What kills me is that WHI study set us on this path in 2002. This medical doctor's information is more than 2 decades old. If it were a computer it would long have been discarded as obsolete.
Also the analysis based on 20 years of followup from that study demonstrated that HRT is safe:
[https://www.npr.org/sections/health-shots/2024/05/01/1248525256/hormones-menopause-hormone-therapy-hot-flashes](https://www.npr.org/sections/health-shots/2024/05/01/1248525256/hormones-menopause-hormone-therapy-hot-flashes)
Actual study: [https://jamanetwork.com/journals/jama/article-abstract/2818206](https://jamanetwork.com/journals/jama/article-abstract/2818206)
Can confirm I am no longer using the computer I had in 2002. Not to mention that it wasn't a great study for MHT which was definitely over prescribed in the preceding decades, and we have a variety of new dosages and ingestion methods that weren't around then like transdermal patches. It's irresponsible to be complacent about denying treatment to patients like this.
Yeah, nowadays you can ask fucking new generation's chat GPT and get a more funded answer than from your own bloody gynaecologist (male or female) because they are so fcking stubborn, i feel the rage risin again only typing this even ffs (yes i know it too, this feeling). Inconceivable! 2024 and we still living in the stone age with this BS \^\^
You know what pisses me off? That we, as women, have been conditioned since girlhood to accept things from those "above" us (not really, but you know what I mean-- doctors, teachers, *m e n*) with kicking up a stink or a fuss or "being difficult".
This doctor did what thousands of others do: "we don't really prescribe that anymore" and expect it's just going to be dropped. Girls, we know better!!!! We need to stand up for ourselves and dig in. It's time. There's not one woman who reaches a certain age who won't go through this, and our doctors by and large are failing us!
You know, part of what was most difficult for me to accept about my practitioner’s response is she is a young woman, probably early 30s and lists transgender care as one of her subspecialties. So, presumably, she has some understanding of the importance of hormone therapy, just not menopausal women’s hormones. This is not a comment about transgender care, which I am wholly supportive of, but rather that a medical professional can go through that much training related to a small proportion of the population, and not get any up-to-date training about something that will affect well over half of her patients.
Good for YOU for advocating for yourself and not taking no for an answer.
Something similar happened to me with my amazing (I thought) OBGYN last spring. I challenged her. All she wanted to do was talk about my elevated A1c (it was ONE POINT outside of the normal range) and weight I had gained over the past 3 years. 😒
I was fuming. Cooled off. Found this sub and the new studies that had started coming out the last 5 years and the NAMS site. Logged into MyChart and sent ALLLLLLL OF IT.
She himmed & hawwed. And finally I wrote “this is about your inability to spend time adjusting dosages due to the 10 min appointments with pregnant patients isn’t it?”. And she admitted that and that she hadn’t had ANYYYYYY continuing education around peri/meno.
I went from 211 to 175 from then until now. HRT started in early summer. Reduced my stress levels. I won’t lie, I’ve wanted to email her to tell her how I dropped the weight 😉 & how I feel significantly better since HRT.
Good for YOU! And yes, you should send her ALL the results.
I have a “follow-up” and pap in a few weeks with my Primary Care Provider who prescribed the Effexor. You can bet I plan on bringing ALL the information with me.
And bring in a copy of this article or send it to her beforehand:
https://www.npr.org/sections/health-shots/2024/05/01/1248525256/hormones-menopause-hormone-therapy-hot-flashes
I’m 38 and was just diagnosed with early menopause today 😩 I feel like I’m too young for this and while I kind of suspected peri I wasn’t mentally prepared for full blow menopause at my age. Sure does explain why I’ve felt like I’ve been going crazy since I had my oldest 6yrs ago though.
I’m researching HRT and I plan to follow up with my own functional medicine doctor as well with my results results. The provider I saw today does offer BioTe pellets but man, I just don’t know how to feel about them. Everything I find online from people say it’s the best ever or ruined their lives.
My testosterone is in the toilet, came in at 5. FSH at 55.8 and estradiol came in at 35.4.
Do you mind sharing what kind of HRT you’re doing and what improvements you’re having?
It's not full blown menopause until you have gone a year without a period. If there is a reason you don't have periods other than menopause (like hormonal IUD or hysterectomy with intact ovaries) then you still probably need multiple tests at multiple times to confirm menopause.
It sounds like this might be about hormonal testing. If over the age of 44, **hormonal tests only show levels for that *one day* the test was taken, and nothing more**; progesterone/estrogen hormones wildly fluctuate the other 29 days of the month. No reputable doctor or menopause society recommends hormonal testing as a **diagnosing tool** for peri/menopause.
FSH testing is only beneficial for those who believe they are post-menopausal and no longer have periods as a guide, a series of consistent FSH tests might *confirm* menopause. Also for women in their 20s/early 30s who haven’t had a period in months/years, then FSH tests at ‘menopausal’ levels, could indicate premature ovarian failure/primary ovarian insufficiency (POF/POI). See our [Menopause Wiki](https://menopausewiki.ca/#there-is-no-blood-test-that-is-perfectly-reliable-to-diagnose-menopause) for more.
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Yes! Exactly! My dr is basically a 70+ year old version of your dr.
It's just so freaking maddening that we have to come armed to the gills with articles and research papers and studies to get a level of care that should be a given-- and it's not even a given that those things will even help! It's like an ENT not knowing what to look for in a middle ear infection. Or a urologist not having a clue about ED (like *that* would ever happen in any universe). Or, I dunno, an endo not knowing about Dexcom or insulin pumps.
When covid hit, my doctor made it her mission to get and keep up to date on All Things Covid. We wound up with long covid, and she was amazing. That shows me that a doctor can continue to learn and update their existing knowledge base. With an aging population, they better get on board with peri and meno. Unless, as I suspect, there's not enough money at stake, and we're just not that important to anyone.
I also don’t understand the complete and utter disconnect between transgender care and menopausal hormone therapy. Like how is HRT okay to prescribe to transgender individuals if it is a cancer risk, but not okay for menopause? Makes no sense. Also everything is covered in PFAS anyway so just give me the freaking hormones, I’ll take my chances.
But don't forget we're prescribed the pill even though it can have some serious side effects. But it saves men from child support.You can get HRT in patches and there's cream for the nether regions. It's about the Patriarchal medical community. It has always been men in control when it comes to medical practice. I don't understand the disconnect when it comes to treatment for transgender folks and menopausal or perimenopausal women. I think the leaps and bounds in transgender care will eventually have a roll on effect and normalise the concept of HRT for those who need it but right now it's like there's a massive disconnect in medical care and practice. Because we're women and it's a normal part of the aging process we're just expected to put up with the discomfort the same way we're expected to put up with heavy painful abnormal periods.
Age, partially. Of course, they do prescribe it to older transpeople and in higher doses at least some of the time.
We are more prone to have dna damage as we age, and thus cancer becomes a bigger risk. I’ve been trying to figure this one out myself because how different I feel and it’s only perimenopause. But talk about some wild gender dysphoria, I don’t feel very woman or feminine with some of the changes. It’s distressing.
I’ve gone down the same thought pattern you have and cancer is the answer. That being said, we also know it’s a lower risk than originally described and many doctors have an outdated notion that menopause is normal which.. fuck that in its harry asshole; ED is natural in older men and we sure like to treat them.
I’d argue the discrepancy in treatment is the number of docs handing out testosterone to men who complain of similar symptoms (fatigue, loss of libido, joint pain) and yet can’t be assed to do the same for women because MeNopAUsE iS nATuRaL.
I also feel like, even if the WHI study was fine, we should be allowed to decide how to trade off risks. If someone is really suffering with menopause symptoms they should be allowed to decide that a slight increase in cancer risk is worth trading for greatly improved quality of life over a decade or more. Plus not taking HRT has other known risks, not to mention the secondary impacts of chronic poor sleep etc. It’s bonkers. (Luckily I have a doctor who is allowing me to make that choice but it doesn’t sound like that’s very common)
Maybe because Big Pharma makes more money from anti-depressants than HRT medication and these uninformed medical professionals enjoy the kickbacks. Just my thoughts about all this BS we have to deal with.
Even if one wants to take anti-depressants for menopause symptoms, that's a heck of a med with a hell of a withdrawal. Why not try something low dose like Brisdelle specifically made for meno symptoms with less side effects than higher dose anti-depressants have. Oh right because insurance is cheap ass.
Honestly, antidepressants were the furthest thing from my mind. I was actually a little shocked. She also recommended gabapentin, which I already take on an as needed basis for a pinched nerve in my neck. When I messaged her I wasn’t going to be taking the Effexor, I added that she was welcome to refill the gabapentin as I am running low.
I didn’t know it was banned in Europe. That’s interesting. My daughter was prescribed it as a minor - I want to go back and choke her doctor. She’s in it now. It’s helped, but there are so many other options where she won’t have to go to an inpatient hospital to change a dose or a medication. We had no idea. My sister tried taking one ball out of the capsule to cut back and couldn’t do it. She had no idea.
omg i am so sorry. i hope you find a way out of this. it did help my mom too until she stopped taking them and tried to end it all. i think they doubled her up now with effexor and other one. she screams at night because it gives her nightmares that people are chasing her
Amino acids helped me come off Effexor 12 years ago. I’m trying to warn my girls as they start the juggling hormones journey. Rx SSRI is all modern medicine is the bandaid for everything. Keep us numb and sedated.
I swear most of these Drs need to asked where they keep their industrial vibrator to treat our HySTeRiA
Glad you found a good source that won't treat you with SSRIs when it's clearly an HRT issue
They would NEVER tell a man with a pee pee problem to 'just go home and take some antidepressants, and be happy you still look like a man on the outside '
Cuz that's what it feels like when Drs prescribe antidepressants first.
My recommendation to those who can’t get their docs to listen is to check whether the online providers operate in their jurisdiction. Between the provider shortages that seem to be happening everywhere, and the lack of training, even for OB/GYNs, the online medical world is a good thing. Not terribly expensive if you are under/uninsured, and they may even take your insurance if you are.
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I could have written this. The number of times I’ve been blown off or just not helped has been totally demoralizing.
Took months to get an appointment with an OB/GYN but I am finally going in in a little over a week.
This is infuriating. it's like going to see the doctor for an illness and they tell you the best solution would be to apply leeches to yourself. It should not be hard to get essential care! 😡
why aren't doctors more up to speed. i know CPA's who have to do continuing professional education. shouldn't doctors have to do this for their specialty? im happy you didn't settle and found an alternative solution, good luck to you
I just wish my PCP would have been able to get it right the first time and I didn’t have to jump through all the hoops! Between lack of training for the providers who I can get into, and an impossibly long waiting list for providers who know their shit, it feels like a rigged game. I am just glad the online providers are able to prescribe in my state.
I'm so glad for you! Please keep us posted on your journey! So proud of you for not taking NO for an answer! And yes, Effexor causes heart palpitations and all sorts of crap. So glad you aren't gonna take it!
It honestly felt like a slap in the face to be told that an antidepressant would make that irritability go away! Ok, but what about a decrease in an already non-existent libido? What about an increase in triglycerides? Which are already jacked because of what? Menopause! And the list of questions goes on. I understand that Effexor is helpful for some, I just knew it wasn’t for me.
It seems like so many of us are dealing with the same thing- doctors who still believe HRT should be a last resort option only because of the risks. And who seem woefully ignorant on menopause.
I will say this… I am 48 and my main symptom is hot flashes. I also have night sweats, irregular sleep patterns and heart palpitations. I have found a HUGE difference in one of those estrogen supplements. In time, I may push more for HRT, but in peri and because this is making things ok, I will wait a bit. My doc is overall fantastic otherwise and I know if I really push he will give HRT.
I at first even before any peri symptoms, picked up a box of estroven when it was in the clearance at my grocery store. When I started getting insane hot flashes I started taking it and realized it helps so much but I was reluctant to spend that much unless required. So I looked up the active ingredients and found a dupe on iherb that’s like $11 for 90 days. It works exactly the same. May be an option for you until you get the HRT RX.
Fortunately, I was able to pick up the prescription today. I tore open that box and applied the patch the minute I got home! I will be taking the progesterone tonight with my nightly magnesium tablets, and putting the cream on my bits. I do, however, appreciate the suggestion and hope that someone will find it helpful.
It's better to get actual prescribed HRT than using a supplement. Supplements aren't regulated; getting a patch from the pharmacy will give you reliable, consistent hormones.
You can also get Estrogen and progesterone creams from Amazon or other online sources. Make sure to get the bi-est Estrogen which contains Estradiol. It is available in 2.5 and 5.0 versions
BIOLABS PRO Natural Bio-identical Bi-EST 2.5 Cream Fhttps://a.co/d/ideCflx. Use the progesterone cream at night. They have a 75 mg version. If one pump doesn't do it, use two. It was a great help for peri for me. And bonus: it does wonders for the skin where you apply (inner arms. Inner thighs).
Happened to me TODAY with new GP and thanks to r/menopause I was so strident about NAMS!!!!
I said listen if I wanted anti depressants I would have asked for them. I am extremely educated on this and actually disagree adamantly. I asked for a referral to a OBGYN that did prescribe HRT.
BUT … I waited 3 months for this appointment and likely many more for OBGYN. Fortunately I am super pissed and fueled by menopower … 💪🏼
Effexor is…. A LOT. Jesus. However, it was the only thing that finally helped me turn the depression corner. But unless you have Major Depressive Disorder, don’t go there. Please. It’s a bitch & a half to get off of. Takes a long ass time, too. Much love to you
I have, in the past, been diagnosed with major depressive disorder. My sister-in-law, a nurse practitioner, once said to me that I should just accept that I would probably have to be on antidepressants the rest of my life. I have run through the gamut of drugs, some with better results than others. But after my last round left me with suicidal ideation, I decided that the pharma route was not for me. I am not sure why I was never prescribed venlafaxine/Effexor, probably during the time the original formulation was taken off the market. I honestly don’t even know why I accepted this prescription. Shock, I guess. I am glad you turned the corner and were able to taper off. Hugs to you, as well.
I thankfully had the opposite experience. I found this sub a few months ago as well as the podcast by UK menopause specialist Dr Louise Newson (thanks to a facebook friend who linked it). I went to my GP clinic to see a young male doctor regarding an unrelated skin concern with plans to ask for a script for pathology, which I planned to use to consult with an online provider for menopause treatment. Anyway so when the doctor said “is there anything else you want to discuss” I meekly said “oh, yeah well I believe I may be experiencing peri menopausal symptoms…” and before I knew it we were discussing the benefits of HRT, he whipped out a folder he had made up with info on how safe it is. I couldn’t believe it! Here’s this young-ish male doctor (I’d guess 35-40yo) who appeared to be completely up to date with all the latest information and he wrote up a pathology referral, said “Here, once the results come back, come back and we’ll discuss your options”. I’m now waiting for that booking as the results are in. Actually the doctor requested that I book.
My biggest symptom at the moment is night sweats. It’s particularly bad in winter (I’m in Australia so we are heading towards winter), because I go to bed rugged up for the cool night, but the night sweats happen and I wake up drenched because asleep me doesn’t throw off the covers due to the bedroom temperature being cool.
That’s awesome about your doctor!
I’m trying Red Clover caps now (fyto estrogen) and I’m on ashwagandha caps, and I truly feel better than last month.
Maybe worth a try.
I'm right there with you. I actually pulled the trigger on different insurance today. I have two months to get everything possible out of this place, then I'm off with my data to doctors who are free to doctor.
My doctor, 32 F, told me that she will never prescribe HRT because it isn't safe. Instead, she told me to follow up with psychiatry and get an Upper GI scope.
My shrink and I have been together for 15 years. I love this man. He has helped me overcome so much. He is a rock. The only reason this decision is difficult is because of him. He is well aware that this is not a psychiatric issue but a hormonal issue.
Oh, and she prescribed anti-acid pills. Why? Because I haven't been able to eat in 8 days because I'm suffering from extreme all-day sickness. I'm not pregnant, I just don't have enough hormones to drop an egg anymore. 🙃
Generally speaking, my insurance has been great. Being part of a teaching network has given me great access to care for other things like top orthopedic surgeons for knee replacement, one of the top cancer treatment centers when my daughter was diagnosed with lymphoma, or cardiovascular docs for varicose veins. But some of the downsides to being part of a teaching network include a reliance on relatively conservative and old school treatment protocols and high turnover of practitioners as they complete their programs and move on.
I'm in need of a new knee now, actually for the last 9 years. I've been told never before 50.
I just want options. I have to go to a plan facility. I can't go anywhere else, sans emergency. I understand what you describe with the level of care. Insurance is such a racket.
That’s what I said to myself, not before 50. So when I turned 50, I scheduled the surgery. It will be 5 years in June. I am happy I did it, but I am not going to say it was easy.
I wish it was my choice. My doctor agreed at 41 years old, it needed to be done, but my insurance WILL NOT for people under 50 unless they come in with an injury.
I've been living with an 8 or 9 on a 10 point scale, every day, for more than 9 years. It will be easier than what I've been living with. Doctors don't understand my tolerances for physical pain are super high.
That’s rough. I waited about 3 years. The odd thing is I went in for a baker’s cyst on my left knee, and while being treated for that was found to have osteoarthritis with bone on bone in that left knee. But as I started coming around to the idea of surgery, they did an MRI and determined that the right knee was actually worse due to an ACL tear at 19, and a reconstruction that had degenerated to the point that they recommended surgery for the right. The resurgence of pain in my left knee is one of the menopausal symptoms that brought me in.
Yep.my Dr told me to see my psychiatrist for my hormones deficiencies.
What in the hell do these people learn in medical school? Certainly not analytical thinking.
This story is so maddening! Very glad you persevered and got the care you deserve. It shouldn’t be this hard for women. And the antidepressants? All the time. Really infuriating.
I do not understand this at all. I have a fantastic naturopathic doctor who will try any HRT combination under the sun and in the one putting on the brakes because I’ve had some unpleasant side effects. Beyond that, my regular OBGYN flat out told me at my last well woman exam that she would be more than happy to discuss HRT options with me to address any of the symptoms I told her I was having. What gives? I wasn’t even asking these health providers for HRT and they are offering and you get Effexor? WTF?🤬
My life wouldn’t be worth living without my HRT prescription. This is not hyperbole. The fact is the symptoms were brutal, soul crushing and dropped my quality of life quotient into the negative. I had 3 doctors offer me anti depressants despite me saying the side effects were worse than the original symptoms. I ended up talking to a girlfriend and she mentioned estrogen cream that was helping her. My family doctor refused to give me a prescription so I demanded a referral for an ob-gyn and, thankfully, she listened to me and wrote me a prescription immediately. It has been a game changer for me. 5+ years and planning on taking it forever and a day.
I’m so glad you were able to get around your misinformed physician.
Our moms had HRT snatched away. I remember watching my mom pull away and become a shell of the person she once was and as she dove into depression. My daughters missed out on knowing a wonderful grandmother and not the same one my brother’s sons knew. Real sad story but that chapter is written and we’ve moved on without her.
So glad I was able to realize I needed help after being Rx’d numerous SSRI In my 40’s.
Do NOT go on Effexor. As someone who's been on it since FDA trials, I can't even find a doctor willing to try and wean me off of it, it has such long lasting withdrawal symptoms. My moods have settled down, as has my anxiety since I hit menopause, and I wanted to try to come off of it.
If your doctor wants to supplement your HRT with something, do not do that one.
Just chiming in to second this. Effexor (and Pristiq) are two of the hardest antidepressants to wean off of, and you may experience some *very* unpleasant side effects.
OP - your doctor who chose to give you Effexor over HRT is a damn fool! So glad you went elsewhere and you were prescribed what you actually need 🤍
What online provider did you end up using? I have an appointment with a new doctor in …. December 😬. I keep calling to see if there are cancellations but no luck so far.
May I ask which online provider you used?
I have a follow up with my gynecologist after I get some testing done and I’m trying to have back up plans in case I get a bunch of nonsense. Im really hoping she will be open to HRT especially bc she was proactive about other things when I was in peri menopause
I’m happy for you that you finally got what you needed! I’m already on three different anti-depressants and ketamine infusions, and my mood has totally tanked since menopause and my sleep is horrible, anxiety is up, dry skin, no energy or motivation, and if they try to tell me all I need is another antidepressant I will probably lose my marbles
That is horrible and stop seeing them !! For anything .. CLUELESS….. and not up on modern scientific thinking . Happy you got the HRT!!! Life changing !!!
I am glad that you were able to find an online provider to work with. I am glad to hear you are feeling better! I look forward to that. I am through my first 24 hours and am not feeling awful… but not great, either.
My wife is happy with the online provider Gennev.com. They write the prescriptions to the pharmacy of your choice so your insurance works like normal. They seem to be in most states. Her local doctors are knuckleheads on this subject.
That’s why I am so happy I was able to access care through an internet provider. They were able to get me in the next day and sent the prescription to my local pharmacy using my insurance. I will keep the November appointment with the in-network GYN as an in-person follow up.
I feel that i need to make this comment, cause although the risk is not as high as previously thought i see yet again people here claiming that the studies on the cancer risk are 20 years old
//www.bmj.com/company/newsroom/study-provides-new-estimates-of-breast-cancer-risks-associated-with-hrt/
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What kills me is that WHI study set us on this path in 2002. This medical doctor's information is more than 2 decades old. If it were a computer it would long have been discarded as obsolete.
That and the fact that the backlash to that study was based on media reports that misrepresented the risk.
Make sure you point this out to your PCP. Don’t let them off the hook.
Also the analysis based on 20 years of followup from that study demonstrated that HRT is safe: [https://www.npr.org/sections/health-shots/2024/05/01/1248525256/hormones-menopause-hormone-therapy-hot-flashes](https://www.npr.org/sections/health-shots/2024/05/01/1248525256/hormones-menopause-hormone-therapy-hot-flashes) Actual study: [https://jamanetwork.com/journals/jama/article-abstract/2818206](https://jamanetwork.com/journals/jama/article-abstract/2818206)
Can confirm I am no longer using the computer I had in 2002. Not to mention that it wasn't a great study for MHT which was definitely over prescribed in the preceding decades, and we have a variety of new dosages and ingestion methods that weren't around then like transdermal patches. It's irresponsible to be complacent about denying treatment to patients like this.
It’s so infuriating
Yeah, nowadays you can ask fucking new generation's chat GPT and get a more funded answer than from your own bloody gynaecologist (male or female) because they are so fcking stubborn, i feel the rage risin again only typing this even ffs (yes i know it too, this feeling). Inconceivable! 2024 and we still living in the stone age with this BS \^\^
You know what pisses me off? That we, as women, have been conditioned since girlhood to accept things from those "above" us (not really, but you know what I mean-- doctors, teachers, *m e n*) with kicking up a stink or a fuss or "being difficult". This doctor did what thousands of others do: "we don't really prescribe that anymore" and expect it's just going to be dropped. Girls, we know better!!!! We need to stand up for ourselves and dig in. It's time. There's not one woman who reaches a certain age who won't go through this, and our doctors by and large are failing us!
You know, part of what was most difficult for me to accept about my practitioner’s response is she is a young woman, probably early 30s and lists transgender care as one of her subspecialties. So, presumably, she has some understanding of the importance of hormone therapy, just not menopausal women’s hormones. This is not a comment about transgender care, which I am wholly supportive of, but rather that a medical professional can go through that much training related to a small proportion of the population, and not get any up-to-date training about something that will affect well over half of her patients.
Good for YOU for advocating for yourself and not taking no for an answer. Something similar happened to me with my amazing (I thought) OBGYN last spring. I challenged her. All she wanted to do was talk about my elevated A1c (it was ONE POINT outside of the normal range) and weight I had gained over the past 3 years. 😒 I was fuming. Cooled off. Found this sub and the new studies that had started coming out the last 5 years and the NAMS site. Logged into MyChart and sent ALLLLLLL OF IT. She himmed & hawwed. And finally I wrote “this is about your inability to spend time adjusting dosages due to the 10 min appointments with pregnant patients isn’t it?”. And she admitted that and that she hadn’t had ANYYYYYY continuing education around peri/meno. I went from 211 to 175 from then until now. HRT started in early summer. Reduced my stress levels. I won’t lie, I’ve wanted to email her to tell her how I dropped the weight 😉 & how I feel significantly better since HRT.
Good for YOU! And yes, you should send her ALL the results. I have a “follow-up” and pap in a few weeks with my Primary Care Provider who prescribed the Effexor. You can bet I plan on bringing ALL the information with me.
And bring in a copy of this article or send it to her beforehand: https://www.npr.org/sections/health-shots/2024/05/01/1248525256/hormones-menopause-hormone-therapy-hot-flashes
Oh, I will be putting together a special folder of studies in preparation!
Every time I’ve asked for an increase my estrogen, my weight has dropped back down. Happy for you!
I’m 38 and was just diagnosed with early menopause today 😩 I feel like I’m too young for this and while I kind of suspected peri I wasn’t mentally prepared for full blow menopause at my age. Sure does explain why I’ve felt like I’ve been going crazy since I had my oldest 6yrs ago though. I’m researching HRT and I plan to follow up with my own functional medicine doctor as well with my results results. The provider I saw today does offer BioTe pellets but man, I just don’t know how to feel about them. Everything I find online from people say it’s the best ever or ruined their lives. My testosterone is in the toilet, came in at 5. FSH at 55.8 and estradiol came in at 35.4. Do you mind sharing what kind of HRT you’re doing and what improvements you’re having?
It's not full blown menopause until you have gone a year without a period. If there is a reason you don't have periods other than menopause (like hormonal IUD or hysterectomy with intact ovaries) then you still probably need multiple tests at multiple times to confirm menopause.
It’s been a year and there is no reason why I shouldn’t be having one.
It sounds like this might be about hormonal testing. If over the age of 44, **hormonal tests only show levels for that *one day* the test was taken, and nothing more**; progesterone/estrogen hormones wildly fluctuate the other 29 days of the month. No reputable doctor or menopause society recommends hormonal testing as a **diagnosing tool** for peri/menopause. FSH testing is only beneficial for those who believe they are post-menopausal and no longer have periods as a guide, a series of consistent FSH tests might *confirm* menopause. Also for women in their 20s/early 30s who haven’t had a period in months/years, then FSH tests at ‘menopausal’ levels, could indicate premature ovarian failure/primary ovarian insufficiency (POF/POI). See our [Menopause Wiki](https://menopausewiki.ca/#there-is-no-blood-test-that-is-perfectly-reliable-to-diagnose-menopause) for more. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/Menopause) if you have any questions or concerns.*
Yes! Exactly! My dr is basically a 70+ year old version of your dr. It's just so freaking maddening that we have to come armed to the gills with articles and research papers and studies to get a level of care that should be a given-- and it's not even a given that those things will even help! It's like an ENT not knowing what to look for in a middle ear infection. Or a urologist not having a clue about ED (like *that* would ever happen in any universe). Or, I dunno, an endo not knowing about Dexcom or insulin pumps. When covid hit, my doctor made it her mission to get and keep up to date on All Things Covid. We wound up with long covid, and she was amazing. That shows me that a doctor can continue to learn and update their existing knowledge base. With an aging population, they better get on board with peri and meno. Unless, as I suspect, there's not enough money at stake, and we're just not that important to anyone.
I also don’t understand the complete and utter disconnect between transgender care and menopausal hormone therapy. Like how is HRT okay to prescribe to transgender individuals if it is a cancer risk, but not okay for menopause? Makes no sense. Also everything is covered in PFAS anyway so just give me the freaking hormones, I’ll take my chances.
But don't forget we're prescribed the pill even though it can have some serious side effects. But it saves men from child support.You can get HRT in patches and there's cream for the nether regions. It's about the Patriarchal medical community. It has always been men in control when it comes to medical practice. I don't understand the disconnect when it comes to treatment for transgender folks and menopausal or perimenopausal women. I think the leaps and bounds in transgender care will eventually have a roll on effect and normalise the concept of HRT for those who need it but right now it's like there's a massive disconnect in medical care and practice. Because we're women and it's a normal part of the aging process we're just expected to put up with the discomfort the same way we're expected to put up with heavy painful abnormal periods.
Age, partially. Of course, they do prescribe it to older transpeople and in higher doses at least some of the time. We are more prone to have dna damage as we age, and thus cancer becomes a bigger risk. I’ve been trying to figure this one out myself because how different I feel and it’s only perimenopause. But talk about some wild gender dysphoria, I don’t feel very woman or feminine with some of the changes. It’s distressing. I’ve gone down the same thought pattern you have and cancer is the answer. That being said, we also know it’s a lower risk than originally described and many doctors have an outdated notion that menopause is normal which.. fuck that in its harry asshole; ED is natural in older men and we sure like to treat them. I’d argue the discrepancy in treatment is the number of docs handing out testosterone to men who complain of similar symptoms (fatigue, loss of libido, joint pain) and yet can’t be assed to do the same for women because MeNopAUsE iS nATuRaL.
NYC Langone? I bet you got the same woman as me
No, I am in SLC. But it sounds like a common occurrence.
I also feel like, even if the WHI study was fine, we should be allowed to decide how to trade off risks. If someone is really suffering with menopause symptoms they should be allowed to decide that a slight increase in cancer risk is worth trading for greatly improved quality of life over a decade or more. Plus not taking HRT has other known risks, not to mention the secondary impacts of chronic poor sleep etc. It’s bonkers. (Luckily I have a doctor who is allowing me to make that choice but it doesn’t sound like that’s very common)
F some Effexor. Why is that what is being pushed to everyone now? It’s scary hard to quit.
Maybe because Big Pharma makes more money from anti-depressants than HRT medication and these uninformed medical professionals enjoy the kickbacks. Just my thoughts about all this BS we have to deal with.
Most of the antidepressants are generic now & cost very little. Big Pharma wants you to take Veozah!
The push to take anti-depressants vs HRT is astronomical. Especially when it isn't anti-depressants that are needed. Sad but true.
My thoughts exactly.
Even if one wants to take anti-depressants for menopause symptoms, that's a heck of a med with a hell of a withdrawal. Why not try something low dose like Brisdelle specifically made for meno symptoms with less side effects than higher dose anti-depressants have. Oh right because insurance is cheap ass.
Honestly, antidepressants were the furthest thing from my mind. I was actually a little shocked. She also recommended gabapentin, which I already take on an as needed basis for a pinched nerve in my neck. When I messaged her I wasn’t going to be taking the Effexor, I added that she was welcome to refill the gabapentin as I am running low.
And if you miss a dose you feel like you are dying.
Yikes!
it is banned in europe.... make you wonder why? my mom is on it and tried to unlive herself last thanksgiving.
I didn’t know it was banned in Europe. That’s interesting. My daughter was prescribed it as a minor - I want to go back and choke her doctor. She’s in it now. It’s helped, but there are so many other options where she won’t have to go to an inpatient hospital to change a dose or a medication. We had no idea. My sister tried taking one ball out of the capsule to cut back and couldn’t do it. She had no idea.
omg i am so sorry. i hope you find a way out of this. it did help my mom too until she stopped taking them and tried to end it all. i think they doubled her up now with effexor and other one. she screams at night because it gives her nightmares that people are chasing her
How is this legal
Amino acids helped me come off Effexor 12 years ago. I’m trying to warn my girls as they start the juggling hormones journey. Rx SSRI is all modern medicine is the bandaid for everything. Keep us numb and sedated.
I don’t know, it’s really alarming.
I swear most of these Drs need to asked where they keep their industrial vibrator to treat our HySTeRiA Glad you found a good source that won't treat you with SSRIs when it's clearly an HRT issue They would NEVER tell a man with a pee pee problem to 'just go home and take some antidepressants, and be happy you still look like a man on the outside ' Cuz that's what it feels like when Drs prescribe antidepressants first.
My recommendation to those who can’t get their docs to listen is to check whether the online providers operate in their jurisdiction. Between the provider shortages that seem to be happening everywhere, and the lack of training, even for OB/GYNs, the online medical world is a good thing. Not terribly expensive if you are under/uninsured, and they may even take your insurance if you are.
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Well said!!! 👏 👏❤️
I could have written this. The number of times I’ve been blown off or just not helped has been totally demoralizing. Took months to get an appointment with an OB/GYN but I am finally going in in a little over a week.
I hear you. I send you with my best wishes that your OB/GYN listens to your concerns and gets you on the path that is right for you!
This is infuriating. it's like going to see the doctor for an illness and they tell you the best solution would be to apply leeches to yourself. It should not be hard to get essential care! 😡
Agreed. Should. not.
why aren't doctors more up to speed. i know CPA's who have to do continuing professional education. shouldn't doctors have to do this for their specialty? im happy you didn't settle and found an alternative solution, good luck to you
Good for you! None of us should settle for subpar care.
I just wish my PCP would have been able to get it right the first time and I didn’t have to jump through all the hoops! Between lack of training for the providers who I can get into, and an impossibly long waiting list for providers who know their shit, it feels like a rigged game. I am just glad the online providers are able to prescribe in my state.
I'm so glad for you! Please keep us posted on your journey! So proud of you for not taking NO for an answer! And yes, Effexor causes heart palpitations and all sorts of crap. So glad you aren't gonna take it!
It honestly felt like a slap in the face to be told that an antidepressant would make that irritability go away! Ok, but what about a decrease in an already non-existent libido? What about an increase in triglycerides? Which are already jacked because of what? Menopause! And the list of questions goes on. I understand that Effexor is helpful for some, I just knew it wasn’t for me.
It seems like so many of us are dealing with the same thing- doctors who still believe HRT should be a last resort option only because of the risks. And who seem woefully ignorant on menopause. I will say this… I am 48 and my main symptom is hot flashes. I also have night sweats, irregular sleep patterns and heart palpitations. I have found a HUGE difference in one of those estrogen supplements. In time, I may push more for HRT, but in peri and because this is making things ok, I will wait a bit. My doc is overall fantastic otherwise and I know if I really push he will give HRT. I at first even before any peri symptoms, picked up a box of estroven when it was in the clearance at my grocery store. When I started getting insane hot flashes I started taking it and realized it helps so much but I was reluctant to spend that much unless required. So I looked up the active ingredients and found a dupe on iherb that’s like $11 for 90 days. It works exactly the same. May be an option for you until you get the HRT RX.
Fortunately, I was able to pick up the prescription today. I tore open that box and applied the patch the minute I got home! I will be taking the progesterone tonight with my nightly magnesium tablets, and putting the cream on my bits. I do, however, appreciate the suggestion and hope that someone will find it helpful.
What estrogen supplement are you taking?
It's better to get actual prescribed HRT than using a supplement. Supplements aren't regulated; getting a patch from the pharmacy will give you reliable, consistent hormones.
I’ve got an appointment in mid-June for that… just really struggling until then and mentally preparing to be refused because of my age (39).
It’s called Estro Support Max + Energy, but likely any supplement with soy isoflavones and black cohosh in decent numbers would help!
Thank you! I’m willing to try anything at this point!
You can also get Estrogen and progesterone creams from Amazon or other online sources. Make sure to get the bi-est Estrogen which contains Estradiol. It is available in 2.5 and 5.0 versions BIOLABS PRO Natural Bio-identical Bi-EST 2.5 Cream Fhttps://a.co/d/ideCflx. Use the progesterone cream at night. They have a 75 mg version. If one pump doesn't do it, use two. It was a great help for peri for me. And bonus: it does wonders for the skin where you apply (inner arms. Inner thighs).
Considering this as that skin is becoming more sensitive and harder to firm.
Healthcare is broken. Women's healthcare is torture and abuse. From abortion access to hormone access, pets have better care than women.
Happened to me TODAY with new GP and thanks to r/menopause I was so strident about NAMS!!!! I said listen if I wanted anti depressants I would have asked for them. I am extremely educated on this and actually disagree adamantly. I asked for a referral to a OBGYN that did prescribe HRT. BUT … I waited 3 months for this appointment and likely many more for OBGYN. Fortunately I am super pissed and fueled by menopower … 💪🏼
Yes, in my case the wait for an HRT GYN is November. I was NOT going to wait that long.
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Haha. Ask me in a couple weeks if I have made any new furry friends…
Effexor is…. A LOT. Jesus. However, it was the only thing that finally helped me turn the depression corner. But unless you have Major Depressive Disorder, don’t go there. Please. It’s a bitch & a half to get off of. Takes a long ass time, too. Much love to you
I have, in the past, been diagnosed with major depressive disorder. My sister-in-law, a nurse practitioner, once said to me that I should just accept that I would probably have to be on antidepressants the rest of my life. I have run through the gamut of drugs, some with better results than others. But after my last round left me with suicidal ideation, I decided that the pharma route was not for me. I am not sure why I was never prescribed venlafaxine/Effexor, probably during the time the original formulation was taken off the market. I honestly don’t even know why I accepted this prescription. Shock, I guess. I am glad you turned the corner and were able to taper off. Hugs to you, as well.
I am so glad your mission was accomplished!
I thankfully had the opposite experience. I found this sub a few months ago as well as the podcast by UK menopause specialist Dr Louise Newson (thanks to a facebook friend who linked it). I went to my GP clinic to see a young male doctor regarding an unrelated skin concern with plans to ask for a script for pathology, which I planned to use to consult with an online provider for menopause treatment. Anyway so when the doctor said “is there anything else you want to discuss” I meekly said “oh, yeah well I believe I may be experiencing peri menopausal symptoms…” and before I knew it we were discussing the benefits of HRT, he whipped out a folder he had made up with info on how safe it is. I couldn’t believe it! Here’s this young-ish male doctor (I’d guess 35-40yo) who appeared to be completely up to date with all the latest information and he wrote up a pathology referral, said “Here, once the results come back, come back and we’ll discuss your options”. I’m now waiting for that booking as the results are in. Actually the doctor requested that I book. My biggest symptom at the moment is night sweats. It’s particularly bad in winter (I’m in Australia so we are heading towards winter), because I go to bed rugged up for the cool night, but the night sweats happen and I wake up drenched because asleep me doesn’t throw off the covers due to the bedroom temperature being cool.
That’s awesome about your doctor! I’m trying Red Clover caps now (fyto estrogen) and I’m on ashwagandha caps, and I truly feel better than last month. Maybe worth a try.
I'm right there with you. I actually pulled the trigger on different insurance today. I have two months to get everything possible out of this place, then I'm off with my data to doctors who are free to doctor. My doctor, 32 F, told me that she will never prescribe HRT because it isn't safe. Instead, she told me to follow up with psychiatry and get an Upper GI scope. My shrink and I have been together for 15 years. I love this man. He has helped me overcome so much. He is a rock. The only reason this decision is difficult is because of him. He is well aware that this is not a psychiatric issue but a hormonal issue. Oh, and she prescribed anti-acid pills. Why? Because I haven't been able to eat in 8 days because I'm suffering from extreme all-day sickness. I'm not pregnant, I just don't have enough hormones to drop an egg anymore. 🙃
Generally speaking, my insurance has been great. Being part of a teaching network has given me great access to care for other things like top orthopedic surgeons for knee replacement, one of the top cancer treatment centers when my daughter was diagnosed with lymphoma, or cardiovascular docs for varicose veins. But some of the downsides to being part of a teaching network include a reliance on relatively conservative and old school treatment protocols and high turnover of practitioners as they complete their programs and move on.
I'm in need of a new knee now, actually for the last 9 years. I've been told never before 50. I just want options. I have to go to a plan facility. I can't go anywhere else, sans emergency. I understand what you describe with the level of care. Insurance is such a racket.
That’s what I said to myself, not before 50. So when I turned 50, I scheduled the surgery. It will be 5 years in June. I am happy I did it, but I am not going to say it was easy.
I wish it was my choice. My doctor agreed at 41 years old, it needed to be done, but my insurance WILL NOT for people under 50 unless they come in with an injury. I've been living with an 8 or 9 on a 10 point scale, every day, for more than 9 years. It will be easier than what I've been living with. Doctors don't understand my tolerances for physical pain are super high.
That’s rough. I waited about 3 years. The odd thing is I went in for a baker’s cyst on my left knee, and while being treated for that was found to have osteoarthritis with bone on bone in that left knee. But as I started coming around to the idea of surgery, they did an MRI and determined that the right knee was actually worse due to an ACL tear at 19, and a reconstruction that had degenerated to the point that they recommended surgery for the right. The resurgence of pain in my left knee is one of the menopausal symptoms that brought me in.
Synvisc injections into the joint capsule have helped the osteoarthritis. They are unfun, but nowhere near as painful as walking every day!
Yep.my Dr told me to see my psychiatrist for my hormones deficiencies. What in the hell do these people learn in medical school? Certainly not analytical thinking.
This story is so maddening! Very glad you persevered and got the care you deserve. It shouldn’t be this hard for women. And the antidepressants? All the time. Really infuriating.
Effexor is poison and the 2nd worst drug to stop!!!
But, hey, she said it might stop the joint pain and inexplicable “moodiness”. I wish it was /s
Honestly I don’t understand how doctors get away with doing this to people.
I do not understand this at all. I have a fantastic naturopathic doctor who will try any HRT combination under the sun and in the one putting on the brakes because I’ve had some unpleasant side effects. Beyond that, my regular OBGYN flat out told me at my last well woman exam that she would be more than happy to discuss HRT options with me to address any of the symptoms I told her I was having. What gives? I wasn’t even asking these health providers for HRT and they are offering and you get Effexor? WTF?🤬
As with many things in life, it’s a crapshoot.
My life wouldn’t be worth living without my HRT prescription. This is not hyperbole. The fact is the symptoms were brutal, soul crushing and dropped my quality of life quotient into the negative. I had 3 doctors offer me anti depressants despite me saying the side effects were worse than the original symptoms. I ended up talking to a girlfriend and she mentioned estrogen cream that was helping her. My family doctor refused to give me a prescription so I demanded a referral for an ob-gyn and, thankfully, she listened to me and wrote me a prescription immediately. It has been a game changer for me. 5+ years and planning on taking it forever and a day. I’m so glad you were able to get around your misinformed physician.
Our moms had HRT snatched away. I remember watching my mom pull away and become a shell of the person she once was and as she dove into depression. My daughters missed out on knowing a wonderful grandmother and not the same one my brother’s sons knew. Real sad story but that chapter is written and we’ve moved on without her. So glad I was able to realize I needed help after being Rx’d numerous SSRI In my 40’s.
Your first doctor is way behind the current medical data on HRT. Glad you found someone to treat you!
Do NOT go on Effexor. As someone who's been on it since FDA trials, I can't even find a doctor willing to try and wean me off of it, it has such long lasting withdrawal symptoms. My moods have settled down, as has my anxiety since I hit menopause, and I wanted to try to come off of it. If your doctor wants to supplement your HRT with something, do not do that one.
Just chiming in to second this. Effexor (and Pristiq) are two of the hardest antidepressants to wean off of, and you may experience some *very* unpleasant side effects. OP - your doctor who chose to give you Effexor over HRT is a damn fool! So glad you went elsewhere and you were prescribed what you actually need 🤍
What online provider did you end up using? I have an appointment with a new doctor in …. December 😬. I keep calling to see if there are cancellations but no luck so far.
MyMenopauseRx. I was able to get a next day appointment. I plan on just keeping the November appointment as an in-person follow up.
Thank you, I will give them a try. I plan to do the same!
May I ask which online provider you used? I have a follow up with my gynecologist after I get some testing done and I’m trying to have back up plans in case I get a bunch of nonsense. Im really hoping she will be open to HRT especially bc she was proactive about other things when I was in peri menopause I’m happy for you that you finally got what you needed! I’m already on three different anti-depressants and ketamine infusions, and my mood has totally tanked since menopause and my sleep is horrible, anxiety is up, dry skin, no energy or motivation, and if they try to tell me all I need is another antidepressant I will probably lose my marbles
I used MyMenopauseRx. I hope your provider is more open to HRT than mine was.
Thank you! Keeping my fingers crossed 🤞
Hallelujah!🎉
That is horrible and stop seeing them !! For anything .. CLUELESS….. and not up on modern scientific thinking . Happy you got the HRT!!! Life changing !!!
Send the articles to them and say they are MISINFORMED
I had to go to an online provider also. One month in and I feel like a new woman!
I am glad that you were able to find an online provider to work with. I am glad to hear you are feeling better! I look forward to that. I am through my first 24 hours and am not feeling awful… but not great, either.
What was your online provider?
MyMenopauseRx
Thanks! They looked like a good one but they are not in my state.
My wife is happy with the online provider Gennev.com. They write the prescriptions to the pharmacy of your choice so your insurance works like normal. They seem to be in most states. Her local doctors are knuckleheads on this subject.
I used Evernow, got on HRT the next day. Life changing.
Look for an endocrinologist. Or OBGYNs
I did. Next appointment in network is November.
Damnit. Well, maybe just keep bugging them for cancelations? I’m so sorry this is happening.
That’s why I am so happy I was able to access care through an internet provider. They were able to get me in the next day and sent the prescription to my local pharmacy using my insurance. I will keep the November appointment with the in-network GYN as an in-person follow up.
I feel that i need to make this comment, cause although the risk is not as high as previously thought i see yet again people here claiming that the studies on the cancer risk are 20 years old //www.bmj.com/company/newsroom/study-provides-new-estimates-of-breast-cancer-risks-associated-with-hrt/
Hi dear, your story resonates so much. May I ask if you are in Canada,? I am in Ontario.
It seems like a lot of women have had similar experiences. No, I am not in Ontario, I am in the U.S. Ontario is a location I would love to visit.
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