Am I too old? Am I too young? How do I know if it’s my hormones?
As a woman, you’re likely familiar with fluctuating hormones, especially estrogen. Some women have an easier time with it, while others have a harder experience. If you've had severe premenstrual symptoms that significantly disrupted your functioning and quality of life throughout your life, chances are you may experience a more difficult perimenopause or menopause. A history of postnatal depression is another indicator. If your mother went into menopause early, you may be heading in the same direction as well.
My youngest patient is 18. She first came to see me with severe bleeding and pain. She has endometriosis and, at her young age, has already undergone keyhole surgery. She’s had a Mirena coil fitted but still experiences bleeding and pain. We discussed several options, and thankfully, the option we settled on has worked well. This is what I call individualized care: a partnership between equals—you are the expert of your body, and I am an expert in what I do. We collaborate to reach a decision that is safe, evidence-based, and then we give it time.
Is it my hormones?
When asked this question, I usually respond, "Yes, possibly." Women know their bodies very well, and if you feel your symptoms may be related to your hormones, they likely are. But let’s balance your hormones and see what happens. These are body-identical hormones, the same as those your body was or is producing (in the case of perimenopause). If the symptoms are hormonal, you should see improvement within 6 weeks, and by 3 months, most symptoms will have subsided. However, if you are still struggling with symptoms, something else may be going on. This could include undiagnosed ADHD, histamine intolerance (MCAS), or other biochemical imbalances, which is why a baseline blood test is often helpful to rule these out.
Am I too old for HRT?
This is a common question, and the answer varies. Even the medical community is divided on this topic.
Humans tend to overcomplicate simple things.
If you have an underactive thyroid, you’re given thyroxine. If you have type 1 diabetes and your pancreas doesn’t produce insulin, you’re given insulin. So why are your own sex hormones considered dangerous while other body hormones are considered safe? The WHI (Women's Health Initiative) study, which I’ve made many videos about and written extensively on, had several flaws. It raised the emotive issue of breast cancer, and the fear surrounding this has clouded our judgment. We’ve forgotten the basics. The basics are: if you’re experiencing symptoms, ask yourself why, and then speak to someone who is knowledgeable about all your treatment options. Discuss the risks versus the benefits, and then come to an informed decision. Often, fear of breast cancer keeps us prisoners in our own bodies—you’re not sleeping well, you’re gaining weight, and you can’t exercise because you’re too tired. These three symptoms alone actually increase your risk of breast cancer.
The point here is to look at the evidence. There’s been an explosion of new knowledge about menopause. Arm yourself with up-to-date information instead of holding on to old news articles or advice like, “HRT causes breast cancer,” or “My mother told me never to take HRT.” It’s your health and your future, so equip yourself with the right information and then make an informed decision. Without knowledge, we are merely guessing and playing roulette with our health.
Final Thoughts:
Get your information from reliable sources, engage your mind, and act according to the evidence. Be an inquirer, ask questions, and don’t settle for being dismissed.
By Dr Purity
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