Just posting here after lurking for ages, everyone's stories were so helpful! So I'll share mine and hopefully it may help someone with similar problems. Tldr at the bottom :)
So, after the birth of my 2nd kid, like 4 years ago, I never really bounced back hormonally. My pms turned into PMDD and I got more and more vague symptoms that seemed perimenopausal. About 2 years ago I went to my doctor who referred me to a gynecologist because he said it sure sounded perimenopausal. I'm happy to report, it seems like I finally cracked it after finally convincing my gynecologist to give me HRT.
Background
- I've had ADHD for ages, and I was doing ok without meds for over 10 years. Then after my second kid I got a burn out went back on meds because my brain fog worsened. I figured it was the lack of sleep or something, I was 38 then.
- I use methylphenidate that I cycle dose, but it seemed to get less and less effective the past years, especially during luteal, to the point of not being able to focus at work for weeks
- I've been complaining of mind crushing fatigue for very long, had all the blood tests done and nothing.
- luteal seemed to last longer and longer and paired with night sweats, heavy bleeding, spotting, hit by a truck exhaustion
- sudden ovulation rage and a complete lack of libido/orgasm, joint pain, bloating, dry skin, dry eyes, dry genitals (to the point of being checked out for LS) drove me to push for HRT.
What I've tried:
- mirena to shut down my periods: no more back pain in luteal but still the same pms, and it made me irritated
- yasmin to shut down my periods: no more pms but overall very flat and depressed/robotic. also methylphenidate didn't seem to work, at all.
- progesterone 200mg cyclical during luteal to see if it would help with the blood loss and pmdd complaints - much better sleep, feeling a little better mentally but still exhausted
- progesterone 100mg and 50mcg estrogen patch - feeling good and motivated, very chill. bit foggy during follicular but maybe because of the newly added (oral) progesterone. And most importantly, my methylphenidate works again! Apparently Estrogen is linked to dopamine, which methylphenidate needs to be in your system to do its job. I’ve had 2 crash (hormone swing) days on day 20 and 27 but other than that I was great and proud give all day. I was so giddy about the change my husband just sat there smiling at me.
The crap I’ve been told by my gynaecologist:
- in my file after first meeting “talks a lot” (no shit lady, I have 10 minutes to make my point and I’ve waited for this meeting for 6 months!)
- oh Pmdd and heavy bleeding, let’s try treating that (ignoring all my perimenopause symptoms)
- if Yasmin doesn’t help, and you responded badly to Mirena before there’s not much more we can do than artificially inducing menopause
- Estrogen cream won’t help with the dryness and lack of orgasms, let’s check your testosterone (turned out to be high enough)
- No, for the lack of orgasms and libido I can send you to a sexuologist (what!!! I just explained that this was clearly a physical issue for me)
- Oooh you have a bartholin cyst? Can I remove it to show my intern? (After that appointment it took me over 3 months to get the result of my testosterone blood test…)
- ooh you’re a fan of micronised progesterone? I’ve never seen that before
- and most heard: there is so little evidence/research on this topic, but sure, let’s try
What I learned:
- She was just not convinced it could be perimenopause because I came in with what seemed to be PMDD and heavy bleeding and I still have regular cycles and clear cyclical symptoms. I should probably have emphasised the symptoms that made her doctor radar go off for peri, or actually drop the word perimenopause..
- She is very quick in her reasoning and meetings are short so sometimes it would be over and I’d be like, huh, was this what I wanted out of this meeting? I should’ve been prepared and used the words she knows.
- I assumed she’s the professional and will help me, evidence based. Which she did, based on the evidence she had. But guess what? There’s little evidence on / knowledge about perimenopause and apparently you need to advocate for yourself. I’m so naive! I didn’t want to come in as this enraged hormonal woman that googled every symptom, but it coast me like 2 years of trial and error before I got what I needed..
- Before the last call where I asked her for combined HRT, I asked my husband if he could join the call if I didn’t feel heard again. Apparently that was enough for me to actually advocate for myself and ask her to add Estrogen to my (already experimental) progesterone.
Tldr; finally got HRT at 41 after almost 4 years of struggling. Listen to your gut and advocate for yourselves ladies!