In my early 40s, I went to my gynecologist and basically asked for a hysterectomy. I had had two babies, my sons, and did not want more children. But I asked for the hysterectomy because my periods had gotten so heavy I was basically hemorraging every time I menstruated. The last draw was when Derek and I were celebrating our anniversary in San Francisco. Despite using jumbo tampons I changed every few hours and pads, I bled all over the hotel's white sheets. And the cramps were crippling. Every. Single. Time. Like rocking on the floor or bed in fetal position until the four ibuprophen I took kicked in. I had to take four 200 mg pills every 3-4 hours to stay on top of the pain. I had dealing with that level of menstrual cramps for 25 years.
So I was done. But instead of a hysterectomy, which is a pretty major procedure and affects hormones if one or both of the ovaries are removed, he suggested an ablation. The ablation he provided was called NovaSure. He would remove the lining of the uterus, the endometrium, with an electrical current, basically cauterizing the tissue lining. I would not be able to have more children. Sign me up, I said. My sister-in-law referred to it as the "napalming" of my uterus.
I could be awake for the procedure, which would take a few minutes, or I could pay the extra money and be anethetized in the hospital. I had given birth to one of my sons naturally and thought I was a badass and so opted for being awake. Foolish, frugal, cocky woman! It was so painful that during the procedure, Derek apologized to me, let go of my hand, and left the room. But ah! No more periods! It was, besides asking Derek to marry me and having two sons, THE BEST THING I EVER DID FOR MYSELF.
So when I started experience what seemed like menopause, I had no idea if it was actually happening because I don't menstruate and haven't since the ablation. My gynocologist tested my hormones, but the results were ambiguous because I could either be in menopause or somewhere else in my cycle (the ablation doesn't affect hormones, and I was still ovulating on a monthly basis, unless I was in menopause... )
The symptoms were all there. Sleepless nights, drenched in sweat, achy hips. My libido plummeted, which was terrible. Derek and I been married 25 years in November, and I attributed our marriage's longevity in part to our weekly conjugal visits. If the waning libido wasn't bad enough, intercourse, when we did have it, starting becoming painful. My gynocologist explained that it was because of something called "vaginal atrophy," the thinning and drying and inflammation of the vaginal walls that can make sex painful and also cause urinary tract infections. Apparently it is referred to as "genitourinary syndrome of menopause (GSM)." I started getting UTI's for the first time in my life.
My god, what women have to bear...
And then I listened to Mel Robbins podcast episode on menopause: "The Number One Menopause Doctor: How to Lose Belly Fat, Sleep Better, & Stop Suffering Now" in which Mel interviewed Dr. Mary Claire Haver. I shared it with female friends. And pretty soon almost every woman I talked to had listened to it. And if you haven't, and you are approaching or in the throes of menopause, you should listen to it. And share it with your friends. What that episode does is explain to women how best to care for themselves during this time. And one of the things Dr. Haver does is debunk all the myths around HRT, or hormone replacement therapy.
I discussed this with my gynocologist and he agreed that I should try. He prescribed me the estrogen patch and progesterone pills. I eventually filled the prescription, but let it sit in a drawer for a while. I suddenly felt that my menopausal symptoms, which seemed to have been in full force a year or two or more, were possibly mitigating on their own. I decided not to use the prescription. The hot flashes were disappating. More importantly, my libido was coming back.
But sex still hurt. I happened to mention it to my regular doctor during a routine visit, and she thought I might try vaginal estrogen creme and see if that helped. She prescribed me this:
I was supposed to use it every day for two weeks and then three times a week therafter, but I'm forgetful, so I've just been using it every couple of days for about a week and a half. And I will just say that it has changed my life.
Of course, there are always warnings. According to the National Library of Medicine,
"Women with increased exposure to estrogen are at risk for endometrial cancer."
I will not get all Fifty Shades of Grey graphic on you, but last night for the first time in a long time, penetration was not only not painful, but pure pleasure. I might have cried if I weren't so relieved and happy.
Here's to keeping the love alive.
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