Almost 4 months ago, I asked about and went on Hormone Replacement Therapy and I’d wish I’d done this 5 years ago. I’m happy to be where I am now, but this journey wasn’t easy. Unfortunately, I am learning, this appears to be the case for most of us with uteruses… which makes me want to talk about it now.

All the time.

Now, caveat, I am not a doctor. Do not take medical advice from me and not everyone should or is eligible for HRT. But having the conversation with a menopause expert who knows you and can share options during this life stage is what I'm advocating.  

Growing up as a child of the 80s and daughter of a baby boomer, menopause was nothing that was ever discussed in the first 2/3s of my life… unless it was the butt of a joke. And perimenopause? Hah, I had never heard that word until maybe (?) 8 years ago. (Ironically, my Macbook just underlined the word perimenopause in red like it doesn’t know what I’m talking about so there is that)

The point being, my knowledge has been very limited on the topic. To me, it meant no periods and hot flashes. I knew about hormone replacement therapy but what I knew of it was that it was bad. It caused cancer. And don’t ask me where I learned that, it’s just all I remember knowing.

My mother never talked about her experience either. In hindsight after her death, this doesn’t surprise me. What I learned after she died is that she had a weird phobia of doctors. She rarely got medical treatment (not even for pregnancy) and had major shame around a prolapsed uterus which, again as an older adult, I’ve learned is a very normal thing, especially for women who have had children. The irony is that, when I was younger, I thought my mother shared “everything” because she was so open about sex (something of which I am especially grateful), but when it came to the topic of menopause, health and aging, my mother shared nothing. I also didn’t now to ask.

For me, like most women in their 20s, 30s and even early 40s, the concept of menopause just floated out there with no real details other than the infamous hot flashes which I witnessed my mother experience. They looked horrible. She really suffered with those and for a long time. But that was it. I vaguely recall one instance my mom mentioning her cycle changes. She’d had weird cycles for 10 years plus from her forties late into her fifties. But that was it. And I have no idea when she actually hit menopause.

Luckily for me, the internet exists and it’s likely through that (and all my wellness reads – yes, even Goop!) that the concept of perimenopause came into my consciousness about 5 to 7 years ago. At the same time, my body was changing. I was no longer able to eat and drink the way I used to without gaining weight, especially in the stomach area. My body fat redistributed. My blood pressure suddenly spiked (again, maybe or maybe not related) as well as I noticed more fatigue and brain fog, even when I was exercising regularly and eating well. I think there was also some mild depression and irritability but it’s hard to know for sure. I went through *some shit* in my forties. My husband and I had period where we weren’t sure we wanted to continue our marriage. I lost my dad. I lost my mom which included a very difficult hospice period. I lost two dogs. My company went through various cycles of restructures and layoffs. Shit was going on so it’s hard to know if all that anger, resentment, irritability and sadness that I was experiencing was just from life or contributed to by a lack of hormones.

When my periods became weird is when I finally started paying attention. I began honing in on the concept of perimenopause. But that interest remained more of an internet hobby. My doctors never brought it it up even as the time between my cycles increased to 30/40/80 days. I especially recall one yearly exam when I shared my last cycle dates and the practitioner just laughed slightly and said, “you’re getting there” as she shrugged her shoulders and went back to my chart. That was it. I did inquire with her and some other docs about my BP. I was perplexed at how suddenly my condition presented itself. The docs chalked it up to old age and put me on meds telling me to eat less salt and lose weight. That was it. No big deal.

When my latest bloodwork came in, I noticed some elevations in areas that I hadn’t seen before. Again, I was told it by the GP everything was “normal.” Which is exactly the the kind of thing that made me feel like I didn’t know what I was talking about! Add to this feelings over the past few years of increased dissatisfaction in my profession as well as feeling out of jive in my social circles. Something didn’t feel right, but I didn’t know what it was. I had also lost some of my motivation to workout and go to yoga consistently which had never been historically an issue. Of course, this was all also happening during (and right after) a global pandemic, itself a trauma in, so all these feelings of anxiety and panic and depression and sadness were being experienced everywhere by everyone. I never in a million years thought to tie it to my hormones. I thought we all just felt this badly.

Then in February of 2023, I signed up randomly for a women’s retreat with a bunch of people that I didn’t know. Always on the hunt for new ways of self discovery, this experience felt like an interesting approach to shake things up. And it was. The weekend was super enjoyable, nestled in the snowy woods where we meditated, shared stories, made candles, danced and sat in ceremony. It was totally out of my norm, but I loved it.

One of the facilitators of the weekend is a Nia instructor (I hadn’t heard of Nia before – but it’s a dance/martial arts/spiritual fusion workout). And this instructor was also passionate about menopause given her own experience going through it and the lack of resources and support she found on that journey. I started following her on social and via her email list after the weekend and, through that, I found her book club. Her menopause book club! The club is actually called Wise Women Rising and the mission expands beyond menopause to all things of support and relevance during this life chapter for those of us with uteruses.

When I saw that they were having their first meeting to discuss a book on menopause, I jumped at the opportunity for learning and discussion with peers going through similar issues. The book, What Fresh Hell is This, was my first in-depth read into the topic and it was SO eye-opening. If you have a uterus and haven’t read up on the topic, I highly recommend reading this book. Even if you aren’t 50 yet! I feel like the more you know even before going into perimenopause, the more prepared you can be. The book make me feel less irrational with so many of the same symptoms I’d been experiencing for the past 5-7 years called out: brain fog, lack of ability to concentrate/focus, weight gain in my abdominal area, fatigue, cholesterol and blood sugar numbers creeping up (normal, but going up), low back pain, insomnia, anxiety, mild depression, acid reflux, headaches, irritability, dry eyes, and weird periods.

The book also goes in-depth on the history of treatment for menopause which is very anger-inducing given how so much of it was been inhumane and drenched in patriarchy, not focused on the well-being of the women but moreso on making women more obliging to men. Gah.

Another focus of the book is hormone therapy and the history of research and testing on the topic. It also dispelled some rumors and beliefs that I had coming out of the late 90s/early 2000s in that all hormone therapy is bad and causes cancer. I won’t go into detail here because there is a lot of good information already out there on the topic, but the net/net for me was that I realized that hormone replacement therapy was potentially a choice for me to consider. It also meant there was an option that could possibly make me feel better as well as might reduce my risk of some diseases as I get older. This was a big A-HA!

When the book club met, it was wild to sit amongst 10 women who were pretty much experiencing all the same things. And while everyone’s journeys and symptoms are unique in their presentation and experience, the commonality was a lack of resources and support. At least I’d found fellowship!

Immediately after, I sent a follow-up to with my GP – and she referred me to an OB-GYN. She wouldn’t even have the HRT conversation. And when I looked up the OB-GYNs at my clinic, I found only one physician with menopause listed on per profile – and listed as an interest, not even a speciality. But she was in-network so I figured it was worth a try.

That experience wasn’t great. The OB-GYN told me that my bloodwork was normal even though I saw for myself an elevation in areas like cholesterol and blood sugar. She told me a lot of my symptoms were just what comes with age. She told me to lose weight (which, gah, really? We are still doing that?). When I pushed on the idea of HRT (and I brought my book with me), she asked me what other symptoms I was having. I said hot flashes and disturbed sleep. And while honestly these have not been my biggest issues, I have experienced them. With that, she shrugged and said we could try it to see if HRT would make things better. She said I was a candidate based on my health history and bloodwork and she put me on a low does of Estradiol with Progesterone.

I came away from the appointment feeling frustrated – I’d hoped it would have been more supportive. I didn’t feel heard. But I had a prescription – one I felt safe enough to take because she did have access to my health history to confirm whether or not I should be on HRT.

This was April when I started HRT. I didn’t see any changes at once. By my estimate, I have been in perimenopause for 7 or more years meaning my estrogen levels are likely very low.

Fast-forward to early June, I was walking into the office and suddenly felt a sensation where something was different. Lighter. I did not credit this to HRT right away. In fact, I wasn’t sure what it was. I just know that the past few years, professionally, I’ve felt some anxiety, a lack of self confidence and a weird feeling of not being liked. It’s been stuff in my head, stuff that I knew logically wasn’t likely true, but I still felt it nonetheless.

Then, that Tuesday in June, I walked in the office excited to see people, excited to engage and I didn’t feel that lack of confidence that I’d been experiencing for some time. And as I got on with my day, the thought came to mind, maybe it is the HRT….

I still am not sure. I am happy to report that the small but steadily increasing weight gain I’ve been experiencing has appeared to have leveled off for the first time in a decade. I’m not losing weight, but I’m not gaining it right now and that’s a huge win with nothing in my diet or exercise routine changing at all.

My sleep has also improved which I’m told is from the progesterone, the sleepy hormone. I’ve always been a decent sleeper but now I’m a GOOD sleeper. And sleep is such a valuable commodity!

In addition to those improvements, I can also acknowledge that my acid reflux has gone down substantially (something I’d never had to deal with until recently and it came awful some evenings when triggered). I also do think my mood swings have improved and my eyes are not as dry. Hot flashes were never a huge problem, but even those are less bad.

So, is it working? I don’t know.

But do I feel better? Yes, I do.

I still feel weird about how I came to the prescription – like I forced the hand. And given I’m not a medical doctor, I have a second opinion scheduled with someone who specializes in perimenopause and menopause. I got the recommendation from my acupuncturist for a physician she says “changed her life” and I’m excited to do the work and figure out what my options really are. This doc is someone who will read my blood work, actually measure my hormones and consult with me on my best options at this stage of peri to increase both my quality of life and my longevity. That said, she has a 9-10 month waiting list (!) to get onto her schedule. (SO FEW PEOPLE DO THIS! CLEARLY THERE IS A DEMAND!)

So, I’m on the waitlist. I’m continuing my learning journey. I just started The New Menopause by Dr. Mary Claire. The book is already proving to be an invaluable resource highlighting more information that has not been at my disposal in our traditional healthcare system.

I guess what this post is trying to share is that we have to continue to advocate for ourselves. No one will have our backs like we do. And I’m so glad I dug into this topic and my own health because I would have just gone about my business with these symptoms and a declining quality of life thinking, “that’s just how it is” but that’s not how it has to be!

Which is always why I’m sharing. 🙂

I will continue to share what I learn. I’m excited to meet this new doc. But I’m also excited about where I currently have landed which is definitely better than where I was.

Image credit Ashley Batz