![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 23 of 23. This is the beginning of the thread.
Posted by katekite on July 17, 2002, at 11:32:27
This is long. A description first of my response to birth control pills, then of peri-menopause, then of other ovarian conditions that can also cause or worsen psychiatric problems.
So, me --- I started a pack of old birth control pills two days ago out of desperation and can't believe the positive difference. Went to an obgyn yesterday and got an even higher estrogen dose. This obgyn listened to my symptoms and response to the Pill and confirmed that I am in very early menopause at 31.
My situation up till now was that after lots of medical tests the only thing wrong was high cortisol (seems to fluctuate normal to abnormal -- next appt July 25). I used to have anxious depression treated by meds years ago, but Prozac had pooped out, several things didn't work, neurontin worked for a while then seemed to have sided effects, things just seemed to be getting worse and worse. ADD got treated with Ritalin, that was good for a while, then couldn't tolerate Ritalin any more due to blood pressure probs.
Here's a run down of my symptoms: mostly moodiness and anxiety and insomnia to begin with. I was diagnosed with GAD, then BP II, then I was normal for a few months, then recently changed to ADD. In the last few months mostly physically sick with wild mood swings. Physical symptoms: things like weird hot sensations mostly in my legs that don't seem to meet the description for hot flashes as they last too long, have over a year now progressed more towards true hot flashes. (anti-convulsants impair cooling so can make hot flashes not the classic flush). Also a bizarre twitchy skin sensation here and there, like a rubber band snapping or a bug crawling (yeah imagine the look on the doctors face). Also weird scalp sensations on and off that have turned out to be a type of migraine without headache. Eye dryness, acne, no libido, no tolerance of caffeine, weird runs of racing heart, odd fluctuations in blood pressure, joint pain, breast tenderness and swelling, feeling bloated now and then, occasional nausea, crippling fatigue. Miserable.
I had been holding off on experimenting with any meds due to having testing done and not wanting to screw it up. The only med I've been on is klonopin. But I was feeling like I couldn't make it till the next appointment -- so I broke down and tried my old BC pills. Within an hour I felt so much more like 'me', and most of the physical symptoms were better, after 2 days now they are really improved, as is my energy level. Many things are just gone completely. It seems like early to post, 2 days, but the difference is really remarkable. Life isn't fantastic, but I'm suddenly functional again. If I had a job I'd be able to go.
In retrospect my periods have been getting lighter for the last year, now last around 3-4 days instead of 7. I am still having them, usually slightly sooner than I expect. But still every 26-27 days. Some women will actually have heavier or longer periods.
Basically what one is looking for is a change... not any particular kind of change.I probably have some cortisol problem too, but it seems that many of my actual symptoms are due to low estrogen or maybe just wildly fluctuating estrogen. Menopause can progress at any pace it wants to: mine started just with insomnia and moodiness and anxiety. It probably could have stayed like that for a year rather than progressing.... so maybe there are other women out there who's ovaries work slightly better and are just stuck at the mood/insomnia stage.
After reading, I've found out the following:1 in 100 women go through menopause before 40 (I'm 31). 1 in 1000 go through it before 30. Menopause is usually defined as an entire year with no period at all. "Pre-menopause" or "peri-menopause" is approximately the 3-5 years before menopause. Probably many many women in their late 30s are in this without knowing.
Women may experience all, none, or one of the menopausal symptoms due to decreasing ovarian function. They may have completely normal periods and show only moodiness, insomnia, or anxiety. They may have only an exacerbation of a pre-existing problem. Since it takes years after pre-menopause starts to actually stop having periods altogether, there are a lot of women younger than 40 with pre-menopause who have no idea why their mind and body feels so wrong.
Women who have ovarian problems at a younger age often have a more difficult time with it, since younger bodies are more used to estrogen and it isn't decreasing gradually but probably fluctuating wildly. This is not to say that a percentage of women who go through it at a normal age don't also have wild mood swings and unbearable symptoms. And many lucky ones have very few symptoms.
Statistically, women with psychiatric problems go through menopause earlier than others (chicken or egg?)
Anyone with any other hormonal issue (thyroid etc) is more likely to have premature ovarian dysfunction.
Anyone who has irregular periods or closer periods or lighter periods or more pain, moreso than in the past should look into this. Most regular docs and pdocs seem to be completely unaware. Or they think of it as normal with increasing age and don't think that it might worsen psychiatric problems. Women with premature ovarian failure tend to be undiagnosed for years.
I found several cases of women who'd been diagnosed as bipolar of some form. Usually it was a relatively new problem, not something they'd been dealing with since their teens.
FSH (the hormone that causes estrogen to be released from the ovaries) is often normal until periods stop altogether. Even after periods stop altogether it can be normal, because its taken at a point in time and it normally fluctuates over the day. Also, estrogen levels can be normal as it too fluctuates over the day. Having said that, if you do get an abnormal test result that will prove the issue beyond all doubt, so it is worth testing.
It seems to be that the only sure way to find out if low estrogen, or fluctuating estrogen, is a problem for an individual with some symptoms who still has periods, is to try estrogen supplementation (usually in the form of birth control pills for women under 40). Estrogen replacement therapy that is given to menopausal women is usually too LOW a dose of estrogen to see much of a difference. One has to evaluate the particular Pill carefully as some contain very little estrogen. The one I am taking has progesterone (norgestrel) and ethinyl estradiol 0.05 mg. (Ogestrol). I'm pretty sure that's a fairly high dose of estrogen.
There was a study once showing estrogen worsened symptoms for some women with psychiatric problems. Docs seem to have heard of this study, but not of others that show equal or greater numbers of women are helped by estrogen... so many docs will prescribe very low dose contraceptives to any woman with a history of mental illness. Or prescribe a progesterone only pill.
The bottom line is that since it seems to be so individual and also hard to predict, one might have to try several different combinations before deciding to give up on it. From reading, I recommend trying two things: first one with a lot of estrogen such as the one I'm taking, then if that seems to worsen things try a progesterone only version (or one with very very low estrogen). Either way, if taking the birth control pill changes your mood for better or for worse, that may be a clue that some hormonal factors are at work and need investigation.
I had taken the Pill as recently as 18 months ago and found it made no difference to my mild depression.... but things have apparently changed markedly in that time (as have my symptoms). So past response does not necessarily predict future response, especially if symptoms have changed.
Disclaimers: estrogen therapy can exacerbate some disorders, long term estrogen therapy in women over 50 is probably bad, and estrogen therapy does predispose to some types of cancers (as the current frenzy over HRT shows). Women who have an intact uterus must take progesterone too or uterine cancer can occur: progesterone pretty much prevents this.
Estrogen is thought to be required for serotonin to work properly, ie in PMS estrogen is low. People who have serious PMS sometimes use estrogen/progesterone therapy that goes for months at a time so as not to have to go through that as often. People with PMS bad enough to require meds, should consider this as an alternative or in addition to SSRIs if they have not tried it already.
There are some other conditions that are unique to women and can worsen or psychiatric problems: PCOS (polycystic ovarian syndrome), and endometriosis. Women with PCOS usually have irregular periods and have gotten hairier than they used to be, maybe gained weight. Women with endometriosis has increasingly painful periods, sometimes pain with intercourse -- anyone who has more than a day of cramps or who's pain isn't easily controlled with tylenol type things should look this up. As we get older both of these conditions are increasingly common.
SSRIs have been used in women who have had breast cancer (who can not take estrogen) to battle symptoms of menopause. SSRIs seem to help in many cases but at a lower effectiveness than estrogen (which works for most menopausal symptoms with upwards of 90% effectiveness).
Women have menopausal symptoms earlier than 40, ie premature menopause, or who have had to have ovaries or uterus removed for some reason, are more at risk of other hormonal situations like thyroid disorders.
And lastly, about female testosterone. Yes we have it and it is normally produced by the ovaries in significant amounts (although way less than men). It is directly linked to drive and to libido. Women who are in pre-menopause or who have gone through menopause or who've had surgeries almost all have low testosterone. It can be replaced. Women who use it say it makes them feel younger, have better libido and have more general motivation. Downsides are that too much will cause hair growth and predispose to irritability. So never wrong to get levels checked and replace if wanted.
Kate
Posted by judy1 on July 17, 2002, at 12:00:18
In reply to estrogen is helping (and I'm only 31), posted by katekite on July 17, 2002, at 11:32:27
Thank you for your great post! My bipolar/panic symptoms were acting up again when I was still nursing (my baby is 5 months) and my doc suggested the same bc pill as you. I think I may be seeing a difference (I'm only on the second cycle), but I may just be hopeful. I doubt I'm going through perimenopause, but estrogen has long been suggested as a possible mood stabilizer. Best of luck-judy
Posted by katekite on July 17, 2002, at 17:41:58
In reply to Re: estrogen is helping (and I'm only 31) » katekite, posted by judy1 on July 17, 2002, at 12:00:18
Hi Judy -- thanks. Your baby must be getting old enough to start to do stuff: that sounds fun. Its interesting with all the BC pills to choose from you have the same one as I do. This pill sure feels like a mood stabilizer to me. Do you mind me asking how old you are? Just curious what ages people start finding BC pills potentially stabilizing.
Posted by judy1 on July 17, 2002, at 21:02:52
In reply to Re: estrogen » judy1, posted by katekite on July 17, 2002, at 17:41:58
Thank you- she's just starting to get into trouble :-). I'm 36! (but I think that's the average age on the board). I think this bc pill is one of the few with a high enough dose of estrogen to make a difference. Hope it keeps working- judy
Posted by SLS on July 17, 2002, at 21:35:51
In reply to Re: estrogen is helping (and I'm only 31) » katekite, posted by judy1 on July 17, 2002, at 12:00:18
> Thank you for your great post!
Agreed!
Which particular preparation or name brand of bc are you using?
From my reading, it seems that natural progesterone does not carry the same high liability to cause or make worse depression as the synthetics. Drosperinone (used in Yasmin) seems to be an exception, and might even have mood stabilizing properties.
- Scott
Posted by judy1 on July 17, 2002, at 23:20:29
In reply to Re: estrogen is helping (and I'm only 31), posted by SLS on July 17, 2002, at 21:35:51
I know when I was pregnant around the second trimester, when progesterone is fairly high- I felt much calmer and didn't need any benzos. Haven't they always called progesterone nature's sedative? take care, judy
Posted by judy1 on July 18, 2002, at 10:18:58
In reply to Progesterone » SLS, posted by judy1 on July 17, 2002, at 23:20:29
Posted by hildi on July 18, 2002, at 11:46:51
In reply to estrogen is helping (and I'm only 31), posted by katekite on July 17, 2002, at 11:32:27
Hi Kate. I'm so glad to read your post. Not only am I glad to hear someone doing so well, but it also offers me hope. I suspect a hormonal problem in myself (I'm 41) and I also really wonder if I have thyroid problems and low cortisol, as well.
I have just found out about zoloft and other SSRI's causing hypothyroidism in some people-
I find this amazing that I have had to find this out myself. . . I have been complaining about physical symptoms to my dr. for so long, and I just recently learned of this thyroid info and my symptoms match this, and adrenal malfunction, too.
Hormones definately seem off wack, also- I seem to be all wacked out emotionally as well as physically these days.
I have been trying different AD's and they all just make me more skaky, nervious, moody, and depressed. I seem to be getting bipolar, or manic lately, too. This is something new.
Kate, it sounds like your Dr indicated menopause and they prescribed bc pills just on symptoms alone. I wish my dr.'s were so responsive. I am sceduled for blood tests next week. In your opinion, will these tests pick-up (accurately) if estrogen/progesterone is low and an option for me???
I am so sick of this-feeling this way. I really think people are thinking I'm nuts and no one can understand how bad I'm really feeling. It seems I'm going to have to find out as much as I can, myself, and demand treatment.
I welcome your opinions on these blood tests- will they be enough for the dr. to go on??
Hildi
Posted by Chloe on July 18, 2002, at 17:41:32
In reply to Re: estrogen is helping (and I'm only 31), posted by SLS on July 17, 2002, at 21:35:51
> From my reading, it seems that natural progesterone does not carry the same high liability to cause or make worse depression as the synthetics. Drosperinone (used in Yasmin) seems to be an exception, and might even have mood stabilizing properties.
>Hi Scott
I started Yasmin about six months ago. I didn't want to try it, because I was afraid of the (*relatively* high, 0.03 mgs) estrogen in the pill. Wow, Judy and Kate, that seems like a lot of estrogen! I am SO glad it helps you both so far. I had never really been able to tolerate BCP's. I always thought it was the estrogen that was making me anxious and labile. Well, after years of being on Micronor (progestin only pill), then a panicky trial on Loestrin (0.02 mgs estrogen+progestin) to control my pms, etc. I switched to Yasmin. And low and behold, my anxiety level plummeted and I am doing ok on it. I did have some break thru bleeding (heavy enough to cause anemia) and my gyn wanted me to go to a higher estrogen pill. But I don't want to switch back to the conventional progestins...I think I really like this drospironone. It does relieve some anxiety for me. So I am taking evening primrose oil (estrogenic properties) for the moment to hopefully avoid another bleeding episode...I do wonder at times about the natural progesterone creams helping my pms, heavy, irregular periods, and general irritability related to the menstrual cycle. Of course I would love to go a more "natural" route. But my gyn does not use these products. And I have not sure I want to mess with something that ain't broke at the moment :)
Chloe
Posted by hildi on July 18, 2002, at 18:05:15
In reply to Re: estrogen is helping, Yasmin-SLS, All, posted by Chloe on July 18, 2002, at 17:41:32
>
> > From my reading, it seems that natural progesterone does not carry the same high liability to cause or make worse depression as the synthetics. Drosperinone (used in Yasmin) seems to be an exception, and might even have mood stabilizing properties.
> >
>
> Hi Scott
> I started Yasmin about six months ago. I didn't want to try it, because I was afraid of the (*relatively* high, 0.03 mgs) estrogen in the pill. Wow, Judy and Kate, that seems like a lot of estrogen! I am SO glad it helps you both so far. I had never really been able to tolerate BCP's. I always thought it was the estrogen that was making me anxious and labile. Well, after years of being on Micronor (progestin only pill), then a panicky trial on Loestrin (0.02 mgs estrogen+progestin) to control my pms, etc. I switched to Yasmin. And low and behold, my anxiety level plummeted and I am doing ok on it. I did have some break thru bleeding (heavy enough to cause anemia) and my gyn wanted me to go to a higher estrogen pill. But I don't want to switch back to the conventional progestins...I think I really like this drospironone. It does relieve some anxiety for me. So I am taking evening primrose oil (estrogenic properties) for the moment to hopefully avoid another bleeding episode...
>
> I do wonder at times about the natural progesterone creams helping my pms, heavy, irregular periods, and general irritability related to the menstrual cycle. Of course I would love to go a more "natural" route. But my gyn does not use these products. And I have not sure I want to mess with something that ain't broke at the moment :)
>
> Chloe
Hi Chloe. I am new to all this birth control pill/hormone stuff-Is the yasmin a bc pill that contains progesterone only? Is drosperinone (sp?) the 'active' ingredient?I just picked-up a glandular concentrate for females-it has ovarian tissue (kind of gross, but I am at wits end and willing to try anything at this point) I am thinking it may help me by supplying me with some estrogen and progesterone-
anyone try any of this kind of stuff to help reglate hormones??
Hildi
Posted by Kar on July 18, 2002, at 18:16:54
In reply to estrogen is helping (and I'm only 31), posted by katekite on July 17, 2002, at 11:32:27
Kate- glad to hear you're feeling better...sorry to jump in but a few weeks ago you had mentioned the possibility of prolactinoma...did they rule it out? I started the Bromocriptine and I'm a bunch better for 2 weeks (some kind of record lately). Since high prolactin= low estrogen, I imagine it has normalized things for me...the estrogen issue is fascinating to me- time will tell if the Bromo is what did it...
Karen
Posted by katekite on July 18, 2002, at 18:51:34
In reply to Re: estrogen is helping (and I'm only 31)-Kate, posted by hildi on July 18, 2002, at 11:46:51
Hi Hildi,
First of all I feel for what you're going through! After a while when you have physical symptoms it is almost impossible not to be depressed and anxious about it, and then its impossible to know if the mood etc is just due to frustration over the physical stuff or if it's its own entity. It gets so so complicated.
Estrogen and progesterone vary widely over the day and month so its quite possible in someone who is borderline (and I mean borderline in a medical way, LOL) that you could come up normal and yet still have problems.
Once you take a birth control pill, though, it does suppress your own estrogen etc and it can take a long time after you come off of it to get your own normal rhthym back. Which is to say it really screws up testing. In a way I've done a bad thing by starting with treatment over testing. The obgyn I saw wants me to do testing after I go off the active pills before I start the next pack of pills.
If your tests come back normal and you don't want to do more testing, and you still are suspicious and want to try it you could always see a different doc or a different nurse practitioner or gynecologist and lie, saying you are on them already and just need a refill. If it didn't help you would just throw them out and have wasted the money.
I don't know -- that would by lying, basically. Then again in this era of screwed up overburdened medical system where each doc has 3000 patients (the average) it seems we don't have the luxury of trusting our medical care to anyone but ourselves, in the end. Some of the specialists I have seen have been nice, but none have even remotely considered the idea of taking responsibility for my case (ie they don't even consider calling the other specialists to see what they think about other symptoms or possible treatment or tests). They can't see the forest for the trees, I think.
I saw my pdoc today and he gave me the name of a reproductive endocrinologist/psychiatrist in Boston (a day's drive at least) -- the closest person that he thinks is truly qualified to deal with psychiatric problems that are caused or weirdly worsened by female hormonal issues. Wow -- I never imagined that one would have to travel that far (I'm close to several really big cities and Boston is not one of them). What does that say about the general knowledge level among regular docs and pdocs?
kate
Posted by katekite on July 18, 2002, at 18:54:43
In reply to Re: estrogen is helping, Yasmin-SLS, All, posted by Chloe on July 18, 2002, at 17:41:32
Posted by katekite on July 18, 2002, at 19:20:48
In reply to Re: estrogen is helping, Yasmin-Chloe, All, posted by hildi on July 18, 2002, at 18:05:15
I did try Promensil, a plant-estrogen compound. It recommends one pill once a day I think, so I took 2 twice a day, and it seemed to help faintly.
If you are helped at all by the duck-airsac-extract or whatever this thing is, then that would be a clue, at least.
That we have to resort to trying non-FDA approved things like this shows that the medical system is dangerously out of balance. We should be able to see a doctor and say, "look, I want to try Y or Z" and they should let us, tell us the risks etc, work with us, be there for if it goes wrong. Of course we will resort to unproven unresearched remedies if they don't work with us, because our problems don't just disappear when we leave the office. Asking to try the BC pill is not like asking for oxycodone. It just makes me so angry!
But anyways....
I wonder about Planned Parenthood type clinics for you -- if you're in an urban area there I bet there is something like that that would gladly shuffle you through and give you a BC pill, without demanding testing.
Posted by katekite on July 18, 2002, at 19:30:54
In reply to Re: estrogen is helping (and I'm only 31) » katekite, posted by Kar on July 18, 2002, at 18:16:54
Hi Karen,
When I said I was being worked up for something similar I meant pituitary problems. There have been a few cases where bromocriptine helps control cortisol overproduction.
To answer, I'm still getting worked up for the cortisol. It seems to be high sometimes and ok sometimes which confuses everyone.
In any case it is just wonderful that you are better lately!!! I know how it is to wonder just what is working. Let me know how it goes.
kate
Posted by hildi on July 19, 2002, at 20:09:47
In reply to Re: estrogen » hildi, posted by katekite on July 18, 2002, at 18:51:34
Hi Kate. Thanks for the reply. I have so much confusion about whats going on with me but at least I am getting some answers from you guys- here on PB. I am finding out so much on this website- I am so very grateful to have found this. It is ironic that I have to resort to finding things out on my own (that ALL of us do), when we should be getting adequite and competent info from our drs. I go to county (no insurance), so I thought I was getting the run-around because of that. . . but apparently many people-even those with big buck doctors-have a hard time , and what makes it worse is that none of the drs are working together to see the big picture . . so much is interrelated. One thing influences another, and so on . . so much that occurs in our bodys (and our minds) influences other things.
I believe that my thyroid is messed-up and I think it is partly that way from my SSRI, which I have just found- causes hypothyroidism in some, especially to those predisposed to thyroid problems, like I am.
I believe my endocrine system is screwed up, too.
And I also believe I am in the early stages of menopause- Which could have been brought on, in part, by my thyroid problem.
All this time that things have been getting crazy in my body, I thought it was just the a/d not working as well as it should- so I increased meds and changed meds a lot. All this did was make me feel worse, get worse, and bring on more symptoms!Kate, In earlier posts by you and others it was stated that SSRI's increase Prolactin? And proclactin reduces estrogen? Did I get this right? That would explain some of what I feel.
I go in for blood tests this Tuesday- Hopefully I'll get some answers soon, but you know , I was reading last night that blood tests for hormones are not an accurate way to measure- and drs should just go on what the patients symptoms are (as far as determining if hormones are needed) and not to rely on the tests alone.
Hmmmm. I am thinking of asking for the pill while I'm where- I may try the bc pill you mentioned earlier- Judy seems to be happy with that particular pill, too.
I also am having them check thyroid and blood sodium levels.I started on maca and licorice to help lower my adrenals (I heard its best to get those in check before starting thyroid meds) and I picked up some 'bovine glands' (ovarian) which are supposed to act the same way on estrogen and progesterone, I guess, as porcine thyroid gland is on human thyroid- porcine thyroid gland is what is in armour thyroid, and some others. I haven't started this yet and I'm glad- if this stuff actually works it may mess up the blood tests on Tues. Plus, I'm not sure if I want to try bc pill or this hormone gland. I don't think it's a good idea to do both together and I want the fastest relief possible- which is probably the pill!
I would be very interested to talk with this doctor in Boston- I would love it! Someone who studies and understands all this stuff- gosh, thats crazy that there aren't more docs that specialize in psychology and the reproduction and endocrine system. I would be very interested to hear what you think of him/her if you do choose to meet this doc.
Hildi
Posted by may-b on July 20, 2002, at 12:23:38
In reply to estrogen is helping (and I'm only 31), posted by katekite on July 17, 2002, at 11:32:27
Kate,
I just wanted to say how helpful this post was. Much of it describes what I experienced. You write with enviable clarity -- [my ambition :) ].
best wishes,
may-b
Posted by katekite on July 21, 2002, at 21:10:18
In reply to Re: estrogen-Kate, posted by hildi on July 19, 2002, at 20:09:47
Hi Hildi,
Sorry I don't know about how ssris affect things. I can never remember how everything affects everything else for more than about an hour after I've read it.
Of course I do get enjoyment out of reading things over and over this way, LOL.
I think I remembered reading that licorice actually increased cortisol. Most of the websites seem to advertise it for 'adrenal exhaustion' which is low adrenal output.
Also since changing one hormone level affects another I guess I'd worry that if you are taking bovine ovarian supplement, licorice and other things, that it could end up pushing the levels of what they are testing into the normal range and you wouldn't be showing what you really are. Probably the reference ranges are wide enough that a small effect wouldn't be noticeable. I'm just a worrywart.
Good luck with the testing Tuesday.
Now that I'm feeling a lot better with the BC pill I've been reading up and think I need to replace testosterone too. It probably never ends, lOL.
Kate
Posted by Chloe on July 24, 2002, at 17:52:51
In reply to Re: estrogen is helping, Yasmin-Chloe, All, posted by hildi on July 18, 2002, at 18:05:15
> Hi Chloe. I am new to all this birth control pill/hormone stuff-Is the yasmin a bc pill that contains progesterone only? Is drosperinone (sp?) the 'active' ingredient?
Hildi,
Most all birth control pills contain both estrogen and progestin. Only the the "mini pill" or Micronor, contains progestin only, and is less effective than than the combo pills. it's most often used in nursing mothers for birth control.Yasmin is the lastest BC pill to come out with this "novel" progestin plus 0.030mgs estrogen. My gyn was very excited about this pill, since no new types of progestins have hit the markets in the US in many many years. It is supposed to help with pms and pmdd since it has some regulating of fliud balance. I.e., if the women does not retain as much fluid, she is not as moody or irritable. Many articles I have read doing google.com searches say that the drug is being marketed as an alternative to prescibing AD's for pms, etc.
It is the only progestin that I have been able to tolerate. The others, norethindrone, desogestrel, and norgestrel all made me very anxious, teary and labile...YMMV
Sorry it took my so long to answer. Hope this helps.
Chloe
Posted by hildi on July 24, 2002, at 18:45:11
In reply to Re: estrogen is helping, Yasmin » hildi, posted by Chloe on July 24, 2002, at 17:52:51
Posted by katekite on July 24, 2002, at 20:34:46
In reply to Re: estrogen - hildi, posted by katekite on July 21, 2002, at 21:10:18
There is really no need to read this, I just had to vent somewhere. I should probably post this in 'social' but it's already written.
I saw a endocrinologist today. She supposedly sees people with menopause. She sounded promising because her research deals with the interaction between growth hormone and estrogen. (ie something with estrogen).
She did not know that estrogen varied over the day. She had heard that FSH was higher at night (well duh, if FSH goes up estrogen does (with a delay so that it is highest when we get up).) And she had to think hard for the high FSH at night idea.
She could not name a testosterone replacement other than Estratest. She said if I took any testosterone I would (not maybe, would) grow extra hair (virtually no one does.) and was uninterested in looking up how to prescribe it for me in forms other than Estratest.
She put forth the idea that I might have an advanced malignant tumor (for the last 9 months?) causing the flushing (despite extremely normal chest xrays, abdominal CT, ESR etc). Only when I said I did not have diarrhea did she give up with that idea. I had to volunteer that I did not have diarrhea, she didn't ask. Come to think of it she had very few questions.
Next was the idea that I have mini-seizures causing the hot flashes. Except, oh look, a normal EEG. (and I think, hmmm why would 200 hot flash seizures a day respond completely to estrogen?)
Her diagnosis of my menopause-type symptoms was that the one seizure I had at 16, after being kicked by a horse in the chest, killed neurons in my hypothalamus that control temperature regulation and thus I have hot flashes starting 15 years later. She thinks that estrogen may have a stabilizing force and that if it helps I should continue to take it, but she doubts it makes that much difference. "The Pill is harmless enough."
I am not in peri-menopause, she says, because I'm too young and my FSH was normal and my periods still exist.
Of course, this diagnosis does not explain the months of breast swelling and tenderness, the fatigue, the mood changes, the acne, the shorter more irregular periods, the tan-without-sun, the muscle weakness, the memory problems, or any other of the things I've had. It certainly gives no explanation for high cortisol.
Rather than consider an uncommon presentation of a common disorder she found a spotted zebra and tried to ride it.
What a loser. She jumped to conclusions. She obviously made not even a mental problem list. She made no attempt to discuss the objective findings. She left the appointment early without providing for either followup or referral.
She must do fantastic research because she has no clinical skills. She is employed by an institution that rated top 10 for endocrinology this year.
I waited two months to see her. It would have been ok if she said, "I don't know." What is so wrong with those words? Instead she made a total and complete fool of herself. I understand that doctors can't know everything. But how about suggesting a test or two, or someone else who might know the field more? Even complete idiots can do medicine if they follow the rules.
There are so many things I resent that I can't even list them.
Aaahhh, that felt good to say!
Posted by may-b on July 24, 2002, at 21:25:48
In reply to stupid doctor vent, no need to read., posted by katekite on July 24, 2002, at 20:34:46
Hi Kate
Sorry about the duffer doc experience -- [Any chance SHE is menopausal? LOL. ]
-may-b
Posted by hildi on July 24, 2002, at 22:46:56
In reply to stupid doctor vent, no need to read., posted by katekite on July 24, 2002, at 20:34:46
Oh Kate- that stinks. After two months of waiting to see this gal she turns out to be incompetent and uncaring. I read about your appoinment in another post and I was waiting to see how it went. Also I was hoping this appointment of yours would be something we could all learn something from. Sounds like you knew many things this gal didn't . . .Here we go again, another eazmple of how we must find out as much as we can on our own. But then, we have to turn back to our drs for the meds, tests, etc. . . and hope they'll be open minded and go along with our suggestions.
I read something today about how to talk to your drs . . .the article said never to bring the info you gathered such as medical research papers, to the appointment with you, and to always present things in a way so that it sounds like it's the doctors idea- not your.
Hmmm. Maybe thats where I went wrong Monday. I had a terrible meeting with my pdoc and I vented a long, ridiculous account of it under post 'theyre letting us down'. . .definately this is no need to read. I was so mad! I just had to let it out. Typing it isn't as much fun as yelling about it, but it still helped.
Yesterday I had my blood tests. However , the dr. didn't indicate to test estrogen. progesterone levels too- Arrgg!! Thats the whole reason I went to the dr. in the first place! Anyway, I go back in three weeks from now to discuss my test results with a different dr., and I will try to set up the hormone tests again.
On and on this goes.
It's frustrating not to know what the hecks going on our bodies. There could be something we could do or take to feel better, but just haven't found the right dr. or test yet. It's a searching and waiting game.
Hildi
This is the end of the thread.
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