When Menopause is a Medical Mystery
It shouldn't be a mystery...but so often no one can figure out where your symptoms are coming from.
I love a good medical mystery.
I’m a big fan of the New York Times column written by Dr. Lisa Sanders called Diagnosis. (Interestingly enough, I recently learned that before she went to medical school to become a doctor, she worked as a journalist…no wonder her columns are so entertaining!)
In case you’re unfamiliar with her wildly popular column – which is now also a Netflix series - Sanders recounts stories about baffling symptoms; stories about the confusing, frustrating, and endless journeys of patients desperate to get to the bottom of what is plaguing them. Many of their symptoms are so strange that you can’t begin to imagine what the problem could be – like the man with insomnia and no appetite who starts conversing with… dead people. (After endless tests and doctors, it was found to be Morvan syndrome, often associated with a tumor in the thymus gland.)
And then there was the story about the 49-year-old woman who, in addition to experiencing sudden jaw problems, suffered from being hot all the time and sweating “like crazy.” It’s obviously menopause, she thought. But the problem was, instead, a large but benign tumor on her pituitary gland.
Why am I telling you this? Well, medical mysteries often surround what is often in plain sight: Menopause. Sometimes it is missed entirely.
I hear these stories all the time. A younger friend who, suffering from heart palpitations, insomnia and anxiety, saw numerous doctors - including a cardiologist, psychiatrist, endocrinologist, and sleep specialist - to figure out what was causing her symptoms. Finally, exasperated, she visited her gynecologist and spilled her heart out. The doctor looked squarely at her and said: "Easy...did it ever occur to you that it might be menopause?"
Or another woman I know who made the doctor rounds: a dermatologist for her brittle nails, an ophthalmologist for her dry eyes, a neurologist for her dizzy spells, and an ear-nose-throat doctor for her tinnitus, before giving up on ever getting an answer. When her periods became unpredictable and erratic, she thought, “Hmmm…could it be…menopause?”
In each case, the women were in their early 40s, an age that normally conjures up images of birth control and fertility, and surely not menopause and a shutting down of our reproductive system. Not that. Not yet.
Menopause has always been associated with a few definitive “markers:”
😰 Hot flashes, night sweats, difficulty sleeping
A full year without periods
Age 51 (the average age of the end of fertility)
But what of women, sometimes as early as their mid-30s, who are experiencing symptoms that can be worrisome, confusing and mystifying at once?
Fortunately, information about menopause is more widely available than ever. I liken that phenomenon to breast cancer: It takes a celebrity to put it on the map.
Because, face it, celebrities get all the attention…more than a “regular” person could ever garner. I mean, are you going to pay attention to someone going on Facebook or TikTok demonstrating what it feels like to become soaked in sweat in the middle of the winter, or writing about their sudden insomnia and weight woes?
Well, if they’re Gwyneth or Oprah; Tracee Ellis Ross or Drew Barrymore, you will pay lots of attention.
And so it began…the normalization, or acceptance of menopause.
Yes, menopause is a good thing to know about, since:
1). We all go through it.
2). The probability is high that you, like a lot of us, got the “period talk” as an adolescent, but never got the “menopause talk” as an adult.
Although there’s finally a lot of information making its way to all of us to help us prepare for what is ahead (or already happening) for and to our bodies, what still lacks is information about when menopause truly begins.
📢 News flash: Menopause begins sometimes decades before you think. Changes begin way before you reach your final menstrual period. Known as perimenopause, this can last between four and eight years (sometimes longer for some women). As progesterone and testosterone levels begin to decline and estrogen levels become inconsistent, so many things are possible:
Your periods become erratic, as does your sleep.
Your vaginal tissue becomes dryer, and sex can be painful or uncomfortable.
You question your memory. (“Where did I leave my keys” becomes replaced with questions like, “What’s the name of that person I know?” and “Could it be Alzheimer’s?”)
Your sleep – (what sleep?) – becomes a hot flash game of “wake-up-and-throw-the-covers-off…and on…again” and “try-to-get-back-to-sleep-dammit!”)
Your waistline is unrecognizable, as is the number on the scale.
A bad mood is your default emotion, along with pesky anxiety and disabling panic attacks.
Over one billion women around the world will have experienced perimenopause by 2025, according to The Menopause Society. Despite this shocking statistic, it’s a surprise to so many women.
So, where do women stand? Once you know you’re in perimenopause, and on the road to menopause, it can become clear(er) sailing. Depending on the symptoms, there are treatments available.
How you truly know is often a conundrum. Try finding an informed physician who won’t poo-poo your symptoms - that may prove to be a challenge. That’s because most obstetrics and gynecology residency programs do not include a dedicated menopause curriculum, according to a study in the journal Menopause. Unfortunately, too many doctors can’t, won’t, or don’t know how to discuss menopause.
One suggestion? You might want to try an at-home hormone test kit. Is what you’re experiencing a hormone-related problem…or a true medical mystery?
Wellcore is one company that can help. They offer an At-Home Hormone Optimization kit that reviews 24 different biomarkers, via a painless blood draw, to identify a hormone imbalance. Additionally, they can connect you with a specialist who can access your treatment options, which will be customized for your specific needs. (These include creams, capsules, liquids, or vaginal inserts.) You’ll be followed with ongoing testing to make sure the program is staying current with your hormonal fluctuations and you’re getting the help that you need.
Interested in learning more? Read all about Wellcore here.
Interested in moving forward? Wellcore is offering thePause readers a 50% discount on their assessment kit. Want it? Click here.