What doctors see

My own doctor is an awesome guy who is willing to think outside the box. He still has some modern-doc-reflexes, but on the whole he is impressively open-minded.

This is a rare thing.

In ages past, doctors had fewer tools to reach for, and proper diagnosis became a professional goal and the focus of their training. Observation and deduction was the motto of the famous fictional detective, Sherlock Holmes, because his creator, doctor/author Sir Arthur Conan Doyle, had been trained to diagnose disease with these same methods.

Only finding what we are looking for

Now, it's a matter of running tests in the hope of showing enough deviation from the norm for them to arrive at a diagnosis. Then they prescribe a drug which often does not address the problem so much as it masks the symptoms. But when the symptoms are suppressed, the patient stops complaining.

That's a medical term, you know: "The patient complained of ..." I don't know when the medical profession's goals shifted from curing to the patient stopped complaining, but it was not progress. Because now, when the patient keeps complaining, the overwhelming tendency of doctors is to decide the patient is not physically ill, they are mentally ill. And should be taking a psychiatric drug.

There's all the difference in the world between actually having a mental health problem, and only having your medical personnel decide for you that you have a mental health problem. People absolutely should get help with any medical issue they have.

Getting help for a medical issue we don't have is a prescription for disaster.

Yet, this is exactly the position of women who go to their doctors for help with issues that doctors don't know how to help with. But they don't say that. They look at lab results and pronounce them "normal" and tell the person there isn't anything wrong with them. The woman goes away feeling dismissed and frustrated, and the more she tries to get help, the more she gets seen as A Problem.

It's not entirely the fault of the doctor; he or she is simply doing what they have been trained to do... and so often, they don't do any more than that. This is what keeps them from seeing their middle-aged woman patient as a person with a real problem who is trying to get real solutions. Because the woman's hormone dysfunction problem is not one they are trained to see.

Adjusting their lenses

When a woman's problem falls into an area that wasn't covered in their training and doesn't show up on the usual lab tests, it's like the doctor's brain (that overly busy and highly trained and not-encouraged-to-be-creative organ that it is) shifts gears. They actually look at the patient in a different way, as in the study, below, where people were distracted while evaluating what a person was saying. If they could not follow what the person was talking about, they fell back on emotional cues:

But those who were kept mentally busy came to a very different conclusion about this woman’s personality. Regardless of what situation she was in, they concluded that she was indeed an “anxious person.” For these people, acting anxious equaled being anxious.
Mixed Signals: Why People Misunderstand Each Other

As a woman journeys from doctor to doctor, vainly trying to get someone to take their symptoms seriously, they inevitably come across as somewhat less than calm, cool, and reasonable. Often, the hormone dysfunction itself prevents someone from easily keeping their grip.

this is the same woman, seen through different lenses
comparison by rpavich

Quickly exhausted, fuzzy-headed under stress, and often at the end of their rope already, it becomes even more challenging to get across a complicated concept that doesn't even have a name except "menopause," and that is a label that is shrugged away as "not much of a problem."

Time itself is now how the cautious doctor prefers to handle their mid-life women patients, with the disaster of previous Hormone Replacement Therapy protocols echoing in their minds.

As I discovered when I tried to get cortisol, it's easier to get what that chemistry teacher was cooking in that camper in the desert. Doctors don't want to give women hormones that aren't birth control. And forget any hormonal help after the age of thirty five. At all. Ever.

Thyroid insufficiency is one of the least treated illnesses out there. And it's so easy to fix!

Ignoring the No-Hormone Disaster

In fact, it was this very medical mindset that catapulted me into menopause -- abruptly and disastrously. My endometriosis had been making my life difficult during my teens, but upon getting birth control pills, it miraculously stopped the pain and monthly difficulties. I was happy taking birth control for years, until I got into my late thirties. And the medical profession took them away.

"What about my endometriosis?" I kept asking. And they kept dismissing me, telling me that I would be in menopause soon. Sure enough, that is just what happened. I got a terribly painful cystic ovary that had to be removed with surgery and then I was dumped into menopause like falling off a cliff.

It was something like being tied to the railroad tracks, and hearing the whistle in the distance, and everyone around me all agree the train's coming but they don't think they need to untie me.

It's now a bit difficult for me to to be calm and reasonable with doctors when I think they are screwing up.

Because I've seen the train that hit me.

Menopause: the ignored epidemic

There's a good reason menopause both sucks and blows.

Women are set up for a rocky transition because modern life bombards us with unrelenting stress, added toxins, and a low-nutrient, processed food, diet. This keeps most of us in a hormonally fragile state from adolescence to perimenopause anyway.

This is the part that sucks.

Then, when menopause hits, we often have trouble because this was a delicate balance at its best, and now several major production plants have collapsed. So we go to the doctor, and get offered anti-depressants. Because they are so afraid of giving women hormones. Even if there might be thyroid and adrenal issues happening along with the known estrogen and progesterone deficits.

This is the part that blows.

No way to escape

Perhaps there is a more neglected patient on the face of the earth than the middle-aged woman. I'm not belittling the challenges faced by those without health insurance, adequate income, or even a shortage of health professionals where they live.

But if we polled the people in physician waiting rooms across the country, the one question I would ask is: "Are your health concerns taken seriously?"

we thought it would be a safe spot

In one 1992 study, the reactions of women to menopause broke down like so:

• 25% of women experience no noticeable changes except the cessation of menstruation
• 50% of women experience some menopausal symptoms, varying from mild to moderate
• 25% of women have more severe symptoms

It seems to me that this is an extraordinary piece of information.

Aren't we told, over and over again, that this is a "natural" thing for our bodies to do and so we are just carrying on about nothing? Why, then, do three-fourths of the women dealing with this "natural" transition have symptoms that are, at best, annoying, and at worst, leaving them unable to lead a normal life?

When I began grappling with insomnia, mood swings, and exhaustion, both my primary physician and my OB/GYN (male) took the patronizing "heh heh, this is what happens when we get older" route. They said it would probably pass shortly. I should get more sleep, try to reduce stress, and make sure I "ate right."

So I tried. I took to the web to form a more detailed plan, based on a consensus I gleaned from big, mainstream kind of sites. Sure enough, these sources expanded on what my doctors had told me. Saved! I had been plucked from my stormy ocean, put on a boat, and delivered to Conventional Wisdom Island.

Here's what the natives on the island were told to do:

• cut back on meat and fat and substitute whole grains
• drink a lot of soy milk
• increase their exercise, especially cardio
• begin stress-reducing routines like meditation and yoga
• become vegetarian
• go to bed earlier

And I was ready to get back in the boat and paddle out to sea again.

I've been there -- vegetarianism had made me fat and sick. Soy milk is not healthy. Yes, it's a source of estrogens, but the wrong kind that can lead to estrogen dominance in the absence of progesterone. All the cardio in my past had aggravated an old hip injury, I couldn't do it any more.

I'd been in a meditation class for two years already, and I was quite good at it. I went to bed early, it was waking up at midnight and not getting back to sleep until five in the morning that was the problem.

Fear of effective treatment

For a year, I tried to wait it out. This was a transition and it was supposed to end.

I took herbs to help regulate my hormones. I tried over the counter, vegetable, forms of estrogen, but they tore up my stomach like a Roto-Tiller. I felt my coping skills, formerly hovering in the high 80's, had plunged into the single digits. I'm normally a cheerful and cooperative person, but now my frustration would boil over in an instant and I'd want to destroy things. With an axe. While screaming.

I started using apps and other electronic devices for both home and work because my memory would short out on me. The last straw came when I forgot some backups at work. I'd been an IT professional for decades and this was as natural as breathing. There was no harm done, but I felt horrible and panicked. I made an emergency appointment at my OB/GYN.

I'll never forget the way the woman PA kept rolling her chair back and back as I launched into my litany of misery. At one point I do believe flames shot from my eyes.

She declared me a "five alarm menopause emergency." And offered me Prozac.

I was starting to get that axey-screamy feeling again. In short, clipped, words, I said that she'd just explained I had an endocrine problem. I wanted an endocrine solution.

And then, because I had demanded it, because I shot flames from my eyes, I got a prescription for an expensive combination of hormones extracted from PREgnant MARe urINe.

It was the end... of the beginning.