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Early Menopause at Age 37
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GodisGr8 posted:
I am 37 yrs old and have found out I am in full blown menopause. My FSH level is 93 and my estrogen level is 15. My last period was March 2010. I found out 2 months later I was pregnant with my third and final child (back info: I had 2 miscarriages in a year and after 6 months of Clomid I did not get pregnant, a fertility doctor told us my FSH level was 24 (I was 34 y/o) and I was in pre-menopause and the chances of me having carrying a baby to term was about 3%). Since the birth of my daughter in January 2011, I have not had my period. I noticed in the last couple of months, I have drastic mood swings, cry easily, have hot flashes, no libido, extremely high anxiety and feelings of death (like my life is over now, which frightens me as my children are so young), depression, cry easily, emotional outbursts, I am irrational, have insomnia, etc. I hate it because these feelings seem to be more pronounced in the night while everyone sleeps and I am wide awake evaluating my future and praying to God to heal my body so I can continue to raise my wonderful children! I hate feeling this way and it is very difficult because I have NO ONE to talk to (my friends aren't going through it yet and my mom is no longer around) about menopausal symptoms, relief, alternatives to medicine, etc. The doctor put me one Premarin 1.25 daily dose, but after 6 days I stopped taking it because my abdomen hurt so bad I was doubled over and I had pain in my kidney region, will it be this way for the rest of my life.....will I have to decide on having all these symptoms or the extreme pain of a HRT? I feel awful because I have a loving husband and great children, who are all just as confused as I am over my recent emotional state. So I wonder: How long will these feelings last? Will I ever feel 'normal' again? Are there safe natural remedies to increase my estrogen level? Are some prescription estrogen pills better than others? Do estrogen pellets inserted in your hip help? If so, do the pellets still get processed by the liver? Can the pellets still increase my risk of cancer? If I do not try an HRT what are my risks of not having estrogen on my body? I feel so alone in this journey and frightened by my body, I can't stand it! Any advice would be greatly appreciated as I am desperate! Thank you!
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goldenlove411 responded:
I can't offer any help but can only say I understand! I just posted a similar story...I cannot believe I am in full blown menopause! I don't know if HRT therapy will work for me and I worry about side effects.
I just want the moodiness, teariness and hot flashes to stop! I want to feel like myself again. I don't want the excess weight around my middle.

I feel so disconnected to the old happy self I used to be....I also wonder if I ever feel normal again. I hope you get some answers too....take care.
 
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Anon_6061 responded:
I can really relate to what you're going through! My symptoms were much the same after an unwarranted hysterectomy. I'm sorry for all you've been through with the miscarriages and infertility treatments. Glad to hear you were finally able to have a baby!

Not only can premature ovarian failure leave a woman feeling like she's going crazy, it's also associated with increased risk for many health problems. So it's generally recommended that HRT be taken.

There are some OTC menopausal supplements that may help. But don't dismiss HRT based on your trial of Premarin. Also, are you sure it was Premarin and not Prempro? I assume you still have your uterus in which case it's generally recommended that you take a combined HRT - estrogen plus a progestin or progesterone - to protect your uterine lining from the proliferative effects of estrogen. It's possible that you got the cramping because your lining was building up from the estrogen with no progestin to counteract it.

There are many combined HRT options out there - pills and patches. Patches available are the Combi Patch and Climara Pro. These bypass the liver. There are a number of pill options. You could also use an estrogen only pill, patch, gel, or vaginal ring and take a separate progesterone or progestin in one of their forms, either continuously or cyclically (and have a "period"). Kind of mind boggling all the options, huh? But that gives plenty to try if some don't work well. It would seem reasonable to try some of these options before going the expensive route of pellets. And estrogen can get fairly high with them which some women can't tolerate and can be a problem tweaking the progesterone/progestin dosage. Since pellets aren't oral, they wouldn't have the first pass through the liver. But nor do transdermals - patches, gels, rings.

I've found that it's best to do my homework and not solely rely on my doctor's knowledge (or lack thereof) and then advocate for what I think is best for ME versus what my doctor wants to prescribe. And if that means changing doctors, so be it.

Hope this gives you enough info to do some homework and get moving to living your life again! Let us know what ends up working for you and how you're doing.
 
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Mary Jane Minkin, MD responded:
Dear GodisGr8,
I'll just add a couple of comments. 1% of women are fully menopausal by age 40; and indeed, many of these women are misdiagnosed for ages (practitioners often think of a bunch of other explanations for their symptoms, without looking for menopause as the explanation.) And indeed, as Anon-6061 points out, not only will you feel better with estrogen, but from a health point of view, you will do much better with estrogen (for your bones, your heart and your brain.) You don't need pellets; they do give you a high level of estrogen initially (which you don't need) and pellets are no safer than any other transdermal method. Given that patches are available, you really don't need a pellet. Patches will give you a good level of estrogen; and with a uterus in place,you need to take some progesterone type medication (a natural or synthetic progestin) with the estrogen.
And if you don't feel comfortable with your health care provider, do find someone else; you are going to be dealing with these issues for a long time, and you want someone who can handle early menopausal issues. The menopause.org website has a list of certified menopause practitioners (certified by the North American Menopause Society) who will be experienced in dealing with these issues-and they will list some folks close to your home.
Good luck, and I hope you find a regime soon that will keep you totally comfortable.
Mary Jane
 
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GodisGr8 replied to Mary Jane Minkin, MD's response:
Thank you for all the great advice. I have made an appointment with another doctor to talk about my options. Therefore, I am absolutely researching all the HRT options so when I meet with my doctor I will have many questions to ask about all the available options. I was unaware of other transdermal methods. Until then, I have drastically increased my intake of soy products and flax seeds.

What are your thoughts on removing ovaries to reduce the risk of ovarian cancer? This weighs heavily on my mind, since my ovaries are not producing very much estrogen now.

Thanks for the menopause website and advice. I greatly appreciate it!
 
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GodisGr8 replied to Anon_6061's response:
Thank you!!! It is great to receive advice from someone who has gone through the same thing. I have scheduled an appointment with another to doctor to discuss my options. However, I want to go into it with as much information about treatment options and be able to discuss the pros and cons of each (rather than them telling me what's best, then going home and doing the research, only to learn, its not for me). Until then, I eat lots of soy products and ground flax seeds.

I do still have my uterus and ovaries. However, this is an issue I will be discussing with the doctor of should I keep my ovaries or not, since they are not producing much estrogen and I worry about ovarian cancer, since it is difficult to detect.

I greatly appreciate you taking the time to respond to my post, you provided me with a lot of great information which I was unaware of before and my doctor did not discuss with me. Thanks again. I will keep you posted!
 
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Anon_6061 replied to GodisGr8's response:
Do you have a family history of ovarian cancer (OC) and are you BRCA positive? Barring this increased risk, a woman's risk for OC is very low (less than 2% which is about the same as a man's risk for testicular cancer).

Are you planning to have a hysterectomy too?

Your ovaries are probably doing quite a bit more than you realize. The ovaries of a woman with all her parts produce hormones into her 80's. I've read that after menopause they produce about 50% of her testosterone (with the rest coming from the adrenals). This testosterone can be converted into estrogen by the process called aromatization.

This study looked at endogenous sex hormone levels in postmenopausal women by organ status - intact (has uterus and ovaries), hysterectomized (but has one or both ovaries), and oophorectomized (both ovaries removed). Women who are not intact had much lower levels of testosterone. And surprisingly, although testosterone levels in intact women drop after natural menopause, they then gradually increase and reach premenopausal levels in ages 70-79 - http://jcem.endojournals.org/content/85/2/645.full.

A number of medical studies show the increased health risks and reduced quality of life resulting from pre- or post-menopausal removal of ovaries. Do a web search for "pubmed bilateral oophorectomy health risks." Here's just one of those studies - http://journals.lww.com/greenjournal/Fulltext/2005/08000/Ovarian_Conservation_at_the_Time_of_Hysterectomy.4.aspx.

I can personally vouch for the many changes caused by ovary removal. Not only did I lose my quality of life, I aged overnight. And hysterectomy caused devastating changes to my figure and internal anatomy as well as my sex life.

So do your research so you understand the consequences of sex organ removal.

As far as HRT, I agree that you need to go to your doctor prepared to ask for the delivery route and product you want to try which may not be what he/she tends to prescribe.


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