Don't Know What You Got 'Til It's Gone

My accidental breakup with HRT, plus a Sunday coffee hang!

Consider this a Public Service Announcement. One I’m only able to issue now that I’m through the worst of the slog that began the moment the half-life of my HRT expired, making me feel like I might just expire too! Dramatic? Perhaps, but my mood swings, brain fog, et al made for more than a little internal drama over the past couple of weeks. So to any of you who may be considering going off of your HRT, putting off the necessary bloodwork to continue it, or are resisting treating your disruptive symptoms even if you are a candidate, I have some advice (albeit not medical!):

Don’t.

I didn’t mean to go off my HRT. This was not a case of experimentation or an attempt at some kind of midlife cleanse. I didn’t suddenly decide to take a “natural” approach (although I would argue that there is nothing more natural than replacing essential hormones that help with pretty much every function in our bodies). I was just...busy. With only three months to go before Midlife Private Parts launches, the to-do lists are growing, deadlines are looming, and I’ve been fully consumed with all of it. And when I’ve had tiny pockets of free time, the thought of using it to get labwork? Let’s just say it was not top of list. Also, I didn’t realize that I was on my last refill.

Truthfully, I had been wondering if the HRT was still helping me. When I first started, I definitely noticed a difference- better sleep, more energy, fewer hot flashes and night sweats. But then that all leveled off, and I think I forgot about the intensity of what was happening in the “before” space. So when I couldn’t get the prescription renewed, I didn’t panic, and figured it wouldn’t be that big a deal. Maybe the universe was telling me my body needed a break.

Um, no.

I was fine for the first week, but then everything changed. I was irritable in a way I haven’t been in a VERY long time. Everything annoyed me. And then I found myself on a Zoom call melting from the heat, and screaming for my husband to turn on the air, on mute of course (although with the new thicket of brain fog, it’s amazing I remembered to turn off my mic). I left a restaurant without my purse. I left a credit card behind at a boutique. I started waking up HOT every night, despite the 66 degree thermostat, and had the energy of a tired sloth. In short, I was a bit of a mess.

In a case of very funny timing, I was listening to an episode of the podcast Everything is Fine, where co-host

Jenn Romolini

talked about going through the same thing while she waited for her HRT prescription to be adjusted. She too wondered how the hell people do it- how do they “raw-dog” menopause?? Doubled over with laughter, I felt so seen!

How did I walk around like this in the “before” space? How have peri/menopausal women been so medically underserved for so long? That last question requires a treatise of its own, and while I’m not prepared to write one at the moment, this article by Susan Dominus from 2023 for the NYT Magazine does an excellent job of explaining the what, where, when and why. I’ve returned to it many times, and this from Rebecca Thurston, a professor of psychiatry at the University of Pittsburgh who studies menopause, gets me every time:

“About 85 percent of women experience menopausal symptoms” Thurston…believes that, in general, menopausal women have been underserved — an oversight that she considers one of the great blind spots of medicine. “It suggests that we have a high cultural tolerance for women’s suffering,” Thurston says. “It’s not regarded as important.”

It’s hard to disagree with her assessment.

Mercifully, I received my prescription last Friday, and resisted the urge to slather MY ENTIRE BODY in estrogen. I am back on track, and mostly feeling like myself again. The truth is that HRT has been a game-changer for me, and this little unplanned separation has definitely made the heart grow fonder. Speaking of hearts, I also experienced palpitations when I was without- the kind I used to get when I was perimenopausal, had no information, and thought I was having a heart attack. I once ended up in the ER because of them. Good times!

It’s scary funny how memory can be so short. I forgot how crappy I was feeling before I started HRT, and now realize just how much it improved the quality of my life. And beyond that, while we are way behind in women’s health research (of the mere 10ish percent of the NIH budget that is allotted to women’s health, only about 1% of that goes to menopause research), there is substantial evidence to show that estrogen can be heart, bone and brain protective. Win, win, win.

So here’s the PSA: Take care of yourself. Keep your appointments. Fill the damn prescriptions. Ask questions, advocate for yourself, and never let anyone make you feel like your suffering is not important. You deserve to feel good. Energized. Clear-headed. Connected to your body. Whether it’s HRT, non-hormonal treatments, or a high-speed fan perched on the side of your night table, prioritize your wellness and find what works for you. Trust your intuition, and listen to your body.

Mine, btw, has finally stopped screaming WTF did you do with my estrogen??!

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Sunday Coffee Hang?

If you’re free this Sunday morning at 10am EST, grab a cup of coffee and come hang out with me and my co-editor

Dina Alvarez

on Instagram, where we’re going live for a conversation to share our story—the story behind the stories featured in our forthcoming book, Midlife Private Parts: Revealing Essays that Will Change the Way You Think About Age.

From our new midlife friendship to the initial spark of the idea, to the collaborative process that brought this book to life, we’ll talk about what inspired us, what surprised us, and what we’ve learned along the way.

Whether you're curious about the creative process, passionate about amplifying women's voices, or simply want a deeper look into what Midlife Private Parts is all about—we’d love for you to join us!

You can find us on IG @patina_life and @thewritestyles.

You can preorder the book here or on the website, which would mean the world to us! Preorders make a huge impact— they help build early momentum and signal to booksellers and media that this book matters and deserves to be seen. That midlife women deserve to be seen (and heard, and understood)! Your early support makes all the difference and ensures that this book will get into the hands of midlife women everywhere!

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Thank you for spending time with me here, and if you want to take a deeper dive on menopause, HRT, and other treatments, check out my Midlife Cheat Sheet: Menopause Edition which will link you to organizations, research, articles, menopause educators, doctors and more.

And if you know someone who would enjoy this newsletter, I’d love it if you'd share!

Happy Friday…
Dina xx