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Menopause (Expert Forum)
I'm Desperate
Answered by
Machelle Seibel, MD - Women's Health, menopause, ReproductiveMedicine
University of Massachusetts Medical School
MA
Questions in the Menopause forum are answered by Dr. Machelle Seibel. Topics covered include menopause issues, depression, hormone replacement therapy, hot flashes, joint or muscle problems, memory problems, mood swings, osteoporosis, sexual problems, skin changes, sleeping problems, vaginal problems, and weight problems.
I'm Desperate
by kathat, Mar 16, 2008 10:54AM
I am 59 and have been in menopause for 3 years.I had an increase in anxiety,insomnia and sweats.However,I have an anxiety disorder(relieved by Zoloft) for years,so did not think connected to menopause.
My menstrual history is early onset(10),extreme PMS, and at 21 I quit having my periods for 4 or 5 years. Then I started again, and then I stopped again. When I was 31 the dr was going to give me fertility pills to conceive, but another doc started me on thyroid and I conceived within 3 months. I have had extreme nausea and vomiting in my pregnancies up to the day I delivered.
Currently my symptoms are on Dec 26th I woke up with extreme nausea, and swollen abdomen and pain and fatty stools all day. My doc tested for bacteria etc and found nothing.I began to have erratic sleep patterns, awake all night and sudden intense fatigue during the day, relieved by a short nap.
My anxiety is so intense I can't sleep more than 3 to 4 hours at a time and I can't function this way.
I went to GYN (new to me) about 2 weeks ago and she gave me Premerin for dry vagina and sweats. I did not mention the nausea to her, as I did not know it may be connected to menopause.I did not like the way I responded to the Estrogen. My breasts and genitals became very sensitive, my clitoris became so enlarged that it rubbed on my pants. The nausea became way worse to the point of smelling food and feeling nausea. I quit the estrgon and bought some progesterone at the Health food store.
It has made the nausea less intense and I even have a few hours a day when I am not nauseous at all.
I feel foolish for playing doctor on my own and I hesitate to return to GYN and tell her what I have done. I am scared I am doing the wrong thing, and want to get it right. Do you see any value in going to a clinic where they do bioidenticals hormones and measure your hormones. Can the Progesterone alone hurt me?
DO you see any value in finding a clinic that will measure hormones
My menstrual history is early onset(10),extreme PMS, and at 21 I quit having my periods for 4 or 5 years. Then I started again, and then I stopped again. When I was 31 the dr was going to give me fertility pills to conceive, but another doc started me on thyroid and I conceived within 3 months. I have had extreme nausea and vomiting in my pregnancies up to the day I delivered.
Currently my symptoms are on Dec 26th I woke up with extreme nausea, and swollen abdomen and pain and fatty stools all day. My doc tested for bacteria etc and found nothing.I began to have erratic sleep patterns, awake all night and sudden intense fatigue during the day, relieved by a short nap.
My anxiety is so intense I can't sleep more than 3 to 4 hours at a time and I can't function this way.
I went to GYN (new to me) about 2 weeks ago and she gave me Premerin for dry vagina and sweats. I did not mention the nausea to her, as I did not know it may be connected to menopause.I did not like the way I responded to the Estrogen. My breasts and genitals became very sensitive, my clitoris became so enlarged that it rubbed on my pants. The nausea became way worse to the point of smelling food and feeling nausea. I quit the estrgon and bought some progesterone at the Health food store.
It has made the nausea less intense and I even have a few hours a day when I am not nauseous at all.
I feel foolish for playing doctor on my own and I hesitate to return to GYN and tell her what I have done. I am scared I am doing the wrong thing, and want to get it right. Do you see any value in going to a clinic where they do bioidenticals hormones and measure your hormones. Can the Progesterone alone hurt me?
DO you see any value in finding a clinic that will measure hormones
Doctor's Answer
by Machelle Seibel, MD, May 02, 2008 08:53PM
, May 02, 2008 08:53PM
To: kathat
I regret the delay in responding. I've somehow just seen your email. It seems you've been having a very difficult time.
I don't see any reason to feel awkward going to your doctor and even changing things. It seems you feel better and that is what matters. However, it would be best to ask the doctor for help as soon as you noticed the symptoms made you feel poorly.
The fact that you got pregnant with thyroid might mean that you are low on thyroid now. Ask to have your thyroid level checked. You also have fatty stools; you might have gallbladder disease or celiac disease or other intestinal problem. Ask your doctor about that. The fact that your symptoms came early, at age 21 or so, and are back now and your feel anxious could be a neurological condition such as temporal lobe epilepsy and can be diagnosed with an eeg. Bioidenticals are in fact very similar to what you are taking, only they a the same formula as the original estrogens a woman's body makes. They do have the advantage of being able to be measured and that could be helpful to you. It is easy to measure and you will know the dose is in the right range for you. However, the belief is that if you have a similar dose with bioidenticals as with non bioidenticals (by that I mean the dose is equivalent) it is likely the risks for breast cancer and other problems are the same. There is much less data on them but virtually no data to make the medical community believe ther carry no risk. Progesterone is safe for most people to take, but you would have to ask your doctor as I don't have enough information on you to say for sure. If you want to try nonhormonal options for vaginal dryness, consider over the counter Replens. Use it daily for two weeks and then twice per week. It can be very helpful to increase moisture. Some women notice a slight white discharge with Replens but it is not an infection. It is the Replens shedding with the lining cells of the vagina which naturally shed but without the Replens, cannot be seen.
Machelle M. Seibel, MD
I don't see any reason to feel awkward going to your doctor and even changing things. It seems you feel better and that is what matters. However, it would be best to ask the doctor for help as soon as you noticed the symptoms made you feel poorly.
The fact that you got pregnant with thyroid might mean that you are low on thyroid now. Ask to have your thyroid level checked. You also have fatty stools; you might have gallbladder disease or celiac disease or other intestinal problem. Ask your doctor about that. The fact that your symptoms came early, at age 21 or so, and are back now and your feel anxious could be a neurological condition such as temporal lobe epilepsy and can be diagnosed with an eeg. Bioidenticals are in fact very similar to what you are taking, only they a the same formula as the original estrogens a woman's body makes. They do have the advantage of being able to be measured and that could be helpful to you. It is easy to measure and you will know the dose is in the right range for you. However, the belief is that if you have a similar dose with bioidenticals as with non bioidenticals (by that I mean the dose is equivalent) it is likely the risks for breast cancer and other problems are the same. There is much less data on them but virtually no data to make the medical community believe ther carry no risk. Progesterone is safe for most people to take, but you would have to ask your doctor as I don't have enough information on you to say for sure. If you want to try nonhormonal options for vaginal dryness, consider over the counter Replens. Use it daily for two weeks and then twice per week. It can be very helpful to increase moisture. Some women notice a slight white discharge with Replens but it is not an infection. It is the Replens shedding with the lining cells of the vagina which naturally shed but without the Replens, cannot be seen.
Machelle M. Seibel, MD
I had a complete hysterectomy in 1987 when I was in my 30’s. I had no libido. None. I managed my menopause symptoms with different estrogen pills. Then came the estrogen scare several years ago. I tried to get off of the estrogen and couldn’t. I work at home so was able to keep a chart of how often, how long and how bad the hot flashes were. The night sweats were the worse.
Then in 2003, I read a newsletter from my gyn about Bioidentical hormone pellets. These tiny pellets are made up of either estrogen or testosterone. They are implanted in my hip every 3-4 months. It's a simple office procedure. Bioidentical hormones are the closest thing to what a woman produces naturally. There is not the risk of breast cancer as in synthetic hormones. Your body only uses what it needs. I did some research and one of the symptoms of low testosterone is loss of libido. I also felt like my name was after every symptom. There was a ray of hope! I talked to my dr about the pellets. She does thousands of women. I found out that a friend also had the pellets and was loving them. So I decided to get them. I get 2 estrogen pellets which I think are 25mg each, and 1 testosterone pellet of 75mgs. I will get these pellets as long as I am able. Hopefully till I die.
I have to say they changed my life. First of all the menopause symptoms went away. But the absolute best was the increase in sex drive. Orgasm, lubrication, desire went through the roof. We were like kids on a honeymoon! My whole self-image has increased. Now after 4 years, we’ve “calmed” down somewhat but really my libido is still strong. I guess I’m trying to make up for all those lost years.
I don't see any reason to feel awkward going to your doctor and even changing things. It seems you feel better and that is what matters. However, it would be best to ask the doctor for help as soon as you noticed the symptoms made you feel poorly.
The fact that you got pregnant with thyroid might mean that you are low on thyroid now. Ask to have your thyroid level checked. You also have fatty stools; you might have gallbladder disease or celiac disease or other intestinal problem. Ask your doctor about that. The fact that your symptoms came early, at age 21 or so, and are back now and your feel anxious could be a neurological condition such as temporal lobe epilepsy and can be diagnosed with an eeg. Bioidenticals are in fact very similar to what you are taking, only they a the same formula as the original estrogens a woman's body makes. They do have the advantage of being able to be measured and that could be helpful to you. It is easy to measure and you will know the dose is in the right range for you. However, the belief is that if you have a similar dose with bioidenticals as with non bioidenticals (by that I mean the dose is equivalent) it is likely the risks for breast cancer and other problems are the same. There is much less data on them but virtually no data to make the medical community believe ther carry no risk. Progesterone is safe for most people to take, but you would have to ask your doctor as I don't have enough information on you to say for sure. If you want to try nonhormonal options for vaginal dryness, consider over the counter Replens. Use it daily for two weeks and then twice per week. It can be very helpful to increase moisture. Some women notice a slight white discharge with Replens but it is not an infection. It is the Replens shedding with the lining cells of the vagina which naturally shed but without the Replens, cannot be seen.
Machelle M. Seibel, MD