We're nearly done with this series on menopause hormone therapy, but I have a few final niggling thoughts about MHT that I need to get off my chest. And if you've hung in there with me for all SEVEN posts - bless you!
I genuinely thought I was done with the series after the last post about risk. But I’ve learned to listen to my intuition over the years, and I’m very much feeling like I need to share a few more thoughts.
But first, a quick story:
My birth plan with my first pregnancy was to “take the pain for as long as I could stand it and then ask for an epidural”. Which was all good until I got to the “couldn’t stand it” part and then received an epidural that didn’t work. As in, I still had total control over my legs and could feel everything.
The brand spanking new anesthesia resident didn’t know how to help me - he was just 17 days out of med school! He simply kept insisting I wasn’t feeling pain when I was. Bless his little gaslighting heart.
My husband didn’t know how to help me. Everything he tried just made me angry so he eventually stopped trying and took a nap.
And I didn’t know how to help me. I was completely panicked and couldn’t figure out how to calm myself down or stop raging at the world through every contraction.
After such a miserable experience, I resolved to never again rely on an epidural as my only strategy for pain management.
For my next pregnancy, I came up with a game plan for managing the pain, practiced it, and went on to have two unmedicated births. And while they were both really hard, the experiences were still better than the complete panic, helplessness, and rage I felt when my only strategy was to rely on a medical intervention that didn’t go as planned.
My fourth pregnancy was different - the pain was much more intense right from the start. I relied heavily on the tools I had to get me through those first few hours and requested an epidural at the hospital. And that epidural was the dreamiest, most magical anesthetic ever. If I could have stood up to kiss the anesthesiologist on the lips, I would have.
(Instead I threw up in my lap while I was professing my undying love for him/whatever drugs he gave me. That’s labor for you.)
So what does any of this have to do with menopause hormone therapy?
Some women just struggle on MHT. It’s not uncommon to need several med adjustments to find the right fit, and even then some women still really struggle with side effects and find that MHT isn’t a sustainable solution for them.
But even if MHT ends up being a good fit for you, it’s rare for MHT to completely eliminate all disruptive symptoms. The goal with MHT is to get to a place where your symptoms are manageable. And that may leave some unwanted symptoms to manage on your own.
So my advice is this: if you’re open to using MHT to help manage difficult menopause symptoms, go for it, but don’t be tempted to put all your eggs in the MHT basket. You may find that it a while to find the right combo of medication before you experience some relief, or that MHT simply doesn’t agree with you and isn’t a sustainable solution.
Working on the foundational pillars of health will give you additional tools to work with, and increase your quality of life in too many ways to count.
Clearly I’m team “prepare for all scenarios”. And when that preparation involves things like better sleep, healing from past trauma, learning to manage stress, letting go of unfair and unrealistic cultural expectations for women, and moving/nourishing your body in supportive, beautiful ways? I just don’t see a downside to that.
xo,
Rebecca
P.S. Both these lists are on point.