If hormones mess with you, what was peri/menopause like?
October 23, 2024 10:52 AM Subscribe
I'm 42 and a number of my friends are entering peri-menopause. For some of them it's been a rough ride. Many have found relief with HRT. I've always struggled with my hormones and I'm worried about what this may look like for me. My doctor isn't super helpful and I'd love to hear from anyone who has experience.
I've always struggled with PPMD. I've never been able to tolerate hormonal birth control, and I had a year long episode of PPD following the birth of my second child. I am also not able to tolerate SSRIs.
I am really scared of what the journey towards menopause may look like for me, really worried that the options my friends are accessing may not be a safe possibility and I've had bad luck with my medical providers taking these concerns seriously.
I'm looking for more supportive medical/GYN care but in the interim, I'm wondering if any of you have had similar experiences and could share how menopause went for you and what tools if any you found helpful. Thanks!
I've always struggled with PPMD. I've never been able to tolerate hormonal birth control, and I had a year long episode of PPD following the birth of my second child. I am also not able to tolerate SSRIs.
I am really scared of what the journey towards menopause may look like for me, really worried that the options my friends are accessing may not be a safe possibility and I've had bad luck with my medical providers taking these concerns seriously.
I'm looking for more supportive medical/GYN care but in the interim, I'm wondering if any of you have had similar experiences and could share how menopause went for you and what tools if any you found helpful. Thanks!
I am so sorry you are struggling with this. It’s a shame that we don’t have better information about menopause, not to mention health care providers who will listen to us.
IANAD so I cannot speak to your concerns about not tolerating HRT in relation to your prior experience with hormonal birth control.
For me, HRT (both estrogen and progesterone) were a life saver. I could not sleep or function without them. In my case, they were recommended by my doctors as they will help with other medical issues besides menopause, and I had no contraindications. Everyone is different, of course.
The best advice I can give you is to find a doctor who will listen to you and answer your questions. That could be OB/GYN, or endocrinology (depends on the doctor), or possibly primary care. I’m personally inclined to go with a specialist but the most important thing is a health care who will listen to you and who is up to date. There are different meds on the market and there is no one size fits all approach.
I hope you are able to get relief. Wishing you all the best.
posted by kyraU2 at 11:23 AM on October 23, 2024 [2 favorites]
IANAD so I cannot speak to your concerns about not tolerating HRT in relation to your prior experience with hormonal birth control.
For me, HRT (both estrogen and progesterone) were a life saver. I could not sleep or function without them. In my case, they were recommended by my doctors as they will help with other medical issues besides menopause, and I had no contraindications. Everyone is different, of course.
The best advice I can give you is to find a doctor who will listen to you and answer your questions. That could be OB/GYN, or endocrinology (depends on the doctor), or possibly primary care. I’m personally inclined to go with a specialist but the most important thing is a health care who will listen to you and who is up to date. There are different meds on the market and there is no one size fits all approach.
I hope you are able to get relief. Wishing you all the best.
posted by kyraU2 at 11:23 AM on October 23, 2024 [2 favorites]
I've been through menopause. It wasn't a picnic, but I really don't think it is anything to be scared about or worried about. I don't think it is generally any worse than what we women endure going into puberty, nor any worse than issues related to the monthly cycle of menstruation, such as bloating, mood swings, cramps, etc.
My doctor put a lot of pressure on me to take hormones. I never understood why, because it's not like menopause is fatal or anything. I tried taking them, but they made me feel so weird (I can't really explain what I mean by weird; just this strange woozy feeling in my head) so I stopped.
I had ruthless hot flashes, usually every hour or two; they made me feel like I was going to spontaneously combust. They were definitely uncomfortable and socially embarrassing, but they weren't debilitating or life threatening. I decided to just power through and endure them. The only thing I did to address them was to sleep with a towel. I had them for 6 1/2 years. The menopause transition phase didn't negatively affect my moods or temperament at all. Now that I've completed the transition and, therefore, no longer have the hormone fluctuations of the menstrual cycle, my temperament is much more calm, steady and even-keeled than it was during my menstruating years, which has been really, really nice. Not having to deal with periods, mood swings, bloating, etc., is wonderful; it makes it worth being "old".
Looking back, going through menopause was much easier than the transition to puberty and the years of periods were.
My bet is that you'll do fine without taking hormones.
p.s. toodleydoodley, above, mentioned that reducing added sugar helped them. During menopause, although I was not overweight, I was advised to lose some weight (only about five pounds) to help relieve my acid reflux. The main way I did this was by eliminating sugar. It could have just been coincidental, but my hot flashes stopped when I lost weight ... perhaps it was because I eliminated sugar??
posted by SageTrail at 11:34 AM on October 23, 2024 [6 favorites]
My doctor put a lot of pressure on me to take hormones. I never understood why, because it's not like menopause is fatal or anything. I tried taking them, but they made me feel so weird (I can't really explain what I mean by weird; just this strange woozy feeling in my head) so I stopped.
I had ruthless hot flashes, usually every hour or two; they made me feel like I was going to spontaneously combust. They were definitely uncomfortable and socially embarrassing, but they weren't debilitating or life threatening. I decided to just power through and endure them. The only thing I did to address them was to sleep with a towel. I had them for 6 1/2 years. The menopause transition phase didn't negatively affect my moods or temperament at all. Now that I've completed the transition and, therefore, no longer have the hormone fluctuations of the menstrual cycle, my temperament is much more calm, steady and even-keeled than it was during my menstruating years, which has been really, really nice. Not having to deal with periods, mood swings, bloating, etc., is wonderful; it makes it worth being "old".
Looking back, going through menopause was much easier than the transition to puberty and the years of periods were.
My bet is that you'll do fine without taking hormones.
p.s. toodleydoodley, above, mentioned that reducing added sugar helped them. During menopause, although I was not overweight, I was advised to lose some weight (only about five pounds) to help relieve my acid reflux. The main way I did this was by eliminating sugar. It could have just been coincidental, but my hot flashes stopped when I lost weight ... perhaps it was because I eliminated sugar??
posted by SageTrail at 11:34 AM on October 23, 2024 [6 favorites]
Response by poster: Thank you so much to the people who've responded. I really appreciate it. And I'm definitely on the hunt for better medical care. While I know some people have smooth sailing, my particular concerns are centered around my (very!) negative experiences with all things hormonal- from puberty, to birth control, to PMS, to post partum depression. Which makes me worry that menopause itself may be rough and also that hormonal interventions may not be possible. I may not have made that lens clear in my question.
posted by jeszac at 11:38 AM on October 23, 2024
posted by jeszac at 11:38 AM on October 23, 2024
Best answer: I've asked the same question in other fora as I have similar issues and am around your vintage, and noticing the earliest signs perimenopause might be around the corner. I've definitely spoken with people who generally couldn't tolerate hormonal birth control but found that HRT for menopause was still helpful. Unfortunately it's very much an "every body is different, you've just got to try things and see what works" situation. When the time comes, I'm going to try to approach HRT with an open mind despite my previous experiences.
I think the use case here is pretty different - not "your body is being flooded with hormones way above what you typically produce" or "your body is riding a hormone roller coaster" but "your body is making way lower amounts of hormones than you're used to functioning with". For me, I think a lot of my hormonal turbulence has been caused by either clear oversupply or dramatic fluctuations. The HRT of menopause isn't either of those so I'm hoping it will go better.
But if not... we'll survive! It might suck for awhile, but so did puberty and pregnancy.
posted by potrzebie at 11:46 AM on October 23, 2024 [9 favorites]
I think the use case here is pretty different - not "your body is being flooded with hormones way above what you typically produce" or "your body is riding a hormone roller coaster" but "your body is making way lower amounts of hormones than you're used to functioning with". For me, I think a lot of my hormonal turbulence has been caused by either clear oversupply or dramatic fluctuations. The HRT of menopause isn't either of those so I'm hoping it will go better.
But if not... we'll survive! It might suck for awhile, but so did puberty and pregnancy.
posted by potrzebie at 11:46 AM on October 23, 2024 [9 favorites]
Best answer: I really found the book by Dr Jen Gunter, Menopause Manifesto, helpful. Also her book Blood.
posted by 15L06 at 11:47 AM on October 23, 2024 [14 favorites]
posted by 15L06 at 11:47 AM on October 23, 2024 [14 favorites]
You can manage your hormones with diet by eliminating sugar and carb cycling. I would not have believed this to be true until I tried it myself for a hormone-related autoimmune disease and realized that it also cured my PMS and debilitating cramps. I used the book Women, Food, and Hormones by Dr. Sara Gottfried and found it life-changing. She is a board-certified gynecologist so the book covers diet and hormones and also a lot about menopause and the safety and efficacy of things like HRT.
posted by stellaluna at 11:55 AM on October 23, 2024 [3 favorites]
posted by stellaluna at 11:55 AM on October 23, 2024 [3 favorites]
Best answer: Forgot to add, i am 59, and still have a period perhaps 2-3 per year. This is why i read the books by Jen Gunter looking for perspective.
I did not tolerate birth control well, and do not take hormones.
But hopefully soon bleeding will stop for good.
posted by 15L06 at 11:57 AM on October 23, 2024 [2 favorites]
I did not tolerate birth control well, and do not take hormones.
But hopefully soon bleeding will stop for good.
posted by 15L06 at 11:57 AM on October 23, 2024 [2 favorites]
The podcast Science Vs has just done an episode on menopause and it's very informative.
posted by BlahLaLa at 11:58 AM on October 23, 2024 [2 favorites]
posted by BlahLaLa at 11:58 AM on October 23, 2024 [2 favorites]
Best answer: Something that is hard to describe therefore it feels like a "nobody told me!" thing: almost nothing that happens in perimenopause comes with a big PERI tag on it. It is in some ways it is a disorder of hindsight, and even in the moment you spend a lot of time going "this is new, is this peri?" This is a freaky headache, is it peri or something more sinister? Man, cheese is really giving me heartburn now, is it peri or has lactose intolerance finally come for me? I now have an entire musical scale of groans and grunts for getting up and down, is this peri or just age?
And, in these modern times: Is this politics, or is it peri?
Some of these things are frog-boilers, you know? One day you realize you've been avoiding certain items of clothing for months because they're too itchy or just don't sit right. You notice the most recent 4 inches of hair growth is a distinctly different texture and that's why the hairdo you've worn for years has been less manageable or doesn't look right or hair color has stopped sticking.
A friend of mine was like, "oh so I finally got a referral for an orthopedist to look at my damn Peri Shoulder" and everyone else in the chat was like "wait, what" and she said "oh yeah, you didn't know about Peri Shoulder? I haven't been able to wipe for 3 months, we got a bidet but my husband still has to come dry my ass for me."
Just...fresh horrors, around every corner. I didn't get peri shoulder, I broke my leg because my tendons forgot how to tendon.
And the frog-boiling is annoying and frustrating for the physical symptoms, but it's really fucking dangerous for the neurochemical ones. In my group chats (all this went down in 2020-2023, so who knows if it was politics, pandemic, perimenopause, or parent-dying??) we started getting real casually frank about our ideation and intrusive thoughts. I had a major burnout event in the summer of 2020, like what they used to call a "nervous breakdown". One of my friends ended up starting HRT as a result of a voluntary psych hold.
None of us understood. We've always been told we get mean or 'crazy' or depressed or whatever because we are SO sad about no longer being a useful member of society but 90% of my menstruating friends never had kids on purpose so we were already happy being useless. It turns out it's primarily just the hormones!
And my friends who did use HRT for some period of time (I should have, but I somehow decided it was easier to rawdog it. It was not.) reported it was nothing like hormonal contraception because you're not really increasing anything, you're just trying to get it to hold steady where it had been up until recently, and then decline slowly in a straight line instead of all over the place.
Track your moods, build a support system of people also going through it, intervene sooner rather than later because waiting for it to pass can be a long game. Don't be scared, just be mindful.
The bad things were real bad, but it wasn't like four years of chronic terribleness. Well yes, externally it was precisely that, but even recognizing I was pretty unstable for several years and it was a very difficult time in the world I had happiness, I enjoyed things, I had lots of gratitude for small things, I learned some interesting things about myself. There is a difficult-to-describe freedom to not living under the authority of somewhat tyrannical chemicals. I've never in my whole life, not even in my hottest moments, ever felt this comfortable in my own skin or recognized my own strength.
posted by Lyn Never at 1:09 PM on October 23, 2024 [28 favorites]
And, in these modern times: Is this politics, or is it peri?
Some of these things are frog-boilers, you know? One day you realize you've been avoiding certain items of clothing for months because they're too itchy or just don't sit right. You notice the most recent 4 inches of hair growth is a distinctly different texture and that's why the hairdo you've worn for years has been less manageable or doesn't look right or hair color has stopped sticking.
A friend of mine was like, "oh so I finally got a referral for an orthopedist to look at my damn Peri Shoulder" and everyone else in the chat was like "wait, what" and she said "oh yeah, you didn't know about Peri Shoulder? I haven't been able to wipe for 3 months, we got a bidet but my husband still has to come dry my ass for me."
Just...fresh horrors, around every corner. I didn't get peri shoulder, I broke my leg because my tendons forgot how to tendon.
And the frog-boiling is annoying and frustrating for the physical symptoms, but it's really fucking dangerous for the neurochemical ones. In my group chats (all this went down in 2020-2023, so who knows if it was politics, pandemic, perimenopause, or parent-dying??) we started getting real casually frank about our ideation and intrusive thoughts. I had a major burnout event in the summer of 2020, like what they used to call a "nervous breakdown". One of my friends ended up starting HRT as a result of a voluntary psych hold.
None of us understood. We've always been told we get mean or 'crazy' or depressed or whatever because we are SO sad about no longer being a useful member of society but 90% of my menstruating friends never had kids on purpose so we were already happy being useless. It turns out it's primarily just the hormones!
And my friends who did use HRT for some period of time (I should have, but I somehow decided it was easier to rawdog it. It was not.) reported it was nothing like hormonal contraception because you're not really increasing anything, you're just trying to get it to hold steady where it had been up until recently, and then decline slowly in a straight line instead of all over the place.
Track your moods, build a support system of people also going through it, intervene sooner rather than later because waiting for it to pass can be a long game. Don't be scared, just be mindful.
The bad things were real bad, but it wasn't like four years of chronic terribleness. Well yes, externally it was precisely that, but even recognizing I was pretty unstable for several years and it was a very difficult time in the world I had happiness, I enjoyed things, I had lots of gratitude for small things, I learned some interesting things about myself. There is a difficult-to-describe freedom to not living under the authority of somewhat tyrannical chemicals. I've never in my whole life, not even in my hottest moments, ever felt this comfortable in my own skin or recognized my own strength.
posted by Lyn Never at 1:09 PM on October 23, 2024 [28 favorites]
Oh and while I did not ever use HRT I waited about 18 months longer than I should have to get on an SSRI. Not all medical management of menopause has to be hormones.
posted by Lyn Never at 1:10 PM on October 23, 2024 [3 favorites]
posted by Lyn Never at 1:10 PM on October 23, 2024 [3 favorites]
Best answer: HRT has worked for me. And I also recommend Jen Gunter's book. But the single best tool I can recommend is the Menopause Society provider search here. Finding my menopause practitioner - even though the wait to see her for the first time was 5 months - was the difference between the first 3 years of stumbling around feeling mislead, alone, and confused, and the last 2, in which I've been supported, educated, and treated with care and respect. Find yourself an expert!
posted by minervous at 1:33 PM on October 23, 2024 [7 favorites]
posted by minervous at 1:33 PM on October 23, 2024 [7 favorites]
Best answer: I am very sensitive to hormones both inside me and pharmacological ones and I am successfully on HRT.
I found out about an online medical clinic specifically for menopause concerns and didn't even attempt to address it with local physicians. I'm in a red state with crap underlying beliefs that are bound to cause bias so I didn't even try. (The online clinic is called Midi health. They are slowly credentialing with insurance throughout the country. I accepted that I might have to be private pay but for me it was worth the convenience of not being invalidated or having to filter through providers til someone listened to me).
Most docs won't do HRT without the magic words "hot flashes" but I first started to wonder about menopause due to heart palpitations and insomnia that felt different from what I've dealt with since I was a teenager. Heart palpitations are not a commonly discussed symptom but somehow I learned it can be due to hormone changes and brought my symptoms to the provider.
I also can't take SSRIs, had to stop the mini pill after childbirth due to moderate depression from it within a day or two of taking it. My period hormones can make me very intolerant of bullshit.
My partner asked me to check with the obgyn about PMDD but I saw the checklist they use to diagnose and realized that my symptoms can be intense but they are not intense like that (I get sensitive to feeling left out or am quicker to anger and less patient with stuff I have asked to address nicely repeatedly, but no SI or HI or such), so I don't think I have PMDD. Just very sensitive.
I say all that because hormonal birth control has never worked for me. I even had psychosis from the Depo shot many years ago. HRT has not caused any of those issues! I use the estrogen patch which is generally safe.
In fact, I have an autoimmune condition that impacts my small blood vessels and my menopause doc conferred with my rheumatologist before writing the script due to known vascular risks associated with estrogen. Estrogen patches are safer than the general public believes because one study was heavily advertised years ago and it marked our culture deeply. Oral estrogen can be risky but the patch is less so, and I believe topical estrogen is also considered safer but I'm not an MD.
I struggle with insomnia right now as my worst symptom. I take progesterone which does help but if I don't go to sleep right when it kicks in, I lose the nudge that it gives me and am easily up for many hours. I now tend to feel more tired from little sleep but I can still function on 3-5 hours of sleep much better than I could at any other point (except maybe early 20s) as this insomnia is so different from what I've known in the past.
Anyway. I'm a hormone sensitive person, and I just wish that birth control worked like this stuff does. I did notice some extra emotional sensitivity when starting the patch so now I just put it on at a time when I think the majority of the initial absorption will happen while I'm asleep and it's been fine. I also cut the patches at first as I didn't respond well to the full dose but now I probably need it.
Finding someone who can help supplement testosterone has been hard. I don't know if docs are scared to prescribe it because my state is horrible about transgender issues or what. My doc recommended DHEA but even small doses make me feel like I'm on the on ramp to psychosis so that is a no go for me. I did tell my psychiatrist about that and apparently it is a known potential side effect, but not typically talked about for whatever reason.
I didn't see anyone mention her so apologies if this is a repeat, but Mary Haver has done good work on menopause education. She does promote a diet for hormone health and does sell some things but her general advice seems sound. She did an extensive marketing campaign recently so I'm sure you can find various podcast episodes with her as the guest speaker.
Happy to discuss some of this more in MeMail if you like.
posted by crunchy potato at 1:42 PM on October 23, 2024 [3 favorites]
I found out about an online medical clinic specifically for menopause concerns and didn't even attempt to address it with local physicians. I'm in a red state with crap underlying beliefs that are bound to cause bias so I didn't even try. (The online clinic is called Midi health. They are slowly credentialing with insurance throughout the country. I accepted that I might have to be private pay but for me it was worth the convenience of not being invalidated or having to filter through providers til someone listened to me).
Most docs won't do HRT without the magic words "hot flashes" but I first started to wonder about menopause due to heart palpitations and insomnia that felt different from what I've dealt with since I was a teenager. Heart palpitations are not a commonly discussed symptom but somehow I learned it can be due to hormone changes and brought my symptoms to the provider.
I also can't take SSRIs, had to stop the mini pill after childbirth due to moderate depression from it within a day or two of taking it. My period hormones can make me very intolerant of bullshit.
My partner asked me to check with the obgyn about PMDD but I saw the checklist they use to diagnose and realized that my symptoms can be intense but they are not intense like that (I get sensitive to feeling left out or am quicker to anger and less patient with stuff I have asked to address nicely repeatedly, but no SI or HI or such), so I don't think I have PMDD. Just very sensitive.
I say all that because hormonal birth control has never worked for me. I even had psychosis from the Depo shot many years ago. HRT has not caused any of those issues! I use the estrogen patch which is generally safe.
In fact, I have an autoimmune condition that impacts my small blood vessels and my menopause doc conferred with my rheumatologist before writing the script due to known vascular risks associated with estrogen. Estrogen patches are safer than the general public believes because one study was heavily advertised years ago and it marked our culture deeply. Oral estrogen can be risky but the patch is less so, and I believe topical estrogen is also considered safer but I'm not an MD.
I struggle with insomnia right now as my worst symptom. I take progesterone which does help but if I don't go to sleep right when it kicks in, I lose the nudge that it gives me and am easily up for many hours. I now tend to feel more tired from little sleep but I can still function on 3-5 hours of sleep much better than I could at any other point (except maybe early 20s) as this insomnia is so different from what I've known in the past.
Anyway. I'm a hormone sensitive person, and I just wish that birth control worked like this stuff does. I did notice some extra emotional sensitivity when starting the patch so now I just put it on at a time when I think the majority of the initial absorption will happen while I'm asleep and it's been fine. I also cut the patches at first as I didn't respond well to the full dose but now I probably need it.
Finding someone who can help supplement testosterone has been hard. I don't know if docs are scared to prescribe it because my state is horrible about transgender issues or what. My doc recommended DHEA but even small doses make me feel like I'm on the on ramp to psychosis so that is a no go for me. I did tell my psychiatrist about that and apparently it is a known potential side effect, but not typically talked about for whatever reason.
I didn't see anyone mention her so apologies if this is a repeat, but Mary Haver has done good work on menopause education. She does promote a diet for hormone health and does sell some things but her general advice seems sound. She did an extensive marketing campaign recently so I'm sure you can find various podcast episodes with her as the guest speaker.
Happy to discuss some of this more in MeMail if you like.
posted by crunchy potato at 1:42 PM on October 23, 2024 [3 favorites]
I'm on HRT, and it's been amazing. I had issues with vaginal skin thinning and pain, and a lot of it has gone away.
posted by heathrowga at 2:46 PM on October 23, 2024 [1 favorite]
posted by heathrowga at 2:46 PM on October 23, 2024 [1 favorite]
nthing Jen Gunter's book, but also her substack newsletter - she publishes about every week and has some great articles about different symptoms and what the data is on various treatments for specific symptoms etc. Some of it's behind a paywall, but I think I subscribed for $35/year last year, which seemed like a bargain compared to a lot of supplements/products being marketed to me. There are a lot of people out there right now talking about HRT and I'm grateful to be going through peri at a time when conversations are happening, research is being done, and egregious errors of the past are being acknowledged and corrected, but sometimes a lot of things I see online start to have this weird snake oil sheen. I'm sometimes disappointed reading Dr. Gunter's b/c she's got a very 'let's see the data' approach, but I so appreciate how she's trying to guide women in identifying their symptoms, making decisions and having useful conversations with their providers.
posted by snowymorninblues at 5:34 PM on October 23, 2024 [2 favorites]
posted by snowymorninblues at 5:34 PM on October 23, 2024 [2 favorites]
Best answer: Oooh, this is a question for me! I struggled my whole life long with everything to do with hormones. And as with most, perimenopause crept up on me and made my life a sanity-questioning nightmare. But! Once I went on HRT (estrogen patch and oral progesterone) I felt a sense of wellness that I had never experienced before in my life. I have never been on a more even keel emotionally, my body is not coming up with new horrors every day, my libido is reliable, and I'm a grand weight for my height. I mean, I'm still falling apart with age, as we all do. But the hormonal aspect has never been better. I cannot recommend HRT highly enough. My one piece of advice is to find a doctor who is okay with putting you on continuous right from the start and skipping over cyclical. I didn't even know this was a thing you could do until I found my blessed wonderful menopause specialist who said she does it with almost everyone because cyclical is just too hard. Every month when I would start the progesterone I would start weeping literally within hours of taking the first pill. Even though I knew what was causing it, I was powerless to stop it. As soon as I went on continuous, everything evened out.
posted by HotToddy at 5:39 PM on October 23, 2024 [6 favorites]
posted by HotToddy at 5:39 PM on October 23, 2024 [6 favorites]
Hated them in my youth (depression mainly), instant (within 2 weeks) improvement in my middle years.
posted by Narrow Harbor at 8:16 PM on October 23, 2024
posted by Narrow Harbor at 8:16 PM on October 23, 2024
Best answer: Another that couldn't tolerate hormonal bc (constant.yeast.infections) but am doing fine on HRT. And kudos to the commenter above who powered through but heat flashes were a nightmare. Fuck those. But really the key is to get a good specialist and keep trying till something works.
ALSO. MANY women including me have gotten diagnosed with things like ADHD at peri because whatever mental coping mechanisms got you through early adulthood stop working. So be prepared to reach out for whatever therapy and meds you need. Don't have to be SSRIs.
posted by emjaybee at 9:02 PM on October 23, 2024 [2 favorites]
ALSO. MANY women including me have gotten diagnosed with things like ADHD at peri because whatever mental coping mechanisms got you through early adulthood stop working. So be prepared to reach out for whatever therapy and meds you need. Don't have to be SSRIs.
posted by emjaybee at 9:02 PM on October 23, 2024 [2 favorites]
Best answer: I can't take HRT because of a medical contraindication - history of migraine. My gyn put me on venlafaxine (Effexor) for hot flashes, which was remarkably effective (if a total bear to come off of.) You said no SSRIs - venlafaxine is a SNRI, but up to your body and you as to whether that's an option or not. Topical estradiol is also very helpful, and has no systemic effect, so that may be an option for you as well.
Echoing all of the love for Dr. Gunter.
posted by gingerbeer at 9:04 PM on October 23, 2024
Echoing all of the love for Dr. Gunter.
posted by gingerbeer at 9:04 PM on October 23, 2024
Oh! Speaking of migraines, I started getting those too after trying hormonal BC to level the impact of my cycle on my reactivity. I get bad ones when there is a sudden change in estrogen. My doc believes the estrogen patch to be safe for me, and I try to time it so I'm putting on a new patch the day I start my period which helps counteract the severe migraine that I sometimes get despite all the treatments. So, HRT helps my hormonal migraines as well.
posted by crunchy potato at 9:19 PM on October 23, 2024 [1 favorite]
posted by crunchy potato at 9:19 PM on October 23, 2024 [1 favorite]
Anecdotally,* I've read that many peri-/menopausal folks who didn't have an ADHD diagnosis and didn't take stimulants before have started taking stimulants as part of their peri-/menopause treatment. So if executive dysfunction is part of what you experience, it might be worth looking into that.
*I think there actually is research on this, but I haven't read it and don't have it easily at hand
posted by librarina at 11:57 AM on October 24, 2024
*I think there actually is research on this, but I haven't read it and don't have it easily at hand
posted by librarina at 11:57 AM on October 24, 2024
Best answer: I also couldn't tolerate BC but have done really well on HRT. Technically, I also have a history of migraines, but the doctor at the menopause clinic was not concerned when I told her details of my history.
I'm not even sure I could list all of the signs of perimenopause. I felt like I was flying apart. Just remember - you have estrogen sensors all over your body, including your brain, and it will be starving for estrogen. I got bad care from OB/GYNs until I found my local menopause clinic.
My migraines changed in that I started getting an aura (never had that before) - the neurologist correctly suggested it was menopause, but didn't actually tell me to see a specialist or get any treatement for perimenopause (!) Mast cell activation syndrome (that is since in remission), uncontrollable weight gain, insomnia, rage, a cigarette smell in my sinuses with every change of the season, sex drive plummeted, joint pain (went away within hours of starting HRT), caffeine intolerance, dehydration, ADHD came roaring back and the meds didn't work until I went on HRT (and then they worked too well!), I rage quit an organization I had founded. Feeling like I'm always yelling (even my voice in my head - like, my thoughts were loud and yell-y). Dry eyes. Brain fog. Being absolutely exhausted and losing muscle mass. And on and on and on.
The r/menopause on reddit is quite good.
posted by vitabellosi at 12:57 PM on October 24, 2024 [3 favorites]
I'm not even sure I could list all of the signs of perimenopause. I felt like I was flying apart. Just remember - you have estrogen sensors all over your body, including your brain, and it will be starving for estrogen. I got bad care from OB/GYNs until I found my local menopause clinic.
My migraines changed in that I started getting an aura (never had that before) - the neurologist correctly suggested it was menopause, but didn't actually tell me to see a specialist or get any treatement for perimenopause (!) Mast cell activation syndrome (that is since in remission), uncontrollable weight gain, insomnia, rage, a cigarette smell in my sinuses with every change of the season, sex drive plummeted, joint pain (went away within hours of starting HRT), caffeine intolerance, dehydration, ADHD came roaring back and the meds didn't work until I went on HRT (and then they worked too well!), I rage quit an organization I had founded. Feeling like I'm always yelling (even my voice in my head - like, my thoughts were loud and yell-y). Dry eyes. Brain fog. Being absolutely exhausted and losing muscle mass. And on and on and on.
The r/menopause on reddit is quite good.
posted by vitabellosi at 12:57 PM on October 24, 2024 [3 favorites]
Best answer: HRT has been a game-changer for me starting in my early 40s. I love my Estradiol patch, oral progesterone, Mirena IUD, vaginal estrogen cream, compounded GLP-1 (tirzepatide), and oral minoxidil to successfully treat all of my Perimenopause symptoms. (Not surprised to see here so many smart, research-driven MeFites are on it compared to the general population!)
I follow Dr. Mary Claire Haver’s work and went straight to affordable menopause telehealth (Evernow) to get immediately put on it, because of all the misogyny and transphobic tales of patient experiences being dismissed by providers at most US brick and mortar medical practices (even in blue states), with long wait times to get an appointment to be seen. The menopause subreddit (r/Menopause) is also a fantastic resource.
posted by edithkeeler at 3:55 AM on October 25, 2024 [1 favorite]
I follow Dr. Mary Claire Haver’s work and went straight to affordable menopause telehealth (Evernow) to get immediately put on it, because of all the misogyny and transphobic tales of patient experiences being dismissed by providers at most US brick and mortar medical practices (even in blue states), with long wait times to get an appointment to be seen. The menopause subreddit (r/Menopause) is also a fantastic resource.
posted by edithkeeler at 3:55 AM on October 25, 2024 [1 favorite]
Mod note: Thank you for posting this question and to all who have answered, we've shared this and other menopause related information on the sidebar and Best Of blog!
posted by Brandon Blatcher (staff) at 9:56 AM on October 26, 2024 [1 favorite]
posted by Brandon Blatcher (staff) at 9:56 AM on October 26, 2024 [1 favorite]
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posted by toodleydoodley at 11:04 AM on October 23, 2024 [6 favorites]