It’s hard to believe, but I’ve been on hormone replacement therapy for six months. It’s amazing to think this much time has passed, as I’ve been living in my new normal for months. But as a recently confirmed perimenopausal woman, I have become quite the researcher and explorer of the menopausal landscape, finding out new information and discovering insightful studies every week. Now that half a year has passed since I was given the opportunity to heal from and emerge from the hell I endured before being properly treated and diagnosed, it’s high-time to reflect and share how I’m doing.
On an Even Keel
I don’t have a mental health history; I never experienced clinical anxiety, depression or anything else. But only in retrospect can I see that I was dealing with a certain level of unease and underwhelm with a completely hormonal basis. For many perimenopausal women, anxiety is a major problem due to the hormonal highs and lows, and in some ways I was no different. I can now acknowledge that I experienced a reduced desire to eat, a sense of being on edge for no particular reason and a state of hyper-arousal in response to nothing identifiable. Some clinicians would call these indicators of anxiety, and I guess maybe that would be correct. These feelings and symptoms are no more, and I feel as normal, unbothered and as calm as I ever did.
The most difficult perimenopausal symptom I’ve had was insomnia. It was as though my body had literally forgotten how to sleep, no matter how tired my mind and body were. Before HRT, this persisted for months. In fact, just two weeks before starting HRT, I was on a lower dose of an antidepressant prescribed off-label for sleep, which helped, despite my protestations about using any kind of medication in that class without an actual depression diagnosis. With HRT, I now average between 6-8 hours of shuteye a night.
Waking Up Dry
The night sweats are no more. Night sweats were actually my first perimenopausal symptom, occurring even before the insomnia started. But I thought it was something else – the room was too hot, my husband was emitting body heat – not hormonal changes! I now sleep and wake up without damp or drenched clothes.
The Unseen Pluses
HRT addresses some of the most bothersome and debilitating symptoms of “the change.” While insomnia, night sweats and low-level anxiousness were my main problems, I am now benefiting from the unseen positives associated with HRT – preservation of bone density, heart health protection and a brain wellness boost, too. While I cannot monitor the health of my bones, heart or brain on any consistent basis, I feel a level of reassurance that my continued health habits (clean diet, working out regularly) will be bolstered by the HRT also working in the background.
An Direct Path that Isn’t Necessarily Linear
HRT is a direct, no-nonsense way to address perimenopausal symptoms. I started on one dose, tried it for several months and then got a dose increase. Though I felt improvement within the first two weeks on HRT and more as time went on, it wasn’t until after I heightened my progesterone and estradiol that the game really changed. This means that many women need to revisit their HRT dosage and/or delivery method to optimize it. One prescription that doesn’t work does not mean HRT will not be effective. It can demand a certain tolerance level for trial and error.
I Do A Lot of Other Stuff, Too
I now understand so much about the influences of hormones on total body systems, especially during perimenopause and menopause, that I continue with a range of habits and lifestyle choices to help ensure I have a healthy future. These include taking various vitamins and supplements, including D3, fish oil, C, cinnamon, magnesium and more. I also work out almost every day, I meditate at least several days a week, I rarely drink alcohol, and I don’t consume much sugar. If in the future, I need to add another supplement, medication or lifestyle tweak that aids a particular symptom or promotes some other physiologic benefit, I’ll do it.
And This Brings Me to the Final Point
Change is going to be inevitable with “the change.” This means that what’s working for me today might not be the fix I need in five years. I may need to decrease or increase my HRT; I may need to add other medications; and I may face health challenges that have nothing to do with perimenopause. As someone who has never needed medication on any routine basis, wrapping my mind around this new normal has been humbling and, honestly, the greatest barrier for me to overcome. But after trying everything natural and making sure my lifestyle was in order, I had no other choices. There are many women out here in PerimenopauseLand who are loathe to try HRT or medications – then, with their backs against the wall and their quality of life sinking – they finally get on hormone replacement therapy and/or antidepressants and feel much better.
My doctor told me I’ll likely stay on my current HRT regimen for at least two years, after which time she thinks I’ll be over the worst symptoms and may be able to step down to a lower maintenance dose of estradiol (There are no contraindications for staying on oral micronized progesterone at any level.) The good news is this is a life change, not a death sentence. Just knowing this for sure is the greatest assurance that will kickstart many women into action that helps them resume living their best lives.
The Real Peri Meno is devoted to all things perimenopause - the science, treatments, care, understanding, personal experiences, relationships, culture and more. The brain child of Keisha D. Edwards, The Real Peri Meno developed out of her own shock-and-awe experience with perimenopause and navigating the disjointed U.S. medical system in search of answers, support and relief.
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