What helped you through menopause?
September 20, 2022 8:16 AM   Subscribe

I am entering surgical menopause because of cancer at 26 years old.

I'm official uterus-free and entering menopause at 26. My hysterectomy was performed last week through the abdomen, and they've taken out the whole thing, including ovaries. My oncologist has also warned that I will be on hormone blockers to control the cancer for at least 5 to 8 more years, which means I'm going to be thrown into menopause.

I was wondering what kinds of supplements or advice you may have for me? I'm mostly afraid that my skin will start sagging, my hair will start falling out in clumps, I will never enjoy sex again, and that I will get early onset dementia and osteoporosis... As one does.

There is also zero chance of me going on HRT as my cancer is hormone sensitive.

I'm definitely ordering some calcium supplements to help with the osteoporosis fear, but do you have any practical advice of what I can eat, or even anecdotes - anything really - to soothe me and to give me a sense of control over my body again?
posted by antihistameme to Health & Fitness (14 answers total) 7 users marked this as a favorite
I'm worried about suggesting foods or supplements -- I'm not a doctor, much less an oncologist. I can't begin to imagine what might cause you another problem with the cancer.

I will (again) praise my Chilipad for night sweats. Hot dang (heh), I can sleep through a summer night again. For daytimes, Frogg Toggs has various-sized "Chilly" cloths that you moisten and put somewhere useful (around my neck, for me). To put these away, fold them while they're still a bit damp -- they do lose flexibility as they dry.
posted by humbug at 8:44 AM on September 20, 2022 [2 favorites]

I was pushed into menopause as part of my cancer treatment as well. The one thing I would encourage you to do is get a bone density scan done as a baseline. I'm sure your docs will have that on the list but it was reassuring to me to know we had a starting point to catch any issues. (It was also one of the least invasive and easiest tests I had to do as part of cancer treatment which was another point in its favour.)

For hot flashes, I made sure to dress in layers. It was a lot of take one off, put one on for a while but it was better than roasting all the time.

Cancer sucks and so does cancer treatment. It was a bigger than I'd expected thing to get used to the "new normal" for my body post-treatment because I'd been so focused on marching through everything. So try and be gentle with yourself.
posted by machine at 8:56 AM on September 20, 2022 [6 favorites]

I don't know what to tell you about the dementia and osteoporosis, but to some extent neither does science because those numbers are very hand-wavy and it's very hard to say that dementia in particular isn't the result of a massive array of factors and how many of those come from the time in which our bodies are still developing - so to some extent, plus genetics, your path is already partially set already. Your socio-economic status as a child may matter as much there, on both counts, as early menopause now.

There's a lot of stuff out there about how to make calcium supplements the most bio-available - I had to wade through it 2-3 times before I decided what I was going to do, but then I won't really know if it's worked unless it doesn't. My partner and I are using this form of Vitamin D et al and this Mag-Zinc, for their own purposes and to support calcium bio-availability. This is the reference I used to pick a calcium, though I haven't settled on a specific brand or choice.

I get that you're worried about premature signs of aging. Remember that most of the data we have about menopause is from ancients like me (hit peri about 40 and finished around 45) and we were already sagging well in advance. Your hair texture may change, but if it starts falling out you should have your thyroid checked. We still fuck, I promise, and (mostly, one still worries a bit these days) without fear of unwanted pregnancy* - you may have to negotiate a couple years of becoming a person who works on their libido rather than just getting to be horny most of the time, but again you were gonna have to do that eventually anyway.

*Not meaning to be insensitive to your situation, I just mean politically.

I have had a number of friends over the years who had to go through early menopause for various medical reasons, and I wouldn't have known unless they told me. Your peers are all going to age in different ways, and there's no reason to expect you will be a dramatic outlier. You've been through a lot, and you are traumatized, and so of course your anxiety over these things is going to be high, but I'm afraid you never really had much control over this even before.

Becoming a chronic sunscreen-user and sun-avoider NOW, well ahead of your peers, may be the best thing you can do to reduce signs of aging.

For the temporary side effects of menopause, the best thing you can do is have a support system. You're gonna be really fucking angry sometimes, and really fucking sad, and I can't imagine that improves if you're in menopause because of fucking cancer instead of just bodies being generally horribly designed and hormones being a terrible mood regulation device. I didn't have hot flashes to the extent some do, but my personal recommendation is live where you can sleep right next to a window AC unit set to 9. I eventually learned to work with my hair texture. I have spent hundreds of dollars on sunscreen until I fond one I like. The Ordinary has affordable skincare basics (not basics honestly, advanced shit, but they sell in packages). See a dermatologist if you're struggling.

You can still thrive, I promise. You are not doomed to old hagdom. You can still be sexy and feel good about yourself. It won't be quite as effortless as it was before, but again if it was ever effortless you're a bit lucky in the first place. You can definitely make this work.
posted by Lyn Never at 9:01 AM on September 20, 2022 [9 favorites]

First: "I'm not dead of cancer." NOT DEAD means actively thinking/listing/doing things that give you joy or satisfaction.

This is me: I'm 79 years old. I went through menopause in my 50s, which was the most awful time I've endured in my life - never again, thank God. *You won't have to* I've had 2 strokes in the last 2 years, so my memory is not so good, but my actual thinking is still as sharp as ever, and I use lots of external reminder aids. I've been actively involved in volunteer activities (taping books for the Library for the Blind, getting donations for the Food Bank) - curtailed primarily by Covid, not age. SEX: of course it depends on your partner; I've been with a highly sexed man 8 years younger than me for 45 years, and we have (ahem) Quite Adequate Sex, every couple of days. We're very glad we're not dealing with pre-menstral and menstral days. It does seem to me that your real, gut-wrenching loss is that you know you will never be able to give birth to a baby, but that truly is in the hands of Fate.
It does seem that if you're missing "a sense of control over your body" you're missing what never existed. "Be Here Now" by Ram Dass is a wonderful book. And anything that makes you laugh. Good luck.
posted by kestralwing at 9:19 AM on September 20, 2022 [12 favorites]

I will always comment this. Testosterone. Check on testosterone. I can’t take estrogen (endometriosis and other side effects.) so I take testosterone only and it’s been amazing for my surgical menopause.

I take a 4 mg troche, which is split in half. So 2mg about 12 hours apart. Dissolves under the tongue. There are also implants and injections.

So do your research into testosterone as an option. And see if that would add any risk or not. A lot of drs are not aware of this option or that people AFAB need and produce testosterone and it reduces in menopause especially surgical menopause.
posted by Crystalinne at 10:09 AM on September 20, 2022 [3 favorites]

I’m going through this too! I second the Chilipad for sleeping, it helps so much. Also a fan or an air conditioner blowing on you at night. I started sleeping under a duvet with a cover instead of all the blankets and sheets, so I could easily kick the covers off when I got too hot at night. When you can’t sleep, get up and go to another room and read a book, not a screen, until you feel sleepy-ish. I started carrying a little travel thing of wet wipes in my bag so I could discretely wipe sweat off my forehead and dampen my wrists and temples at the same time to cool off. I quit wearing much makeup because it just got smeary when I got hot, and I haven’t really missed it - I just wear Bare Minerals powder foundation now and waterproof mascara.
posted by terridrawsstuff at 10:25 AM on September 20, 2022 [1 favorite]

You should be able to use topical/vaginal estrogen to help maintain vaginal and vulval health because it’s not absorbed systemically. Really look into this on your own and find a provider who is knowledgeable about it—not all of them are. Vaginal atrophy is a lot harder to reverse than prevent.
posted by HotToddy at 10:32 AM on September 20, 2022 [6 favorites]

I know this probably isn’t the answer you’re looking for, but the thing that helped me the most with menopause was that I DTMFA. It reduced a lot of my stress and aggravation, and of course stress and aggravation make everything else worse.
posted by MexicanYenta at 12:27 PM on September 20, 2022 [4 favorites]

there are a lot of new menopause books out there, and i have read a ton of them. my limited understanding is that surgical menopause is "harder" because it comes on all at once, while "natural" menopause gradually comes on. those are all generalizations of course.

the thinking on HRT has swung back to "it's okay for some people and the risks aren't that bad for most people" so a lot of the current books are really focusing on that since for so long it was "HRT BAD!!!!!!". i understand you can't take systemic hormones due to the cancer, but if you're having vaginal problems (atrophy, dryness, pain with penetration, etc.), i'd ask your doctor about vaginal creams/suppositories. i don't know if they'd be okay for you or not.

here are some of the books i thought were decent (my comments from goodreads follow in italics):

The Menopause Manifesto: Own Your Health with Facts and Feminism . this was fine. not the worst and not the best menopause book i've read. i did like that it was mostly science and not all woo "embrace your womanhood" crap.

The M Word: How to Thrive in Menopause. this was fine. i've been reading a lot of menopause books so a lot of it was familiar info. there were a few topics i hadn't seen discussed in depth in other books tho: changing body shape/fat distribution, changing skin, constipation.

Hormone Repair Manual: Every Woman's Guide to Healthy Hormones After 40 . FINALLY a book about menopause that is only about the medical stuff! i have read several others that focus way too much on "the change" and "feeling free" and "no longer being a woman" and none of that is anything that i care about. this book was about what is happening to your body/mind, things that may help, things that may make it worse. no woo, no fluffy "this is YOUR time" stuff.

What Fresh Hell Is This?: Perimenopause, Menopause, Other Indignities, and You . this was a much better look at menopause than a few other books i have read lately. it was written during the beginning of the pandemic, so it is brand new and doesn't have that "boomer vibe" to it for lack of a better word. it was inclusive of all genders, and had an appendix(?) on trans women which i found very interesting, even though it didn't apply to me. but it's still not quite what i'm looking for. i'm not worried about becoming "invisible," because i always have been. i'm not worried about losing my "femininity." i am worried about the strictly medical stuff: how is this going to fuck with my mental health; how do i make hot flashes go away; how long am i going to have to deal with this shit. unfortunately, those aren't questions that can be answered by anyone else.

Our Bodies, Ourselves: Menopause. too much "honoring" and "celebrating" and "next phase of life" crap. as someone who never wanted kids, i don't feel a loss at my fertility going away. i don't feel less feminine by not having a period anymore.

posted by misanthropicsarah at 12:42 PM on September 20, 2022 [19 favorites]

Non hormonal things I found helpful fighting vaginal atrophy.

Good quality lube, you may need to experiment to find what works for you I find KY pearls very helpful but you may have to experiment to find what works for you I keep a selection of them depending on my moods and what we are doing.

Also using specialised moisturising lotions you insert into your vagina every few days. They don't contain hormones but basically treat the skin in their much like lotion on your face helping to keep the internal skin soft and supple. They work use them.

If you're a fan of Penis in Vagina type sex then Ohnut rings are a life saver. They prevent my husband from going too deep so we can both relax and enjoy sex. My husband reassures me that sex still feels just as good for him wearing them.

Use it or loose it is an actual thing. Even if it's not PIV, regular masturbation has helped keep things ticking along.

Watch out for an increase in incidences of thrush and UTIs as lubrication and self cleaning get thrown out of whack.
posted by wwax at 2:56 PM on September 20, 2022 [2 favorites]

KY inserts that melt transvaginally once a week, a box fan for sleeping, antidepressants can really help with hot flashes, gabapentin for insomnia (my worst surgical menopause symptom), a spray bottle of water at bedside, layers cause the freezing that can happen after the hot flash also sucks, a sense of humor and patience to lose patience
posted by yodelingisfun at 8:17 PM on September 20, 2022 [3 favorites]

I had my ovaries removed when perimenopause had already begun, so I had an idea of how that was. And then the operation speeded everything up dramatically. It was a bit overwhelming, but it was over very quickly. Maybe a couple of months. And then I was absolutely fine, in a way I appreciate my new state of being with less hormonal fluctuations through the month, and it was definitely a relief that it was over so fast. I also appreciate that I am alive, I must say.

My skin is drier and my hair is greyed*, more bristle and not as thick, but not terribly. I had my bones checked and they are just fine, not everyone gets osteoporosis. I am struggling with some other issues, PTSD and long COVID, but on those days where the brain fog lifts, I feel smarter and more clear-headed than before. I mentioned on the free thread that I felt very happy at my job yesterday. Not everyone gets early onset dementia, either.
I don't take any supplements or hormones, I do think about keeping a healthy diet and walking my 10.000 steps a day. Unfortunately, one of my long COVID symptoms is joint pain, so harder exercise is off limits to me, but I know plenty of post menopause women who run or work out in gyms, and ride horseback (for some reason, it's a thing among the 50+ women here). Walking is very good, though.

*Obviously you can color your hair. I did for a while, and then stopped during corona. FWIW, several of my friends stopped dying theirs when they saw mine after lock-down, and I remember a girl at university who was younger than you are now, with completely grey hair that everyone admired. But if you choose the color option, go for a much lighter tone than your original color, that will look far more natural, because your skin tone changes too.
posted by mumimor at 12:24 AM on September 21, 2022 [3 favorites]

I would add to the excellent suggestions above: carrying around old fashioned barley sugar lollies and a spray mister of Evian, or similar, for the moments of flashes and feeling weak all over. You could ask for these if your friends or family ask ‘let us know if you need anything!’ Godsends!

After your surgical wounds heal, and the post op check up, I would start basic weight training.
Nothing crazy, even just 25 minutes a day with either light hand weights or your own body weight. Squats and lunges with no weights. Arm, back and shoulder weights in a regular practice helps keep up your alignment especially if your illness puts you supine or sitting for a long period of time.

Weight training helps keep your bones as strong as possible, and it’s mentally helpful to do something by yourself, for yourself and see some strength in your body. Doing basic weights helped me feel I was doing something relatively simple every day to gather mental and physical strength.

I agree with wwax that it is good to keep up a solo sexual practice where you feel safe to explore what it is that will get your flow happening naturally, and getting used to using lubricants. With partners ask for feelings of safety as you navigate a new era in your sexual life, and assert your feelings if you feel pain or anxiety.

After my surgery, I found that post orgasm and/ or piv sex could bring up pelvic pain and also mental struggle. Lying in Supta Baddha Konasana - reclined and supported butterfly pose - post sexual experiences is so therapeutic. Take all the weight and stress from the pelvis by supporting your knees as they fall to the side and target your breathing and thoughts to freeing any tension you are holding on your pelvis. Even without sexual activity, this is an excellent pose to do each day with intentionality, but it is especially helpful after excitation of that part of your body.

After we have our hormones radically altered via surgical menopause, involuntary urination can be a Thing. Kegel exercises and pelvic therapy is really important.

I’d also say, be prepared for feeling lonely with menopause symptoms at your young age. It’s an awful feeling and if you wanted children, that is also something that can feel alienating from your peers. Going through such intimate surgery is likely to unleash some anger (as Lyn Never wisely notes) and grief. Getting yourself into a regular therapy practice is vital to combat all of the above - complicated feelings that are not addressed can compound the distress of menopause at any age, but particularly when you are having a set of experiences mostly unfamiliar to your peers.
posted by honey-barbara at 12:58 AM on September 21, 2022 [1 favorite]

I just want to note that the mental health aspects of menopause are not just feeling bad about menopause. Those hormones are part of the system that generally keeps mood even, which you may have some familiarity with if you had pre-menstrual or ovulatory mood swings.

I'm not talking about being mad or sad about the situation, I'm talking about out-of-nowhere self-harm ideation, the kind of rage events that could get you to go viral if they happen in public, unable-to-stand sobbing over something that should be only mildly irritating like a small broken thing or an Excel formula that won't work, going from 0 to homicidal in an instant over current events, crying over anything from a mild correction at work to having someone be "too nice" to you to complete meltdowns over a sad animal on a TV program. Instances of severe emotional dysregulation. I was delighted to be done with pretty much every aspect of the menstruation era, but I was in that slide between peri and proper menopause during the 2015 primary and then finished during the subsequent presidential administration and it was not, to put it mildly, a good time.

Get meds if you need meds. Have a support system. Find some older menopausal people to buddy up with if you can, just so you can text someone about the murder you're not committing and get back-pats because they know about the not-murdering. This shit does even out eventually for most people, and not every single day is going to be that bad, but don't just write it off to being bummed about circumstances - there are actual biological mechanisms in play and they CAN be mitigated even without HRT.
posted by Lyn Never at 9:21 AM on September 21, 2022 [3 favorites]

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