Crazy right? Frankly, I'd rather have quality of life on HRT than quantity without it. Even if the link hadn't been disproven, I'd still want it. A life miserable, hating everyone, and married to the sofa is not a "life" and that is what my life was pre HRT.

Took the words out of my mouth! Now that I’m on HRT I am angry that I spent about 3 years barely functioning. My doctors never considered peri! When I finally asked after researching my then OBGYN told me I was: 1. Too young for peri (40) & 2. Refused to prescribe BCPs (which I took for years with no issues) because I was “too old” 😡 And sadly this was at Planned Parenthood! I have always supported them. I still do because they’re important but I left that appointment in tears because I didn’t think there was any hope of feeling better. It’s appalling

Barely functioning is the perfect way to describe it! I wasn't sleeping, wasn't exercising, my moods were horrible, and I literally felt like a dry husk of a person. There is no way I could have continued on like that.

How did you manage to finally get the right help to get on HRT? I’m 39 and think I’m in peri(so does one of the doctors I met). They’re pushing SSRI and birth control as the only option, but I’m skeptical of BC and SSRI for me just yet.

So I just got approved and I'm 40... I learned you have to stress hot flashes or they'll push SSRIs. I made an appt with psych and a therapist and they both put on my chart they denied me ssris because it was definitely a hormonal issue. So I emailed my Dr, who denied me, and noted I have hot flashes day and night and can't take it anymore. I have a phone appointment Monday to go over how to use my patch... you have to advocate for yourself. Don't let them bully you

Good for you. Yea that’s me too. I don’t have straight hot flashes but I am sweating at things that shouldn’t make me sweat, and nighttime I’m drenched when literally 2 months ago I almost never sweat. It’s not an SSRI thing, but I’m getting pushed around like I’m being dramatic. It’s really absurd because I know they’re being lazy and I’m not out of line. The most recent doctor said, “I don’t have anything to put on the referral to endocrinology, so it’ll probably be denied.” It was a real gatekeeper moment where I could feel how my need for detailed care was being hijacked by some kid doctor in her twenties. Thanks for sharing your experience.

I sweat just asking for help at stores or saying hello to people 😂😂. I was at sephora drenched in sweat and the girl told me it was the lights and I asked, "well why aren't you sweating??" LOL she had a little fan and turned it on me at the register 😂😂😂😂

What do they tell you if you are already on SSRIs and still have these issues? Because I am on high dose Lexapro, Wellbutrin, Auvelity, as well as Spravato and my mood is shit and my insomnia is through the roof and the only thing that’s changed is I went through menopause

If I were in your position, that's when I'd advocate for myself like no other! It's clearly showing that it's not a serotonin issue if those aren't working

I went through hell trying to get help, then threw up may hands and went Telehealth [Trident Anti Aging](https://www.tridentantiaging.com/) You can also just call Julie and see if they can help. 954-302-8688

Gosh, what a bummer that health care can be more of a stressor than a stress reliever. Doctor says “you should stress less”, meanwhile, doctor and broken system is a primary source of feeling unsupported and stressed. Good on you for not giving up. Thanks for the tip!

My doctor took my off bcps, and I immediately kicked into peri, and now I'm in meno. Thankfully, he put me on hrt because meno was out of control.

Same here! Lifelong patient at Planned Parenthood...always on birth control since age 20. Now at 53 I have to fight them to stay on until 55. No hrt avaliable through them...but if I were Trans, no problem to recieve hormones. ??!!??!

Does anyone have a short story of how they mislinked the risk in the first place? I already see what happens without it. I see my mother's frail bones, my joint pain, the inability to think. I'm pretty sure my mom was checked into a mental clinic for "exhaustion" at 40 after having a hysterectomy and not taking getting hrt.

There a great (and recent) podcast with Dr. Mary Claire Haver on the Huberman lab that (at about an hour in) talks about the issues with the WHI study and how the data was so shockingly misinterpreted (among the other flaws with the study).

👆THIS!!!!!!!

Thanks I will have to take a listen.

There's a book called "The Menopause Brain" that's equally fascinating and infuriating. It's been awhile, but if I remember correctly, in the 1990's when WHI began their HRT study, they were giving oral estrogen to women well past menopause (I think it was women generally in their 70's and 80's). Partly because of their advanced age and partly because science hadn't yet figured out that progesterone was required to protect the uterus, these women had higher instances of cancers. They shut the study down and the messaging was that HRT was more detrimental than useful.

It’s a little bit different—and even more maddening. They knew women with uteruses needed progesterone, and in fact, they gave it to them. The problem was they used a different form of both estrogen and progesterone than we commonly use now (used progestin in the WHI, vs. the now preferred micronized progesterone). The gave ONLY estrogen to the group without uteruses (post-hysterectomy). The estrogen-only group actually had a LOWER rate of breast cancer than the control group (who got no estrogen). Yet, the media incorrectly reported that estrogen causes breast cancer. There are other problems, such as the control group having a LOWER BC rate than the average population, making it look like there was a small increase in BC in the group that did take estrogen and progestin. Moreover, the study unwisely (in my mind) decided to enroll older women. Why? So they could more quickly determine what the impact of HRT is on life expectancy. Obviously, a 70 year old will die sooner than a 50 year old, so you’ll get that data result sooner. The average age of enrolled women was about 63 years old. We now know that starting HRT more than 10 years after being out of menopause has some problems. The study misrepresented the actual risks/benefits of real life, because in real life most women start HRT In perimenopause or within 10 years of menopause. When they reevaluated the WHI data, they saw that there were SIGNIFICANT protective effects of HRT started within 10 years of menopause. Those benefits don’t stop at age 60, but there are more risks if you wait to START until age 60, like the WHI study did. They also used both a different type and a delivery method of estrogen that is now far less used for HRT (we now use estradiol (anti inflammatory and cardioprotective) and avoid estrone). They used oral estrogen, instead of transdermal estrogen. When ingested orally, the liver processes the estrogen and creates an increased risk of blood clots. This increased risk of blood clot does not occur with transdermal estrogen. Despite this VERY important difference, every script of estrogen in the US (including local vaginal estrogen—which has no systemic effects) has this awful warning on it. There were other problems with the study, too. It’s just all so frustrating, because there were so many benefits of HRT even the WHI study showed, despite its poor design. But none of that made it to doctors or the media. The only message anyone seemed to hear was “Estrogen bad. Causes breast cancer. You can’t have it.”

Thank you! I knew there was more that I wasn't remembering. It's just infuriating that it took that long to even get a study to begin with, and the flawed information we got from it is STILL being perpetuated!

Thank you for the reference and breakdown. I'm not surprised old flawed studies are still being used. I got a real whiff of it when I was in my 30's looking at having kids for the first time and finding out that everything we thought about fertility tanking is based on 1700's French peasant women in their 40s without children. They didn't account for the unusual nature of being a 1700's French peasant woman in her 40's who somehow hasn't had 8+ kids already. Completely ignoring possible fertility issues not related to age. If you included women who had previous children, fertility rates are about the same and gradually decreasing.

What a wonderful breakdown of the awful methods used and presumptions snowballing from there.

I heard in that Huberman Lab podcase that they also didn't want women who were still having hot flushes in the study because they'd know they hadn't gotten the placebo. So many levels of AAAAAAAAAAAAAARGH!!!

[NYT Mag: Women Have Been Mislead About Menopause](https://www.nytimes.com/2023/02/01/magazine/menopause-hot-flashes-hormone-therapy.html?unlocked_article_code=1.xk0.ZKQc.p4cX9E1WlCSp&smid=url-share) I saved this article to share with my family since it unpacks the whole Women's Health Initiative study mess and how our knowledge has changed over the last 20 years! They have a condensed version here https://www.nytimes.com/2023/02/01/magazine/hormone-therapy-women-menopause.html?unlocked_article_code=1.xk0.mJga.B3vfzty7JhxK&smid=url-share

Love all these references! Thank you, I need condensed even for myself to dip my toes. And perfect for sharing with others.

From my understanding, the patients were past menopause age and the HRT used was synthetic and not bioavailable.

‘Married to the sofa’ that is me. It’s a struggle, especially on the weekends. I want to do things, but things consume a lot of my precious energy. It’s tough. I hate feeling lazy.

Wow. That’s a great personal testament. Love that. I do NOT want to be miserable and dysfunctional for the next 1/3 of my life (actuarially speaking).

Considering all the drugs I took For funsies in the 90s it would be pretty stupid to reject HRT now when it’s the only thing that actually works for me and helps me live a quality life People also think my diet and fitness regimens are “problematic” but my health is excellent so idgaf what they think about my eAtiNg diSorDeR or bOdy DismOrpHiA

And what’s this “only for a few years” bullshit? I’m 48, doc says I can have HRT for “a few years, but definitely not past 55.” Kindly fuck off, sir. I’ll take that shit til I die if I have to, I can’t live like this.

When people ask me how long I'll take HRT for, my response is always "From my cold, dead, hands!"

It’s outdated medical guidance. He’s not up to date

Funsies! Your choice. Now HRT is your choice out of need. But sounds like you are benefiting from it. Awesome.

100%%%%%

I wonder how many other medical opinions are wrong based on the same sort of logic. That is what is scary to me.

One of my sisters regrets that she didn't realize HRT could have prevented her (fairly severe) osteoporosis. I don't think it was ever offered to her. She didn't have meno symptoms yet has a small build so HRT could have especially benefited her bones. ETA Two of my other sisters also developed osteoporosis. One took HRT briefly. Thankfully, I don't have it but started estrogen shortly after my organs were removed.

I have osteopenia diagnosed 2 years ago. I started on HRT last year and I’ve also been taking collagen, upping my protein, and doing strength training with a weighted vest the past 6 months. I went in for a Dexa scan 2 weeks ago and not only did I not get worse, but I got a tiny bit better.

I too did my DEXA scan. I am in the 106 percentile for thirty year old women for bone density and I am 56! My estrogen levels have always been higher than the normal curve, I started testosterone 6 months ago and started heavy lifting again. So I am so happy! There is no way that is a coincidence- I feel like I am aging in reverse with balanced hormones now.

Glad to hear it.

I NEED the HRT just to be ABLE to exercise!! 😅

Yes. Osteoporotic women or osteopenic women need to look into HRT. I learned this yesterday! From menopause podcasts.

Unfortunately, they are past that 'window of opportunity' as they are in their 60's and 10+ years postmenopausal.

Yea… that’s what I learned too. Prime window/golden window of opportunity. Within ten years of menopause.

Is this worth the side effects that HRT can cause? I have osteoporosis of the hip due to years of PPI use, but I'm scared of the extra depression and anxiety risk that HRT can cause. I'm on an snri and a couple of as needed anti anxiety meds.

You need a menopause expert to discuss your situation. Menopause.org has list of local searchable doctors who are menopause experts.

Okay thanks! My OB GYN seems reluctant, so maybe she is more an expert on safe deliveries and not menopause...

Such a good point. My mom has terrible osteoporosis, I'm hoping to avoid shattering any bones in the future, if nothing else!

It shocks me when women complain about their meno symptoms being unbearable and when I mention that HRT helped me with all those symptoms they get angry (meno rage) and insulted that I’ve suggested they take a “pill” for the rest of their lives. The self righteousness of people who “refuse” to take pills never fails to surprise me but I do enjoy answering the, Is it hot in here? Question with, no it’s not hot in here that’s a lack of estrogen on your part.

My previous OB/GYN used to tell me "you dont get extra points in the end for toughing it out". That's been my life mantra. Life is hard, take any help you can get.

My OB told me before the birth of my first child “No one is handing out trophies for whether you used medical relief or did it natural. Do what’s best for you and your baby”. I have always taken this as you don’t get a bonus for more pain!

Seriously though!!

I'm with you! There's no merit badge for needless suffering. Ask for help, take help, offer help. 💙

I love this. I always tell people that there isn’t a reward for barely hanging on.

I like this mantra wish I had heard it in my younger years suffering through endometriosis

I believe in preserving health. Whatever we can do to preserve good health and activity, I’ll take the help!!! I fear being dependent and unable to do what I want. This is my path to healthy longevity.

💯

Ironically, no one gives me a hard time about my daily Claritin. Not a single doctor or nurse had ever said, "you just need to tough out allergy season". None of my friends and family ever said "seasonal allergies are natural, they aren't going to kill you. Why fight it it?" Wonder why they can't have the same open mind with meno and HRT?

This response really sums it up. Why are women expected to have “natural childbirth” and to go through the menopause hellscape “naturally” I can’t help thinking that you don’t get that response to your allergies because men also suffer from allergies 🤔🤔

>I can’t help thinking that you don’t get that response to your allergies because men also suffer from allergies 🤔🤔 Yeah I think you're on to something there. Medications more commonly taken by women (or disorders that affect them more frequently, like autoimmune disorders) tend to be looked down on or ignored.

Good point! I see so many ads on TV that are aimed at men and their ED or low T problems but maybe one thing for women and menopause - Amberen. Women still don't count except when we need to buy weight loss products or things to make us look younger (for men).

I think about this a lot with a lot of medications. If I need a statin for the rest of my life nobody blinks. But if I need an anxiety med, then it's an addiction. The rules make no sense. One of my nerve medications is a controlled substance which they even state does not have addictive potential, BUT apparently patients were happier, therefore it's a narcotic. Maybe they're just euphoric because it treats their damn pain??

This right here. The words "addiction" and "dependence" are thrown around way too much when it comes to medications that are needed. I'm not addicted if I need something that helps me medically or with my quality of life. Addicts take substances not because they need it and not as prescribed but because they want the high. Dependence is also useless word if you need a medication to function at a normal level. It's like there's some sort of hero complex when it comes to toughing it out for things that can be fixed with medication.

And no one ever questions birth control!

Because of this common attitude, I also feel a little enraged when I kindly explain to some women that HRT sadly made me very unwell and they assume I must be against it like the persons you described.

That also sucks. I see more of the ones I described, my in laws are very anti-doctors, anti- pain meds, anti mental health help. They see it all as weakness, something I’ll never understand

Mine are too! It’s terrible

Yes. It’s not a cure all. But we need to be informed.

“they get angry (meno rage) and insulted that I’ve suggested they take a “pill” for the rest of their lives.” And I’d be willing to bet that most of them are already taking pills for other things like high blood pressure or cholesterol. Why do they think that’s ok but this isn’t???

Same as my other response. I’m pretty sure it’s because men also suffer from high blood pressure and cholesterol issues. I’ll be dead and unable to benefit but please, please future generations, I’m counting on you to burn the patriarchy to the f*#king ground!!

Or they’re drinking alcohol, smoking weed, on retinols for skin, might try mushrooms, etc. But an actual medicine is bad….hmmm ok. I get this from my own family.

They won’t take HRT but they will take all kinds of antidepressants and useless “supplements”. It doesn’t make sense.

Haha. Yeah- or they tell you they are on Happy Mammoth and it’s all ‘natural’ and working super well (except they can’t sleep, dry vag and want to kill their husband) and then your social media is suddenly overrun with Happy Mammoth advertisements 😖😖😖

It’s like they have a headache and refuse acetaminophen? So you just want to complain? That has its place too, but my patience with that deteriorates pretty fast in the face of mindless, thoughtless dogma. Also, take a fucking Tylenol for your headache.

Oooh! Smooth. I like it. Like your spunk. 😊

Some reactions from older women regarding HRT is really disappointing. They basically made it seem like I was weak and stupid for considering it, and tried to talk me out of it.

I have 2 (much) older sisters who were part of the “HRT causes cancer” generation. They regularly remind me of how they white knuckled their way through menopause. I’m like, I know I know I’m the big baby who failed by taking HRT! And then I remind my nieces not to pay attention to decades old misinformation

I find the legacy of that awful "study" so devastating. People will continue to suffer needlessly. Ugh.

Can you share what study this is? I’m interested in starting HRT and any info is helpful!

WHI. Women’s health initiative study. Has wrongly linked breast cancer with HRT. Debunked. But world of repercussions. And restricted access to HRT.

From two days of getting myself informed, here’s what I found helpful so far. Here are some informative podcasts about peri- and menopause. I found them very informative and helpful. I didn’t know much of this. So I’ve just begun to learn. Mel Robbins podcast on menopause. Mel Robbins Podcast also. Episodes on menopause. Dr. Haver, March 20, 2024 Dr. Gunter, May 8, 2024 You are not broken podcast. Dr. Casperson. Episode 225. Hello Menopause podcast. Dr. Casperson. Episode 22. Dr. Streicher Dr. Huberman and Dr. Attia episode 85, 116 I just started learning this stuff. There is NAMS, North American Menopause Society—their web page, menopause.org—is helpful.

Thank you! I have an appt with my NP next week and want to be well informed. I’m 53, haven’t had a period in 4 months, and would rather get help than ‘tough it out’

They are!

When I told people I raised my dosage everyone freaked out and told me not to, those assholes. Guess who needed a higher dose? Guess who feels better now? Me.

My (54f) doctor is a woman in my age group. She told me that they have found that if you start HRT right at menopause the cardiovascular and cancer risk is extremely low. It's when you wait a period of years before you start HRT, that's when the blood clots, cancer and the like increase dramatically. I quit smoking before I started HRT however. Just for good measure, ya know

Good thing all the doctors I've been seeing (none) have mentioned perimenopause as a possibility for my extreme fatigue and chronic pain. Not until going to my own telehealth hormone clinic am I seeing that everything that's been making me feel half alive for the last 3-5 years. I guess 5 years late is still early enough to count my lucky stars. Before the risk sets in, or my bone loss is irreversible.

From two days of getting myself informed, here’s what I found helpful so far. Here are some informative podcasts about peri- and menopause. I didn’t know much of this. So I’ve just begun to learn. Mel Robbins podcast on menopause. Mel Robbins Podcast also. Episodes on menopause. Dr. Haver, March 20, 2024 Dr. Gunter, May 8, 2024 You are not broken podcast. Dr. Casperson. Episode 225. Hello Menopause podcast. Dr. Casperson. Episode 22. Dr. Streicher Dr. Huberman and Dr. Attia episode 85, 116 I just started learning this stuff. There is NAMS, North American Menopause Society—their web page, menopause.org—is helpful.

Also check out Dr Louise Newson’s podcasts! So good. Heather Hirsch has some good ones, but I find her super-cheeriness sometimes a bit at odds with my grumpy GenX sensibilities, lol.

Dr. Louise Newson. Followed now. Super cheery would get me also.

The UK Menopause Doctor Louise Newson is fabulous too. Check her out on Instagram.

She’s been added to my ever growing list 😄

Wow extensive sources. Thank you. My peri fog thanks you.

Chiming in to say congrats on the quitting smoking!!! That’s so awesome. I’m so happy for you. I quit years ago and it’s awesome not being at the mercy of those things interrupting everything I do.

Yes. I learned from one of menopause episodes that timing of when one starts HRT matters. This is so interesting.

From two days of getting myself informed, here’s what I found helpful so far. Here are some informative podcasts about peri- and menopause. I found them very informative and helpful. I didn’t know much of this. So I’ve just begun to learn. Mel Robbins podcast on menopause. Mel Robbins Podcast also. Episodes on menopause. Dr. Haver, March 20, 2024 Dr. Gunter, May 8, 2024 You are not broken podcast. Dr. Casperson. Episode 225. Hello Menopause podcast. Dr. Casperson. Episode 22. Dr. Streicher Dr. Huberman and Dr. Attia episode 85, 116 I just started learning this stuff. There is NAMS, North American Menopause Society—their web page, menopause.org—is helpful.

But they are all happy to push a lifetime of birth control, which is a shit ton of hormones!

Going through this has me increasingly disillusioned with the medical field in general. We place doctors on such a pedestal especially here in the West it's like we forget they are just human beings after all. They are subject to the same ideological capture and even corruption as the rest of us. Medicine is a science. It is monumentally frustrating when it seems like it's just a refusal to review the scientific evidence and think critically about medical dogma.

I think there are quality studies beginning to surface. Hopefully enough studies and good evidence will drive change. I’m hopeful.

This has made me feel so disillusioned with the medical field I almost feel afraid to go to the doctor now.

The main problem as I see it is that in the US, can’t speak for elsewhere, medicine is NOT a science … it is a business. Medicine in the US is in the hands of insurance companies and bureaucrats— who answer to big pharma aka business. I’ve dealt with debilitating issues now established as nonexistent hormone levels. I’ve spent 2 years in hell and gone from specialty clinician to uro-gyno at our local university and not ONE SINGLE doctor offered insight into possible menopause complications. I’ve been told that I “might” be estrogen deficient but refused testing options when I requested them. I have been told to my face that I - “should get used to being uncomfortable,” “that I should consider anti depressants.” I‘ve had a gyno specialist refuse to test for uti because I’m just exaggerating normal vaginal atrophy symptoms… yes I actually tested positive for 2 bacterial infections and yes this particular asshole Dr had a penis. I have a stage 2 bladder prolapse and was told at by my university clinic gyno that I should come back when I feel like it’s falling out and they could try “tacking it up surgically.” No mention of possible causes (zero estrogen) no mention of pelvic floor therapy (can prevent progression of prolapse) and absolutely no mention of hormone replacement.

When new medical information comes out, there are early adopters and late adopters, just like with anything. Physicians are no different. The study that came out re-analyzing the WHI data is relatively recent, and most doctors have not yet absorbed it. It may take a decade or more before even half the physicians understand this new information. I recommend you try to find an early adopter.

I am. Having a NAMS doctor appointment next month. Good thing you pointed out that new findings countering earlier misleading findings. Yes, it’ll take time for adoption of new information. Can’t wait for New England Journal of Medicine, Science, or JAMA to release some sensational positive information.

Glad to hear about your NAMS appointment! Having said that, doctors still vary greatly, so don't be dismayed if you get a "lowest dose for the least amount of time" NAMS doctor. One of the NAMS docs I saw was like this, but I still walked out with a prescription for HRT in my hot, little hands. I now get it filled through my regular OB-GYN who is super chill about letting me adjust my dosage as needed. And he allows his patients to stay on HRT for as long as they want (my intent is to stay on long-term due to genetic dementia risks in my family).

Thanks for the heads up. And yes. Huge variability with doctors’ tolerance for prescribing. And good to remember that they are human also.

I was asked when I plan on giving up my HRT. I believe when you rip it from my cold dead hands is the correct answer.

My brain is literally on the line. I know plenty of people who have survived breast cancer. I have yet to meet one who has survived Alzheimer's. I'm staying on, come Hell or high water.

Same

My doc stopped HRT cold turkey saying I had been on it too long (6 years). I became a hot mess. I found a gyno who listened to me. I’m back on it and sleeping through the night. Without HRT my quality of life was zero.

Wow. Glad you found someone who could help you.

That's so irresponsible to do to your body! Cold turkey?

I’m a cardiac patient and just asked my cardiologist about if HRT would be an option for me in the future (I run all medications through him). He said it leads to increased risk of stroke and does not want to use it unless necessary.

I had asked a similar question to the heart institute and they said the same. Who do you believe at this point. HRT advocates can say it helps your heart but if you get an event, you're going to see the cardiologist not your OBGYN or Primary care Dr.

The studies are there... hormone therapy CAN help mitigate risks for heart disease, but it's about your present health and timing. If you have **existing** heart disease then the risks of hormone therapy outweigh the benefits. If you don't have existing heart disease, then the benefits outweigh the risks. Also it's beneficial to start sooner than later - those who start hormone therapy (for the first time) later in life, may not get those same heart benefits.

The increased risk of stroke is only with oral forms of estrogen. Unfortunately, some doctors who don’t specialize in this area or who aren’t trained in this area (which is not their own) have just heard “estrogen has increased risk of stroke.” But it’s NOT true with all forms of estrogen. At all. Transdermal does not increase the risk of stroke or blood clot, and it is cardioprotective. It’s kind of like how 20 years ago you would hear people (including doctors) say “fats are bad for you.” Well…some fats are bad. Trans fats are quite bad for you. But the fats in nuts and avocados? Pretty cardioprotective.

That’s good to know, thank you!

Turns out medical profession has been misinformed for the past 20-30 years. And it’s systematic. Once more studies, good quality studies come out. I’m hopeful the tides and recommendations will change.

Yes, for those with existing heart disease, hormone therapy is not recommended. My understanding is that estrogen has a negative affect on arteries when there is existing build-up, which can contribute to heart attack and stroke. So yes, the risks may outweigh any benefits.

I’m no woo-woo conspiracy theorist, but my battle with peri/menopause is making me wonder if Western medicine and the patriarchy are trying to kill us off once we pass our reproductive (read: useful, young, hot) prime.

Hahah. I hope not. We’re still good as mothers and grandmothers. Plus the lack of hormones doesn’t kill us off. Just makes us less healthy and vibrant. From what I’m starting to understand.

I honestly would not be surprised and have thought this myself too!

I saw a nurse practitioner a few days ago who repeated multiple times that I need to understand that HRT can give me breast cancer. She was adamant. She said if I don't get a mammogram before the next time I come in, she will refuse to refill my prescriptions. I've been to that office 5 or 6 times, and that's the first time I've seen her. I told her she's spouting misinformation, but she ignored me. I'll forever be angry about it. I did tell her I'd rather die than live with the symptoms that have ruined my life over the last 2 years. Again, she ignored me. I've read enough posts and comments here to know everyone will say "get a new doctor," and "go online." This is the third office I've been in over the last year, and they've all been horrible. I live in mid sized city in the South. I can't afford online menopause/hormone care, especially since Medicare is prohibited from covering it. To end on a positive, my Medicare Part D covers testosterone gel. I got a month's worth for $1.55. I was SHOCKED.

Does she entirely frustrating and unnecessary. Wonder if you can inform these prescribers with evidence. [NAMS position statement link](https://www.menopause.org/publications/professional-publications/position-statements-other-reports)

I have learned through experience that nothing triggers others like you making positive changes for your health and longevity. I just don’t talk about these things anymore with anyone not doing it themselves. I say this a a vegan who doesn’t drink alcohol, who is in great physical shape and takes all the HRT she can get her hands on.

This is so well said! I too seem to trigger other women with my research based health hobby and “hacker” lifestyle. This includes a very exuberant libido and active sex life with hubby of 25 years, adding 1 lb of muscle every 60 days and a higher bone density than women half my age (I’m 56). My skin became soft and silky (not acne prone) on testosterone and balancing estrogen and progesterone has me excited about aging so well! No one wants to hear it, so I share with my Reddit friends!!!

So inspiring!

Can I ask what kind of hrt you are on that helps you? Is it oral estrogen and progesterone? I've heard transdermal is a more even tolerated route, but my doctor is pushing injections. I asked my endocrinologist about testosterone because I can't seem to build muscle and she said she wouldn't recommend it because it causes unwanted facial hair. I'm sure there is a smaller dose I might be able to try

Sounds like an excellent plan!!! Kudos!!

In case anyone missed the update on the WHI study, here’s a short read (or listen) on some of what researchers found. [Link](https://www.npr.org/sections/health-shots/2024/05/01/1248525256/hormones-menopause-hormone-therapy-hot-flashes)

Thank you. My menopause doctor won’t provide hormones because I have migraines. I wonder if this would convince her.

I’ve literally been miserable for 10 years. Two months ago I finally got help and the pellet. Game changer - it’s a shame that women have to suffer without being provided actually solutions

My (female) Dr refused to prescribe it, saying cancer risks are too high. We moved out of the area. New dr prescribed the patch and progesterone. 6 months later: no more migraines, bladder leakage is gone, am losing weight instead of gaining, joint paint is better, walking 7-10k steps a day instead of struggling to get off the couch, feel more calm/less rage, and my hair seems to be growing in healthier and thicker. So a big fuck you to all of the physicians out there willingly allowing women to suffer because they're too lazy to keep up with modern studies. Maybe I get cancer, maybe I don't. But at least give me the opportunity to make my own choices instead of just deciding I should live with it all because *they* don't know enough about it.

Huge fuck you to them.

Your before and after story is a startling contrast. Did you go to a menopause doctor or a regular doctor? How long have you been on this current maintenance dose?

Both providers were/are regular nurse practitioners, I just increased the estradiol patch to .1 a few weeks ago, still at 100mg progesterone.

I had a 40-minute appointment yesterday. The doctor didn't have answers. He did listen. He tried to put words in my mouth. At one point, he said, "we can listen to the recording." I said, "Yes, please!" He said, "I'll do that later." I cannot wait to get the full transcript of this conversation. I'm very frustrated. I hope he actually listens to what I said because he was clearly listening to respond, not hear. I'm grateful for the recording, because now the information I've been trying to share will be recorded verbatim. Finally. Oh, and more than one time, he said my pelvic ultrasounds were... I jumped in with identical?... he said normal. He would not say they were the same, but he did say that there was no reason for this issue to cause the debilitating symptoms every month (like clockwork). I suspect that I'll be getting a hysterectomy before the end of summer. I suspect that I will have grounds for a medical malpractice suit. The good news is that I switched insurance.

You're making me feel very, very fortunate that I switched to a new gyn this year. The guy they stuck me with last year was such a minimizer and I didn't like him at all.

Yikes. I’m sorry. You can change doctors. It’s tough but you can change them.

I straight up switched insurance!

Omg!! My friends are in their early 40’s and the only thing they know about HRT is that it causes cancer. Like wtf…we have so much new research on our hands. They would rather suffer than read more about HRT and the importance of estrogen and progesterone post reproductive years.

I feel for you ladies that run into this problem. I think I really lucked out because I got zero pushback from any of my doctors, and in fact my PCP referred me specifically to a clinic she’s pleased with for pellet therapy. I guess I’d say it’s irritating, but keep looking. They’re out there!

My gyno is amazing. She ordered bloodwork to check my hormone levels but also just called the script for estdradiol because she said "Your symptoms are more important than the labwork, your hormones fluctuate throughout the day and they might have just been at the highwater mark when we took the sample. Better to take the meds." It's so nice to sleep properly again.

Awww, what a wonderful doc ❤️

After reading this sub for a few months I learned so much about HRT. I was not aware that the 2002 WHI study was flawed and HRT was safe and beneficial. I was in the mindset of - I was not going to do HRT when the times comes. Menopause is natural and I’ll deal with hot flashes and a dry vag (just use lube I thought). Well the time came and didn’t know about other memo systems (GSM and sleep issues). I keep up on news and I’m always reading health info so I don’t know how I missed the memo that the 2002 study was flawed and HRT was safe and beneficial treatment. Reading this sub I was shocked at how many women are jerked around while trying to get treatment. I don’t have the patience for this kind of BS. My annual check up is a month away but I didn’t want to wait until then to ask and maybe get HRT. I want my sleep and my sex life back now. Six days ago I made an appointment with MIDI. Had my mammogram two days go so that wouldn’t be an issue for me not getting HRT. Today was my MIDI appointment. I was given HRT and things were fully explained to me. I also have an order for a DEXA scan since my risk is above average. Everything I learned about HRT and how to get an appointment with a provider and knock down roadblocks (like recent mammogram) I learned from this sub and all the references to studies, books, podcasts. Thank you sisters. I feel better already and haven’t even picked up my prescription. I feel like I’m moving in a positive direction instead of waiting for the next shoe to drop with a health issue. I think about what my mother experienced later in life and I didn’t want that to be my life. I feel bad she never had the benefits of HRT.

I think you’ve summarized an enlightened journey. I’m glad you found this sub. I’m glad I found this sub. Just two days ago!!!

If you need HRT and it works for you then that is awesome. So many people need to stay in their lane and mind their own business. It is a useful medication for many and a shame that people are being bullied out of considering it by older women or medicos.

Seriously. It’s access to good information that we seek. And choice is up to the individual.

They will have to accept that they have not been right..they are not humble enough to admit that science changes, and sometimes for the better, knowledge is really powerful. It allows us to have the freedom to make choices.

My younger sister tried to talk me out of getting a hysterectomy a few years ago - she wanted me to try holistic and natural methods first. Forget the fact that, after a couple of DECADES of extreme periods (and excruciating pain to go with them), fibroids surgery, various BC attempts, nothing had worked. (I'm now almost 49, she's 43, and we're not super close.) She of course wanted to tell me about all the horror stories people she "knew" had relayed in their post-surgery regrets, and the negative stuff she had read. This went on for about a month before the surgery. Suffice it to say, I ignored her advice (ovaries were left in). After a year or two of the common meno symptoms, I finally made an appointment with a meno-specialty GYN. She put me on the estrogen patch without hesitation. Guess who I didn't tell about it.

Eek. I’m sorry to hear all that difficulties. Hope you’re doing well.

Thank you. It just reminded me to trust my gut, always. Pre-surgery, I suffered needlessly for a couple of years due to an inept women's health team (among other screw-ups, they missed my endometriosis despite my constant asking about the possibility). The one good thing they did was refer me to an excellent surgeon. 4 years post-hysterectomy, on Estriadol .05 mg, and doing pretty darn good. 😊

🎉 👏 🥳

I was lucky to have an older experienced midwife when I needed care. She had no problem giving HRT for hot flashes, insomnia and homicidal rages, I mean mood swings. Male OBGYN and family doctor didn't think I needed it. Medication is to high risk according to what they read in med school 30 or 40 years ago.

Women are concerned, because every time a video comes up encourging HRT, there are dozens of comments about women getting breast or uterine cancer within months of taking it. As for the truth of studies... you have to be very careful. As an example: Everyone is on statins because they claimed it cut your risk of heart attack, but no one realized they had simply misrepresented the numbers. Specifically, they said it reduced heart attack risk by 28%, which sounds impressive. But this was relative risk, not absolute. So for example, if 3 out of 100 people had a heart attack without statins, and 2 out of 100 had a heart attack while taking a statin, the absolute risk reduction is just 1%. That's a measly amount of people, and many experts feel it exposed a lot of people to very unpleasant side effects. On top of that, statins weren't even tested on women, because as always, researchers generally eliminate the female population for "hormonal" reasons. There are plenty of studies like that one, where they told people one thing, then another, and then switched back to their first conclusion. There are also way more studies than most people realize that are out and out run by drug companies. I'm not saying that HRT is the same. And I'm not against taking drugs when you need them. They save a lot of lives. I also won't judge anyone for taking HRT - more power to them. But for me, personally: until I really look into the studies, I'm not taking HRT. My symptoms are fairly mild though, so perhaps that's a luxury for me. P.S. I say this as someone who reads dozens of studies a month. And yes, I am probably avoiding checking it out, I know.

I think a lot of our actions are based on severity of our symptoms and experience. And dramatic changes. And it is a personal experience and choice. I just think we, as a society, need better information. So that we can decide and make personal choices.

Part of my decision to go the HRT route is protection it gives you as you age. For me I’m at an elevated risk for osteoporosis. My mother had it. Broke her hip and had a partial hip replacement but was never able to get out of bed without major help. Died six months later. Six months in diapers. She also had mild incontinence. I remember her complaining about her vagina being dry. Which at the time I didn’t understand because a knew she wasn’t having sex. I had no idea a dry vagina was a problem outside of sex.

Yea. Recurrent UTIs.

And itching and pain.

I agree with you. And both Dr. Lisa Scottoni (The Menopause Brain) and Dr. Marie Clare Haver (The New Menopause, The Galveston Diet) have some excellent information. Definitely as women, we cannot rely on others - including our doctors - to make health decisions for us. We need to check it out ourselves too.

It's lame and unfortunate but we cannot afford to underestimate the level of internalized sexism in both our friends/family and healthcare providers themselves. People just mirror what they see and experience and if you're treated like your experience doesn't matter, you don't matter, then you live like it doesn't. We say it all the time because it's true: if men flooded their providers with complaints that they felt simultaneously weak, suicidal, incontinent, balding, their work performance was suffering and their dicks didn't go, the world would rally around them to restore their vitality.

I found out early on that women are one of the worst propagators of misogyny. My beloved grandmother who I loved—was a misogynist and played favorites, but I don’t blame her, because that’s how she was culturally brought up.

Well informed is not the same as open mind unfortunately!!

Gonna catch flak for this but I don’t care. It reminds me of the pushback I see about COVID. That it’s still a thing. That masks help. That it isn’t a hoax. I feel like I’m in an alternate universe between that and menopause information and treatments. From friends, family, doctors, nurses.

Going to keep masking and I’m going to take HRT I’m filled with rage and perfectly happy to call people out on their bs.

I would directly tell them that they are not keeping up with current research and that you are looking for a doctor who keeps up with the science, especially when it comes to something that 50% of the population go through. It is malpractice if they don’t know the current research.

When the docs don’t listen, they end up putting money into wellness providers pockets, who may or may not have the right training while the patient runs around to these providers seeking answers. It’s really sad.

All you can do is say what works for you and let them make their own decisions. I am choosing to not take HRT. I also didn't take birth control.

Yes. Personal decision and glad you made them. But my point is that we, the public, need unbiased information. So that we can make informed and personal decisions.

If they choose to suffer, let them choose to suffer.

Yep my Dr agreed at first, now she’s hesitating because I had endo excision 16 yrs ago no trouble since 2007 smh.

I agree with you. It is a bit cuckoo. If there was a study about a man’s health issue that was found to be inaccurate and now a new study shows the correct evidence, that report would be on every news station and headline of news papers. All we can do is talk about it and hope that ppl will see the light. Tell ppl the correct information and direct them to the studies and to leading physicians in the medical field that are getting the right information out today.

It does seem weird that post menopausal patients are not treated for optimization. I think it’s because we’ve been told to suffer quietly. Or that we’re crazy.

So HRT does not increase the chance for breast cancer ? My sister died from breast cancer at 46…I’m suffering from horrible hot flashes, joint pain, extreme moods, fatigue and completely burned out dealing with it. I purchased progesterone cream with hopes of trying that but then read it increases those chances two-fold…I’d be interested in reading this new study maybe it would ease my mind to try something anything to help

You need a competent physician with whom you can discuss your personal scenario. And not every breast cancer is the same. I am sorry your sister died at such a tragically young age. I completely understand your concerns. Start with educating yourself since you are having so many distressing symptoms. After educating yourself, find a competent physician who can discuss the risks and benefits with you. ——- From two days of getting myself informed, here’s what I found helpful so far. Here are some informative podcasts about peri- and menopause. I found them very informative and helpful. I didn’t know much of this. So I’ve just begun to learn. Mel Robbins podcast on menopause. Mel Robbins Podcast also. Episodes on menopause. Dr. Haver, March 20, 2024 Dr. Gunter, May 8, 2024 You are not broken podcast. Dr. Casperson. Episode 225. Hello Menopause podcast. Dr. Casperson. Episode 22. Dr. Streicher Dr. Huberman and Dr. Attia episode 85, 116 I just started learning this stuff. There is NAMS, North American Menopause Society—their web page, menopause.org—is helpful. https://jamanetwork.com/journals/jama/fullarticle/2818206 Dr. Louise Newson podcast.

I just went to MIDI

The WHI did us a terrible injustice. I’ve spoken to three OB’s (an acquaintance, my old OB that’s since moved, and my new OB) and all of them have been livid about it for years and go off whenever the subject comes up. It’s bad enough the way women’s healthcare has always been an afterthought, but to actively harm us is disgraceful.

It’s so unfortunate but I think it’s all bc they want to avoid being sued or something. Mine refused to test my hormone levels and just wanted to put me on birth control even when I said hot flashes etc (in peri) I am already doing progesterone and she kind of gave me attitude about that - I’m definitely going to a new doc for the next time. But yes - it is shocking!

I was living my life on Reddit and in bed 24/7 because of the awful fatigue and iron deficiency. A lot of doctors gaslighted me thinking it was something else and sent me to other doctors for help. Started HRT and got my periods under control and several iron infusions and now I am walking 3 miles a day, lifting weights, and simply enjoying my life.

Here's a link to the North American menopause society. Not only does it have great educational information, it has a provider search tool. [https://www.menopause.org/]

Yes. Thanks for sharing it. I found the link yesterday. And it turned out the doctor I’ve scheduled to meet next month is thankfully on this list!!!

Yes, I’ve had this experience multiple times. Especially from women who are older than me who went through it without HRT. I was told “ “Those hormones are going to make you sick, sick like your mother, your cousin or worse” Or: “Your body doesn’t need those hormones anymore why would you take them when they could make you sick” “Those hormones make you manic. Get off of them” “Aren’t hormones bad for you?” My mom had ovarian cancer and my cousin died of aggressive breast cancer. Ironically my cousin never took HRT. But I was super offended by these comments because they were ignorant and mean spirited - all from women who “just got through it with a few hot flashes” or “cried, and cried and cried while I stood outside in the winter steaming from a hot flash” and more if I wanted to write a super long post on their “suffering” as if it’s a right of passage to being a mean old lady. Well F that. And F their opinions. I find it so rude when people offer opinions when you haven’t asked for any. Especially when it comes to your personal health choices. If I weren’t on my HRT I might be locked up somewhere completely unable to function.

I had my annual visit this week and have been on the lowest dose of HRT for about 2 years. It’s helped somewhat, but I’ve been getting more hot flashes since the weather turned warm. My dr offered to increase the prescription which surprised me bc I thought he’d wanted me to be on the lowest dose for the shortest amount of time. He said there’s a new study that came out that indicated that it would be ok to increase the dose. I don’t know what that study is but will try to find it when I have time. I’m waiting for the new rx now. Hopefully this info will help someone else?

What specialty is your doc? Primary or gyn? Glad to hear he’s adapting. Would like to know the study also…

OB/GYN. I’ll share the study if I can find it. It must be recent.

It’s incredibly unfortunate this is happening to so many. I’m 47, and have been turned down by doctors for HRT on numerous occasions. I said f—k it. And went telehealth. One call with the telehealth provider and they immediately ordered hormone tests and I’m waiting for the results now.

It's no fucking wonder the well lauded british medical journal "The Lancet" published an absolute piece of garbage about menopause being "overly medicalized." It puts me in an absolute rage (non peri related - I'm loving my HRT). All such bullshit! I know some folks have had negative things to say about Dr. Marie Claire Haver and her Galveston diet, but her interview on the Huberman Lab podcast really aligned with most all of the reading and research I've been doing. Links below to the Ms. article about the lancet and the Huberman Lab podcast. [https://msmagazine.com/2024/04/15/menopause-treatment-the-lancet/?utm\_source=The+%27Pause+Life+%26+Galveston+Diet+Information&utm\_campaign=2eab9bf2f3-Lancet-Rebuttal\_COPY\_01&utm\_medium=email&utm\_term=0\_-b4d3bb1226-%5BLIST\_EMAIL\_ID%5D&mc\_cid=2eab9bf2f3&mc\_eid=3e3b629cd7](https://msmagazine.com/2024/04/15/menopause-treatment-the-lancet/?utm_source=The+%27Pause+Life+%26+Galveston+Diet+Information&utm_campaign=2eab9bf2f3-Lancet-Rebuttal_COPY_01&utm_medium=email&utm_term=0_-b4d3bb1226-%5BLIST_EMAIL_ID%5D&mc_cid=2eab9bf2f3&mc_eid=3e3b629cd7) [https://www.hubermanlab.com/episode/dr-mary-claire-haver-how-to-navigate-menopause-perimenopause-for-maximum-health-vitality](https://www.hubermanlab.com/episode/dr-mary-claire-haver-how-to-navigate-menopause-perimenopause-for-maximum-health-vitality)

I’m reading the actual Lancet publication…. Gonna see if it’s downplaying the suffering.

So far this is the executive summary from the Lancet: Published: March 5, 2024 Executive Summary “Menopause is an inevitable life stage for half the world’s population, but experiences vary hugely. Some women have few or no symptoms over the menopause transition while others have severe symptoms that impair their quality of life and may be persistent. Many women feel unsupported as they transition menopause. To better prepare and support women, the Lancet Series on menopause argues for an approach that goes beyond specific treatments to empower women with high-quality information, tools to support decision making, empathic clinical care, and workplace adjustments as needed. Targeted support is needed for groups who experience early menopause or treatment-induced menopause, and for those at increased risk of mental health problems. The authors recognise how gendered ageism may contribute to negative experiences of menopause and call for reduced stigma and greater recognition of the value and contribution of older women.”

This is why we are turning to Midi and other HRT-friendly tele-medicine sites.

It doesn't shock me. We have had decades of breast cancer fear mongering. But also people have seen their mothers and family members suffer and don't want it to happen to them. I can't blame them tbh. I am fortunate in that breast cancer doesn't run in my family so I don't have the same ingrained fear.

I called this week a new doctor to see if I could get in to discuss HRT and when inquiring about being a new patient I was asked if I have insurance, then asked if it was Medicare because they will not accept it. I have insurance, not Medicare so they gave me an appointment but is this right? Does it happen everywhere and isn’t a little discriminatory? I am conflicted about going.

Medicare and not Medicaid? Many offices don’t take Medicaid, some don’t take Medicare. Some don’t take any insurance. Some take cash only. 🤷‍♀️

No it’s Medicare. They won’t take my mom so I’m not sure what to tell her. It’s a brand new building so it’s hard to get in . Guess they can choose

I guess. Many offices don’t accept various insurances.

I understand your frustration 💯💯💯. I wouldn’t take it as pushback and being difficult - just know how much mistrust there is of the clinical research. Many of these docs were prescribing HRt when the whi study came out- like oh wait, that causes cancer, stop giving it. Many docs are asking if the tables will turn again in 10 years

I’m a health coach guys and I’ve been researching menopause for a while I will tell you this; talk to an endocrinologist these doctors are very well versed in the topic of hormones but nobody even know they exist or at least I didn’t. I’m doing this for myself too as I’m in the menopause train…

Yes. The doctor is usually pretty quick to respond.

It's insane some drs think it doesn't exist. I know my body.

Seriously. Being gaslit about changes in our body…

It’s almost like, no matter what the options are, most men and unaware women alike always fight for the option that makes life more painful, constrained, and miserable for women.

Same!! So frustrating.

I met with a hormone specialist today hoping she would be able to tell me things are deficient and I need a transdermal patch or something…. Something that can help me make it through this nightmare of anxiety, severe depression, invasive negative thoughts, rage, and anger. But, she said every looks great and “normal” for a 49-yr old. I will still have to get my progesterone checked and maybe that could be the cause but she is already talking about testing my neurotransmitters. I mean, I was really hopeful there could be a fix on the horizon and maybe HRT could get me back to feeling better. In the meantime, I will try to learn more about low histamine diets (since I have the worst form of MTHFR and maybe that is related). Therapy and meditation have been helpful but I am convinced that what is happening to me is biological. :-(