The British Menopause Society issued a newsletter this week warning women in the UK about high-dose estradiol prescriptions and the damage they can cause.
In some cases, the BMS points out, higher doses are appropriate because women are taking their hormones transdermally and don’t absorb well.
But in the UK, there is an approach I’ve covered before, one that involves prescribing ever-higher doses of estradiol, after starting out high in the first place. We are talking far in excess of product guidelines. Rogue levels.
And that can lead to tachyphylaxis, which is when people believe they need more of a drug to keep getting results. This happens with estrogen, as estrogen is addictive. And when it comes to menopause mood symptoms, the higher doses can be causing the symptoms that prompted the person taking them to seek help in the first place.
Everyone working in the field, and women experiencing these symptoms, as the BMS warns in their newsletter, needs to be aware that women with pre-existing mental health conditions might be more sensitive to mood changes in perimenopause, as well as more sensitive to adverse effects when they are given excessively high levels of estradiol.
This is the exact opposite of what anyone needs in perimenopause.
Imagine being at the end of your rope with menopause symptoms, and then finding yourself experiencing even more in the way of anxiety and depression when the thing you were told would fix everything only seems to be making it worse. Imagine it happening at a clinic you are paying big bucks out-of-pocket for – maybe all the bucks you have. It can take months to see a GP in the UK these days, let alone a menopause-informed ob-gyn, so imagine that it truly feels as though there is nowhere else to turn.
And then imagine that a guiding body knows this is happening, and the only thing they do, or they can do, is send out a newsletter to members.
It’s almost like they are powerless to stop it.
In other, related news, this week on the podcast, I speak to British psychotherapist Paula Rastrick.
She entered perimenopause with pre-existing mental health conditions, was put on crazy-high and increasing amounts of estrogen at a private clinic, and then spent a long time sorting it all out. She’s made it her mission to try and stop this by talking about it, and also to help women who’ve experienced trauma, who are highly sensitive, to get through perimenopause without experiencing the same thing.
#F—-FeminineForever
My mind was blown this weekend when I saw what could only be called a loving ode to Robert Wilson’s 1966 book Feminine Forever on Instagram this weekend out of the UK.
Let’s not forget Wilson was paid by a pharmaceutical company to write perhaps the most odious book ever written on the subject of menopause, as his son confirmed after his death.
Here is a sample passage: “The unpalatable truth must be faced that all postmenopausal women are castrates… no woman can be sure of escaping the horror of this living decay.”
Science stuff: Ovaries edition
Getting your ovaries removed to prevent ovarian cancer is looking less and less like a good idea. A new study published in Menopause, the journal of The Menopause Society in North America, links premenopausal bilateral oophorectomy – with or without hysterectomy – to more chronic medical conditions and physical decline later in life.
Aside from reproductive function, ovaries balance endocrine function across the body, including the brain, muscles, bone, blood vessels, heart, and the gastrointestinal tract. Prior research into their removal has suggested an association with cardiovascular disease, cognitive impairment, or dementia, with most issues noted in operations that happened before the age of 46.
Hysterectomy – removal of the uterus – is still the second most popular surgery in women, after cesarean section. Although rates are falling, this study reports that 23 percent of women 40 to 44 and 45 percent of women 45 to 59 opted for ovary removal at the time of hysterectomy to prevent ovarian cancer – even if their risk was considered average.
In a 22-year follow up on group of 500 women, more than half who had the removal, researchers found an association with increased risk of arthritis, asthma, obstructive sleep apnea, bone fractures and walking a shorter distance during a six-minute walk.
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“The most important thing I want women to understand about their disproportionate risk of Alzheimer’s disease is that it can be a wake-up call to take care of yourself. You have to be on your own priority list. If you spend the entirety of your mid-life—say, age 30 to 60—only taking care of other people, you are not positioning yourself to age well after 60.” - Jessica Caldwell, PhD and director of the Cleveland Clinic’s Women’s Alzheimer’s Movement Prevention Center
• Alzheimer’s Disease Is Something All of Us Worry About as We Age. Here’s the Newest Thinking on Prevention Maria Shriver’s Sunday Paper
• “Menopause taught me to quickly say, ‘You know, it may only get worse. So just love yourself now’.” Shania Twain on music, menopause and loving her body ‘more now than ever’ New York Post
• We need more non-self-hating humour menopause writing about vaginas: WELCOME TO YOUR MENOPAUSAL VAGINA: This is a time of vaginal maturity. McSweeney’s
• Veganism may not be the answer to your midlife hormonal issues The Midst
• Lately I’m obsessed with how youngers are normalizing things that I’ve long done but always been ashamed about. Specifically doing girl math (and the least amount possible) eating girl dinner (because I’m tired of being excited about cooking for one) and going on hot girl walks, because I live in the desert and they get very sweaty. Vox
• If anyone in NYC catches Joanne Schultz’s off-Broadway show A Tale of Love and Perimenopause (in previews from September 28) can you get in touch and tell me about it? TheatreMania
• British columnist Emma Beddington appears to believe in magic pills: I have started HRT. So why am I still in an absolute seething rage? The Guardian
• How to design menopause leave policies that really support women in the workplace The Conversation
• Women are celebrating: With menopause parties, Gen X is celebrating middle age without the shame and stigma Fortune
• ALEXANDRA SHULMAN'S NOTEBOOK: The cancer risk of HRT should be made clear Daily Mail
• Yes, menopause can even change your poop Scary Mommy
Thanks for this. I, too, was stunned by the Feminine Forever Insta post!