24 Comments

I appreciate the multitude of ways you explain things--including facts, stories, analogies and utilizing words like fuckitude and fuckery.

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I always told my kids that we were a perfect storm of hormones. They were having puberty and I was having puberty backwards. They understood. 🤗

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I found your explanations at the end particularly interesting in terms of how to think about whether testing & further investigation are merited or not. Excellent info, as always. I really appreciate the effort you invest to teach us. Thank you!

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Thank you!

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Great and very useful analogy and article 🙌🏻

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Thank you!

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Ugh, as a sociologist that life expectancy thing really grinds my gears! FWIW I find the analogy to puberty really helpful

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Excellent 👌 I am particularly galled by the misinterpretation of average life expectancy data. Fucking bullshit indeed!

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It's amazing how we can be misunderstood, & how people can take things the wrong way, but it happens...

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Another fabulous read. I have struggled with trying to use mht and nothing seems to work for me even in tiny doses. I don’t have debilitating symptoms either. Peri was awful & dreadful but I am almost 5 years post-meno and yes, I need extra sleep but I sleep amazing and have through the whole transition and beyond. I need to be more mindful of stress. I still have some warm flashes both day/night but they aren’t awful and my mood can be a bit flat at times but it isn’t on a rollercoaster. Trying to find the right mht and failing over and over created massive stress for me because everyone states it is “Life Changing”. I am grateful to not be cycling anymore and having pmdd and having a uterus along with massive progesterone sensitivity, I really don’t want to “have” a period in menopause, I mean, isn’t that the one thing most of us look forward to? lol. Everyones journey is different but I found mht to be a huge pain in my a**. I can’t say I am not a bit salty for not having it been life changing for me but it made my quality of life much worse than no mht. Thanks again for sharing your incredible knowledge and expertise with us.

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Dr. Jen - You are an international treasure! Keep up your writing and speaking, including analogies. Go crazy with the metaphors and similes, too - and keep blinding us with science! (And yes, I instantly clicked with "menopause is puberty in reverse," including in a skeptical feminist way. That is, puberty made me valuable and interesting in patriarchal terms; menopause makes me irrelevant, uninteresting, or even invisible again. Fortunately, I don't believe that nonsense, but what a wild ride!)

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Great article - I’m 50 - knee deep in it all and have been saying I feel like I’m 13 again🤪.

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So many women have had bad experiences with they're reproductive health and beyond. Imagine what it is like to have thyroid medication increased to toxic levels instead of being treated for menopause issues or a gyn. insisting on performing a hysterectomy (ovaries not removed) and finding out there was nothing wrong with my uterus (pathology report) it was perimenopause. We all have a story to tell if there is a physicain who is willing to listen that is key.

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i am going to take this opportunity to put a question out there. i started birth control at 14, and am still on it at 51(i take lutera). my doctor says i can stay on it in lieu of hormonal therapy. my rn girlfriend says i should likely be on estrogen and i have read some texts saying one should stop pills in their early 40s.

i do not feel any menopausal symptoms yet. i sleep great, no hot flashes. haven't read a period in a couple of months. what should i do?

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I am right with you here, 52 and been on some form of hormonal contraception all my adult life. I was changed from combined to mini pill due to risk in my late 30s and found that I rarely had periods on the mini pill, so was hard to pinpoint if/when they may have stopped. I also have MS and that (and the medication I take for it) can also cause meno-like symptoms. My GP (I am UK based) recently ran FSH tests on me and said I was likely through the menopause, her advice was to continue the mini pill for a year then stop. Currently trying to find as much info as possible on best way forward and what may occur when I do stop!

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I’m not Dr Gunter or even a doctor, but reading the details of your scenario and thinking about it in the context of what I’ve learned from Dr Gunter’s work and posts thus far — I think this is a fantastic question (not that you requested my opinion, I understand.)

I don’t know if I’ve thought about or formulated questions about *other* people experiencing menopause who already take medications for something else (well, besides myself).

I can only speak about my own experience, but it does get complicated because, as in your case, one may take meds that have symptoms that mimic meno or perimeno — Or, as in my case, one may take meds which mask some of the meno/peri meno symptoms.

Hoping you get some good info!

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Another great post. Thank you so much for doing this. I learn so much!

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When people don’t understand my more complicated explanations around menopause and I tell them it’s like a second puberty and why, they suddenly get it!

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Soooo i heard that doctor on an podcast share that story that women arent suppose to go thru menopause bc it didnt happen historically—-that’s why we all need mrt/hrt. 🤯 cool article. Thk you as always!!

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All i can say is a doctor not knowing that is embarassing!

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Can you help us make sense of the many menopause doctors on Instagram who recommend and use testosterone? This compilation shows most of them using pills or cream. Are we to presume their all post menopausal and using it for low libido (the only use it’s OKd for, right?) or what else is going on here??? https://www.instagram.com/reel/C64r82MAP_X/?igsh=MW56cmZoN2F4eDE5aw==

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The Menopause Society and International Menopause Society have guidelines and I have the info here. https://vajenda.substack.com/p/testosterone-and-menopause I suspect influencers promote testosterone because it gets attention and followers or because they make money from prescribing it. Or maybe they don't know the literature. Or all of it. If the data for testosterone were amazing, the guidelines would not recommend only for libido.

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Thanks! It’s so confusing because they are all MDs (allegedly).

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