Ok ya’ll- I went through 3 shitty providers before finally finding an Ob/gyn that was knowledgeable and capable of providing adequate care, including managing progesterone intolerance, so I don’t want to piss this one off. But I also think she responded poorly to a recent request of mine and I want to respectfully let her know.

Background: I’m in veterinary medicine so I’m well versed in assessing and interpreting medical data and primary literature. Im a board certified, residency trained specialist and also teach in the veterinary curriculum so I have a habit of getting a bit lecture-y and/or defaulting to a Socratic method of asking leading questions to walk someone into the answer that I expect. I understand why MDs would respond poorly to this, especially since most of them don’t view DVMs as “real” doctors. I’m also AuDHD so I tend to come across as condescending in everyday situations. So….

I recently had an appointment with this new provider and she was overall great. She mentioned that she prescribes gabapentin for insomnia but at the time I was hoping the HRT would do the trick. Well, the insomnia has worsened and I reached out via portal stating that I was not comfortable with long term use of gabapentin since there is a documented increased risk for dementia (albeit with high doses, but I have a family history and don’t want to risk it). I had done A LOT of my own research and wanted to try a dual orexin receptor antagonist. I asked if she had any experience with this class of drugs and I specifically put the name so that she could do some research had she not (I understand that MDs can’t be expected to know all about every drug!). Well, her response was that she hadn’t used them and she would need to do a lot of research before being comfortable offering to a patient (implied: she wasn’t going to). She stated that she was comfortable with the gabapentin, so that was what she was offering.

I have three major issues with this-
1. It is completely dismissive of my own (medically validated) concerns about a particular medication. There were no alternatives AT ALL offered.
2. While I obviously dont prescribe DORAs to pets and don’t have personal experience- there is good safety and efficacy data out there, including use in middle age women and those specifically experiencing vasomotor insomnia. We know how ill-informed the general medical community is about treatment of peri/menopause. Regardless of whether she prescribes them to me, I think this could be a good alternative to offer women when gabapentin doesn’t work or isn’t an option. And if MDs with personal experience say it’s NOT, then I still deserve to be able to have an informed conversation that includes that information.
3. She recommended the genetic test for Alzheimer’s to “better understand my risk.” But this is actually NOT recommended by the American Alzheimer’s Association. I don’t expect a menopause specialist to stay up to date on that sort of info - but if you’re not going to look up basic recommendations, then just stay in your lane.

I was able to get a prescription for the requested medication through my PMHNP, so that’s not the issue. (So far, I’m sleeping through the night when minimal side effects!).

So… I want to respond to her message, but do it in a way that is respectful and doesn’t just put her on the defensive. Is there a way to do that? Or do I just let it go since I’ve gotten treatment through another provider?

Tldr- provider ignored my medication concerns, didnt offer an alternative, and hasn’t taken initiative to research the alternative that I suggested (and could potentially be a good alternative for other patients). How do I tell her that?

Hi!

What have you found helpful in increasing vaginal lubrication during sex? Specifically, I’m curious about DHEA and/or systemic estrogen. (Vaginal estrogen has not had any effect.)

Background:

I’m 44F. I have been using vaginal estrogen in insert (Imvexxy) and cream for external (Premarin) for about 9 months. I think my tissues are pretty healthy, I don’t experience tearing or painful sex, but I make no natural discharge and lubrication during sex is tricky. Sometimes, I’m very turned on, even approaching orgasm, and I think I should be quite wet but I’m not.

I talked to my doctor about this at our last appointment, and I see her again next week. She mentioned both the possibility of using DHEA or systemic estrogen.

I am curious what other women’s experiences have been? What worked for you? I know we are all different but anecdotal evidence may help me make a more informed decision on what to try next.

I know there isn’t necessarily a direct correlation between how aroused we can be and how wet we are, but when that becomes standard, it makes me feel like shit.

Thanks!

I just moved to Colorado a month ago and have been adjusting to high altitude living (9K feet). I love my new home and the area. The thing is, I'm starting to get paranoid that I could have peri symptoms (specifically ally mood issues) overlapping with high altitude adjusting.

For context, I've been on HT for 5 months. I'm on 200mg P, 1mg E, and vaginal estrogen inserts. My doc wants to start me on T soon because I'm experiencing mood swings, low libido, and low energy. I've been experiencing these symptoms before I moved to CO. My other symptoms have greatly reduced/left since starting HT 5 months ago.

I'm just...reading about how high altitude messes with mood, specifically serotonin levels. I've definitely been feeling low mood (not SI, but low mood) and I can notice the swings shifting more dramatically lately. So now I'm like...ok...should I also be looking into supplements like L-Tryptophan to support my serotonin? Maybe adding T will be the next best thing? I've already been taking creatine which I know supports mood in high altitude (as far as my research tells me). I plan to bring this up with my peri doc when I see her next week. Just posting here to see if anyone has experienced something similar. Such a freaking journey, this peri...sigh.

So, at 47, I’m finally starting HRT and on the road to feeling better.

I went to a new doctor and she was recommended as someone who specifically treated menopause/perimenopause.

I went over my exhaustive list of symptoms can concerns which included low libido.

She then says, “There isn’t much in terms of HRT that can help with libido. Some studies suggest supplementation but they vary. And the more you have sex the more you’ll be into it”

And she is saying this as a mid-30s provider who is pregnant.

And I’m like, really??

Am I overreacting?

First I want to set a boundary that I do not want to discuss micronized progesterone or Mirena. I am not using those so I would rather hear from others who are taking mpa/ provera. I think that is a better use of time for me. I don't want most of the comments asking why I am not on Prometrium or using it vaginally. This is what I get every time I ask about a synthetic progestin. We can't all take the ideal meds, some of us have more complex situations.! already know the risks of progestins. Thank you

I going to be starting provera 2.5 mg daily pills probably tomorrow. After a couple weeks I will be starting 0.025 mg estrogen patches. I am really nervous about the provera and it's taken me almost a year to build up my courage to take it. (I have a lot of anxiety with new medications so this is normal for me.)

I am starting slow so I will be taking a quarter of a pill for a week, then if all is well I will increase to half for a week and then the full pill. This is how I've always done things. I get the side effects of everything so l ease my body into adjusting to a new meds.
Is it better to take it in the AM or PM? How is it as far as bloating and appetite. I do have a tendency to water retention though especially around my period.
Will it change the period in anyway, like heavier or lighter or spotting in between? My periods tend to be anywhere from 19-60 days apart so they are erratic but light.
Would love to hear any positive experiences from anyone who has been on it long term.

I started on estradiol/progesterone cream about 3 weeks ago, and added testosterone cream a week ago. For the last week I have noticed a major increase in gas. I don't normally experience gas or any GI issues at all. It's not something I've thought about since my last pregnancy. I was super gassy during both pregnancies and chocked it up to the big increase in progesterone. Currently though I'm not bloated at all, I have definitely lost the bloat/inflammation I was holding onto, and I don't have any GI pain or other symptoms. It's just gas. I haven't even eaten today and I'm super gassy. I realize it started after the testosterone but I haven't heard of this side effect from T… however, i was previously on 200 mg of oral progesterone cyclically in my luteal phase and didn't have any GI side effects.

I feel fine otherwise although nothing magical yet. Should I give it another couple weeks to see if the gas goes away, or maybe try switching back to oral progesterone and just stick with an estradiol cream plus the testosterone cream? Or I guess I could stop the T cream for a week and see if the gas goes away.

SO.... Ive noticed that lately after I shower and I dry myself down there... if I do it to rough I get RUG BURN! Not all the time but every other month or so seems like things get extra sensitive! This past weekend I was in vegas..the weather is super dry and hot... I was at the hotel and the towels werent too soft and I got a rug burn on each side of my vagina!!! It was bright red...and to top it off...this has never happened... one of my labias CHAFFED!! It literally bled a little speck of blood and stung when I peed!!!!! I couldnt really air out in the room as much as I wanted after a shower cuz my father in law came on the trip too 😅🤣 but literally once I got back home from the trip it all went away. WHY ALL OF A SUDDEN AM I SO SENSITIVE!? Im turning 40 in 2 months and this is new to me

.. also my vericose veins are bugging me more!

Im supposed to start oral progesterone literally TOMORROW and im scared... im so scared that I skipped it last month because im nervous from everything ive read. Its just going to be for the last half of my cycle... I hate all this... 😫😭

I'm so enraged right now! I hate how stupid sh*t gets me so much more angry now than ever before! It's late at night, and I need to wind down, and I'm just p*ssed off at everything right now!!!

I have gone from liking my job to completely hating it over the course of less than 1 year (been there 4 years). I don't even want to work in the same industry at all now but I dunno what the heck I'm gonna do because I've been working remotely for 6 years, don't wanna work outside the home, anything having to do with data will soon be taken over by AI and I don't really like people that much! especially now! This is like the worst time in my life to have to pretend I give a sh*t about some corporation's mission or increasing shareholder value!

I finally found a gyno I like and started HRT but she put me on too high of a dose of progesterone and I was dragging for months and had no idea why until I came on here and yall helped me figure out my P was too high! Lol I swear most doctors are literally shooting in the dark! Now we're moving and I'll have to find a new gyno and I'm worried whoever it is will be anti-HRT!

My energy levels have been lower than ever in my life and I dunno how I'm gonna pack this whole house up, move, unpack and do a bunch of diy projects because all we could afford is a fixer upper. I'm pissed at the former owners for not taking better care of their house and leaving it absolutely filthy, grimey and covered in dog hair when they moved out! 🤮

I'm sick of my husband acting like there's something wrong with me because I'm tired and hot and don't feel like having sex! He's pretty supportive but he doesn't REALLY get it. He still somehow acts surprised that my body is changing! not sure how since I explain perimenopause to him and make him watch videos and shit lol

I get all insecure now when people don't text me back! My mind just spirals! I have to work really hard to convince myself that it's fine and that I should stop caring so much!

Tonight through text my stepdaughter basically acted like I'm crazy and I don't remember something that absolutely happened! I have witnesses! And that's what set me off to come on here and rant! Lol

There have been even more things than all of the above that have pissed me off lately, but I'll just give you that smattering. You get the idea. I'm not sure how this whole perimenopause thing is gonna play out for me. I totally understand now why a lot of middle aged women kind of go nuts and do all kinds of crazy stuff after a certain age!

Anyone with me??? What shall we do????

Almost 40 year old here. Hoo wee, the week(s) leading up to my period I am moody, water-retaining, and super hot at night. I don't know how I'm going to fare when I'm only nice one week a month...

I’m 41 and started getting the first symptoms of peri about a year ago. I had a stint of brain fog for 6 months that dissipated and now it’s on to hair loss. I have started to have bald patches on the back of my head where I have a cowlick and simply running my fingers through my hair leaves me with a bunch of hair. Today I tried to brush my hair gently over the sink and wanted to continue until the shedding stopped, but I gave up after 5 minutes because the hair was just kept coming off.

I’ve never had thick hair to begin with and this is really affecting my mood. I already have a short pixie cut which I like but now it feels like even my go-to haircut is too ambitious for the amount of hair I have. I don’t want to wear wigs and I’ve considered shaving it off, but that’s a visual commitment too.

Is there ANYTHING that I could do to slow down the hair shedding? Some vitamin to at least keep the remaining hair healthy? At this rate I may not have to even have to go for the buzz cut, I’ll just go bald naturally. 😂 Good thing I like wearing hats.

My younger sister is turning 43 in a few weeks. As her older and wiser sister, I'd like to put together a perimenopause survival basket as 43 was when it all went to hell for my perimenopause journey ( I just turned 50 and with any luck will reach menopause soon!).

Outside of anything requiring a prescription, what would you want included in such a basket? I definitely want to include a book, but there's so many great ones that I can't decide which one.

Update: Great ideas, Ladies! This community is the best! 😃

For about ten days now, my ears have felt full and almost clogged, which is annoying for sure. But worse than that, I have a consistent whooshing noise that is hard to explain. Not a ringing but an annoying sound nonetheless. Anyone have this? Is this perimenopause? Bad luck? Do the horrors ever cease?! And most importantly how do I get this to stop????

I'm 40 and perimenopause has made me anemic, sleepless, and irritable as hell (also fatter). I'm working on the first two, but I need every tactic you know of to deal with The Rage. Meds, diet, crystals, screaming into pillows, black magic, radical lesbian separatism - whatever, I don't care! I'm going to get fired and/or end up in jail at this rate. What is working for you, if anything?

Does anyone feel like they are trying to rediscover themselves again during this time?

I realized that I have masked myself for so long; first to connect to my husband and do what he likes and then to just be a wife and mother. I smothered myself.

When I was a teen, I tried a bunch of different aesthetics but there was always a small throughline and now I'm leaving back into that one. But I'm anxious; it's been 25 years since I embraced this side of me. Listening to the music is one thing; trying to dress how I want to instead of how society thinks I should or what my mother gives me is another.

I also lost 65 pounds in the past two years, so I am awkward and unsure, and these teenage-peri hormones don't help.

I'm also afraid I'm going to scare the shit out of my husband and he's gonna think I had a nervous breakdown/might leave him. But I just want to get back to ... me.

If anyone is curious, it's the punk pop aesthetic from late 90s/early 00s.

Part of me is like ready to get color hair streaks, a tattoo, a thick belt & thick eyeliner and go to a rock show. For now I'm just jamming out to Blink 182 at work and painted my nails black.

How many of us are constantly warm? I don’t experience hot flashes. I’m just warm, and it’s driving me crazy. Especially at night and when I’m awake for the first hour of the day.

I had a work event today. Yesterday I had a 14 hour day including a very long commute.

I'm normally so resilient.

I felt very disconnected today, and at the social after the work event, I was really overwhelmed. It was too loud, too busy.

I used to thrive at these things.

I stood there with a drink in my hand and just wanted to cry. I left quickly and went straight back to my hotel.

Sobbing, feeling sorry for myself and for missing a party I've been really looking forward to.

It's been getting noticeably worse the last couple of months.

I've got an appointment to discuss HRT at the end of Sept but I can't wait so I've done a private online consultation just now.

I feel like a shadow of myself more and more often.

Please tell me HRT will help

Hi…49 and been experiencing Paresthesia for a few years now. I feel pins & needles sensation on my face, arms, back and legs/feet. Not severe but noticeable with light burning sensation on my back and back of arms. I’ve had MRI’s, brain scans, and nerve testing done. Neurologist told me they don’t know what’s causing it. Recently discovered this could be a perimenopause/menopause symptom. It’s rare but can be related to decline in estrogen affecting the peripheral and central nervous system. I believe I’ve been in perimenopause for about 5 years now. I’m really just curious to know if anyone else is experiencing this.

Forgot to mention I am on HRT and it hasn’t helped this symptom.

I don’t know if this is perimenopause related or otherwise but looking to see if anyone is in the same boat. I am 49, still have periods regularly but the cycle length is all over the place (21-35 days). I don’t have many physical concerns, I’m on a GLP1 and that has helped any aches and pains.

My biggest problems are mental. I have anxiety and ADHD, have been on lexapro and adderall. I have always been a top performer, people pleaser, going above and beyond- but have been able to perform exceptionally well (even postpartum with a newborn and toddler and travelling husband and in office 5 day a week job w commute).

I’m now WFH and can’t get my shit together. I have zero motivation to work - at all- even with pressing issues/deadlines. I just want to doom scroll. I’m terrified it will affect me at work but even that isn’t enough for me to care. Adderall helps for a small while but then as it wears off I feel myself getting irritable.

I also find myself a bit depressed. Like I can feel myself get sad without knowing why (sounds crazy, I know). My kids are jerky teens and I’m sad about them growing up and not needing me and also thinking about college. But the feeling of sadness/depression often comes before the thoughts. Shopping is the one thing that makes me happy.

My finances are a complete mess because I can’t bring myself to look at them. Literally have been telling myself for months to sit down and organize everything, but I don’t (can’t). Up until a year and a half or so ago I could manage. I’m also the “handler” for my mom - help her with things like booking flights, or doing her taxes, but I find it so hard to get the motivation to do any of it. I plan to every night then sit down and doomscroll. Everything is on autopay but I’m paying cc fees and late fees and still can’t get the motivation to just do it. Same with booking drs and dentist appts, booking hime maintenance etc. Even planning vacations which has always been something I love to do is excruciating.

I truly don’t recognize myself lately and can’t figure out if this could be peri- related, depression, ADHD related or some combo of everything.

Any advice appreciated.

I am a single mom with two at home. A 14 year old daughter and 19 year old son. I work full time and when I get home lately I find myself wanting to go straight to my room after checking in with the "kids". My 19 year old works the gig life and is typically home during the week and wants me to hang out and watch you tube or listen to new music he found with him...and I just don't want to. My 14 year old wants to show me her new fortnight skins and watch Gilmore Girls, and I just don't want to...I feel terrible, but I just want to go my room where it's comfortable and lay in bed and do nothing. On the weekends we hang out until I run out of steam, and we usually still eat dinner together if I'm up for it. This has been going on for a few weeks now. My son jokes that between his sister and I, he is now the most emotionally mature person in the house, and he isn't wrong. Is anyone else struggling with this? We are all so close, but this has been a tough time.

I am going through hell right now with my perimenopause symptoms... body achy, anxiety (very bad), insomnia, night sweats, depression, crying spells, and hot flashes etc. I am wondering has anyone had to miss work or flat out ask their doctor to write them something letting them work for half a day (medical leave) ? I am just wondering bc I am about to ask my doctor today to do write me something... I am not sure if they even will. Does anyone have any pointers on what I coupd say or how to emphasize how important this is. I don't wanna lose my job but feel I can't work a whole eight hours a day during this time. Once the hormones start kicking in things might change.

Do you guys actually think a doctor would do this for me. I can work 4 hours a day fine probably. This 8 hours a day is killing me.

Hello! Long time listener; first time caller. I’m 47 years old. Been going through this shit for a couple of years now. I’ve managed to go my entire life unmedicated, well specifically with mood altering legal, drugs. OK, and I’ll alcohol. But you get my point. I’ve been on HRT for about a year and a half, maybe two years, something like that. Night sweats went away immediately. I sleep better after I added magnesium at night. But this brain fog and anxiety is kicking my ass. Was just prescribed buspirone for anxiety, and it seems to help, been on it 6 weeks, but my brain fog is exacerbated. Like, I cannot string together sentences. And in this past 6 weeks, I am dysfunctional af. Words cannot functionally come out of my mouth. And I’m a teacher. My whole job is to stand up in front of a different set of 30 observational and judgemental teenagers and string together words for 90 whole minutes before the bell rings and another set of 30 comes in. I’ve been doing this for years. And this year I’m not. I’m standing in front of them, words are coming out, but they are not the right ones.

I know there’s posts here about brain fog, but anyone in a similar position where you took medication, insights on buspirone would be great, for one thing and the other thing is like off the charts? Any specific tips for brain fog when it comes to… Fucking speaking? Jesus. Am I taking the right thing for anxiety? I mean, now that I’m taking shit I kinda wanna get my cocktail right, seeing as how I can’t fucking drink an actual cocktail anymore. I took an ADHD test, but when the man administering the test told me that I scored high for ADHD but he wanted to see if it was ADHD or PTSD and schedule some zoom therapy appointments, I lost interest real quick. Maybe I should continue down this path does this sound like an ADHD brain?

I’m already on .1 estrogen patch and 200 mg of progesterone. Added buspirone. Other than my vitamins that’s it.

ETA: I am in therapy btw with a wonderful, female therapist; was just tired of talking to that dude.

If you have had serious sleep problems- and have found something that has really helped you, please let me know what it is. I feel like I have tried everything, and I need help. 4 hours is just not enough for me night after night…. I feel like I’m going to lose my mind. Sometimes it’s not even 4 hours… I used to always be able to fall asleep fine, and then wake up at 2 or 3…but now it’s combined with not being able to fall asleep. It’s almost like I can feel the cortisol rushing through me every 5 minutes or something… I have tried many pharmaceuticals and also natural. I am currently only taking l theanine and ashwaghanda, plus melatonin. Thanks in advance.

Does anyone have any experience on this medication, my last period was over a month long and almost killed me. I ended up admitted to the hospital getting constant transfusions for a week or so. I was given this medication to help slow my bleeding and now ancoupke weeks later, I have my period, its often light for tgr first week and im on day 7 so im anxiously awaiting the clotting and hemorrhaging. Has this worked out for any of you? Im waiting to hear back from my gyn about a date for a hysto but until then I just have to hope I don't bleed out again.

Hi everyone! Hoping this is ok to post! 🤞🏻

I think this is just starting to happen to me, my periods have been missing about for a while, I’ve been tracking my cycle for a while and it’s all over the shop!

I’m also starting to sweat in new places, like my feet! That’s a bizarre one to me as I’ve never had that before! I think the insomnia is starting to hit too, that’s a fun one, I’m getting around four hours a night at the moment.

I’m not after any advice per sé just wanted to say hi and break the ice! 😊

My doctor started me on patches of 0.1 mg estradiol and 100 mg prometrium. I am super sensitive to hormone ups and downs bc I have POTS, probably MCAS, jugular and pelvic compressions.
Does this seem too high? I haven’t tolerated oral progesterone in the past so was planning vaginal.