I recently received a phone call and the woman on the other end, who is also a medical doctor, was very distraught. She had just lied to her doctor so she could receive treatment for menopause. She knew it was wrong to lie because she hates it when patients lie to her, but she felt she had no other choice.
I've known her for some time. When we first met she was skeptical and she questioned my motives and my information. When we first met she was in her late 30's and feeling very good. She was running a very busy ob/gyn practice, had just given birth to her second child, and was in a very good marriage. Her husband, equally busy, is a surgeon. She was taught that menopause was no big deal and she told me so. She was insensitive to her patients suffering and chalked it up to maladjustment to growing older. She told me, "Some people just like to bitch and complain."
About 2 years after we met she called me at 11:30 pm and was crying. She said that she couldn't sleep and that she had surgery in the morning. She hadn't been able to sleep all week and she was a mess. She couldn't take sleeping pills because she had to be sharp. She had measured all of her ovarian hormones, estradiol, testosterone, progesterone and dhea and all were exceptionally low. What should she do? What was the treatment so she could get on with her life?
I started to tell her about replacing her gonadal (ovaries are gonads) hormones but she didn't want to hear it. She said she only needed estradiol and wanted to know which product and dosage. So I told her 0.1 mg Vivelle dot and said she would feel much better if she replaced all of her gonadal hormones because she had suffered gonadal failure (ovarian failure) which causes multiple, chronic hormone deficiencies. She wouldn't hear of it, said thank you and good bye.
About two weeks later I received another late night phone call from her and again she was crying. She was feeling very disconnected from her family and husband. She had very little patience with her children and husband. She had no interest in sex and missed it very much. She felt very distant from her life, as though she was watching it from a distance rather than living it. She asked if omitting the other gonadal hormones may have something to do with it. I said "There is only one way to find out. Try using them." But again, she only wanted testosterone and not progesterone because she had a hysterectomy for a fibroid a while back. So I sent her to the internet pharmacy website I use to purchase the Intrinsa patch, a testosterone patch for women currently unavailable in the United States but available in parts of Europe.
A month passed and this time I got a call early in the morning from this woman. She began to tell me that overall she was feeling better but something was still missing. She was sleeping better, though she could only sleep about 5-6 hours at a time, and she was feeling a bit anxious. I suggested progesterone and she said she really didn't think she needed it but would try it.
Just one week passed and she called to tell me how wonderful she felt. She said she was feeling great and began to question why women are denied progesterone just because they had their uterus removed. I agreed. We talked about adding dhea and she said would try that as well.
Months passed and I then I received the call that I was telling you about at the beginning of this blog. She was very distraught because she had to go to another doctor to get her prescriptions written as she stopped using the free samples in her office and needed to get her own prescriptions. She went to a friend of hers and was floored by the reaction. Here was a fellow ob/gyn she had known for years telling her that he would not be party to giving her cancer and ruining her life. He reminded her that she had a career and family to think about and that she was being selfish for wanting to treat her menopause. He said it was unnatural to tinker with nature. She told him that she wanted treatment for profound hypogonadism, a real illness, identical in women and men. He told her that she could call menopause anything she wanted but he would not be party to her self-serving nature.
So she went to another doctor she knew and lied. She said she had an early menopause and that for 5 years she has been on an estradiol patch and progesterone cream. She did not mention that she was wearing the Intrinsa testosterone patch. She lied that she still had a uterus. She lied because she wanted to keep her job, her mind and her family.
She lied and felt terrible about it.
She is a doctor and she lied to another doctor to get treatment.
I told her that in time things will change, that it will become routine for women to get treatment for profound hypogonadism, just like it is routine for men to get treatment. I helped her understand that when women are appropriately treated for profound hypogonadism they no longer need sleeping pills and anti-depressants and they can have sex again. When women are treated they can compete for jobs because they have the energy and thinking skills of younger workers. I helped her understand that she did what she needed to do to protect her health and her family's well-being.
I asked her about how she was going to change the way she treats menopausal women in her practice.
Then she did something that I didn't expect.
She thanked me for helping her feel better and said she had no plans to change. She clearly did not have the support of her colleagues and would not go out on a limb for a patient.
So I decided to write this blog about her journey and the abandonment of women by a woman doctor. Her experience and her choice to not treat hypogonadism show the resistance you may face when you try to get treatment. To all the women that are looking for treatment don't let a doctor stop you. If one says no, then go to another. Once you are being treated you will not only feel better, you can also be proud of yourself and know that I am proud of you too.