Being post-menopause feels like being unshackled, pt 1
But perimenopause sucked (until I got the hormones)
I’ve been wanting to write about menopause for a while, especially on the day of menopause, but I got distracted as always. I also wasn’t sure where to start, but now I’m several months post-menopause so I guess I can start at the beginning.
** Note: Something I’ve found most women don’t know (and I did not know until recently)—menopause is just one day, the year mark of no periods. Everything after that is post-menopause, which I’ve been since mid-January 2025. I’m on the young-ish side at 49, but the women in my family hit menopause early-ish.
But first let’s talk about perimenopause, something I originally thought hadn’t affected me much. I’ve always had a lot of weird little health quirks and issues. I have Ehlers Danlos, type III hypermobility which brings with it things like joint pain (in my 20s and 30s, I used to partially dislocate my shoulders just sleeping), digestive issues that are normally associated with diabetes (the wonderfully named “dumping syndrome” and poor blood sugar regulation), POTS, etc. I’ve always had to sleep naked since I was a kid, even in winter, because I’ve always run hot; I used to come close to heat stroke often in summer. Also since I was a kid, I’ve had issues with dizziness and low blood pressure. My body has always been a little haywire—but I hadn’t realized that that worst of it occurred around puberty, when my hormones were going insane.
Several years ago, things around my health got so bad that I finally started chasing down answers, which is how and when I got the Eds diagnosis. My heart felt out of whack—my heart would sometimes start racing for no reason and get “stuck” for hours or even days, sometimes seemingly spurred by a new supplement. I had intense sleep inertia; in the mornings my heart rate would be in the low 40s and my breath rate also qualified as bradyapnea. I would try to wake up but would essentially black out repeatedly until I could finally fully wake. I eventually got a CGM (continuous glucose monitor) and was horrified to find that my spikes and crashes seemed to qualify for pre-diabetes, and that the periods of blacking out coincided with severe nocturnal hypoglycemia. I had random heart palpitations, occasional panic attacks, and felt like I was falling into a deep depression (which I attributed to COVID upending our lives).
It felt like my body was falling apart, but it was all things I’d experienced and dealt with most of my life so I didn’t think it was anything but business as usual. I knew I was in perimenopause, but I thought that wasn’t impacting me, because I’d only had two brief hot flashes. I thought all perimenopause was was hot flashes and wild menstrual cycles. (I would skip 3 months and then gush rivers of blood for three days, stop and then do it again a week later, then I’d skip 4 months, 2 months, 6 months, and be regular for 5 months, and on and on.)
It wasn’t until my libido was completely gone, my clitoris had gone completely numb (and I mean completely), and things had almost completely dried up that I sought hormones—all I cared about was saving my hair and my sex life. I didn’t know the hormones would completely save my health, and my life, too.
I hate going to the ob/gyn, so I hadn’t for years. I finally made an appointment, but I was dismayed at her lack of knowledge on MHRT (menopause replacement therapy). She said she’d be “fine” prescribing it unless I had some contraindication like clotting disorders and blah blah blah. I foolishly mentioned having the Factor V Leiden gene mutation but that I only had one copy and had never had a clot, even when I was younger and smoked a pack a day while on the pill. She looked at me in horror - she didn’t want to give me MHRT, would want me to see a hematologist.
I had already done the research and new that transdermal estrogen, versus oral, did not significantly increase clot risk since it bypassed the liver. I knew if I were a risk, I’d have gotten a clot by now. I was considered an “increased risk” because my dad had had clots, and my grandmother as well - but my dad ONLY had clots because of yet-undiagnosed lung cancer (cancer makes red blood cells “stickier” and more prone to clotting); my grandmother was in her late 60s, overweight, had a poor diet, and did not exercise at all.
I made my own judgement call and used online services, but one of them sent me to a doctor who also griped about my gene mutation and would only give me the absolute lowest estradiol gel dose possible (in addition to progesterone). When I complained of low libido, she sent me a list of “female-centered” porn sites to try. This is when I searched for other options. I was already very familiar with those porn sites. She assumed I was some stifled middle-aged woman not in touch with her sexuality. But I was no stranger to porn. And kink. I used to masturbate like breathing (no, really), had a massive collection of toys, could orgasm with minutes and five more more times in a row. Getting in touch with my sexuality and looking at porn were not the fucking solutions I needed.
So I did what I always do—spent months on deep research dives into menopause. For once, the Instagram algorithm gods gave me something useful. They showed me Dr. Rachel Rubin, a “urologist trained in sexual medicine” who was educating other doctors - and women - about menopause and who understood that sexuality matters. She openly talked about the importance and benefits of MHRT, including the highly-sought after (by women) benefits of testosterone. She was in DC, 9 hours away by train. She wasn’t taking new patients, but her associate, Dr. Christine Vaccaro, was.
I made an appointment. I traveled the distance. I had the most pleasant experience with a doctor that I’ve ever had in my entire life. She agreed that having smoked somewhat heavily while on the pill and never having had a clot meant I was very low risk, and she greatly increased the dosage of my estradiol gel and progesterone, and she prescribed testosterone gel for my numbness and lack of libido. The desert became an oasis.
I started seeing a ton of new growth in my hair. Sensation and my libido returned. Sleep got better. I had energy again, I exercised more… I started lifting heavier and heavier weights and now have muscles for the first time in my life. I drastically changed how I eat (I stopped existing on pasta and pastries with a few servings of vegetables in-between). My blood sugar swings leveled out. My heart stopped being erratic. I wasn’t hit with bouts of dizziness every time I moved. I wasn’t bloated constantly.
It’s been about 9 months since I started proper MHRT with testosterone, and I sailed into menopause and post-menopause feeling as good as can be. And it’s only now, months later, that I realized my health in perimenopause mirrored my health in puberty.
I’m about 6 months post-menopause now, and I can honestly say I feel better than I ever have. Menopause has been a life-changer in the very best way. I’ll get into the psychological and emotional aspects in pt ii, but the gist of it is I feel completely liberated in a way I never imagined possible. I fully believe that menopause is what’s allowed me to finally see clearly and to grapple with a lifetime of abuse. When you’re younger, you hear older women talk about how, as you age, you stop giving a shit. And you can’t really understand what that means or how it feels until you’re there, but I’ll tell you it is absolutely glorious.
People to follow for up-to-date and useful hormone and menopause information. Educate yourself, because most doctors have no clue, including ob/gyns:
Dr Christine Vaccaro (This is who I see in DC for my MHRT - she is FANTASTIC.)
Kelly Casperson MD (and her podcast, “You Are Not Broken”)
Menopause Doctor (Dr Louise Newsom)
Must Read Books: