When I was first starting my medical practice, menopausal problems were not taken very seriously. Hot flashes and premenstrual syndrome (PMS) were the source of a lot of jokes. Well, it isn’t funny when you feel awful and your life is falling apart. I can’t tell you how many times I’ve had women apologize for “wasting my time” with their complaints or tell me, “Thank you for listening to me.” I would always assure them that hearing their symptoms is essential for my finding the correct solution for their problem.

There are a few patients seared into my memory bank who forever changed my attitude about menopause. I once was called to do an endocrine consultation on Joan, a patient in the psychiatric ICU with “hirsutism” or excess facial hair. When I went to see Joan, she indeed had a moderate degree of facial hair. However, after reviewing her chart, I was astonished to learn that she’d been a banker with no prior psychiatric history. She’d undergone a total hysterectomy with removal of her ovaries for a benign condition the summer before and I was horrified to learn that she’d never been given hormone replacement.

After the surgery, her mental condition deteriorated to the point where she’d lost her job. She was put on various psychotropic medications but continued to do poorly. She’d become suicidal and ultimately was admitted to the psychiatric intensive care unit. It had not occurred to anyone that perhaps she needed hormones. When I started her on HRT, I saw firsthand how restoring deficient hormones can produce a total transformation in a person’s life. This woman eventually went off all her psychotropic medicines and was able to go back to her normal life. It still brings tears to my eyes as I think about how she was made to suffer needlessly. At the same time, it is incredibly gratifying when you can use your training and experience to help a person become whole again. That’s what drives most physicians – the desire to relieve suffering and help people.

Excerpt from “Outliving Your Ovaries” © 2012 by Marina Johnson MD. Dr. Johnson was a medical writer and pharmacist before medical school and utilized these skills to research 450 medical journal articles to develop her book. She has no financial conflicts of interest or ties to any pharmaceutical company. Her only objective is determining the most effective, safest therapy for patients.

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