Dr Johnson Patient

Women in their forties or fifties are often in the “sandwich” generation with responsibilities for children and husbands while caring for aging parents. It’s further compounded if they work outside the home. They may have been previously adept at this type of multitasking but now find themselves “overwhelmed.” These are obvious symptoms that get your attention and affect your productivity and well-being.

Mary came in to see me on a myriad of prescription medications. She relayed to me how she’d gotten on all those medicines. In her 40s when her periods started changing, she developed insomnia and depression. She was started on sleeping pills and antidepressants and initially felt better. When her periods stopped, she was put on Prempro and she gained 30 pounds in the first year. (women without estrogen often gain weight around their middle but it can also be worsened by oral estrogen.) Because of the weight gain and oral estrogen, she was diagnosed with high blood pressure and started on blood pressure medications. From the oral estrogen and weight gain, she developed high cholesterol and had to be started on cholesterol medications. Her weight gain continued and she developed fluid retention often seen with oral estrogen. She was then started on “fluid pills” (diuretics), to deal with her swollen hands and feet. She later developed anxiety and worsening depression at all the changes occurring in her body. Her antidepressants were increased and she was started on the strong, anti-anxiety medication (Xanax) which made her feel like a zombie throughout the day. She became sluggish throughout the day but she couldn’t sleep at night with her sleeping pills and was up doing laundry. Because of her fatigue, she was then started on Adderall, which is a potent amphetamine to give her energy! Her weight gain had also caused her to develop reflux and so she’d been given a potent acid blocker, (Nexium), which relieved the reflux but gave her bloating and constipation and she was miserable. So in essence she had been put on seven prescription medications when she probably just needed to be treated with topical bioidentical HRT.

I wish I could tell you Mary’s story is atypical, but sadly it’s an oft-repeated scenario that occurs in all too many women when their symptoms are simply treated with a drug instead of correcting the underlying cause of the symptoms. Often drugs are given to treat the side effects of the initial drugs that were given! In pharmacy circles, this is often called “polypharmacy.” After restoring appropriate levels of topical bioidentical estrogen, progesterone and testosterone, many of these prescription medications can often be gradually tapered off.

Excerpt from “Outliving Your Ovaries” © 2012 by Marina Johnson MD. 

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