I am a healthy 42 year old woman. I had one child when I was young. I am not overweight, I have no underlying health issues and take no medication. I only go the doctor once per year for my annual checkup and of course my mammogram. I did everything I was supposed to do. So why out of the clear blue did I start skipping some of my periods, having horrible night sweats, and suddenly gain 8 pounds over the past 9 months? I worked in a BHRT clinic for a couple of years in my early 30’s so I was trained enough to know that these were classic menopausal symptoms. I was like many others that thought that would not happen to me, these things only happened to my mother and grandmother. I had my labs drawn 3 times, all three times the labs looked like those of a 60 year old woman. All of my levels were imbalanced and to the extreme opposite of where they should be.
My annual exam was due, so I scheduled my appointment with my OB/GYN. I showed up with my labs in hand and a desperate description of my symptoms over the past several months. He took a glimpse at the labs, asked no additional questions and made the quick diagnosis, “yep, it’s the beginning of the end.” I think I went into tunnel vision, I didn’t expect him to be so harsh with that statement. I was then instructed to prepare for my physical exam and we would talk more once he returned to the room. I had enormous respect for my doctor, I had seen him for about 5 years, but the kicker is, I never had anything wrong with me during that 5 years. I would come in for my exam, no questions or concerns and off I went not to be seen for another year. I had never had a scare or issue with this doctor. He handled it less than delicately. He could read my body language that I was clearly distraught and in disbelief. I was entitled to be somewhat surprised seeing I am only 42 and that isn’t the “norm”. I asked if this was normal, he said nothing in medicine is normal. Then he went on to explain that I was not the “average” for sudden menopause, as if I needed the correct word to describe myself. After the exam, he popped in with 2 options written on a prescription pad. I could take “the pill” meaning a birth control pill to attempt to regulate my cycle or I could just go “all in” and begin the Estrogen (Premarin). He recommended going “all in” and explained that this way it is easier to just encourage my ovaries to stop working and we would take it from here. My mind was blown. I was on the spot, I explained that I didn’t like the fact of taking the Estrogen (my prior BHRT training echoing in my head). He asked me if I liked having erratic periods, weight gain and hot flashes. Touche’ doc, but this is something I will always have to take and it has side effects, am I wrong? He shrugged it off and said everything has side risks/effects as long as I maintained my annual mammogram, I would be fine. I felt angry at the fact that I deserved more information about what he was giving me. He was approaching the door, hand on handle ready to leave. No options, no compassion just cold hard facts.
I got to my car and literally just broke down. I cried that entire day and was very distraught that night. I stared at the estrogen prescription in disbelief. I reached out to friend of mine that was a physician for some advice. He knew I wasn’t crazy nor overreacting. He asked if my doctor drew his own labs for comparison and then asked if any labs were drawn when I was not symptomatic. I had to stop and think, throughout the 9 month of hormone spikes and drops I only drew my labs when I was feeling bad. He said hold off on filling the prescription, give it a few more weeks and draw my labs when my symptoms were better. So I did just that. My labs came back and looked like that of a healthy 30 year old ovulating woman. I started thinking about the past 9 months of the erratic periods and crazy lab values and it hit me that granted, my ovaries are beginning to retire but they aren’t gone yet. My good days far outweigh my bad days, I had more periods than I had missed periods. I am likely peri-menopausal but I am not menopausal yet. I understand the concern of lacking estrogen in my system for a long period of time causing vaginal atrophy etc, but I am not there yet. I did not get the proper attention or care in this case. My doctor should have drawn his own labs, especially knowing that once I started taking synthetic estrogen, my ovaries would die for good. He never asked me how many periods that I missed or other important questions.
The moral of this blog is even with the utmost respect you may have for your doctor it is ok to ask for a second opinion. I was so sad for other women that may have been in the same situation I was in that did not know what I knew about hormone replacement. The way my doctor pitched it to me is as if this was easy breezy and life would go on flawlessly. I was misled and not informed properly. It is ok to ask more than one professional about your situation, it is ok to not feel good about a decision somebody else is making in regard to your own health. Get informed, it is the best decision you could ever make for yourself.
