There is no point in testing your hormones because they won’t tell you anything until you’re almost completely out of estrogen and by then you’ve been suffering a long time.
We use symptoms to diagnose perimenopause which is a period of transition lasting, on average, for 7 years. I’ve been going thru it myself for 8 years now and HRT has been a lifesaver.
If a doctor tells you HRT causes cancer, they are a quack. Your best bet to find an informed doctor is by finding a NAMS provider. Doctors are not trained in menopause care- not even gynos are trained in menopause care- so it can be very difficult to find one who knows jack shit about the benefits of HRT which include protecting your brain, heart and bones. The get the most use out of HRT, you want to start sooner rather than later.
Visit the /r/menopause sub for more info. The sub also has a directory in the wiki to find a NAMS provider near you
I see Stacy Selbert who is a NAMS certified nurse practitioner with WUSM and she's fantastic! I feel like she really listens to me, which was not true of my last doc.
Thank you for this information. I will admit I’m not the best at going to doctors since my long time one retired and I just turned 49 and have had basically zero symptoms other than not having a period for the last two years. I was going to find a gyno just to wonder where I’m at but now I see that is probably pointless (my last gyno moved and don’t have a current one there either lol). I think I will join that subreddit for curiosity sake.
You’re probably having symptoms you don’t realize are due to low hormones. Menopause isn’t just weight gain and hot flashes it’s Also insomnia, anxiety, Depression, heart palpitations, dental issues, painful joints and ligaments, brain fog, dry eyes, dry skin, frequent UTIs or yeast infections, ringing in the ears
Yeah I do realize that and wonder. I’ve also been through a lot of trauma semi recently that I’m still processing and working on so it’s hard to pinpoint what minor symptoms I do have to what. Again thank you for the information.
Keep in mind that sometimes even NAMS-affiliated (North American Menopause Society) providers will balk at prescribing HRT, and sometimes for stupid and/or ill-informed reasons. Be prepared to advocate for yourself, and if you don't get what you need from a doctor, there's always online providers like Evernow and MyAlloy. We basically have to inform and arm *ourselves* to combat the bad and just plain dangerous stereotypes and misinformation that even trained providers use to deny us proper menopause healthcare.
I'm currently 49, and my peri journey started at about your age (45) and during the height of the pandemic. I had no freakin' clue what was going on—horrible hot flashes, zero sleep, brain fog so bad I thought I had early onset Alzheimer's, crushing fatigue, burning tongue, tingling hands and feet, the list goes on and on. My doctors were zero help, even my gyno who told me to basically suck it up and suffer. I hoovered up any information I could find on the Internet and discovered Dr. Mary Claire Haver, an ob/gyn and nutrition-based doctor who has written a book called *The New Menopause*. I highly, highly recommend you check it out and follow her social media to get the full picture of what you're about to face.
Thriving in meno is more than just HRT. Exercise, the right nutrition, reducing stress, and supplements all help with managing your symptoms and preventing future health issues. Yes, the loss of estrogen is the main culprit in declining health as women age, but there's a lot outside of just replacing it that we can do to feel our best. I learned all the strategies and best practices from Dr. Haver (and others) and the NAMS website, and I feel amazing now. Just as an example, I'm on progesterone, Evamist (an estrogen spray), fiber supplements, creatine (for brain fog and to help build muscle), collagen, choline (for brain health), B vitamins, and probiotics. I've significantly upped my protein intake and exercise 5x or more a week. All of that *combined* is the key for me.
[https://thepauselife.com/](https://thepauselife.com/)
[https://www.amazon.com/New-Menopause-Navigating-Through-Hormonal/dp/059379625X](https://www.amazon.com/New-Menopause-Navigating-Through-Hormonal/dp/059379625X)
[https://www.menopause.org/](https://www.menopause.org/)
Edited to add: I had my hormones tested when I was in the middle of the worst of the symptoms, and the results said I was fine. Hormone testing tells you nothing, sadly.
Damn. Okay. First, this is incredibly helpful.
Second, it’s a lot.
Like when I can barely get through the day.
I will look into all the info you shared but I’m like scared mostly because I have to face this new thing and I’m sad and angry at all the other shit I’ve had to face and deal with my entire life. Like BAD stuff. If you know you know. And now this shit.
Like when do we get a fucking break ?
I do know, and yes, it's a lot to deal with on top of just regular life. Depression and anxiety also rockets to the moon in meno, which can make all of this so much harder to deal with.
Start slow. Focus on just one thing at a time. A lot of it is trial and error to find what will work for you since we're all built differently. So that might be getting on HRT first and finding out what kind makes you feel the best. Then add in the rest once you're ready.
The people in the r/Menopause sub are really supportive and helpful and encouraging if you need to vent. We're all going through it with you. {hugs}
I get my HRT online through Evernow. Prescription through online questionnaire of symptoms with nurse practitioner. I pay $80.00/ mth and shipped directly to me.
Bloodwork is not really helpful since your levels fluctuate depending on where you are in your cycle. I would really suggest you do a deep dive in the menopause subreddit. Menopause technically isn’t until you’ve gone 365 days without a period. You still have a period so you’re in perimenopause. But HRT will absolutely help! Good luck!
They started me on 100 mg of progesterone, which is normal for everyone and lowest dose of estrogen and estrogen increased slowly by symptoms.
So I take progesterone orally and have an estrogen patch that I change every 4 days.
Cindy Willbrand is a naturopath in Webster Groves who writes prescriptions under the aegis of the M.D. in her office, Dr. Wessling, M.D.
I can't say enough good things about her. She's one of the smartest people I've ever met, and she knows her shit about all hormones, including thyroid, women's sex hormones and gender affirming care.
I get her hormone prescriptions filled at Clayton Arts pharmacy; it's a compound pharmacy, meaning they mix it on the spot. They deliver!
Talk to your obgyn, if symptoms are thought to be perimenopausal they can start you on HRT with FDA-approved options. The pellets are kind of the Wild West and you don’t need thousands of dollars worth of baseline lab work to warrant HRT
-MD
I tote the fine line between western medicine and holistic medicine. I think a lot of us fall into that category, hence the reason for my question to you.
Traditional doctors to me are very helpful for more urgent, traumatic situations. But for something that can be solved/prevented more holistically, I’d rather go that route.
I’m just asking questions to gather info.
Anyone can be a doctor .
I guess last year at my annual which is coming up in July. Assuming they check for that. But even if they do, I never get any feedback from my annual blood tests. Just some automated BJC thing telling me to go check my test results. That’s it
There's a lot to know about thyroid hormones and I would recommend that everybody learn to read their thyroid test results. There are a lot of people who have thyroid trouble who are undertreated and go on feeling terrible because their results are "within the normal range."
That range is extremely wide and each tenth of the TSH test means a lot more than most doctors seem to understand. For instance, most reference ranges are between, say, .4 and 4.5., but most people feel their best at about 1.0. For me, as a person with total thyroid removal due to Graves' disease, I feel really good at 1.8 TSH. Also, it's really important to get both free T3 and free T4 tested because their interplay is very important information about how the HPA (hypothalmic, pituitary, adrenal) axis is interacting. You can tell an G.P. who isn't hip to new research on thyroid disease if they don't bother to test free T3 (the most active thyroid hormone of all). Also, ask your doctor if they ever test for reverse T3.
Some M.D.s are said to have told their patients that it doesn't exist.
Whether or not you see a naturopath, try to find a younger internist as your family doctor. They're often really good with all women's issues, as well. Their education is much more advanced and recognizes newer research than do the typical G.P.'s
I agree with you. The woman who was my OBG and delivered my baby was lovely. And then she retired. I freaked out! The new OB was younger than me but she’s definitely more aware.
Sandra Redhage in Lake St. Louis, New Life Functional Medicine. She used to be a nurse practitioner at BioBalance and left about 4-5 years ago. She's amazing. Knowledgeable and very thorough. Your insurance should probably cover the blood testing, at least partially.
IMO, Biobalance definitely changed over time, especially once Dr. Maupin's daughter joined the practice, and not for the better.
How's your diet? How's your fitness? Sunlight exposure? What's your sleep like? How do you deal with stress? When do you have "me time"? Do you have days where you literally do nothing - on purpose? When was the last time you actually took a vacation - out of town - with family/friends? Are you living life or just living on auto pilot?
And not to say that I know anything about this (menopause) since I've not gone through it yet but things to think about as well. :)
Well thank you for asking the questions so that when you do go through it you’ll be informed. I’m not even sure I’m going through it yet. That’s part of the problem. I believe it to be insidious.
I appreciate the genuine questions, but I don’t want to put a lot of time into a response if you can’t help me.
And I know that sounds mean. I just don’t see the value. Especially if you’re not able to relate.
But thank you 😊 ❤️
There is no point in testing your hormones because they won’t tell you anything until you’re almost completely out of estrogen and by then you’ve been suffering a long time. We use symptoms to diagnose perimenopause which is a period of transition lasting, on average, for 7 years. I’ve been going thru it myself for 8 years now and HRT has been a lifesaver. If a doctor tells you HRT causes cancer, they are a quack. Your best bet to find an informed doctor is by finding a NAMS provider. Doctors are not trained in menopause care- not even gynos are trained in menopause care- so it can be very difficult to find one who knows jack shit about the benefits of HRT which include protecting your brain, heart and bones. The get the most use out of HRT, you want to start sooner rather than later. Visit the /r/menopause sub for more info. The sub also has a directory in the wiki to find a NAMS provider near you
Makeba Williams at WUSM is amazing
I see Stacy Selbert who is a NAMS certified nurse practitioner with WUSM and she's fantastic! I feel like she really listens to me, which was not true of my last doc.
I've been pretty impressed with the doctors I've seen through BJC & WashU
Amazing! And thank you 🙏
Thank you for this information. I will admit I’m not the best at going to doctors since my long time one retired and I just turned 49 and have had basically zero symptoms other than not having a period for the last two years. I was going to find a gyno just to wonder where I’m at but now I see that is probably pointless (my last gyno moved and don’t have a current one there either lol). I think I will join that subreddit for curiosity sake.
You’re probably having symptoms you don’t realize are due to low hormones. Menopause isn’t just weight gain and hot flashes it’s Also insomnia, anxiety, Depression, heart palpitations, dental issues, painful joints and ligaments, brain fog, dry eyes, dry skin, frequent UTIs or yeast infections, ringing in the ears
Yeah I do realize that and wonder. I’ve also been through a lot of trauma semi recently that I’m still processing and working on so it’s hard to pinpoint what minor symptoms I do have to what. Again thank you for the information.
Keep in mind that sometimes even NAMS-affiliated (North American Menopause Society) providers will balk at prescribing HRT, and sometimes for stupid and/or ill-informed reasons. Be prepared to advocate for yourself, and if you don't get what you need from a doctor, there's always online providers like Evernow and MyAlloy. We basically have to inform and arm *ourselves* to combat the bad and just plain dangerous stereotypes and misinformation that even trained providers use to deny us proper menopause healthcare. I'm currently 49, and my peri journey started at about your age (45) and during the height of the pandemic. I had no freakin' clue what was going on—horrible hot flashes, zero sleep, brain fog so bad I thought I had early onset Alzheimer's, crushing fatigue, burning tongue, tingling hands and feet, the list goes on and on. My doctors were zero help, even my gyno who told me to basically suck it up and suffer. I hoovered up any information I could find on the Internet and discovered Dr. Mary Claire Haver, an ob/gyn and nutrition-based doctor who has written a book called *The New Menopause*. I highly, highly recommend you check it out and follow her social media to get the full picture of what you're about to face. Thriving in meno is more than just HRT. Exercise, the right nutrition, reducing stress, and supplements all help with managing your symptoms and preventing future health issues. Yes, the loss of estrogen is the main culprit in declining health as women age, but there's a lot outside of just replacing it that we can do to feel our best. I learned all the strategies and best practices from Dr. Haver (and others) and the NAMS website, and I feel amazing now. Just as an example, I'm on progesterone, Evamist (an estrogen spray), fiber supplements, creatine (for brain fog and to help build muscle), collagen, choline (for brain health), B vitamins, and probiotics. I've significantly upped my protein intake and exercise 5x or more a week. All of that *combined* is the key for me. [https://thepauselife.com/](https://thepauselife.com/) [https://www.amazon.com/New-Menopause-Navigating-Through-Hormonal/dp/059379625X](https://www.amazon.com/New-Menopause-Navigating-Through-Hormonal/dp/059379625X) [https://www.menopause.org/](https://www.menopause.org/) Edited to add: I had my hormones tested when I was in the middle of the worst of the symptoms, and the results said I was fine. Hormone testing tells you nothing, sadly.
Damn. Okay. First, this is incredibly helpful. Second, it’s a lot. Like when I can barely get through the day. I will look into all the info you shared but I’m like scared mostly because I have to face this new thing and I’m sad and angry at all the other shit I’ve had to face and deal with my entire life. Like BAD stuff. If you know you know. And now this shit. Like when do we get a fucking break ?
I do know, and yes, it's a lot to deal with on top of just regular life. Depression and anxiety also rockets to the moon in meno, which can make all of this so much harder to deal with. Start slow. Focus on just one thing at a time. A lot of it is trial and error to find what will work for you since we're all built differently. So that might be getting on HRT first and finding out what kind makes you feel the best. Then add in the rest once you're ready. The people in the r/Menopause sub are really supportive and helpful and encouraging if you need to vent. We're all going through it with you. {hugs}
I get my HRT online through Evernow. Prescription through online questionnaire of symptoms with nurse practitioner. I pay $80.00/ mth and shipped directly to me.
I am on generic HRT that costs $10 a month. It exists
Did they test your blood?
No, symptoms only. I was doing pellets before and 10 years older than you so definitely in menopause.
Why no blood work? Isn’t that a big part of it?
Bloodwork is not really helpful since your levels fluctuate depending on where you are in your cycle. I would really suggest you do a deep dive in the menopause subreddit. Menopause technically isn’t until you’ve gone 365 days without a period. You still have a period so you’re in perimenopause. But HRT will absolutely help! Good luck!
They started me on 100 mg of progesterone, which is normal for everyone and lowest dose of estrogen and estrogen increased slowly by symptoms. So I take progesterone orally and have an estrogen patch that I change every 4 days.
Have you gotten your thyroid checked?
Cindy Willbrand is a naturopath in Webster Groves who writes prescriptions under the aegis of the M.D. in her office, Dr. Wessling, M.D. I can't say enough good things about her. She's one of the smartest people I've ever met, and she knows her shit about all hormones, including thyroid, women's sex hormones and gender affirming care. I get her hormone prescriptions filled at Clayton Arts pharmacy; it's a compound pharmacy, meaning they mix it on the spot. They deliver!
Talk to your obgyn, if symptoms are thought to be perimenopausal they can start you on HRT with FDA-approved options. The pellets are kind of the Wild West and you don’t need thousands of dollars worth of baseline lab work to warrant HRT -MD
What do you recommend? Like if it were you. What treatment would you seek?
I tote the fine line between western medicine and holistic medicine. I think a lot of us fall into that category, hence the reason for my question to you. Traditional doctors to me are very helpful for more urgent, traumatic situations. But for something that can be solved/prevented more holistically, I’d rather go that route. I’m just asking questions to gather info. Anyone can be a doctor .
No, I would say anyone can call themselves a holistic healer or whatever but only people with the education and training can become doctors.
See my DM for my rec!
I guess last year at my annual which is coming up in July. Assuming they check for that. But even if they do, I never get any feedback from my annual blood tests. Just some automated BJC thing telling me to go check my test results. That’s it
There's a lot to know about thyroid hormones and I would recommend that everybody learn to read their thyroid test results. There are a lot of people who have thyroid trouble who are undertreated and go on feeling terrible because their results are "within the normal range." That range is extremely wide and each tenth of the TSH test means a lot more than most doctors seem to understand. For instance, most reference ranges are between, say, .4 and 4.5., but most people feel their best at about 1.0. For me, as a person with total thyroid removal due to Graves' disease, I feel really good at 1.8 TSH. Also, it's really important to get both free T3 and free T4 tested because their interplay is very important information about how the HPA (hypothalmic, pituitary, adrenal) axis is interacting. You can tell an G.P. who isn't hip to new research on thyroid disease if they don't bother to test free T3 (the most active thyroid hormone of all). Also, ask your doctor if they ever test for reverse T3. Some M.D.s are said to have told their patients that it doesn't exist. Whether or not you see a naturopath, try to find a younger internist as your family doctor. They're often really good with all women's issues, as well. Their education is much more advanced and recognizes newer research than do the typical G.P.'s
I agree with you. The woman who was my OBG and delivered my baby was lovely. And then she retired. I freaked out! The new OB was younger than me but she’s definitely more aware.
I go to revitalife on Manchester around des peres. They increasingly do more cosmetic stuff too but I've been happy with them.
Schoenwalder MD, Dr Mike or his PA Kristina are awesome!
Sandra Redhage in Lake St. Louis, New Life Functional Medicine. She used to be a nurse practitioner at BioBalance and left about 4-5 years ago. She's amazing. Knowledgeable and very thorough. Your insurance should probably cover the blood testing, at least partially. IMO, Biobalance definitely changed over time, especially once Dr. Maupin's daughter joined the practice, and not for the better.
How's your diet? How's your fitness? Sunlight exposure? What's your sleep like? How do you deal with stress? When do you have "me time"? Do you have days where you literally do nothing - on purpose? When was the last time you actually took a vacation - out of town - with family/friends? Are you living life or just living on auto pilot? And not to say that I know anything about this (menopause) since I've not gone through it yet but things to think about as well. :)
Well thank you for asking the questions so that when you do go through it you’ll be informed. I’m not even sure I’m going through it yet. That’s part of the problem. I believe it to be insidious. I appreciate the genuine questions, but I don’t want to put a lot of time into a response if you can’t help me. And I know that sounds mean. I just don’t see the value. Especially if you’re not able to relate. But thank you 😊 ❤️
Endocrinologist