It might be Hysterical, if it weren’t so outrageous.

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The theory is, I have a medical comorbidity complicated by Thyroid Disease (Hashimotos), or maybe I am just nuts.  As some of my readers know, I am exploring the ongoing effects between hormonal disturbances (effects women as well as men) and anxiety/obsessive disorders.

Many people experience no adverse effects during hormonal fluctuations; however this is about those who do. I have read thousands of posts from people who are in support groups and taking potentially dangerous drug concoctions, herbal remedies and hormones while still suffering through this phase of their lives.

Hormones are most in flux during puberty and pre-menopausal stages.  Some people begin to feel more marginalized during these times, as their body and sometimes their mind goes through changes.

For women, think of it this way, for roughly half of the month (or half of your life) you or your partner, or sister, or mother, may be negatively affected; multiply that by half of the population and you can see how prevalent the problem is.

In the medical community women are still considered second-class citizens.  It is well established that women are more hormonal and occasionally emotional, but they should ever be dismissed as simply hysterical or mentally ill.  Sometimes there is controversy within subsets of women instead of presenting a united front, which diminishes their power. Challenging the medical community is one of these important issues we women must stand together. We will all need medical care at some point and that care should be based on your gender and not second-guessing.

What many physicians still fail to acknowledge is that female bodies operate differently from males and cannot simply be interchanged.  They simply have little or no scientific data.

We do know women are more prone to psychological issues; this is a biological fact based on biological events.  Yet women are still not treated equally in medical studies.

Women aren’t properly represented in scientific studies.  By Melinda Wenner Moyer 

…Clinical trials are men-centric as well.  According to a 2006 study in the Journal of Women’s Health, women made up less than one-quarter of all patients enrolled in 46 examined clinical trials completed in 2004… Sex also impacts how a person responds to medication: Women taking antidepressants and antipsychotics tend to have higher drug concentrations in their blood than men do; they also require half as much influenza vaccine for the same level of protection, though they are always given the same amount… Of course, this bias isn’t malicious—just a little lazy. Because males don’t have a menstrual cycle, their hormones do not fluctuate much over time, making them a more homogenous study population and ensuring that results are easier to analyze and interpret. (Slate)

Instead they remove our lady parts, which is barbaric.  If you think that statement is hyperbolic then consider this, how many men are castrated each year due to hormonal or psychological difficulties?

Hysterectomy in the United States: Facts and Figures

The United States has the highest rate of hysterectomy in the industrialized world, and according to the Centers for Disease Control and Prevention (CDC), hysterectomy is the second most frequently performed surgical procedure (after cesarean section) for U.S. women. 

Approximately 600,000 hysterectomies are performed annually in the United States, and approximately 20 million American women have had a hysterectomy [3]. Studies show that anywhere from 10 to 90 percent of hysterectomies performed in the United States are not medically necessary, evidenced by the fact that today, approximately 90 percent of hysterectomies are performed electively [2].  The National Women’s Health Network (NWHN) believes that unnecessary hysterectomies have put women at risk needlessly, and that health care providers should recognize the value of a woman’s reproductive organs beyond their reproductive capacity and search for hysterectomy alternatives before resorting to life-changing operations.  https://nwhn.org/hysterectomy

For 45 years I had a regular cycle of 28 days and suddenly that stopped two years ago after surgery to remove an ovary and very large cyst.  I have since learned of the hidden joys of perimenopause.  I have also experienced an alarming and unnatural spike of anxiety/obsesive symptoms that I am particularly interested (and frankly scared) of exploring.  These indications have progressively increased and worsened this year.  Perhaps these are warning signs which will reveal a key to my overall health, hence the endocrinologist appointment.

It is only recently that I have realized I have intermittently experienced onslaughts of OCD-like symptoms, mainly obsessing (Pure-O).  Anxiety runs in our family. But this is something different; accompanied by several weeks of vomiting, gagging, lack of appetite and weight loss; usually after a major hormonal shift (child birth, ceasing breast feeding, surgery, a major illness). So I started to search for similar cases in the medical data and found many:

Obsessive-compulsive disorder

New-onset obsessive-compulsive disorder (OCD), a relapse of OCD, or a change in OCD symptoms may occur during menopause. Fluctuations in OCD have been correlated with the menstrual cycle and with pregnancy, suggesting that hormone levels may contribute to the disorder.[20]     http://emedicine.medscape.com/article/295382-overview

As a stop-gap measure for my most recent episode which is lasting months instead of weeks, I began a low-dose estrogen patch and an SSRI (Prozac) as recommended, until I can see an endocrinologist.  I am also trying magnesium, B12, Estroven and fish oil. The theory is that I have shifting estrogen levels which are affecting serotonin levels and causing brain health abnormalities.

When I was initially diagnosed with Hashimotos Disease, the endocrinologist gave me Synthroid pills and tested my blood every other month until he decided the TSH numbers were correct, and that was it.  It did not matter how I was feeling, all that mattered were the numbers.  When I returned with complaints he asked me why I was back in his office and stated that what I was feeling was impossible and dismissed me by saying there was no need to ever come back.

Doctor, Shut Up and Listen By NIRMAL JOSHI. JAN. 4, 2015.  The New York Times.

A doctor’s ability to explain, listen and empathize has a profound impact on a patient’s care.   http://ht.ly/HjE5Z

I am now on the hunt for a new endocrinologist. I have narrowed it down to three – two are older and more experienced, and one is younger and just starting out.  Who to choose?  Specialists take many months to see, so I made appointments with two of them so far, a month apart.  I hope the first one, the youngest, is a keeper. Before choosing them, I researched these doctors as much as I could online (see below*).

Tomorrow I have to re-consult with my OBGYN who I was initially annoyed with, when he told me to consult a mental health specialist for my hormone problems!  The OBGYN stated that it was easier to treat the mental health symptoms than it was to treat the hormonal ones.  I found this shocking. However, after much research, it turns out that he is right, in a sense.  It is cheaper (and easier for them) to try to treat my symptoms with an SSRI, than to find and fix a possible underlying problem.

It must be noted that perimenopause is not considered a disease, I am not as concerned with hot flashes, night sweats, etc. which I have been experiencing for over a year – as I am with the effects on my brain, weight loss, the vomiting, and being unable to eat for more than two months.

As I stated earlier, there is very little reliable data available regarding women’s health and hormones, or their effects on general well-being, mainly because the medical establishment has almost always used the male species as the preferred medical model.  Why?

Science Codex.  Women aren’t men – yet studies often apply results in men to women.

“It’s rare to see this kind of commitment to research in women’s health. I can count the institutions on my fingers,” Pinn said. “The issues Northwestern is working on will hopefully unlock the answers for many of these health issues. The results will have implications for the health of women worldwide. To improve women’s health care, it’s important to generate new knowledge.”    http://www.sciencecodex.com/women_arent_men

There are others who say hormones are so complicated and diverse that they are difficult to study.  However, complicated problems have never dissuaded scientific study before, only lack of interest or funding.  This is important because there will never be funding available if women settle for cheap alternatives like SSRIs which are routinely thrown at feminine problems. We must demand more.

Note: Most of the information readily available to women is found online. Much of it is anecdotal and herbal and touts a “natural” remedy while trying to sell you their product; there are few medical sites with real scientific studies.

 Warning

While supplements are among the most commonly used to help control menopause symptoms… It’s important to note that research is still ongoing to determine their effectiveness. To date, no supplement has consistently been shown to work better than placebo in managing symptoms.

Also, keep in mind that dietary or herbal supplements may have side effects or interactions with each other or with other drugs. Some may be unsafe to take due to certain medical conditions. Consult with your doctor prior to using. (webmd.com)

SSRIs are also not without risks and there are no studies that have proven their effectiveness nor studies which fully understand how they work; so we throw a pill at it and hope for the best.

As women we simply need to advocate for more women’s health studies. You can be damn sure that if these problems affected male mental functions and/or the penis, a cure would have been found years ago!

The question this week is, why aren’t more women pissed off about these issues?  Share a reply below.

*There are many sites online for consumers to comment on their doctor.  Simply type the doctor’s name in your browser and a site like Healthgrades.com, ratemds.com, lifescript.com, npidb.org, and doctorsdig.com will appear.  These sites should only be used as a guide or a starting point, and are certainly not definitive. As with most rating sites, people who are dissatisfied are often more motivated to take time to rate them.  So if you like your doctor, take a moment to give them a good rating, it is completely anonymous, takes minutes to do and may help someone else like you.

You might think it is easier to stay with a doctor you are not fully satisfied with because the process of finding a new one takes so much time. Don’t be discouraged! You are worth it!

References:

Find-an-Endocrinologistwww.hormone.org or call 1-800-HORMONE (1-800-467-6663)

Hormone Health Network information about menopause www.hormone.org/Menopause
www.hormone.org/MenopauseMap

Mayo Clinicwww.mayoclinic.com/health/hormone-therapy/WO00046
www.mayoclinic.com/health/bioidentical-hormones/AN01133

MedlinePlus (National Institutes of Health): www.nlm.nih.gov/medlineplus/hormonereplacementtherapy.html

Natural Treatments

http://www.webmd.com/menopause/guide/menopause-natural-treatment

North American Menopause Society:  www.menopause.org 

Perimenopause

http://www.ourbodiesourselves.org/health-info/what-to-expect-perimenopause/

Premenstrual syndrome (PMS)

http://www.mayoclinic.org/diseases-conditions/premenstrual-syndrome/expert-answers/pmdd/faq-20058315

Science Codex.  Women aren’t men – yet studies often apply results in men to women.

http://www.sciencecodex.com/women_arent_men

U.S. Food and Drug Administration information about bioidentical hormones:  www.fda.gov/ForConsumers/ConsumerUpdates/ucm049311.htm

Women aren’t properly represented in scientific studies. by Melinda Wenner Moyer  (Slate) http://www.slate.com/articles/health_and_science/medical_examiner/2010/07/drug_problem.html

Women’s Health Initiative (U.S. Department of Health and Human Services):  www.nhlbi.nih.gov/whi/

Yoga

http://www.healthline.com/health/menopause/alternative-treatment#Yoga8

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