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I Said I’d Never Take HRT for Perimenopause…

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I have never been one to be uncomfortable at the gynecologist. Maybe it was upbringing with the latest version of Our Bodies, Ourselves in the living room and parents who were very open with us kids about how bodies work and how to take care of them, maybe it's just my nature. Whatever it is, I have never been tense with the gyno, and never really cared if it was a man, a woman, older, younger, as long as the doctor was professional and got the job done.

When I found out I was pregnant, I realized not all OB/GYNs were created equal. After getting that positive at-home test, I made an appointment with my regular OB/GYN practice and once it was over I immediately researched alternatives. The “good enough as long as it was professional” vibe wasn't good enough when I felt as though I was a paycheck and a burden and not a brand new fearful mother-to-be.

I ended up going with a midwifery practice that was associated with a hospital, and the experience was amazing. I was heard, respected, and treated with care. No question was stupid, no need was dismissed, and I was sad when I had my last post-delivery appointment with them and had to move on.

I bounced around with doctors until I found an all-woman practice in a nearby city. I chose a practitioner who was NOT an obstetrician as that was no longer a need for me. She and I vibed well, and I saw her for my well-woman visits. We'd discuss motherhood (our kids were only a couple of years apart in age), growing older (she was only a few years older than I), and fashion (we both had the passion and my appointments would always be just before the Nordstrom Anniversary Sale).

I Said I'd Never Take HRT for Perimenopause…

Visiting my Gynecologist to Discuss Perimenopause and HRT… Was Not Good

All was good until I went back after the pandemic. I wasn't able to see my regular practitioner because she was away for training. I went to another in the practice who made the experience feel like a self-service car wash. It was rushed, impersonal, and I felt like I was a paycheck not a patient. The next time I got to see my regular practitioner was this spring when I went for my wellness exam and to discuss perimenopause and possible HRT. I saw her, and then one of her colleagues at a following appointment.

The two appointments were demoralizing and disappointing. Two women professionals who had both gone through menopause themselves, neither obstetricians, one who specializes in hormones and menopause, both treating me as though everything I was going through and everything I knew was completely normal for women going through perimenopause, as though it was all in my head and my fault.

Finding a NAMS-certified Practitioner for Perimenopause

I began to do some research. I learned about the North American Menopause Society, and that practitioners could be certified in Menopause. I knew that a lot of these practitioners wouldn't be covered by my insurance, but as a friend once said as we were discussing perimenopause over lunch, hormones are cheaper than divorce.

I found a Certified Nurse Midwife (CNM) in nearby Takoma Park, Maryland through the NAMS website and made an appointment for a Menopause Consultation. I was psyched just to know a menopause-specific appointment was possible!

Dude. DUUUUUUDE. Seriously. Dude. This appointment was mind-blowing.

The office is a second-story walk up on the main drag. After filling out forms and being asked for my insurance cards just in case they could finagle some coverage, I went into the exam room which was made so homey with a matelasse coverlet over the exam table, a table lamp on top of a Shabby Chic-esqe chiffonier, and a comfy leather chair where I sat.

And I sat there well over an hour as we discussed my symptoms and she dug deeper asking probing questions about my physical and mental symptoms, my medical history, and the medical history of relatives. We discussed my lifestyle – what I ate, what I drank, if I smoked or used any recreational drugs, what supplements I took, my activity level, my relationships, my feelings about work, motherhood, and midlife. She connected so many dots for me, and never made me feel foolish, overdramatic, or that anything I was experiencing was unimportant.

She also didn't say anything about weight, didn't recommend more activity than what I was already doing, and didn't even blink when we discussed more personal topics. It made me feel confident to speak up, while my last menopause-related appointment left me with a lack of a voice.

No blood test was taken, because blood tests cannot determine if you are in perimenopause. Hormone levels fluctuate through your cycle, even if your cycle like mine is every three days, then every three weeks, then every three months. Blood tests, however are useful to ensure your symptoms are not due to another cause (my gynecologist already did these tests the month prior).

Before choosing format of each hormone, we discussed each style, effectiveness, and reviews from other patients who used them. Hormones can come blended, can be in creams, patches, pills, pellets, and much more. There are also different concentrations and methods of sourcing. Also, your provider should discuss how they work with one another, and which combo is best for your body and situation.

The HRT I Was Prescribed for Perimenopause

HRT for Perimenopause
The three hormones I am now taking

I was prescribed an estrogen patch (Estradiol 0.05 mg/day, replaced weekly), progesterone pills (100mg, one each evening before bed), and testosterone (1% gel, two clicks applied each morning to my calf or thigh). Since my insurance wouldn't cover any of this, she worked with me to find the pharmacies near me that had the lowest prices for the patch and progesterone through GoodRx and sent the prescription for testosterone to a compounding pharmacy in Pennsylvania she trusted and worked with for years.

She explained how long it would take to feel the effects, and why each of these was prescribed. She said I could continue with Wellbutrin XL, but said after a few weeks on the hormones I may not feel I need it. Unlike the hormone expert gynecologist who prescribed this antidepressant but told me nothing about how or when to take it or why she prescribed it, she went over how Wellbutrin works, possible side effects, and dispelled my fears about seizures. We scheduled an appointment for three months in the future to see how things were going and to tweak any prescriptions.

When I left, she gave me some doctor samples of Wellbutrin XL 150 knowing my insurance barely reduced the price of the prescription. Hearing my insurance woes and how I had been trying for several weeks to find free or reduced mammograms in my area (I'll delve into that in a future post), she provided me with a coupon for a $99 mammogram at a place about a half-hour away.

I also got a “goody bag” of magnesium, lube, mouthwash for dry mouth, and various other samples that could benefit a person going through perimenopause. I left with all my questions answered, more information than I could find Googling, and a warm feeling of being heard, seen, and understood.

After leaving, I received messages in the portal about my prescriptions and tips on how to take them and she said I could contact any time with questions. Big change from my gynecology practice that didn't even upload my blood test results until I called the office and demanded them.

The Results (So Far) From Taking HRT for Perimenopause

Results from Taking HRT for Perimenopause
The size of the estrogen patch I wear and replace once a week. It can be worn on the lower stomach or the bum. My first patch I put on my lower belly and it lasted two days before it bunched off and fell off while I was sleeping. I find with my soft curves the patch works best either high on the rear but not so high it's near waistbands, or on the side of the lower belly that won't bend, shift, or rub as much against clothes when sitting, standing, and walking.

I haven't even been on the hormones for a month but I believe I already see a difference. The biggest one is the reduction of pain. I was experiencing joint pain and all over achiness and stiffness, regardless of activity. I had been to doctors over the past year regarding it and everyone said I was healthy and it had to be just getting older or having too much weight on my frame. I knew it was something else and was thrilled to find that pain reduce and my feeling of brittleness subside.

I was nervous about our family vacation; I knew there would be a lot of walking and I wouldn't have my creature comforts (Eight Sleep mattress pad, CBD and epsom salt baths, TENS unit, Hyperice) to battle the pain I usually got from long days on my feet or prolonged exercise. I didn't have to worry. Other than sore feet from walking miles, I felt great and woke each day from Airbnb and hotel beds without the usual pain and stiffness.

HRT container
The testosterone comes from a compounding pharmacy. It is in this container; you twist it two clicks and a gel comes out the hole on top. You use this like an applicator to rub the gel into your skin (I was prescribed applying it to my calf or thigh).

I also feel a bit more even keeled. I don't know if it's the Wellbutrin, the hormones, a combination of both, or the relief of finally being heard and helped but I feel more in control of this roller coaster we call life. Also, by having someone listen to me, believe me, and prescribe a possible solution, it helped clarify what I was experiencing to my family. They believed what I was feeling, but it's impossible for them to truly “get” it.

My husband and I have had many discussions since the appointment with the NAMS-certified CNM, and it has helped us be on the same page and understand where each of us are coming from. The real test was this road trip; similar vacations in the past couple of years have usually included several arguments. This trip, we were able to talk through most difficulties making the vacation really enjoyable.

Side Effects from HRT

My provider let me know ahead of time that the estrogen patches could be annoying. Where they were placed could cause them to bunch up and/or fall off. She also gave me the heads up that the adhesive is strong and may be hard to take off (best is after being in a warm shower for a while, using liquid soap and fingernails and balling up the adhesive and rubbing it off on a piece of toilet paper or paper towel).

She also let me know that there is a chance hair will grow thicker and faster where the testosterone gel is placed. It's like she could read my mind; she immediately after mentioned that placing the testosterone gel on my scalp would not increase hair growth on my head. I really appreciated that extra bit of info because I totally would have gone down that rabbit hole to see if it worked as I have dealt with hairloss in my 40's.

Progesterone is taken at night because it can make you sleepy and also help with sleep and night sweats. There is an increased chance of uterine cancer by taking estrogen, but by also taking progesterone, it reduced that increase. If you have pre-existing breast cancer it may grow in response to taking estrogen.

Digestion can be affected by HRT, especially when it kicks in. In general it has been okay, but I did have one bout a week after starting where I spent a good hour or so in the bathroom. Since then, things have been normal. I didn't see a lot about this online (this was the first article I found that even mentioned it), so I wanted to share in case you experience similar.

Seasons Change, People Change

Before I had my daughter, I had this goal that the only times I would be in a hospital is when I was born, and maybe when I died. I don't know why I had that goal, maybe it was growing up the granddaughter of a Christian Scientist. That goal ended when I ended up going to a hospital to give birth and a few years later, having three different surgeries for my broken arm.

I also lived my life not wishing to take any sort of medication. I'll take an OTC pill to heal whatever minor thing that ails me, but due to my upbringing and my husband, I have always tried changing my diet and lifestyle before heading to the pharmacy. After my issues with hormonal birth control and my mom's experience with HRT, I swore I wouldn't go that route again. And after seeing my dad's issues with antidepressants, I swore I also wouldn't go down that road.

And now, here I am at 48, on hormones and antidepressants. And I don't feel as though I failed, in fact I am fucking proud of myself. It's stupid to be a martyr when there are options out there to help you. I don't know if this will solve everything, but for the first time in several years, I feel as though I am heading in the right direction.

Your Results May Vary…

If you are experiencing perimenopause symptoms and considering hormone replacement therapy, don't rely on me, don't rely on Google and surely don't rely on TikTok. Now that I went to a NAMS-certified practitioner, I see how much inaccurate and dangerous information is out there about HRT, BHRT, and anything to do with hormones.

There are some sketchy telehealth companies that will prescribe willy-nilly, hormone membership programs that offer referral credits to lure in more customers, and plenty of subreddits and Facebook groups sharing how to get hormones without a prescription and what cocktails you mix up on your own to battle your symptoms. There are still plenty of professionals who are still using that one study to claim that HRT is evil and will automatically riddle you with cancer. Get a second opinion.

Menopause support, whether it's a visit with a specialist or a prescription for hormones, is often not covered by insurance. Some hormones are not even available at regular pharmacies in low enough doses to be appropriate for those going through perimenopause. We can rant about the patriarchy (you know I love doing that), but check out CostPlus and GoodRx to get better-priced prescriptions.

GoodRx took three months of Estradiol patches from $265 to $85 and three months of progesterone from $230 to $20. My testosterone gel came from a compounding pharmacy so I couldn't use either program. However, it was just under $75 for three months of gel and overnight shipping in cold packs.

There is no right or wrong way to go through perimenopause. For some, the experience is a blip in their lives. For others like me, it can disrupt your entire life. And for as many ways we go through perimenopause, there are ways to deal with the symptoms. While HRT may not be right for you, right now it is right for me. I respect your decision, and thank you in advance for respecting mine.

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43 Comments

  1. I had such a similar experience. We are about the same age and have very similar symptoms. I went to my regular OB/GYN for my annual, shared my symptoms and they suggested birth control. I walked out with 4 months of samples. I had done quite a bit of research and wanted the estradiol patch and progesterone but was told birth control was pretty much the same thing. I decided to try it for 3 months. About 10 weeks in, I gave up. The pill made me feel terrible more than it made me feel good. I called back, was told to go on SSRI. I googled and didn’t really have the symptoms that SSRIs would mange (well, I am moodier than usual) but no hot flashes or issues there. It was a fight to get on the patch. I felt like they weren’t listening but just throwing stuff at me hoping it would maybe work or I’d stay quiet. I was persistent enough and am on the patch. Waiting to assess until 3 months, as suggested.

    Thank you for sharing your story.

    1. And thank you for sharing yours. The more we speak up and share, the more we bring light to the ways medical professionals are doing menopausal women dirty and how all of this is not in our heads. Good luck!

  2. This post is amazing! I’m only 42 but my mom started menopause early so I’m anticipating needing this information soon. Thank you for being so open about the process, it’s so helpful!

  3. Thank you for ALWAYS being so open and willing to share! This is extremely detailed and helpful. And as someone who has struggled in the past with shame around needing to be on antidepressants–“It’s stupid to be a martyr when there are options out there to help you.”–you are so RIGHT! I’m proud of myself, too. <3

  4. Alison, I’ve been a long time reader and can’t thank you enough for writing this article. I had early onset menopause as a result of cancer treatment in my early thirties. Probably stopped around 10 years ago. (I’m in my mid-fifties.) For the past year or so I’ve had painful symptoms “down there” that I thought were related to my diabetes treatment. (Long story.)

    Thanks to your article, I went to the NAMS website, found a NAMS certified gyno who miracle of miracles had an opening just a few days later. Just saw her today and she immediately recognized that my painful issues were due to the low estrogen. She’s putting me on a low dose of estradiol. Can’t believe I’ve been suffering all this time unnecessarily.

    So again thank you. As the doctor said to me today, unfortunately our bodies don’t come with owner’s manuals. So yeah, we have to figure things out piecemeal. This post was a godsend.

  5. Alison I’ve been following you for for you years (bc grown ass women rule) but this is the first time I’ve commented. Thank you for sharing your journey! We don’t talk about perimenopause and menopause enough. Everyone experiences it differently but god it’s nice to know we are not crazy and we are not alone. I didn’t know NAMS existed until I read this blog. I moved to Huntsville a year ago haven’t been able to find a provider who will prescribe my testosterone cream….I was facing having to drive to Chattanooga. Thanks to you, I did find a nurse practitioner locally, although the wait is insane. Just tells me what a need there is for women’s healthcare in this area. But that’s a conversation for another day. Keep doing you!!!

  6. Thank you for this, I could probably write a book on my experience with OB/GYN’s.

    It took me FIFTEEN YEARS and countless “new” doctor tryouts to find ONE who did a simple ultrasound to confirm my self diagnosis of severe endometriosis and PCOS. We discussed options, but at the time the situation was so dire I wanted everything O-U-T. She found me a great surgeon who tried to do laparoscopic removal but ended up going in through my c-section scars to get it all – the tumor on my ovary was the size of a grapefruit. He was able to take all but one ovary, to avoid surgically induced menopause.

    Two years later, I was diagnosed with breast cancer during my routine mammogram. I am third generation, though no connection to my mom or grandmother’s type of breast cancer. We all had different types, treatments, outcomes. Mine was hormone positive, so I have to take medication to block my hormones for 5 years.

    A year later, I “think” I have signs of perimenopause, but it’s hard to know for sure due to the above as well as other medical issues (mostly rheumatoid arthritis). I DO get blood work every three months, and we check my levels of various things, low magnesium and Vitamin D almost took me OUT.

    I recently listed to a podcast (Menopausepalooza with Dr. Mary Claire Haver) from the Big Boo Cast that was very helpful. It’s on their paid patreon, but so informative! https://www.patreon.com/bigboo. More women need to discuss this publicly for so many reasons, Reduce the stigma, help us all know what is going on, and to let research companies know we need them to get on top of finding us solutions – half the population will go through this eventually, it shouldn’t be such a mystery!

  7. Thank you for being so authentic and forthright. I am 68 and have always felt extremely guilty and defective because menopause was a blip for me. Like I have had one hot flash. But I know for so many women it’s terrible. I resonated with your goals of trying to avoid the medical merry-go-round and that you have been proactive with your research and health. I do feel sort of dismissed by my doctor (who tends to focus a lot on testing rather than what I am actually feeling). And it enrages me that mammograms are not paid for in your state. In my state, screening mammos are free, but if they find something, then it becomes diagnostic and no longer free. A really dumb thing. Again, thank you for writing this.

  8. This is so helpful — thank you for writing about this! I’m a few years behind you but I expect my perimenopause symptoms to ramp up in the next 3-5 years. I’ve grown weary of my current OB/GYN — it feels like if you’re not pregnant you’re a distraction — so I’ve looking for a GYN-only practice, and it turns out that several of the GYNs in my area are on the NAMS list. I’m kind of excited for my next annual exam now!

  9. I had about 6 years of nigh sweats, hot flashes, depression (although that could have been part of my mental health diagnosis, but maybe exasperated by perimenopause). I didn’t say anything to anyone. I thought that since women had been going through this for years, should just get through it. I did go to NAVA health center (https://navacenter.com) for 2 years. They put me on hormones even though I barely ever had any night sweats or hot flashes anymore. They put me on all “bio-identical” and compounded hormones and insurance didn’t cover them – $300/month- paid straight to them so I don’t know how much profit they made. My migraines returned and I didn’t notice other differences yet. They put me on so many supplements and sold them at their centers. I’m done with them, but I’m considering hormones again but through a traditional source.

  10. Like Spacegeek and Nancy, I am a superflasher. I am nearly 69 and will probably be on HRT for life. I had my last period in 2008 and was almost immediately plunged into menopause hell. At one point I was having between 40 and 50 hot flashes per day. I had crashing fatigue, cold flashes, joint pain, multiple daily PVCs that got me sent for a cardiac evaluation (normal), insomnia, and more. The only thing on the lengthy laundry list of menopause symptoms I did not get was heavy periods. Mine tapered off then stopped during 2008. I am now on HRT and my NAMS gynecologist and I are still tweaking the dosage. I have been on 1 mg of estradiol and .2 mg of norethindrone acetate (progestin)for the past year. That dosage has gotten my hot flashes pretty much eliminated during the day and down to 2 sweat drenched hot flashes every other night. I saw my doctor just last week and we are again adjusting my dosage. We are keeping the 1 mg of estradiol and upping the progestin. She has suggested waiting 8 weeks to see how the new higher dosage works and then adding Prozac if I don’t feel improvement.

    After reading “Menopause Matters” by Avrum Bluming, M.D. and Carol Tavris, PhD. in 2019 my fears about any danger for me in taking HRT were relieved. I suffered needlessly for years. I am angry about the poorly designed Womens Health Initiative study that in 2002 caused the incredible backlash against HRT that is still with us today. The tide has turned a little. Most menopause specialists now advise that most women can safely use HRT if they are within 10 years of their last period. However, they still advise using the lowest dose possible for the shortest time possible. There are some of us that have very poor quality of life without HRT. I am 15 years past my last period and am still symptomatic. Because I am nearly 69, I am on Medicare. Medicare does not like a woman of my “advanced age” to be on HRT. I thank my lucky stars that I have a menopause specialist who is willing to fight them to get coverage for me.

  11. I’m so happy that you chose HRT! I’m a 65 year old who has been on bio-identical hormones since I was in my late 40’s. I learned there are hundreds of symptoms of peri menopause, I would get out of bed in the morning and the bottoms of my feet hurt! Who knew? After having saliva testing done by an anti-aging/functional medicine doctor, I started on a progesterone pill and an estrogen cream with testosterone from a compounding pharmacy. It has never been covered by insurance and there was a time in my life where I struggled to pay the expense, and questioned the importance of balanced hormones. Looking back, I am so glad I did! My physical and emotional health are worth it ~

  12. Read Menopause Matters by Avrum Bluming M.D. and Carol Tavris PhD. It is eye opening and will allay many fears surrounding HRT.

  13. Thank you for sharing so much and being so open and honest. My provider who manages my thyroid hormones does menopause hormones as well. I have thought my symptoms weren’t that bad but reading what you’ve experienced makes me think I need to investigate more and see if hormones would help. Would you share the mouthwash for dry mouth? Dry mouth is one of my top issues currently.

  14. I’m reading your column on my lunch break, and the project I was *JUST* working on is an updated flyer for our local Breast & Cervical Cancer Control Project (or program, depends on your area). It’s a long-established (30+ years) federal program that can pay for mammograms and Pap tests for women age 40-64 without insurance, with insurance but who can’t afford the copay, or who have Medicare part A but not part B. If breast cancer is found through being a client of the program, a companion federal program will help you get treatment. Ask at your local state Department of Health office or sleuth on CDC.gov/cancer/nbccedp

    1. I’ll write a whole post, but the hospital in our county that offers free mammograms got bought by a new company. The phone number is out of service. I called the state department of health, they gave me the number of another person, who gave me the out of service number, and then a different number. I got through to the hospital, they said they’d call me back and never did. I left messages and emails for the head of the department of health for my county and no response. I tweeted my county executive and it was ignored. I called another county, they said they can’t help me because I am not a resident. I asked my mom’s oncologist who got me in contact with a social worker who focuses on those who can’t afford breast cancer treatment; she gave me the same numbers and said sadly she’s a expert in other counties not mine. So yeah… after weeks of run around with my terrible fake insurance and radiology companies and various health departments and hospitals I’m grateful for a $99 coupon.

      1. INSANITY!
        I’ll see what I can find out about providers in your area. Someone has to have the contract…or perhaps has breached one?!

  15. Alison, glad that you found a NAMS provider and are sharing your experience. Dr Jen Gunter’s “The Menopause Manifesto” is a good resource if others aren’t already aware of it.

    I’m also surprised about your difficulty getting mammograms covered. Maybe try a health outreach event that offers breast cancer screening?

    1. I’m surprised about coverage for screening mammograms as well. Those are preventive care and under OBAMA-care type coverages should be covered.

      As someone who has a family history of breast cancer -Mother and both Aunts- I think that in the glow of HRT you failed to mention that family history can impact the riskiness of HRT.
      I’m fine with advocating HRT for those without family history and bad sympthoms, everything is a choice, but the statement about HRT causing pre-existing breast cancer to grow is dismissive of the risks of breast cancer. There is no cure for breast cancer that has recurred.

  16. I’ve been on the .0375 Estradiol patch and Progesterone 100mg at night for a couple of years now after a battle to get anyone to listen to me too. Thank you for sharing this. I’m doing my best to share my Perimenopausal experience with sisters-in-law, younger cousins, neices, etc because we need to be talking about this. I found waterproof makeup remover takes off the sticky patch residue without much effort and no irritation. I figured if it removes waterproof mascara and long wear eye liner it would work and it does a great job. My provider switched me to a different brand (Mylan) of patch about six months ago and I haven’t had any issues with it coming off since.

  17. Oh my dear woman–your last two posts have really made a difference to me. I’m in the throws of hot flashes every 50 minutes and have SUCH joint pain. My mom had hormone-receptive breast cancer, and I have eschewed HRT as a result. But maybe a conversation with my provider would be good… just to understand the risks. I’m suffering and my family is too. Thank you THANK YOU for talking about this.

  18. Alison, Thank you so much for this thoughtful, informative post about HRT and menopause–and the importance of working with a healthcare provider who will listen to you.

  19. This is such excellent information, thank you.

    I am now going to forward this post’s link to my Congressman. Insurance companies should feel some pressure to step up.

    1. Thank you Allison for this post and sharing your experiences with perimenopause. It has been helpful to hear an honest experience. Thank you!

  20. Good for you Allison! I’m on the same dosages, minus the testosterone. I did switch brands of patches to Mylan as the adhesive works better (doesn’t rub off as easily and doesn’t give me a rash). My HRT is at least partially covered by insurance and I plan to fight tooth and nail to stay on it for as long as possible. I’m a “super flasher” and it doesn’t mean anything good (20-30 flashes a day). I wish men would routinely get hot flashes – then heads would roll!!

  21. I was on no prescriptions until a year ago, and now I’m on three, and I’m 60 years old! Meaning I was also very resistant to being on any kind of drugs, like you. I took a strange pride in it. I’m glad you’re feeling better!

  22. I finally went on HRT patches after 3 years of trying to deal with symptoms “naturally”.
    I’m on the Climara Pro patch (weekly) It is a combo of estrogen and progesterone. I had a similar problem of the patches not being sticky enough and falling off (due to sweating etc).
    I now buy “tegaderm bandages” to put over the HRT patch. These stays on and keep everything in place regardless of exercise, swimming, showering or sweating. I buy 2 3/8″ x 2 3/4″ transparent film dressing on Amazon. I get a pack of 100. Hope this helps!

  23. For prescriptions, you can also try Costco or Sam’s Club. Call them to check prices, availability, or check their websites. Even if you aren’t a member, you can still get prescriptions. Just tell the checker at the front that you are there for the pharmacy.

    1. Also, thanks to the Affordable Care Act, screening mammograms for women over 40 should be covered FOR FREE every 1-2 years. I would encourage you to double-check on the cost of a mammogram with your insurance and providers in your area.

  24. It is crazy that most of us never even hear of Perimenopause until we are within a decade of it, and while many women never have a baby, we all go through this. For me it was longer and more wild than actual Menopause. I described symptoms to my GYN and got the shrugs “yep, normal, just wait it out” and that was about it.

    My theory is there’s no real money to be made, unlike Pregnancy, so it’s ignored by big health.

  25. Thank you for sharing your journey. I am also 48 and have recently started to have ridiculous conversations with help practitioners. I mean I have heard some wild things before but the talk of “it’s normal, you’re just getting older ” is certainly applying to anything and everything these days.
    The assumptions of my lifestyle based on my body/age range from annoying to downright offensive.
    As a mother of a 15 year old daughter I find that empowering her to learn about her body, to recognize what is or not normal for her is important and can change how she lives her life.
    Every journey is a journey but FWIW my mother used patches for the longest time and they really helped her with no other complications.

  26. Allison I take the exact hrt dosages in the patch and pill as you, but my patch is the size of my thumbnail so it doesn’t peel off. As if it comes in a smaller size at the same dosage by a different manufacturer and you’ll be more comfortable. Just a tip.

  27. Thank you for sharing. More of us need to talk about this. For years, I was telling my long-time OBGYN (our relationship started with my first pregnancy in 2001 and outlasted my marriage) about the hot flashes, insomnia, brain fog, fatigue, chronic congestion (as a non-allergy sufferer, this was incredibly frustrating to manage and get diagnosed) and she’d just shrug it off. A woman MY AGE. She refused to prescribe HRT because of the “cancer risks” (without explaining what they were). I suffered and tried to find home remedies (CBD, scheduled naps) but when things got really bad and I felt like I was going crazy, I went back to see her and she said “you know, most women don’t even experience symptoms of menopause.” And that was it. I broke up with her.
    I know see a Nurse Practitioner who listened to me, let me cry, acknowledged all the problems, even that the congestion can be hormonally caused. She put me on a low does of HRT and when my insurance refused to cover the one she prescribed, worked with me to find one that was covered.But all this begs the question: why do we have to go through so many hoops to find Rx that ARE COVERED BY INSURANCE (I know the answer, cough cough, patriarchy) but anyway, I love that more women are talking about their experience because we all go through it and we live longer in a state of menopause than we do any other phase (assuming normal life expectancy) so let’s de-stigmatize this natural cycle of life. Oh, and put some medical research money into more studying. Good luck, sisters in peri-meno-post!

  28. Thank you for sharing. I wish would have help me during my journey. Now 70 with HRT and still have a hot flashes, but not as often.
    Will share with my niece’s, younger siblings and daughter. Now turning 40, 50 & 60’s.

    Where should I send you a Starbucks card?

    Marta G – Modesto, CA

  29. I had to read your hrt post as I’ve been on a journey with it myself. Good on you finding someone helpful. I didn’t start until a few years after my P stopped. Regret that now. I suffered the last 2 years of peri-meno flashes from hell which were not great as a sales rep. I looked like I was being interrogated for murder during meetings with water dripping off my forehead and puddling in my seat … you trust me don’t you? Joint pain, weight gain etc. I initially went with one of those HRT specialists that didn’t take insurance but had all these admin fees, expensive consults…and testing but got me on compounded bio identical which is what I wanted. She put me on testosterone as well. Turned me around and I felt so much better. HRT and adding in running to my exercise routine! My joints felt so much better. Started IF also and lost 30 pounds. But sooo expensive and I kept feeling like it wasn’t sustainable so I decided to consult with my gyno who is part of meno org. She said NO to testosterone said it was terrible for heart. Reluctantly put me on pharm grade bio identical combo patch at lowest dose. Haven’t felt the same since and it’s been a fight to get Rx refills. After my annual she put me thru pap, mammo, pelvic, ultrasound, and endometrial biopsy to confirm I had a benign fibroid before she would renew Rx. Cold turkey stopped hormones to complete all the testing which I thought was bad practice. I also have had high cholesterol since menopause but no other issues. I still have to meet with nutritionist and PCP to address. Ultimately she wrote an Rx for stronger dose but still no testosterone. It’s been good so far.. sleeping better and flashes stopped. Time will tell. Fighting the urge to go back to the compounding version. It’s worth noting that compounding is not fda approved so my Dr indicated there could be variations in strength dose to dose Rx to Rx which she did not support. Why is this so hard. At least it’s getting more attention than before and I imagine down the road future generations will have an easier time. Thanks for sharing your experience and keep us posted.

  30. I have read your blog for years and this article is what has made me want to comment for I think the first time! I am a few years younger than you but thanks to people like you, I recognized symptoms of perimenopause in myself early and sought help. When I was debating how to approach my health care provider, what medicines/supplements to try, and how to explain my symptoms, your website was where I looked first because your honest descriptions of your own health journey are what I remembered when I began facing some similar issues. Thank you for talking about this and providing resources as I have found that my friends are often uncomfortable or vague when giving their own experiences. So thank you!

  31. We all have different “symptoms “ and the severity can be wildly across the board. So our approach to managing our issues should be different. It’s not a one size fits all. For me, the decision came down to wanting to improve the quality of life. I couldn’t fathom feeling the way I was feeling for the next 10 years. There are things that I think could still be improved and I plan on discussing with my doctor at my next appt. But the difference in the last year since starting HRT is huge and I only wish I had started it sooner.

  32. Alison, for anything and everything it’s so important to find a doctor and/or health professional who makes you feel comfortable, listened to, and respected. Good for you for being willing and able to find someone who fulfilled these important needs. And double yay for finding relief and a program that is working for you.

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