Hormone Replacement Therapy (HRT) - The HeaRT of the Matter

I was getting my hair done a couple years ago at my favorite salon, along with five other women 'of an age', when talk turned to the Change. Most of us were loudly proclaiming our favorite natural remedies and fixes. The woman in the chair adjacent to mine finally spoke up apologizing to the roomful of menopausal goddesses for having “caved”, finally starting HRT (Hormone Replacement Therapy)..

“It's just that I couldn't sleep,” she told us shamefacedly. “I couldn't sleep at all. I was so tired I couldn’t function. And nothing else worked.” We all leapt in to assure her that there was no need to feel guilty. The risk-benefit ratio seemed pretty clear to all of us. Underscored for us was that we women need to support one another through this process rather than judge anyone, including ourselves.

But I have to admit that I was feeling pretty smug and blessed that I was coping without HRT. My symptoms were manageable. What’s that thing they say goeth before a fall? Oh yeah, pride. I no longer have a surplus of that. I eventually ended up on low dose HRT myself. And honestly, I wish I’d taken it sooner.

First welcomed as a godsend, now seen as a terrifying, politically incorrect alternative for menopause symptom relief, HRT may actually be neither. In deciding whether we wish to consider HRT as a viable option, we really need to evaluate our personal risk-benefit analysis. In other words we need to list pros and cons, and then weigh those pros and cons in order of importance.

History of breast or other reproductive cancers in your family would cause you to rate your risk higher. Family history of blood clots, stroke, or heart disease also put you at higher risk. If you have or have had any of these conditions yourself, the risk may be too high and you'll want to look elsewhere for help. And if you are a smoker? HRT is not a great idea for you; your risk of heart attack, stroke and other cardiovascular disease spikes.

On the benefit side, if your hot flashes are 30+ per day, so intense that you are nauseous, or your sleep deprivation from insomnia is making you psychotic, then HRT may be a valuable help in the short term. More risk is associated for all women with long term usage of HRT, so taking it to “get over the hump” may be an option. Above all, do not feel guilty if you decide that the herbal, natural route didn't work for you and you need to avail yourself of HRT. Our own Beej-Venus tried herbs and immediately stopped using them because they “gave me a rush”.

If you should decide to consider HRT as an alternative, be sure to stay aware and re-evaluate periodically whether you might be ready to slowly decrease and ultimately discontinue your hormones. Above all, be gentle with yourself and choose what’s right for you. (Next blog entry, we’ll examine briefly both bioidentical and synthetic hormones. Material partially adapted from our upcoming book -to be released very soon. We’ll keep you posted. For the latest, visit our mothership blog at menopausegoddessblog.org)

Burn It Again For The First Time, Menopause Goddesses Escape The Tyranny of Constrictive Clothing

While I didn’t actually burn my bra the first time back in the late 60’s/early 70’s, I did so symbolically. I simply refused to wear one in honor of the emancipation of women. Of course, I caved later when I entered the workplace, strapping myself into my 34B harness every day. It didn’t bother me all that much at the time. Now with the advent of menopause, a lot of us are ‘burning’ our bras. (Okay, not really - we don’t want to contribute to air pollution.) However, we are saying good-by to discomfort, binding, and entrapping clothing. Maybe it’s also time to let go of uncomfortable and constricting ways of being. We can break free - just like we did in the 60’s. (Visit our site at menopausegoddessblog.org)

A Pause Felt 'Round The World

Menopause is a singularly unifying experience for all women. It transcends social, cultural, economic, language, and other barriers to bring us together in a flash. Literally. Case in point: I climb aboard the Budget van at LAX to ride to the rental car lot. Our driver is a gorgeous fiftyish African-American woman with heroically long fingernails and beaded tresses. She looks really good (for her age.) As I embark, she asks me if the van’s temperature is too cold. In fact, it is nearly arctic - and feels just fabulous to me. Before I can voice my opinion, however, she eyes me critically. “Oh, I don’t need to ask you.” she told me in full voice. “I know you understand how it is. I’m hot all the time these days, so I have to check to see if I’m freezing my poor passengers with the A/C cranked up so high.”

We bond emotionally, instantly, recognizing each other as fellow changelings. My husband follows me to the front, content to observe our cameraderie. He doesn’t mind the cold; he’s had to live with the human furnace lately. Three other passengers in their 70’s mumble that they are fine and sit in the rear of the bus. She shares immediately, “I could not figure out what was wrong with me! I was hot, sweating all night. It was awful. My mom told me ‘honey, you’re just goin’ through the Change.’ Well, I never expected this! What do you do for it? And how long is it going to go on?” HRT wasn’t an option she wanted to consider, at least not yet. I tell her about natural progesterone cream. “It will save your sanity by letting you sleep.” She writes down the recommendation while continuing to drive down Sepulveda Boulevard, seemingly steering with her knees. She roars with laughter when my husband chimed in “It saved MY sanity! I have to live with her.” She shows me a cute little fan that she wore on a string around her neck, and I have to get out my pen and notepad. Horror stories are swapped. We discuss clothing and herbs and trade tricks (eg. sticking one’s head in the freezer for a few minutes, during the worst of a flash). Bras? “Can’t wear ‘em no more. Just can’t stand ‘em” she says. I lifted my shirt up high to show my pink cami top, proclaiming “You have to get these - to wear as your bottom layer, so you can strip down and still be decent.” “Got ‘em! In every color!”, she rejoined.

We are menopausal goddess sisters. Are we different? Sure. She’s a city girl. I live rurally. She works with the public and I am a solitary entrepreneur. She’s African-American and I’m Caucasian. But we are both women going through the biggest life transition we’ve ever encountered. And we can’t help talking to each other about it. We embrace like family at the rental lot admonishing one another to ‘Stay cool’. As we step off the van, the lone woman in the trio at the back smiles and nods at both of us. Her male companions simply look shell-shocked.

The Heat is On - And We Can’t Turn It Off

PMS. The bloating, the cramping, headaches and irritability - who could have known that it was the barest hint of what was to come?? Who imagined that we could and would feel so so so much worse? Hot flashes may be the most intense of physical changes symptomatic of the Change. When your body temperature goes from 98.6 to 3098.6 in the space of a heartbeat, your attention becomes solely fixated on that HEAT! No matter what clever euphemism is chosen to describe these incendiary bursts: power surge, short personal trip to the tropics and the like, the fact remains that they peg the discomfort needle well into the red zone.

The word “Flash” is actually a misnomer except in relating the intensity and speed of onset. It can be likened to a strike of a lightning bolt. Flash conjures up images of “short”, “burst”, “over with quickly”. But alas, that is rarely the case. A flash can last 5-15 minutes, or more for some of us. A menopausal theory of relativity applies here. (As so much with womanly experience, this is scientifically unproven, but anecdotally FACT. Just ask a group of midlife women.) As we approach the heat of light, time slows down and that five minute hot flash seems like a blazing eternity. Telling us to go to hell is an empty threat. Been there, done that.

Our Goddess group ultimately have agreed that the next person who tells us that they think of hot flashes as wonderful ‘power surges’ gets the full brunt of our fury. Power surges are a serious hazard. Ask any electrician. We need industrial strengh surge protectors - we are frying our circuits!

(excerpted from the upcoming book by and about the Goddesses.)