It’s good to hear that you want to receive treatment for hypogonadism (peri-menopause).
It would make sense that an endocrinologist would be the doctor to see for both illnesses as hypothyroidism and hypogonadism are both endocrinopathies, or deficiencies of endocrine organs.
Ask your endocrinologist to treat both however don’t be surprised if your endocrinologist declines to treat the hypogonadism. Unfortunately, endocrinologists, like every other medical specialty, are not trained or encouraged to treat hypogonadism in adult women over age 40, which is a completely arbitrary decision and not medically supported. Don’t take it personally and look for another doctor to treat your hypogonadism. Any MD, ND, DO, Nurse Practitioner, or Physician’s Assistant can treat hypogonadism.
Whether your endocrinologist or another doctor is treating your hypogonadism, it is very important that you are not undertreated. You are an adult woman and should receive enough medication to raise the levels of your ovarian hormones to that of an adult. Here is a link (<url removed>) to my non-profit website which has recommended levels.
Both hypogonadism and hypothyroidism can significantly contribute to depression and mood swings. Getting treatment for both should improve your overall health, completely stop the hot flashes, and decrease or eliminate the mood swings. It should also improve the quality of your sleep by helping you fall asleep easier and stay asleep longer. If you still need more help with your sleep adding a 1 mg timed release melatonin tablet at bedtime should be helpful. If you choose to use Benadryl to sleep know that it will interfere with sexual response, so take it after sexual activity.
If you ever stop treatment for either or both of these illnesses, the ill health of hypogonadism and hypothyroidism will return. In other words, treatment for both of these endocrinopathies is lifelong.
I’d be happy to answer any questions you may have as you begin treatment.
Posted by Beth Rosenshein
If I am perimenopausal, should I see my gynocologist or is an endocrinologist sufficient? I ask because I have a first appointment pending with an endocrinologist for hypothyroidism and I would rather have one doctor treat both. I am also being treated for depression and this endocrinologist is who my psychiatrist prefers that I see.
I had my first hot flash last week and have had a terrible time sleeping for close to a year in addition to terrible mood swings.
Posted by Brenda Mayer
I am glad to see that the symptoms of EDS are improved. It makes sense. Treating your hypogonadism helps your body work better, which can reduce the impact of other conditions.
I went to your forum, hormonalterrorism, and found it very informative. I would be happy to contribute and will be joining your group soon. You are providing a tremendous public service to women in the UK and all over the world. You are helping to give a voice to women who would otherwise not have one.
You are a pioneer and I admire your work.
Posted by Beth Rosenshein
I completely agree with you that menopause should be an option. The transition from the body supplying hormones to a woman supplying them could be a smooth transition if only the medical community would acknowledge hypogonadism in women and then treat it!
It is also difficult for women in the United States to receive treatment. Many doctors follow their personal beliefs about menopause, treating it as a rite of passage and something women should be glad of! This is completely medically inappropriate, scientifically unsound and unfortunately an all too common occurrence.
The best way to counter this is to use the medial names for peri-menopause (hypogonadism) and menopause (profound hypogonadism). It becomes much harder for a doctor to dismiss treatment of these illnesses in a woman because every doctor is trained to treat the identical illnesses in men. By using the real name of these illnesses we can make the treatment of hypogonadism in women so commonplace that most women will never have to endure the unnecessary ill health and poor quality of life of profound hypogonadism.
It is good to hear that you are receiving treatment and have started a forum. What is the web address of your forum? I’d love to visit it.
Keep up the good work!
Posted by Beth Rosenshein
I'm in London. I read your fascinating book- found a doctor offering Bio Identical Hormone Therapy and I'm now on a low dose of hormones.This treatment is virtually unheard of in the UK and our NHS is hostile about treating hypogonadism so we pay for decent treatment. I have been using the hormones less then a month but already I have noticed an improvement.
I have started a small forum for women wishing to educate themselves about hypogonadism and I speak openly about the health issues surrounding ovarian failure.
My real anger is with those ignorant people who view ovarian failure as some kind of "rite of passage" this is insulting condescending nonsense.
Surely it is time to banish such ridiculous notions and develop effective treatments for hypogonadism and the health risks it presents.
The menopause should be an option - not uncontrolled hormonal terrorism.
Posted by Jacksfullofaces
You are at a good age to start thinking about beginning treatment and to begin supplementing your ovarian hormones. As your ovaries produce less and less hormones you will need to provide those hormones back to your body. Eventually, as your ovaries fail, you will have to supply all of the ovarian hormones for your body.
We are extremely fortunate to have the information we need to supplement our hormones in the healthiest way. The goal of endocrine medicine has always been to use bio-identical hormones and to find the best way to administer them.
Since you still have gonadal function your dosages will be relatively small. Remember that as you transition from hypogonadism (peri-menopause) to profound hypogonadism (menopause) you will have to increase your dosages until you are supplying all of your ovarian hormones.
I understand that you do not have insurance. The cost of pre-packaged products is far greater than compounded products. Therefore, I would recommend that you use a compounding pharmacy. Typically, each hormone replaced is about $30-$40. Dhea is very inexpensive and can be easily obtained from an online vitamin store. The average cost of dhea is about $5/month. If you were to start with progesterone and dhea your out of pocket would be about $40-$50 per month. As time goes on and you add estradiol and testosterone your cost would go up to about $90-$125 per month.
As I said in my blog, you first start with testosterone cream, 1-2/mg at bedtime. If you find that your doctor is unwilling to prescribe the testosterone cream than you can use a higher dose of dhea. Instead of starting at 5 mg/day of dhea, use 15-25 mg/day taken every morning. Increasing your dhea should increase your testosterone as well as many other healthy hormones. The next hormone to supplement is progesterone. A good daily dosage is 10-30 mg/day, applied at bedtime. The last hormone to supplement is estradiol. You can start with 1-2 mg/day, applied at bedtime. Remember all of these dosages will need to increase as you start providing more of your ovarian hormones.
Once you have insurance, request that your doctor bill for the treatment of hypogonadism. It is very common for pre/peri-menopause treatment to be denied while men with the identical medical condition, hypogonadism, almost always have coverage. Since insurance covers hypogonadism in men it would be discrimination based on gender to not cover it for women.
I’m sorry that I do not know of a doctor in Fort Lauderdale, Florida to refer you to. Any doctor, MD, DO, Naturopath, Nurse Practitioner, or Physician’s Assistant should be able to help you get your prescriptions.
As you begin treatment please let me know if I can help you further.
Posted by Beth Rosenshein
i have no medical coverage and and have no been to a doctor in over 5 years. I am 45 years old and need a good doctor and med. coverage. I want to find out more about Pre/peri menopause and bio=identals.
Can any one help. I live in Fort Lauderdale, FL
Do you know of a good doctor and/or medical plan?
Posted by frantastic