Surgical Menopause

While I have no regrets that I gave the green light for my hysterectomy back on September 18, 2017, the ongoing effects of the removal of my ovaries have caused a great deal of consternation.  I had some frame of reference for what menopause would look like, but no good resources on how surgical menopause is different from gradually experiencing the diminishing levels of estrogen.  I wish I knew then what I know now not because I would have made a different decision, but I wish I’d had a better plan in place or was ready to put a plan in place.

The symptoms of menopause, surgical or otherwise, that I’ve been dealing with, in no particular order, are …

  1. Hot Flashes.  This is a big one.  I don’t usually drip with sweat, although I’ve seen others deal with that; for me, the hot flashes usually feel like I’m getting a fever over and over and over again.  It feels so weird that I actually had no idea what I was experiencing at first.  I take medication that mostly controls the hot flashes during the day, but I still get them at night and if I’m stressed and so I constantly wear layers to take of and put on and then take off and put on … and so on throughout the day.
  2. Internal thermostat confusion.  I’ve never been so irritated that people in Florida keep their A/C set on frigid when it’s boiling hot outside. This means that the temperature differential is gigantic.  GIGANTIC.  Since my internal thermostat is in a perpetual state of confusion, I’m hot outside and then I go inside and get the weirdest combination of being hot and freezing at the same time.
  3. Dryness … everywhere.  It’s not PC to talk about vaginal symptoms, but when you hear the words “vaginal atrophy,” things start to get real quickly.  Basically, without estrogen, the lining of the vagina gets very dry and thin, prone to bleeding and pain when stretched.  This, in a word, sucks.  It’s awful.  No one said anything about vaginal atrophy and it’s the WORST.  Plus, there’s basically no real treatment for it without taking estrogen, which I can’t take.  The most effective treatment for vaginal atrophy without hormones that I’m aware of is laser therapy.  There are a variety of lasers on the market, none of which are approved by the FDA yet.  I personally had the Mona Lisa Touch treatment, which was 100% out of pocket.  It has helped, some. Also, now I use hydroponic acid (yes, I know that sounds awful) and that is also helpful, some.
  4. Bones.  As many of you already know, I have mets throughout my bones.  A lovely side effect of not having estrogen is bone health is affected.  To combat the weakness in my bones due to the dead and dying lesions/tumors and the bone health atrophy due to surgical menopause, I get a monthly injection called Zometa.  Now my bones are strong, but there are also lots of side effects to taking Zometa long term, including osteonecrosis of the jaw (ONJ), which is basically when the jaw bone dies. I’ve heard that this can be related to current or previous cavities or root canals, neither of which I’ve had, but having a good dentist is key.
  5. Heart.  Not only is your heart health impacted by chemo, menopause can also exacerbate heart disease.  Heart disease is a big issue for women and women in menopause even more so.
  6. Muscle Mass.  Going into menopause gradually means that you loose muscle mass gradually.  Going into menopause abruptly via surgery and then suppressing all of the estrogen left means that your muscle mass is affected abruptly.  I’ve never been much of a fan of working out or building muscle, but now I have to focus not just on cardio, but also on building muscle.  Jeez, I didn’t need yet another reason to have to exercise …
  7. Mood Swings.  I probably shouldn’t say much here since I’m not always aware of my mood swings; however, let me say that I feel less in control of my emotions since my hysterectomy.  Of course, since that happened in close proximity to learning that I have a terminal diagnosis, sometimes it’s hard to differentiate where something has come from; however, it’s harder to stay in control and I definitely have more moods.  If you want more information on this, you might have to talk to my husband.

I’m sure there are other things; however, one other symptom of menopause and chemo is that my brain doesn’t work as well.  I don’t remember as much as I did and my executive functioning has been affected negatively.  Menopause creates extra struggles and extra issues; however, I am still happy that we acted swiftly to deprive my cancer of its fuel.

Bottom line, if you have a woman in your life who is experiencing menopause or surgical menopause, give her some space, give her a hug, and don’t expect her to be the same. We all need some extra TLC and empathy.

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