Guest Post: Menopause–I Chose the Meds

A guest post by physician Judy Washington:

Menopause was not easy for me. I need to be high functioning at all times as a very busy Family Physician.  I have spent years counseling women about menopause and how to manage it.

Funny thing happened on the way to turning 50.  I experienced menopause. It was a totally mind altering and mind-numbing experience.  I admire those women who can tough it out.  I am not one of them.

The first time I went to a lecture on Bioidentical Hormone Therapy I was 40.  The co-presenter was a beautiful female Family Physician.  She talked about having fatigue, difficulty sleeping and concentrating and feeling like she had a serious illness but all the usual tests were normal.

She started Bioidentical Hormone therapy by consulting with a compounding pharmacy.  Her presentation was about using saliva testing to measure hormone levels.  I jumped right in consulting and started writing prescriptions for patients.  I have never gotten so many grateful hugs.

Then the research brought some doubts about the safety and risks.  After that, I spent time examining the evidence regarding benefits, risks and quality of life.

I was secretly hoping it would never happen to me.  I changed my diet, increased my running, and  started yoga and pilates.  Caving in to overwhelming gastrointestinal distress, I stopped the soy and the other natural stuff because of an allergy to some of the plants and tree nuts.

The symptoms hit and I was knocked off my feet. No really, I had one hot flash that was so bad I almost fainted.

That was while working with a resident.  She said and I quote, “Dr. Washington, are you having a hot flash? My mother gets those.”

Actually, I was held hostage by fatigue, hot flashes, and body aches.  All my blood work was normal.  I had to see patients, teach residents and medical students, perform surgical procedures, prepare lectures and attend meetings.

Well, it is hard when you are burning up one minute, cold the next and you can’t sleep.

My husband was a good sport and very empathetic. Fortunately for me, my best friend is an OB/GYN and a menopause specialist.  Her words of wisdom were, “Do what you think is best, but I am taking the hormones and I have no regrets”.

Well, I started the hormones and haven’t had a moment of regret.   Sorry naturalists.  I chose the drugs. Yes, compounded progesterone in olive oil and estradiol.

This choice is not right for every woman.  It was for me.

I will be 5 years into my decision May 2013.

At that time, I will start to taper my medication dose as recommended by the medical literature.

We will just have to wait and see.  My friend actually is a few years older than me and after a 5 year hiatus is delivering babies again and having a great time.

Judy Washington, MD FAAFP, is a board-certified Family Physician.  She has spent her medical career first in private practice and later in medical education. She is now working as a college health physician.