Menopause and Me: One Year on HRT
When my sister and I were teens, my dad essentially had a different heart procedure every other year, and my mom was going through menopause. Mommy saw a psychologist, took long solo car rides, and she took over a room in our house and put a lock on it so no one else could go in. In my teens, my mom and I fought often.
I remember storming down the unsatisfying short staircase of our split-level, telling her to go to hell, and she standing at the top of the steps saying she'd see me there. I thought she was so selfish and unsupportive; I had no idea.
Once, when I was 16, I went into her closet while she was at work and tried on this silky slip thing I found in the back and had never seen before. I thought it would look cool in a vintage way with a leather jacket and jeans. It didn't give the desired effect, and instead of being smart and putting it back where I found it, I left it strewn on my bed and headed to school.
When my mom came home, she found it. When I came home, I found in place of the discarded négligée my beloved navy satin sleepshirt, cut into dozens of pieces. I thought she was the worst parent ever; how could she damage my possessions like that? Such disrespect, amirite?
My mom continued seeing her therapist, and she also got on hormone replacement therapy (HRT). As a very empathetic and selfless teen (yeah, right), I didn't see the correlation or really care. But things improved. My mom didn't spend as much time locked in the den, for instance. And we didn't fight like cats and dogs—well, not nearly as much or with so much ferocity.
My mom stayed on HRT until 2018 when she was diagnosed with breast cancer. Over the years, doctors encouraged her to wean off of HRT, but she refused. She remembered what it was like before, and she didn't want to go back. But after her surgery, her oncologist forbade her, and every other doctor backed her up.
My mom had a partial mastectomy to remove the cancer; no need for additional treatment. She recovered well… until she went off HRT. Now that she is no longer here to read this, I can write this… it was if she aged a decade in a month.
Over the following year, she began getting those bruises older individuals get so easily and so intensely from minor bumps or scratches. She hunched over. She would seriously injure herself from activities she used to enjoy. She needed naps and had less of an appetite. And it affected her emotionally.
When she passed, we found a file folder on her laptop of essays she wrote for a memoirs class she took. We found a quick recap of a 2006 trip to Africa, an essay written in 2015, as well as assignments from 2020-2024. The writing of the 2015 person sounds as though it's written from a different person who wrote the pieces in 2020. Sentence structure, tone, style… it got simpler and it got more… glass half empty.
I took my mom to her doctors' appointments. At the end of each appointment, they'd ask if she had any questions or anything else she wanted to discuss. And each time, she'd ask if she could get back on hormones. The doctors chuckled and, as though she was some silly, senile old woman, would gently tell her no, she had breast cancer, she was too old for hormones, and they wouldn't even work at this point.
Driving home, she'd tell me she didn't care. She'd risk getting breast cancer again to have the vitality from her HRT days. I thought she was being melodramatic, and I exhausted a lot of hot air on those drives, trying to talk her off a ledge. But now I am almost 50 and have been on HRT for a year, and I totally, completely get it.
Menopause and Me
I don't know when I began experiencing perimenopause. To this day, I don't know if the issues were due to Lockdown, COVID, financial concerns, the crash after a pretty personally fantastic 2019, being stuck in a not-large home with two not-small humans, ripples in my relationship, or “The Change.” But I started unraveling.
The first thing was sleep. My mind was racing; I couldn't go to sleep because I was constantly thinking of what I needed to do, what I forgot, what I couldn't forget, the lyrics to that song, the relationship between two characters in a book or TV show, what we need from the grocery store and the ever-present ideas for a future blog post or essay. I found some relief from Equilibria CBD and Peloton-guided sleep meditations, but I still often found myself staring at the ceiling for hours.
Then, I began to have night sweats. I could have the perfect day, not eat late and not look at screens late and work out and no alcohol and no caffeine and plenty of water and greens and I'd still wake at 3 am in a pool of sweat. My husband bought me an Embr Wave as a Christmas gift, he was so concerned with my hot flashes and night sweats.
My husband was driving me batty. His breathing would send me into a murderous rage. We would be in the middle of an argument, and it was like I was watching it from above, seeing how I was in the wrong, but I kept fighting my position, and I couldn't stop it. Libido was gone, and I felt like a stranger in my body, shocked by my reflection, never sure how it was going to react or act or change or disappoint.
I pedaled out a lot of my aggression on the Peloton bike we coincidentally ordered the week before Lockdown. I used to weight train at a gym every weekday morning, and now I was getting up before the sun and sweating out 30, 45, 60 minutes or more with Christine, Denis, Tunde, and Cody.
Then I tore my meniscus, and I was off the bike for weeks. Once it healed, I hurt my back. Once that healed, I injured my Achilles and could hardly walk.
When I could workout, I'd need two days off, it took so long to recover. I'd wake and barely be able to walk, my back was stiff, my feet hurt, my ankles struggling to move. I was slathering myself in CBD lotion and using my TENS unit almost every evening.
I'm not married to a “Huberman Husband,” but if there was a similar cutesy name for Rich Roll, he'd fit the description. My husband was plant based, athletic, hadn't had a drop of alcohol in years, was curious and open-minded, a certified yoga instructor who goes to bed watching documentaries about archaeology and history.
He would send me podcasts where Dr. Stacy Sims and Dr. Lisa Mosconi would discuss perimenopause and ways to manage it. They taught me a lot and sent me down a perimenopause rabbit hole on Google, Tiktok, and YouTube.
I did cold showers, fancy breathing, teas, tinctures, pills, powders, shakes, supplements, weighted blankets, brown noise, binaural beats, CBD, THC, DELTA-8, going plant-based, grounding, cutting out alcohol, cutting out caffeine, magnesium spray and castor oil in my belly button and I could go on but SEO does best with shorter paragraphs. Tl;dr nothing really gave me enough relief, and it was affecting my job performance and my family.
I began researching HRT. I learned how that one inaccurate study caused the fear of HRT causing cancer. I learned how hormones have advanced since my mom started them in the early 90s. Pills and patches and pellets and creams… I decided to try. I was willing to try anything to save my sanity and my marriage.
I went to my gynecologist to discuss a prescription for HRT but ended up with a prescription for Wellbutrin XL, a suggestion for couples counseling, and a book on assertive speaking. I kept researching, found a local provider who is part of the North American Menopause Society (NAMS), and got on HRT. It has been a year.
HRT helped greatly. I no longer felt I was in a battle with my body. I was getting more sleep, and per my WHOOP, that sleep was higher quality. My periods got more regular, and I no longer had cycles where it felt my uterus was cleaning out her attic. I didn't feel so dry, my joints stopped hurting so much, and I needed less time between workouts to recover.
HRT alone didn't save my marriage; each of us seeing our own therapist also helped greatly and continues to be a benefit. My therapist questioned if Wellbutrin was helping and if I would maybe benefit from medication for my ADD.
I was referred to the practice's psych evaluator, who increased my Wellbutrin and added Lexapro, which didn't turn me into a focused phenom but helped me see the world isn't all gray, and I could accomplish things to completion. And this combo got us talking, respecting how we are both and together going through change, and we reconnected.
One Year on HRT
I am not who I was in 2019. But I feel my current cocktail of chemicals and counseling has made life pretty damn good. This body may not my bestie, but she is again a friend. And so is my husband. We've been together on this planet longer than we've been apart, and this experience feels like we completed a flight of stairs and have been awarded with a better view.
My estrogen is in the patch form. I started with the bigger patch that was changed weekly, but the adhesive sucked. I switched to gel, applied each morning, but that was a pain in the ass and a lot of waste (individual daily foil packets). I am now on the smaller patches switched out every few days, but I suck at staying on the schedule and end up keeping one in my bag in case I realize middle of the day that I was supposed to change it out yesterday.
My progesterone is little white footballs that are so smooth and small I don't need water to wash them down. I take one each night after brushing my teeth.
My testosterone is cream in a plastic tube. Three clicks applied to my left calf or thigh one morning, the right the next. My other morning meds are a tiny white disc of Wellbutrin XL and a larger white pill of Lexapro that needs a handful of water to be washed down.
I still take a lot of supplements, and I'll get into that in a future piece. I don't know if they make enough of an impact on perimenopausal symptoms to include here (except sea buckthorn, which is the best for itchy ears). My mind has quieted enough to see how my actions and choices affect my comfort and to see my mom in a whole new light of respect, empathy, and understanding.
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This is an amazing story of your journey back to being “normal”…is there such a thing? Since I’m from a much earlier era, we didn’t have too much help as far as HRT and other medications. It was more of “just deal with it”…so, if we were irritable, or felt like taking someone’s head off…just hold your breath, hold it all in, and go about your business!
Thank you for sharing your journey with us. I would never had guessed any of this was going in your life…not by reading your blog, seeing your fashions, or just your expressions.. so happy you found the help you needed. You are blessed to have a husband that stood by you through all of this. Keep looking up!
I love this content! Your writing on this subject is so smart and insightful! I appreciate you sharing your experiences and your mom’s too. After your first post recommending finding a doctor through NAMS, I immediately did, and what a difference! My NAMS doctor is so knowledgeable about menopause in a way I didn’t know to expect. Several friends have begun seeing her too. This post was perfect timing. For the last month, the very sound of my husband’s voice had become unbearable. He would say perfectly pleasant things like, “Do you want to go out to dinner?” and I would think, “I just want you to stop talking!!!” I read this post and thought, it’s the hormones NOT the husband! After a month of murderous thoughts, I inexplicably got my period (I’m 55 years old) and the rage subsided. I’m so grateful for your work, your amazing timing, and this lovely community of women who sensitively respond and share their experiences.
Thank you for sharing this!!
If “Better Living Through Pharmaceuticals” was a blog post! Good for you for availing yourself of the science out there and curtailing your suffering. Thank you for sharing your decision, which hopefully will encourage more women to seek care for whatever they struggle with and in whatever form that works.
I was diagnosed with Hormone Positive Breast Cancer almost 2 years ago (1 year after my mom, many years after my maternal grandmother – we all had different types with no known correlation based on genetic testing) right as I think I began Perimenopause. Several years prior I had a Radical hysterectomy (leaving one ovary that was healthy, the other was not), so it’s hard to tell. After my partial mastectomy & radiation I had to begin Tamoxifen (for 5-10 years) so I have a hard time knowing which symptoms are from cancer treatment and which are from menopause symptoms. The oncology team refuses to permit any hormone therapy. I’ve been using cooling blankets to help with hot flashes. I also have RA and had to stop biologics while on Tamoxifen so the joint pain is intense. Copper gloves/braces help some and water aerobics. Thank you for sharing the link to the North American Menopause Society (NAMS). SUCH a helpful resource. So many doctors felt like I didn’t need gynecological care after my hysterectomy – but I still have female issues my PC can’t address, and I DO still have the one ovary – and with PCOS it’s not a great relationship.
Ally, what is the testosterone creme for? I started HRT (less than a month ago) and am using likely the same patch and pill (which has improved my sleep exponentially), but they did not prescribe the testosterone creme.
The testosterone cream has given me energy and strength and better recovery from workouts. It also helps with libido.
Thank you for writing so bravely about your experiences in order to help others.
I’ve been on the road you’ve traveled. It’s hell on earth! I saw so many doctors, tried so many remedies, both prescribed and over the counter and, nothing helped! I couldn’t think, barely work, was hot all the time and cried for no reason. I was truly suicidal towards the end. That was, until I met Dr. Rhoda Cobin, my endocrinologist, now retired. She did tests and found the perfect solution for me! Like you, it turned out to be the patch. It’s over 20+ years later and I’m still on them. I’m determined to stay on them. Thank you for your story. I’m crying, but not because I’m sad, but because I know that you feel alive again, just like I do. ❤️
It’s funny I had some similar experiences. I had been having perimenopause symptoms probably for a while but none were affecting me on a near daily basis until spring of 2020 when the Covid lockdown occurred. Initially I wondered if my symptoms were stress related and then finally, I clued into the real cause when hot flashes started happening with regularity. (So many other symptoms can initially be foisted off to other causes, but taken altogether.) Unfortunately my gynecologist left the practice and my next appointment was with the PA who I had never met before – and way too young to relate.
Another year went by and still things hadn’t improved even though I tried many things (various supplements, CBD, new sheets, etc.). I had shifted to being post-menopausal since I hadn’t had a period in over a year but things hadn’t improved and I felt I had no one to turn to. Online, I found Dr. Jen Gunter on IG (https://vajenda.substack.com/). I read her book and so much of my experiences of the past 4 years made sense. I also realized it wasn’t too late to get help in the form of HRT. I was fortunate that at the time there was a local women’s medical clinic that was focused solely on menopause and osteoporosis needs. I immediately got an appointment. The doctor was super, asked lots of questions, knew her stuff and didn’t make me feel crazy – it was such a relief. I was on HRT. She was great – I told her about taking a sleep aid almost nightly to help me stay asleep and she said I should be able to stop taking it after being on the progesterone for 48 hours and she was spot on! After about 2 weeks on both meds – I started to finally feel some relief.
Another notable thing is that I had been battling a frozen shoulder injury too. And even though I was working out regularly plus PT, I didn’t start to really get better until I had been on HRT for about 3-4 months. Now I hear that low estrogen can affect joints, etc. and I totally get it.
Also, my skin became drier, especially my face. I was always oily/combination when I was younger, and now it’s more normal-to-dry, even with HRT. My changing my skin type, plus with not wearing make up during the lock down – I now no longer have any idea what I am doing in that area.
Funny thing, I asked my mom (now 80) what her experience was during this time and she hardly remembers it. She was no help whatsoever 🙂 In the meantime I am trying to prepare my younger sister and younger friends so they are more prepared and can take action sooner than I did.
Thanks for spreading the word!
So much respect for this post. As always, I love your honesty, and I am so happy that you finally found a combo that is making you feel better. I had a complete hysterectomy at 35 because of advanced endometriosis, so I have been on estrogen patches for 35 years. Early on I found a NAMS healthcare provider that has been a true godsend. Of course I read (and sometimes panic) at the studies showing HRT to be a problem, but she is always up to date on it, we discuss it every year at my annual exam, and she is adamant that the advantages outweigh any risk given my medical history. I’m happy to see that old study being parsed for the actual details of the participants and new research being conducted.
Thank you for the thoughtful and honest essay. Your remembrances of your mom made me tearful. So happy to hear that you are doing well.
My doctor took me off HRT very abruptly because I was turning 60. No transition advice, no follow up. Symptoms said, ‘I’m baaack’ and farewell sleep, plus all the other goodies. I’m now in the process of being hormone tested so I can get back on HRT and also testosterone (yes, please to enjoying intimacy again)via naturopath to prescribing nurse. I’ve been following Dr. Mary Claire Haver, ob/gyn now focused on menopause, and the rest of the ‘Meno Posse’ on Instagram with great research based info for all of us. Grrrr to poorly trained, behind the times doctors!
Thank you for being so open. There is a part of me that wishes we could sue the authors of the 2002 Women’s Health Initiative study for pain and suffering. I had my last period in 2008 – yes, 16 years ago. I still have persistent vasomotor symptoms, though, finally being on a close-to- appropriate dose of HRT has helped tremendously. We have learned a lot since the very flawed 2002 study came out, yet many doctors are still reluctant to prescribe hormones. Even those who do prescribe subscribe to the mantra “lowest dose possible for the shortest amount of time”.
I was misdiagnosed with fibromyalgia shortly after my last period. I never believed the diagnosis was correct. Fout years after that last period I had figured out that all of my symptoms fit under the menopause umbrella. I fired my fibro specialist and found a new gynecologist who put me on hormone patches. The HRT helped somewhat. I now know the dose was not high enough. Two years after starting the patches, my doctor retired and my insurance company decided they’d no longer pay for the patches. The doctor suggested in 2014 that I wean off the patches since I was then 6 years past my last period. I foolishly assumed she knew best. I didn’t think the HRT was helping me much because I still had many hot flashes and insomnia. I know now that my dose of HRT should have been increased. Instead, I went off HRT and I was slammed with rebound hot flashes. My health was at its nadir. I suffered for 5 1/2 years before I read some new literature on menopause and concluded that I never should have gone off of HRT and that,in fact, I had been on an inadequate dose between 2012 and 2014.
I found a new doctor in 2019 (I was then 65). She believed the lowest dose possible mantra. She tried me on 3 different ultra-low-dose birth control pills. I failed each one in turn. They did nothing for my symptoms, but led to spotting. The doctor sighed and months after my initial visit looking for relief said she guessed I would need traditional HRT. Duh! To make a long story shorter, I was not able to be on a high enough dose of estradiol to alleviate most of my hot flashes and night sweats until October 2023, 4 years after my initial visit to this doctor and 15 years after my final period. That only happened because I switched to a new Ob-Gyn who has allowed me to take a dose of estradiol three times higher than what the other doctor first prescribed. (I did self-experiment with doubling my dose a full year after being put on .5 mg of estradiol. When I found that the number of hot flashes and night sweats went down, I asked doctor #1 to write a new script. I upped the dose again in October 2023, right before changing doctors to see if I could reduce the hot flashes that woke me on average 4 to 5 times a night. At 1.5 mg of estradiol I actually have some nights with no hot flashes or night sweats. Other nights I have a couple of wake ups because of vaso-motor symptoms. I’d love to try 2 mg of estradiol, but the new doctor believes that I can live with my current symptoms and just repeats, “you are getting older.” I will be 70 in October! I have not decided whether or not to doctor shop again.)
I highly recommend that every woman read “Estrogen Matters” by Avrum Bluming and Carol Tavris. A second edition will be coming out next month. (Many gynecologists are now recommending the book to their patients.) Dr. Bluming is an oncologist who specializes in breast cancer. Dr. Tavris is a psychologist. Their book is extremely well researched and documented. It will allay the fear that so many of us have regarding HRT. For me, their book was truly life changing. My quality of life had been in the toilet for years. Had it not been for their book and Mache Seibel’s book, “The Estrogen Window”, I might still be suffering. I fully intend to be on HRT for the rest of my life!
What a moving post. Thanks for your honesty and clarity about what going through perimenopause can be like–and the solutions that can help. Wish I’d read this a decade ago, when I had my gallbladder removed and suddenly and unexpectedly stopped having my period. For good. I felt absolutely horrible, as you described, but bought into the “don’t take HRT!” myth and suffered. Even now, I have the exhaustion, irregular sleep, and constant injuries you described. I definitely encourage people to explore their options! Voices like yours, speaking out about this topic that used to be verboten, will hopefully change many women’s lives. (And men’s! And families’!) Thanks again.
I 100% agree that HRT is life changing. I went through the horrible symptoms for about 6 months before I was able to get on HRT and my plan is to NEVER get off. Surely there has to be a black market for HRT if my doctor says we aren’t renewing. : ). This was a really good read – thank you for being so open and honest.
oh, the itchy ears!!!! and everything else. I love this post. I might re-read it every week to remind me that I am not alone. The thing that gets me most is how you understand your Mom better. I went through the same thing when my Mom died 5 years ago. How do we make sure our daughters get this BEFORE we’re gone? Thanks again
Cannot agree enough about the impact of a hormone patch. I have often said they will have to pry my patch from my cold dead fingers when I’m gone. They have made a huge difference in my life.
Ali, I am so sorry for what you have been through, and am very glad that you are in a better place.
I had a complete hysterectomy in my 40’s, and will never forget how awful I felt before I could start on HRT. HRT was a critical and beneficial part of my life for years.
Then I moved to a different part of the country, and the physician I found cut me off. It was traumatic.
Good for you for persisting and reaching a good solution.
Yes, estrogen patch, progesterone capsule. My god, I remember waking up, pooled in sweat, feeling as if steam was rising from my skin!
I also recommend finding a very good female internal physician. Mine is very smart, and empathetic.
I recently discontinued the Lexapro, since I feel that my depression was situational, and I had worked through a lot with a therapist. You have to be slow and careful if you decide to stop taking meds!
Yes, be proactive with taking care of your own health and well-being!
What a roller coaster ride for you- and your family! I’m glad you could learn from your mother’s experience while taking it further for yourself. I have been following you for years now. Take care ~
Thanks so much for this post, Ali, and for the new peri group. I have an appointment in a month with a new PCP. After spending two years in DK, I feel like there’s so much health stuff to catch up on. I never saw the same doctor twice, so there was never an opportunity to discuss medical history or needs. I’m exhausted all the time, Here’s hoping there’s a path forward from that!
I went through a similar journey. I tried almost everything because I was at the point of being suicidal. I hated my life, my husband, my job and everything else. I cried a lot. I slept all of times, mostly during the day at work. I was a complete mess like your were until I discovered the estrogen patch. Now, you’d have to pry them from my cold, dead body! I’ve been on them for many years. I’ve fought with my insurance companies many times when they refused to pay for them or offered a crappy substitute! Once again, I’m happily in love with my husband and my life. I can smile and laugh. And, I thank God for the hormone patch.
Thank you for your honesty and vulnerability, I so appreciate hearing your story and it’s sparked me to make a doctor’s appointment.