sick and he had to yank himself into a caregiving role). It had nothing to do with hormones and everything to do with the fact that, at 49, he really didn't like that he had lost motor and brain functioning, that he was suddenly "an old man," that he was suddenly mortal.

I can't imagine that a hysterectomy would be any less traumatic, at least for many women. No matter how old they were, no matter how many kids they already had, no matter how medically necessary it was. We tend to define women by their childbearing ability, and now suddenly she doesn't meet that criteria any more. Wouldn't you be cranky if you suddenly, overnight, felt like everyone was looking at you thinking, "Sexless crone!"?

She may be thinking other thoughts, or having other fears, but what I'm getting at is that it's perfectly normal and expected to be utterly fucking freaked out by this sort of life change. If you're actually a friend, help by listening -- actually listening, not just "Hey, how are you?" And if you're not enough of a friend to have a conversation with her about everything that might be wrong -- not just the stuff that's annoying you, but everything -- then you have no place making recommendations for her medical care at all.
posted by occhiblu at 9:56 AM on June 26, 2007 [2 favorites]

On top of everything else being said here, there's the added risk of breast cancer in patients on hormone replacement therapy. For me this is not merely a statistic: my mom had a hysterectomy in her 40s, went on HRT for years and last year was diagnosed with breast cancer.

This is for her and her doctor to work on together. It's your job as her friend to be supportive. And that's all.
posted by hollisimo at 10:19 AM on June 26, 2007 [1 favorite]

Aside from agreeing with the "she's depressed" and "you're not a doctor" comments, I'm really curious why, of all the responses, you flagged the "talk to her boss" response as best.

You claim this person is your friend, but you evidently can't bring yourself to deal with her in a direct way, preferring indirect, external, and impersonal responses to the situation. If you say this woman is your friend, then be her friend and don't try to pawn this off on someone who isn't.
posted by mkultra at 10:22 AM on June 26, 2007 [1 favorite]

If she's "sensitive," then the best possible thing for you to do is to leave it alone, no matter what your motivations are. She tells you she's fine, and anything your boss does about this is only going to call attention to her emotional situation more, and that's only going to make her feel worse.
posted by zebra3 at 10:34 AM on June 26, 2007 [1 favorite]

I think you need to decide whether she's really your friend, or, as I suspect, just a coworker you're friendly with.

If you're her true friend, I suspect that after all this time she'd have confided in you already her feelings about her surgery, in which case you could have tried tactfully mentioning that she seems to act a bit more "down" than she used to, and suggesting that she seek help for her bad moods. I would still say it isn't your place to suggest anything as specific as hormone therapy unless you're a health professional.

If she's just a friendly coworker, you should be there for her and support her in a professional way. You could try asking her if there's anything at work you could do to make her life easier, as you feel she has seemed upset lately and are wondering if there's something you could do to help, but that's the limit.

If you really have warm feelings towards her as a friendly colleague, you shouldn't go to her boss and tattle on her behind her back for having bad moods. That's quite a bitchy thing to do to someone, and should only be considered an option if she's making your work life unbearable and you can't think of a way to tell her that directly.

Most likely, you need to leave well enough alone and let her and her family deal with this.
posted by hazyjane at 10:46 AM on June 26, 2007

@mkultra--

The reason that I flagged the one response that you mentioned is because it actually addresses the question that I asked. (The supervisor is actually a friend, also.)

We (close-proximity coworkers) have tried most, if not all of the things mentioned. We have all stayed away from direct confrontation of the issue because we don't want to hurt her or make her think that we hate her.

We do have genuine concern for this coworker; however, the working situation is becoming pretty unbearable for the rest of us. Yes, I realize that she's probably dealing with a lot of stuff, but we're not the enemy and she really needs to stop treating us like we are.

Personally, I think suggesting HRT is a lot less offensive than suggesting that she needs to see a counselor or therapist...although there is a lot of merit in counseling.

Two years ago (pre-surgery), a nice, long heart-to-heart would have been possible, but now, I think she would just get very defensive and think I would be out to "get her" or something. She's changed a LOT. I just don't think she would welcome any of the coworkers approaching her on this matter.
posted by Mrs. Smith at 10:53 AM on June 26, 2007

It seems like it would be perfectly appropriate to approach her or your supervisors on the work matter -- that is, stick to how her behavior is affecting the office.

It would be TOTALLY inappropriate to go to your supervisor and suggest anything at all about HRT. I think that's what people here are getting itchy about. Discussions about a coworker's medical care should not be part of discussions about making office life functional. Otherwise bosses would be given prescription privileges for Prozac and valium.
posted by occhiblu at 10:58 AM on June 26, 2007

Mrs. Smith, I think you are getting a lot of flack b/c your question is one most of us find highly inappropriate - if you are her friend, be a friend. If a friendly co-worker, than just address work issues and drop the HRT thing. It is NEVER appropriate to suggest out of the blue that someone should use HRT.

It is appropriate to offer an ear or a should, be sympathetic and to offer to help someone who is having a hard time. You might be surprised if you approach her in a totally open way of the response you might get. Frankly, the tone of your question was quite condescending and your tone in follow up posts has indicated hostility - its easy to see in a situation where there is lots of underlying hostitility how it might be hard to have a heart to heart. I suggestion you approach her with a lot compassion and you might be surprised at the reponse. Definitely drop the HRT and me me me attitude though.
posted by zia at 11:19 AM on June 26, 2007 [2 favorites]

oops, meant to say:
or a shoulder
posted by zia at 11:40 AM on June 26, 2007

How do you tell a friend/coworker who has had a hysterectomy that she really, really needs to be on hormone therapy?

You don't. That's not appropriate. You're not a doctor, you're not HER doctor, and from the way you talk about her (as if she's a problem that needs to be fixed, instead of a person who is suffering), it's pretty clear that you're not her "friend" either. The chorus of "that's not your business" is not from people misunderstanding your question or trying to "flame" you. Her medical treatment is really none of your concern.
posted by almostmanda at 11:52 AM on June 26, 2007 [2 favorites]

"Survey after survey has linked hormone replacement therapy to cancer, strokes, blood clots and heart disease." For this reason, it's inappropriate for you to suggest your co-worker undergo HRT in order to make your eight daily hours at work more pleasant.

Try talking to her instead, using open-ended questioning. In other words, do not assume that a) her problem can be boiled down to a simple lack of oestrogen or progesterone, and b) that you know the answers. She may be going through something complex (grief for the loss of her body's integrity and youthful vitality) or simple (work's driving her crazy). It could be lots of things. So just talk to her. Even though you're afraid to, it's the only thing - the only thing - that will work. Find out how she's doing, and if there's any particular support she needs. Let her know you're on her side.
posted by hot soup girl at 12:05 PM on June 26, 2007 [1 favorite]

You say that you would prefer not to suggest a counselor or therapy because that seems rude to you. However, what you notice is a problem in her mood and attitude. You suspect that it is due to hormonal issues, but all you really know is that she is having some sort of huge problems that need to be addressed. Suggesting to her that she needs HRT implies that you know what she's going through, and you know how she feels, and you know what she needs. But, what most people are telling you is that you don't know these things, and it is rude of you to act towards her as if you do. Suggesting to her that she needs therapy only implies that you have noticed a distressing alteration in her behavior, which is true, and that you would like for her to find a more peaceful mental state, which you do. It avoids assuming that you know what's best for her.

I'm not outright saying you should suggest her seeking therapy. That depends on how close you two are. You claim to be friends, but it seems odd that this is only now coming up, after two years? But, if you really are close enough to her to be supportive, to act as a shoulder for her to cry on if she wants it, and to confront her about personal matters, then what you should suggest is that she seek help for her mental state, in general. You are mistaken that that suggestion is more rude than claiming you are aware of what treatment she needs.
posted by Ms. Saint at 12:12 PM on June 26, 2007

Hormone therapy is not indicated if her hysterectomy did not remove the ovaries, but instead the uterus only. Many women, surprisingly, do not even know if they had a 'partial' (uterus only) or 'total' (ovaries plus uterus). And you'll never know if she doesn't know or tell you. Her doctor may not even have told her or she may not remember.

Some of the responses on here are pretty awful. The poster has basically said a friend and coworker is acting like a shit in the workplace. Perhaps the temporal association with the hysterectomy is coincidental, perhaps not. But having one's uterus [or prostate, etc.] is not analogous to an amputation, as someone earlier pointed out so hysterically.

Go to your supervisor. Your coworker needs a time-out. If she chooses to deny the problem then she gets canned, or she chooses to be an adult and gets help.
posted by docpops at 12:23 PM on June 26, 2007

Also, hormone therapy is often ineffective for mood issues. Anti-depressants are better, and safer in the long term, if one chooses medical therapy at all, vs. CBT, diet, etc.

And no one has a right to act like this at work this long after surgery. If this is her response to a hysterectomy, god help you if she has to confront something with a less defined solution.
posted by docpops at 12:27 PM on June 26, 2007

docpops, I mentioned the amputation, it is not a hysterical response.

I had a hysterectomy at the age of twenty-nine. I lost a body part and it profoundly changed my life and what I thought my life was going to be. If you don't think that a hysterectomy can have lasting physical and emotional consequences, I most sincerely hope you are not a gyn.

It's not the end of life, it's not the end of the world, but it is for many women, a life altering event, as is any major surgery that affects how one's body functions. One and a-half years is not an outlandish amount of time to still be dealing with the effects of such a change.
posted by faineant at 12:51 PM on June 26, 2007 [1 favorite]

Well, docpops, that's a fundamental difference of opinion, and it's one reason why this thread makes me itchy. It is actually her right to act crabby. It's also the supervisor's right to decide when that's become excessive and act accordingly. Going around behind someone's back at the office and complaining about them--that doesn't promote peace and doesn't tend to be looked on fondly by management, either. And telling the boss that a coworker might need HRT? In what kind of workplace would that be taken as anything but meddling?
posted by zebra3 at 12:54 PM on June 26, 2007

@docpops: Thank you for your informed, logical, and compassionate answer. I checked your profile and see that you actually do have the credentials to weigh in on both the medical issues, as well as the tact to answer a question without flaming.

@everyone else: Thank you for your input. It seems that I was being a little self-centered in my attitude and I do apologize. I am not a medical professional (nor do I play one on TV), so perhaps jumping to HRT was a little harsh. I really didn't expect the flaming that I got here, though.

I am honestly concerned for my friend and I do want her to get better, but perhaps it's not my business to "fix". I'm not sure what I will do at this point, if anything.
posted by Mrs. Smith at 12:55 PM on June 26, 2007

Mrs. Smith - while I know my opinions stated above are strong, I wouldn't consider that flaming you. Flaming you would be insulting you directly, instead I (and most other posters here) simply warned you that the actions you were considering were highly inappropriate.

Your initial posts did in fact come off self-centered - being angry at your "friend's" negative moods and seeming to expect her to change her lifestyle and/or medical treatments to accomodate *you*. Meanwhile, one can tell from this thread that this is a woman who has had a major operation, who may or may not be severely depressed, and whose so-called "friends" are talking about her shitty attitude behind her back and conspiring to get her to take hormones in hopes that it will make their lives easier.

I don't necessarily think this makes you a bad person - it's easy to fall into a self-centered way of thinking, and it's also really easy to fall into the trap of office gossip. Furthermore, in my experience, office gossip often makes the parties involved in the gossip more sensitive to actions of the gossipee. For example, if Laurie and Bella were talking to me constantly about how over-sensitive Gayle is, it would probably make me start to REALLY pay attention to the times when Gayle is oversensitive, and blow those out of proportion.

Maybe you've just boxed your friend into a corner. I would suggest to your supervisor that you all work on some teambuilding if you feel that the workplace vibes are not chill anymore.
posted by tastybrains at 1:13 PM on June 26, 2007

Oh, one last thing. Sometimes we all just need to remind ourselves:

We can't change other people. We can only change how we let them affect us and how we react to them.
posted by tastybrains at 1:15 PM on June 26, 2007

Oh, and by the way, I have asked her how she's doing (often) and she always says she's fine.

"Well, to be honest, you don't seem fine." Etc.

Two years ago (pre-surgery), a nice, long heart-to-heart would have been possible, but now, I think she would just get very defensive and think I would be out to "get her" or something. She's changed a LOT. I just don't think she would welcome any of the coworkers approaching her on this matter.

So exactly how did you anticipate informing her of your medical diagnosis and prescribed treatment? You figure that's going to go over a lot better? Tell the fat one she needs some diet pills too, see how that works out.

In theory its nice that you're looking not just at the problem but also a possible solution. In practice, however, it means you're dabbling in medicine and being amazingly inappropriately presumptive and nosy. You need to address with her the ways her behavior is impacting you and your other coworkers and not draw conclusions that you're not qualified to.

Yes, I realize that she's probably dealing with a lot of stuff, but we're not the enemy and she really needs to stop treating us like we are.

So next time she treats one of you badly you say "I don't know what's going on with you, NAME, but I'm not your enemy and it's not okay for you to treat me like one." End of story.

Don't share your random speculations about why she has become a jerk.

Don't share your armchair quarterbacking doctoring about what you think it making her a jerk.

Simply tell her that it's no okay to be a jerk to you. She can solve this however she likes. Hormones, valium, methamphetamine, electro-shock, whatever.
posted by phearlez at 1:17 PM on June 26, 2007 [3 favorites]

[a few comments removed -- this is getting way too far afield. take insults and sarcasm to metatalk or email.]
posted by jessamyn at 1:24 PM on June 26, 2007

docpops, you're completely ignoring the fact that the question asks how to get the co-worker on HRT. Not how to help the coworker, but how to get her medicated. Which is why people are saying it's inappropriate.

Because, unless the questioner is an MD and her co-worker is her client, asking how to force someone with whom she's barely even on conversational terms onto medication is inappropriate.

Talking about the woman's inappropriate behavior at work, and how to fix that, makes sense. Diagnosing her with a hormone deficiency and prescribing medication does not.
posted by occhiblu at 1:26 PM on June 26, 2007

occhiblu, I agree with you. But I would posit also that many respondents were being didactic to make their own points about the poster's insensitivity. A reasonable, objective response would stay away from personal criticism of the poster and could even read between the lines to get at what the poster obviously is asking for help with. That's always been the gold standard and defining facet of AskMeFi.
posted by docpops at 1:33 PM on June 26, 2007 [2 favorites]

This is one of those do-unto-others situations.

Imagine that you are Ms. Crabby. Imagine a backstory for your crabbiness - your husband is sleeping with the pool boy, or your kids are on drugs, or you woke up one day and thought, Christ, is this all there is? Or you actually had a full hysterectomy, and are suffering from a lack of hormones. In any case, your crabbiness is out in force at work; maybe you're aware of it, maybe not, maybe you just don't care.

Imagine that a friend/coworker in your office - let's call her Mrs. Smith - approaches you in the break room one day, or perhaps drags you out for lunch or coffee. She says to you, "Ms. Crabby...."

What would you want someone to say to you about this? How would you want them to approach you? How would you feel if a coworker approached you and suggested you need to be on HRT/get therapy/etc.?

If she really is your friend - that is, she confides in you, you confide in her, you hang out occasionally outside of work - then I would bring it up very gently outside of work. Say that you know she's said that everything is fine, but she's not acting like everything is fine, and you're worried about her, and want to help if you can.

If this is not the sort of relationship you have - and I have a bunch of coworkers with whom I am friendly, but we're not, you know, friends - then use the chain of command; it might as well be good for something.
posted by rtha at 1:49 PM on June 26, 2007 [1 favorite]

I'm still pissed about that "not an amputation" remark, no matter how credentialed docpops might be. I find it really hard to believe, also, that "most women" don't know whether they had their ovaries removed or not. You can't help but miss them when they are gone. You feel phantom pains that only serve to remind you that they are missing.

I had already had my children when I was forced to face a hysterectomy at 36, and I still tried everything else first, and when I finally went into the total abdominal hysterectomy (yes, ovaries gone too) I felt I was making a logical, rational decision, and knew it was the last recourse.

I prepared for it in every way, and I still found myself incredibly emotional, grieving over my lost womb in a way I never expected, and undergoing both therapy and HRT. The emotional and physical aspects are just stunning.

I'm 5 years past it now, and I'm only JUST back to my old self. I'm not surprised your co-worker has changed. The fact that it has been so many months since the surgery doesn't mean much--people heal at different rates. Every other time I had surgery, I was back up and going well ahead of schedule. This is different.

Why I should have had such an extreme emotional reaction, I can't tell you, but all the old cliches about not feeling like a woman any more were scarily spot on.

Even if she says she is fine, a supportive shoulder, *away* from work, a little understanding and a lot of patience can go a long way for your co-worker. Talking to her boss really just sounds intrusive to me.
posted by misha at 1:54 PM on June 26, 2007

misha - I should have said it's not uncommon for women to not know if the ovaries were removed. It goes for men too, as far as things like gallbladder, etc. I expect that the mefi population, to their credit, is much more astute and aware of their own bodies than the general population. Just my observations over twenty years.
posted by docpops at 2:11 PM on June 26, 2007

docpops, there are any number of ways to be affected emotionally and/or physically by a hysterectomy. There is no way for us to know what it is the OP's co-worker is reacting to. She may be reacting to the end of her reproductive years. She may be reacting to the sense that she is no longer sexually desireable - for all we know, her husband (SO, whatever,, should she have one), may have had trouble dealing with the issue of her sexuality as well - it happens. She may, as several people said upthread, have other ongoing health issues. Situational depression is hardly a leap.

You equated a woman having a hysterectomy to having a prostate removed. I'd liken a hysterectomy more to a man having to have half his penis removed. Can he still (assuming all else is well) function sexually? Probably. Think it might change how sex feels to him? Possibly. Think it might affect the way he sees himself as a sexual being? Probably. Think it might change the way a partner sees him? In a perfect world, hopefully not, but - no guarantees, are there. Think you might be talking to that male patient a year or so down the road about his depression? It's a pretty fair bet, I'd say.

If you think that because the uterus isn't visible it is less a part of how women may define themselves, you'd be very wrong. "What makes you female?" is an issue many women never consider until they have a hysterectomy or a mastectomy. It can be traumatic (or not) to consider how you feel about your body missing some of it's female parts.

I've talked to a lot of women over the last 20 years who've had hysterectomies. The responses are as individual, of course, as each individual. Some women do go through the surgery with little or no emotional or physical fall out. Playing the odds as a doctor, you can say a hysterectomy is generally a surgery women tolerate well and have little trouble adjusting to. But that tendency to view a hysterectomy as a (if you will) minor major surgery bleeds over into impatience with or ignoring those who have very real emotional and/or physical concerns or problems after surgery.

To address one of your other points, HRT is not generally indicated after a partial, no. However, I'd love to know the number of women (I've spoken to many, but my experience is anecdotal only), who've ended up on HRT within 2 or 3 years, because, like me, their ovaries ceased to function after the surgery. Every doctor I saw within that second year after surgery told me what I was feeling couldn't be menopausal symptoms, because I still had my ovaries.

My experience was not universal, not even anecdotally, and I'm quite aware of that. I do know, based on my own experience, and from talking with others, that the tendency for people to dismiss someone's pain, someone's concerns, someone's grief because 'it's just a hysterectomy, you should be over it by now, you were too old to have more children anyway' is pretty damn offensive. That was my actual point with the amputation analogy - nobody else gets to decide how long it takes someone to grieve a loss.

The issue of the workplace being affected I addressed - it's up to the co-workers supervisor, not the coworkers.
posted by faineant at 2:16 PM on June 26, 2007 [3 favorites]

[seriously PLEASE, if you're not answering the question take it to metatalk or email]
posted by jessamyn at 2:16 PM on June 26, 2007

I would like to contribute my opinion that there is a bright line between ameliorating someone's inappropriate workplace behavior and making unsolicited suggestions or comments about their private medical issues.

The original poster should respect that bright line and only involve herself on the side of addressing the inappropriate behavoir through proper channels. If you do not wish to address her directly about these issues, address your supervisor or her supervisor, or ideally both.

There are a large number of very good reasons why unsolicited medical advice from laypeople is considered inappropriate and bad manners. For instance, you may be wrong and the observed behavior could have nothing to do with your co-worker's recent operation.

Also, if you are someone whose opinion could be used to evaluate your co-worker's performance (and if you complain about her, how could it be otherwise?) you could be found in violation of Federal laws about discrimination on the grounds of health-related conditions.

For example, suppose you went to your supervisor and said, "Ms. X needs to start hormone therapy now, her behavior since her hysterectomy has been unacceptable." Suppose then your supervisor went to Ms. X and said, "Start taking hormone therapy or you are fired." As well as being medically ridiculous (hormone therapy has real risks of death and serious morbidity and many eligible women choose not to elect it because of those risks), this is a clear violation of Federal law.

Employers in most cases are not allowed to tell their patients how to manage their own health issues. The exceptions, such as a truck driver who becomes blind being discharged from his truck driving job, are usually more clear-cut than the situation described here. Even so, the truck driving company and its officers could not say "Look, Fred, treat your glaucoma with eyedrops so you don't go blind in a year; otherwise we'll just fire you now so we don't have to do it later." That's a clear violation of the laws.
posted by ikkyu2 at 3:05 PM on June 26, 2007 [3 favorites]

There are two issues, 1) your co-worker's emotional pain, and 2) the effect of her behavior on you. It doesn't seem from your posts in this thread that you can do anything about #1 if you don't think she would be receptive to an open non-judgmental shoulder to cry on/friend to talk to. As for #2, yeah you might have to go to the boss, and that might seem kind of mean, but it also might get her to realize that she needs help. Even if it doesn't help her, there is a point where compassion has to give way to having a decent work environment. If she's having as much of a negative effect as you say, now might be that time.

[I don't think you're being flamed. People were reacting to the tone of your question and your professed intent to say something very very inappropriate to a co-worker. The answers are useful if they enable you to avoid a bad situation and construct a more useful way of addressing the problem.]
posted by Mavri at 3:11 PM on June 26, 2007

How do you know she's not already on hormone therapy?
posted by Miko at 4:05 PM on June 26, 2007

I once told a coworker who was having destructive mood swings that I thought it was hormonal. I literally did have the "are you on the rag?" conversation with her. And she was my boss. It actually worked out great, believe it or not.

After one big blowout, I went into her office privately and said, "We've had some interactions lately that I haven't been happy about. Do you agree?" She did. I said, "Look - I'm a girl, you're a girl. I was going back over the dates of old emails, and I noticed these episodes happened pretty much exactly 28 days apart." There was a long pause while this soaked in and then she burst out laughing. Thank God. I tipped her off to the wonders of Pamprin, and things got dramatically better.

I think this worked out well for a couple of reasons. One is that I've had hellish PMS myself, so I knew the signs. I was pretty certain that I was right. Also, I was able to speak from my own experience, so it came off as sharing between peers, instead of me trying to "fix" or diagnose her. And she was was kind enough to listen instead of telling me to piss off and mind my own business, which she certainly would have been entitled to do. It really depends on the person.

Since you guys are friends you may be able to discuss the issue of mood and hormone in general terms. Like: "Wow, I think I must be starting early menopause because I've been having all these hormonal mood issues. I can't imagine how you were able to deal with having the hysterectomy," and see where the conversation goes from there.
posted by selfmedicating at 6:44 PM on June 26, 2007

How do you know she's not already on hormone therapy?

Seconded. From UPenn's site, side effects can include "water retention, bloating, nausea, breast soreness, mood swings, and headaches."

Anecdotally, I've known several women who found HRT after hysterectomy to cause moodiness and personality changes.
posted by desuetude at 8:05 AM on June 27, 2007