Disclaimer: This article shares the writer’s personal experience with hormone replacement therapy and is not medical advice. Everyone’s health needs are different. Talk with your healthcare provider about your symptoms, treatment options, and potential benefits and risks before making changes to your care.
No one warned me about my forties. No one told me that before you reach the age of menopause, there is a lovely little chunk of your life leading up to it that will completely derail your entire train of life–perimenopause. I had never heard of it, but as with everything these days, information started to pop up on my social media feed that made me take a deeper dive into what perimenopause actually is and how it affects middle-aged women.
As I read article after article, I kept finding that women from all over were experiencing some of the same things I was feeling. Looking back, it started after I had my daughter in 2018 (I was 38), and I felt things start to shift. I had uncontrollable anger and rage that I had never felt before. I was ultra-sensitive to sounds, got overwhelmed and overstimulated so much more often, and just felt on edge all the time. I honestly just thought it was part of the postpartum process; I asked my doctor about it, she prescribed me an antidepressant, and when I started to feel better, I assumed we had fixed all my issues. But I was wrong.
After being on the same antidepressant for almost seven years, I started to feel the symptoms creep back in: overwhelmed all the time, emotions were all over the place, my fuse was shorter than it ever was before, and I just didn’t feel like myself anymore. When I went to my annual exam, my gynecologist told me to find a good therapist, maybe change medications, and hope for the best. But I was not satisfied with that answer. I started reading up on hormone replacement therapy (HRT) and how previously, it had been something people were afraid to try because there hadn’t been enough research to support it. But recently, HRT was being used to treat symptoms related to perimenopause, and the results were life-changing, according to the patients who used it. As I learned more about HRT, I decided it was worth looking into to see if that may be the missing piece that I had been looking for to help me start feeling like myself again.
What I didn’t realize is how much all of this was affecting my husband. Last spring, he finally told me he had been feeling distant and was starting to think I was pulling away from him. He assumed that all of the anger, frustration, disinterest, and short temper were directed at him and honestly thought that I wanted out of the relationship. When he told me this, it broke my heart because even though I had tried to tell him that this phase of life I am in was a difficult one, I never imagined that he would think it was because of him. After several long discussions reassuring him that my change in behavior was not directed at him, nor was it in my control, we started to communicate better, and my husband finally started to realize how much perimenopause was affecting me.
He started doing his own research on the impact perimenopause has on marriage, and what he found was eye-opening, to say the least. On Instagram alone, he found hundreds of accounts devoted to marriage support during this phase of life and quickly realized he was not alone. Reading other husbands’ experiences similar to his own, shuffling through lists of symptoms caused by hormonal shifts, and becoming more aware of how hormones directly impact so many aspects of life, he found clarity and peace that we were going to get through this tough spot. Once I saw that he was starting to understand the driving forces behind his uncertainty, I knew it was my job to reassure him that we would work together to navigate the highs and lows that go hand in hand with this stage of life.
I reached out to an online telehealth organization focused on women’s health and met with a provider. She was absolutely wonderful, and for the first time in years, I finally felt heard and seen. Everything I described to her was textbook perimenopause, and she said she meets with women all the time whose story sounds identical to mine. After initial bloodwork, baseline tests, and medical history, we began experimenting with hormones with a goal to reach optimum functioning and help me feel like myself again. It was a lot of trial and error, adjusting doses based on my feelings and trying to account for various outside sources that may be having an effect on some of those symptoms. One of the hardest ones to target was my libido, and after several medical adjustments, she finally decided to prescribe testosterone cream, as that seems to have a direct impact on sexual health and libido. By the 8 to 10 month mark, my clinician and I had found the sweet spot–a combination of progesterone, estrogen, and testosterone in just the right amounts, and it was like a dark cloud had been lifted. My husband started to notice a difference, and because we were openly communicating better and he had an understanding of what was going on behind the scenes, there was less tension, which led to strengthening our bond now that we both realized we were not going to let perimenopause derail our 12-year marriage. I know historically, people were hesitant to use hormone therapy because of what they perceived to be negative effects and the assumption that it causes or contributes to cancer, but recent research has shown that is not the case. And to be completely honest, if using hormone replacement therapy can improve your quality of life and strengthen your relationship with your spouse, that is exponentially worth it to me.
