I Hate to Mention It

Several years ago, Mike and I were sitting in a packed auditorium, waiting for the speaker to arrive. The cooling in the room was inadequate, so I fanned myself with my program like an old lady at a tent revival. Pretty soon, I noticed that the woman next to me was leaning closer to catch some of the breeze, in addition to the one she was generating with her own program. I foolishly made some comment about the heat.

The next thing I knew, I was getting an earful about her hot flashes. We were complete strangers, but that didn’t stop her from  regaling me with tales of menopausal woe. When I tired of the topic, the woman leaned across me to discuss her hot flashes with my husband. Her own spouse looked at me, shrugged, then pretended to be engrossed in adjusting his wristwatch.

Call me old fashioned, but I think medical symptoms should be off-limits when chatting up strangers. Except maybe if you need to say, “I think I’m having a heart attack. Dial 9-1-1.” That’s okay.

It’s not that I’m squeamish. My work with hospice patients has provided plenty of firsthand experience with conditions far more gruesome than menopause. I just don’t think we need to tell each other about every twinge, and I was determined not to be one of those women who bitched and moaned her way through midlife. Well, not any more than usual.

However.

I am in my early 50s and I would like my brain back.

Two months ago, the blues landed like a wet wool blanket on my normally pleasant life. Objectively, I have nothing to feel sad about so this weepy nonsense is really annoying. Some days, the blanket lifts and is replaced by worry, worry, worry. Which causes me to be awake at 3 a.m., and the resulting tiredness makes me — how else to say it? — stupid. It’s hard to focus and harder still to learn something new. Then for several days I feel like myself until, for no reason at all, the whole thing starts over.

I have a pretty good brain. I use it all the time and would like to have access to it again without this hormonally-induced haze. In terms of lifestyle, I’ve done all I can do. My weight is appropriate, and my diet is light on animal fat. My alcohol intake is minimal, and the dogs make me exercise every day of my life whether I want to or not. In search of professional advice, I went to see a nurse practitioner who specializes in perimenopause (the phase that leads up to menopause). After the usual undignified examination and some blood work, she declared me healthy, offered up some literature on topical estrogen options and a sample thereof. I left the office feeling downright hopeful.

That optimism might’ve last longer had I not actually read the literature she gave me. All the pamphlets said the same thing.

Estrogens increase the risk of cancer of the uterus.

Using estrogens may increase your risk of heart attack, stroke, breast cancer, blood clots, and dementia.

Both my parents suffered from blood clots, as did my grandmother, who experienced multiple strokes before a fatal one in her early 60s. And you don’t have to be old for a clot to develop. There is no age restriction and no good place in the body for a blood clot to lodge. I have a family history, and even if the risks are low, the possibility of ending up in that small group is unacceptable to me.

I am disappointed that this roulette wheel is the best modern medicine can offer perimenopausal women. You can get relief, but the medication could also cause you to develop a life-altering or fatal condition as a result of the medication. I personally know two women who lost that gamble, one of whom spent months recovering from a pulmonary embolism.

But the dearth of good solutions is also not a huge surprise. Until the second half of the 20th century, a woman’s life expectancy didn’t extend much beyond menopause, so few resources went into researching that phase. “Female troubles” were considered trivial and were often attributed to mental instability. Consequently, we’re a little behind in coming up with ways for women to manage the very real effects of hormonal changes. Until recently, nobody cared.

Back in the 21st century, I perused the internet, googling for alternatives. Vitamin B6 and Omega-3s were mentioned, along with herbs like ginseng, St. John’s wort, black cohosh, and dong quai. None of the articles suggested potencies or dosages, so I guess I’m supposed to wing it. I read about stress management as a way to control my symptoms, but the only stress in my life these days is coming from my symptoms, so that didn’t help much. I am waiting for a call from the nurse practitioner to see if she has any other ideas. I need my brain and I want it back, so I am willing to try just about anything that doesn’t threaten to kill me.

Published in: on June 5, 2013 at 7:25 pm  Comments (15)  
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15 CommentsLeave a comment

  1. I figure I’m close behind: there’s a complimentary/signed copy of Our Bodies, Ourselves the Menopause edition at the birth center. I keep thinking I need to borrow it for awhile so maybe I can be ahead of the curve. :)

    • How did I not know about that book? I’m going to look for it on the library website right now. Thanks, Olga.

      ~MY

  2. Oh Michelle,
    I can deal with most everything else but I hate the foggy mind! We should have a retreat so that we could all commiserate but most of us would probably forget when and where it was being held.

    • I’d rather send several brilliant researchers in the field of women’s health on retreat. Think of all the women in the Baby Boomer generation who need answers, especially since we’re probably going to live for another 30 to 40 years.

      ~MY

      • You are so right! I have some “issues” that I have tried to speak to several male drs about and they start acting like middle school boys and won’t even discuss. “Umm, umm, that is not my area… you need to talk to your gynecologist.” Well, the problem with that is she won’t talk to me about the medicine that HE prescribed. which is what is causing the problem. GAHHH. I agree that more research should be done. I suspect that there may be some research going on now as we have many more women in the medical field. Also there may be more women in the position of making monetary decisions which has great influence on what research gets generous funding.

  3. Bless you for writing this. I am in perimenopause now and I hear you sister! I am doing good things for myself and determined to make the best of this transition which I deem natural. Reading this post you wrote is one of things that makes me feel better. Thank you.

    • I’m glad it was helpful to you. I waffled for weeks about whether or not to write it, but considering how many people have read this post since I put it up yesterday, it seems to have struck a nerve.

      ~MY

  4. I know exactly what you are talking about with these symptoms. The more troubling news is the fact that a few of the seniors I work with have watched me experience ‘my personal mini-vacation’ and told me “oh I still get those hot flashes and brain fog,” and these ladies are in their late 80’s – mid 90’s. Perhaps these hormonal changes are actually the cause of dementia for many.

    • You’re right, Gloria. Some of these symptoms stick around even after menopause, which is yet another reason why the medical community needs to throw some more money at research. Now that we’re living so long, it’s become a quality of life issue.

      ~MY

  5. Ovarian cancer surgery at age 43 put me into instant menopause. Maybe it’s different when it is so abrupt. I had soaking night sweats and hot flashes for about six months, and then they went away. I honestly never felt the brain fog you describe. My brain feels overwhelmed sometimes because I work too much, but I can’t blame that on hormones. Well, I could … and I might now that you mention it.

    As far as medical support, my guess is that no one cares. If it were men going through all this, there would be a federal menopause czar. I do not recommend the estrogen-free lifestyle. That’s a whole new list of symptoms.

    • Donna, I assume that estrogen replacement is off the table for you because of the past history of cancer. This is the case for other women I know, who have either a personal or family history of breast cancer and can’t risk the exposure to additional estrogens.

      The brain fog and mood upheavals are unbelievably disruptive. I’ve tried to think my way out of them, but it’s hard to fight chemistry. On the up side, hot flashes have passed me by. This only seems fair.

      ~MY

  6. I too experienced surgical menopause at 37 but had no hot flashes, night sweats or brain fog. I just wept for two days after the surgery. I took estrogen for a short time. At 45 I had my first heart attack probably as a result of having ovaries removed at such a young age. (just my opinion)………..

    • I bet you’re right, Dolly. One of the health benefits of estrogen is that it provides cardiovascular protection for women. Once it’s gone, the chance of heart attack rises. Then you’re left trying to guess about where your greatest risk lies: with the lack of estrogen or with the hormone replacement therapy.

      ~MY

  7. I’m 49 and have been experiencing many of the symptoms you’ve described, Michelle, although not much in the way of true hot flashes yet. The insomnia is what I find disabling and getting enough sleep is a real struggle. Swimming a lot with a Masters group (8 to 10K yards/week) seems to smooth out a lot of the emotional problems and anxiety. Moving up from “exercise” to fairly intense exertion has been life-changing for me. I can’t recommend it enough.

    • Now there’s some news I can use, Peg. I’ve been walking daily and swimming twice a week, and the more intense exercise does help lift my mood. Hurray for endorphins! Maybe I need to add an extra session of swimming or some other cardio. Thanks!

      ~MY


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