I Swore I Wouldn’t Do HRT
They told me that getting old sucks, but I didn’t believe them.
Everything I read/heard/absorbed told me that perimenopause is a natural part of growing older, and I didn’t question this for a long time. In retrospect, I should’ve known this shit wouldn’t go well for me — I’d already been through an oophorectomy (surgical removal of an ovary). That experience, if nothing else, should’ve clued me into my body’s extraordinary ability to screw with me, especially in the face of something that is supposed to be “natural.”
But really, what does it mean to age naturally? We all lose the ability to read fine print, and no one tells you to tough that crap out, right? This is why reading glasses are a thing. This is why they’ve been a thing for a long time. Why isn’t good health care for perimenopausal women standard protocol? Why the cultural silence and sidelong looks when the body rebels at age forty-whatever? How many of you tried to talk to family or friends about this and been stonewalled? It’s weird, right?
So here is my story: way back in the olden days of the early twenty-teens, a few years before my hysterectomy, I was young and, well, not precisely healthy, but optimistic. I’d been having some trouble with pelvic pain. You probably know what I’m talking about: cramps. BAD cramps. The kind of cramps that felt as if an ancient, mythological, evil goddess was shoving greedy fingers into my uterus and ripping out gobs of my soul.
You know that pain. We all know That Pain.
I stuck it out for a while. Years. My forties were, hmm… interesting, as in “may you live an interesting life” applied to my health. And then one day I found myself sobbing in my ob/gyn’s office which is never a position I enjoy. It feels a little too desperate and awkward for my sense of self-worth. I’m a feminist. I’m strong. I’m a badass.
Yet, there I was, literally hysterical because I dimly remembered what life was like before Ms. Red Pain of the Apocalypse visited, and I wanted that life back. And also, hadn’t I been through this before with my right ovary? I kicked her right out the door. So, what the heck was going on in there now?
My doctor is a kind woman, and I appreciate that she actually listened to me once I found the courage to go to her, because what followed was tests and more tests. Tests to check my uterus. Diagnostic experiments with drugs. Medical adventures to try my patience. I’d already experienced that exploding ovary several years prior (when ovarian cysts grow to gargantuan sizes and then randomly burst, it feels like an acid filled balloon going boom), and I was DONE. Since Left Ovary was working just fine, I didn’t miss Right Ovary at all. Left Ovary and I had a tidy arrangement: she would provide me with all the estrogen I needed, and I would leave her the hell alone in there, happy and content.
Life rarely goes the direction I expect.
I had several ultrasounds with a quietly sympathetic tech. Eventually, I had a biopsy done (which, OW, and that sentiment coming from a person who has experienced broken bones and not cried might give you an idea of how much a uterine biopsy hurts). I had a D&C (dilation and curettage, otherwise known as Scrape All the Bad Stuff Out of There).
None of this helped. The Red Pain of the Apocalypse continued her visits unabated, and entirely unwelcome, because I was done with all that childrearing stuff and all of its messy uselessness. Thus, my hysterectomy occurred on November 1, 2016.
I was so damned happy about it that when I woke up from surgery I cried tears of joy (or maybe it was just a weird reaction from the anesthesia, but whatever, I’m not going to stress over semantics). Recovery sucked, I’m not going to lie. I was in pain. Cranky. Exhausted for way longer than I expected. I walked around clutching an ice pack to my abdomen. I suppressed every sneeze that tried to sneak up on me. I had many pillows: pillows for my bed to arrange my body just so, pillows for the car so I wouldn’t tear Things That Should Not Be Torn, and a handy little stool for waiting in line at the election eight days after my surgery. I was going to be okay. I was determined. My doctor told me that I had fibroids and the hysterectomy was entirely successful in ridding me of these things.
Fibroids. No cancer. No endometriosis. Not even adenomyosis, as had been suspected. Just a bunch of loud-mouthed fibroids having too much of a party in my inside lady-parts. Stupid things.
All in all, good news, right? Honestly, I didn’t care what the hell had been plaguing me. My uterus was gone! I had one ovary left, and she and I had an agreement. We were pals. Friends. She was cool and I was cool and we were cool together and we would be cool for the next forty-odd years and then I would die peacefully in my sleep. Amen.
Full recovery from the surgery took about six months. I started hiking again. And then I started running. I left my house and the sun was outside just where I’d left it, and everything was amazing for about six months. And then…
So, the thing no one tells you about hot flashes is that some women get a few a day, and that’s normal. Some women get maybe one or two at night, and that’s also normal. They’re awful and annoying and they wake you up and you’re drenched through, but fine. Everyone goes through it, right? That’s what I told myself, anyway, especially when things began to get dicey. You see, apparently, Left Ovary harbored a great resentment towards me for evicting her friends Ms. Uterus and the Red Pain of the Apocalypse. Apparently Left Ovary was lonely. Depressed, even.
And she just plumb went crazy in there.
Hot flashes every hour. Then every half hour. Sometimes every fifteen minutes. I’m not talking just during the nighttime. These damned things happened 24/7, like mad bombs going off in my body. These were drenching, ten to twenty minute long hot flashes that often morphed into each other because no sooner did one end than the next began. During the day, I didn’t care. I worked from home and I could do endless amounts of laundry if I wanted to (I didn’t want to, but when you sweat through your clothes, that’s the reality).
I hung in there through the dehydration and weirdness and embarrassment when my face went bright red in public. I bought a different mattress (cooling gel, ha ha, what a joke). I bought new pajamas with magical wicking properties (also, ha ha), and then new sheets with super-de-dooper breathable fabric (HA HA). I went to bed with an ice pack on my chest for months, and more on the floor by my bed, in a little cooler, for when the one on my chest absorbed my nuclear radioactive energy and went limp, like some kind of nightmarish, damp potato stuck to my skin. I set the air conditioner on frigid. Like an idiot, I was totally against the HRT thing, because, well, I didn’t want the cancer worry, and the stroke anxiety, and the failure of not being able to face this life change naturally. I was a badass. Remember? Everyone goes through this, I told myself. It’s a normal part of life.
Not sleeping for five weeks is not a natural part of life.
It’s a recipe for depression and worse things. Let’s be real about this, okay? If anyone tells you it’s normal, tell them to take a hike, preferably off of a cliff. Women should not have to suffer this ridiculousness while pretending that life is peachy, just because it’s always been this hideous for all the other women who have gone before us. At one point our species didn’t have clothing or fire or freaking aspirin, and we fixed those problems. Perimenopausal individuals should not walk around thinking any of this is okay.
Cue sobbing in my doctor’s office again because screw “natural menopause.” I needed potions and pills. I needed a new religion. I got gels, creams, and three different doses of estrogen patches to tackle an ever challenging jungle of hormone fluctuations.
I’d like to say that this story has a happy ending, but like most things in life, it’s normal to not have closure. It’s been three years. Things are not perfectly stable, but I’m also no longer personifying my left ovary, so I’m counting that as a win of sorts. I sleep enough. Sometimes. And sometimes I don’t because the hot flashes break through my hormone replacement and I’ll go a week or more without sleep, which is just … ugh. There aren’t any really great treatments for this, because modern medicine hasn’t taken this situation seriously. Menopausal symptoms and their management is considered a new field. There simply aren’t a lot of options. Black cohosh supplements only get you so far (approximately four to six months, in my personal experience).
Going through natural perimenopause is just like everything else in life: it’s easy for some people, and not so easy for others. So, be nice to yourself. If that means you need chemical help to keep you from scooping out your brains with a spoon because you’re desperate for sleep, then that’s okay, because it’s okay to ask for help.
It’s okay to be human.
Maybe it’s time for us to cut women a break and listen to their struggles when they speak up. We should let women speak about their pain, instead of expecting them to just tough it out, or worse, not believing the scope of it. It’s not all in our heads. Women deserve support, not disbelief. Debilitating hot flashes exist, the same way erectile dysfunction exists. Perimenopause isn’t always simple or easy. Women deserve treatment, not derision. And anyone who thinks I’m wrong or weak or somehow failing as a woman can pry my estrogen from my hot-flashed, sweaty, determined hands.
Good luck with that.
Disclaimer: I’m not a doctor. Please go to your doctor and get help if you need it. We owe it to ourselves to do this, and yes, I know how hard it is. Do it anyway.