Sunday, May 23, 2010

Making medical decisions in menopause: A workshop

I have a patient who worked as a day trader. You've got to have the metaphorical equivalent of certain male parts to do this kind of work--remaining focused, aggressive, and ruthless in a high stakes, high stress undertaking. She came to me because her world as day trader had fallen apart with the onset of menopause. When the market crashed in early October, 2008, she reported that she'd sat frozen in front of her computer, knowing that she needed to react and regroup yet unable to do anything but watch the debacle.

"You have to understand." she said with uncharacteristic (for her) tears in her eyes, "This was not me."

She proceeded to tell me about other pre-menopausal activities that had been her, namely extreme sports and risky jobs the likes of which I never once considered as options for my cautious self. Yet despite these major changes brought on by diminishing levels of estrogen, her gynecologist declined her request to consider estrogen therapy; she was not, after all, experiencing hot flashes.

One of the best kept secrets about the myriad of changes brought on by menopause is the profound effects that the loss of estrogen has on the brain. There is no doubt that some women do just fine in cognitive and emotional ways through menopause and beyond, but many do not. When my patients report that they are "doing just fine" post-periods, I always ask "How's your mood" and "How's your memory?". Not unusual, then, for me to uncover evidence that, in fact, they are not doing just fine at all.

If you are interested in hearing more about making the complex decisions involved on the road to our 600 month birthdays and beyond, please consider joining me for a menopause workshop on June 5th from 10:30 to noon at my Denver office. Please call 303-393-0300 to register; the non-refundable $20 fee is due at the time you sign-up. You do not need to be my patient to attend. If this topic is of interest to you but June 5th is a no-go, leave your name and number with my staff, and we will contact you with dates later in the summer when I will present the same material.


kenju said...

I have always been decisive to a fault, but not since menopause. I am finding it hard to make any decisions nowadays - and I hate it.

Sandra said...

Thank you so much for this post! My main pre-menopause symptoms have been anxiety, fear, and feeling like an idiot. I have a rare hot flash but mostly the symptoms have been mental. I hope this is a phase that passes eventually because I don't want to be like this for the rest of my life! (Yes, I do have an appointment to talk to my doctor about it.)

Mauigirl said...

I've been noticing a tendency to forget words lately - they're on the tip of my tongue but I can't find them. I couldn't remember the word "tango" (the dance) or Jean Paul Sartre's name recently. Living in fear of Alzheimer's Disease, I am relieved to hear it is probably more likely menopause!

LexyG. said...

Whoa, this hit too close for comfort. I keep finding your words ringing true on each article on every page.

This mental confusion -- combined with one of the things you wrote about people who have quit smoking, then developing dementia down the road -- is scary news.
I quit smoking in 2007 after being diagnosed with Stage 3-PBC liver disease and then became diabetic...

I also believe that being aware of this connection will bring some peace of mind to those who suffer with it...personally, my self-confidence is pretty much shot!

My humor still seems to be intact! "Menopause with a side of tobacco recession, please" (Some women may be headed for dementia whether they like it or not.)

Anonymous said...

I started my PhD at 50, three years ago. Last year, my father (a doctor) died. A month later I started what became the beginning of menopause. Since then I have been plagued with an assortment of "conditions", pains, memory glitches, and ailments. What I used to experience on the 2nd day of every period (and for 3-4 months after the birth of my children) has become the "norm." What a ridiculous challenge! At this age, we're smart enough to know what is happening, but completely helpless to do much about it. And here I am writing this instead of writing a thesis! (But I WILL finish dammit!!)

RamblinLamb said...

I would join you but I am in Washington. Darn it.
I've been dealing with that darned brain fog and inability to do anything since 2008 -- and its just now, due to an idel conversation with a friend, that I am realizing its the menopause thing.

Darn IT --- why didn't my doctor think about this?
Oh, yeah, it's time for a new doctor too!