I Didn’t Know I went Through Menopause
One day, back in the spring of 2021, I was a 46-year-old mom of a four-year old. He was my first and only child. Yes, you read that right, I gave birth to my first and only child at 42 years old. I also got married for the first and only time at 44, but that’s a whole different blog post. Back to the spring of 2021. I’m the mom of a four-year-old, and I was tired. I mean TIRED. I know, a 46-year-old mom of a four-year old probably should be tired. But this was something else. I would get up each morning, dragging and dreading the tasks at hand: get up, get us ready, cart him to school, go home. I would be so exhausted when I got home that I would immediately go back to sleep — for most of the day. And then I’d wake up in time to pick him up from school, where I’d stay awake until dinner and then by 8PM I would be back asleep for the night to do the same routine over and over again. It seemed like no matter how much or how little sleep I got, I was so exhausted the next day that I simply could not function. Thank goodness for my husband — whenever I was simply too tired to function, I could always count on telling him, “I’m so exhausted, I need a nap” and off I’d go to sleep and wouldn’t have to worry about our son, dinner, or anything parenting related.
Finally, one day that summer, I decided I’d had enough. We had moved back to our hometown in 2021 during the pandemic and I hadn’t had health insurance for a few years and therefore hadn’t been to a PCP in a while. I re-establish with my former physician’s office and see a new doctor. She said to me “It’s been a while, why don’t we just run labs on everything.” When I came back for my follow-up, imagine my surprise when she said “So, first off, you have Hashimoto’s. You’ll have to be on a thyroid medication the rest of your life. Also, your hormones indicate you are postmenopausal.” I said “Post-menopausal? As in like, I’ve already hit menopause, went through it and am now past menopause?” She said “Yes. Did you not know you were going through it?”
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Of course, hindsight is 20/20. My sex drive had gone down. I was exhausted as hell. I had some minor weight gain without changing diet or exercise. But that was about it. I never had hot flashes. Zero-night sweats. No mood changes (although I guess if you asked my husband, he might have a different opinion on that). I had suffered my whole life from depression, anxiety and sleep issues, so while those are symptoms of menopause, it was nothing new. The only “real” symptom I had was a lack of a regular period. I had periods, but only a couple of them and they were extremely light. Other folks, in addition to my physician, wonder how I didn’t know I was going through menopause when I did not have a period. My response was that I was breastfeeding for a couple years, and when I stopped breastfeeding it took a while for my period to come back, but when it did it was so light and so few and far between, I just assumed my postpartum body at my advanced age (literally labeled geriatric pregnancy) was just in all sorts of “WTF is happening” mode. Menopause never crossed my mind because I was also only 44. It had been suggested to me by friends after numerous complaints on Facebook that it was probably perimenopause, so I thought maybe my body is just “getting ready” for menopause. Nope. Not only are we not in perimenopause, but we have run right past menopause and are now post-menopausal.
So now what? During that physician’s appointment my doctor said that hormone replacement therapy (HRT) was not recommended because of the side effects of reproductive cancers. I recalled reading somewhere that HRT might cause breast cancer or ovarian cancer, so this made sense to me. I never looked into it further. Until this last week when HRT was all over the news cycles. The U.S. Food and Drug Administration (FDA) updated its approach to hormone replacement therapy (HRT) for menopause, lifting broad “black box” warnings as new science shows the benefits can outweigh the risks for many women. Research highlights that starting HRT early — before age 60 or within 10 years of menopause — can ease symptoms while also supporting bone strength, heart health, and brain function. To make care more affordable and available, the FDA is approving new treatment options and generics, opening the door for more women to access therapies that can improve quality of life.
One of the things that I am thankful for in this PhD journey is learning how to read academic articles. Now, I can go back and read the original Women’s Health Initiative studies, the follow-up articles, and compare that with the recent news about the federal government’s rollback on black box labeling for HRT and determine what’s best for me going forward. It is important to understand that even though HRT might now be considered more safe, we also cannot just go full throttle into prescribing it for every person and in all instances. What I’m getting at, is that more research needs to be done on women’s health, specifically in this new era of HRT warning rollbacks. My physician refused to prescribe HRT to me, so I can imagine that she also has to read up on current uses and how to prescribe and to whom; I imagine this is the case for most physicians across the US. While relief from menopausal symptoms is an exciting thing to look forward to, we also need to move forward with caution and care. At least that is the plan for me.
